Dissertations / Theses on the topic 'Game therory'

A lack of credible evidence demonstrating the effectiveness of play therapy and the use of therapeutic board game in play therapy exists (Phillips, 2010; Matorin, 1996). Parent involvement is a key variable in the effectiveness of play therapy (Kottman, Stother, and Deniger, 2001). Formative research was used in this study to evaluate of The Super Family Board Game™ (SFBG) in order to develop an effective therapeutic board game aimed at enhancing family cooperation and cohesion. As the first formative evaluation of a therapeutic board game, this study provides future research implications for developing and testing therapeutic board games.

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The emergence of technologies that promote the users' immersion has pointed the interest of researchers into the healthcare field. These technologies, when combined with electronic games, have obtained good results by being used for therapeutic purposes. Commercial games have been widely used to that end, however, it is still required the supervision of health professionals for a better targeting in the patients' treatment. To decrease the burden of the supervision, tailor-made games with monitoring capabilities have been developed. The problem with this approach is that the quality - in terms of gameplay - of those games is low due to the lack of playfulness. To solve this problem, a good scenario is add monitoring capabilities to the treatments using commercial games. Given the lack of proposals with this approach, it is necessary a mechanism to assist developers in building applications for monitoring patients during the gameplay, according with predetermined characteristics set by health specialists. In this work, we propose the NuSense, a plugin-based framework to support in developing applications for the automatic monitoring of people in environments applied to game-based therapies, motor rehabilitation and physical exercises.
O surgimento de tecnologias que promovem a imersão dos usuários tem despertado o interesse dos pesquisadores da área da saúde. Essas tecnologias, quando aliadas aos jogos eletrônicos, têm obtido bons resultados ao serem utilizadas para fins terapêuticos. Jogos comerciais vêm sendo amplamente utilizados com essa finalidade, contudo, ainda é necessária a supervisão de profissionais de saúde para um melhor direcionamento no tratamento dos pacientes. Para diminuir o nível de supervisão necessário, jogos sob medida, com capacidade de monitoramento, estão sendo desenvolvidos. Porém, a qualidade desses jogos – em termos de jogabilidade – ainda é baixa, devido, muitas vezes, à falta de ludicidade, ou seja, torna-se difícil atrair a atenção do paciente. Para resolver esse problema, o cenário ideal é o uso de jogos comerciais com capacidade de monitoramento. Diante da falta de propostas com esse enfoque, torna-se necessário um mecanismo que auxilie os desenvolvedores na construção de aplicações para o monitoramento de pacientes durante o gameplay, de acordo com características pré-determinadas pelo profissional de saúde. Neste trabalho propõe-se o NuSense, um framework baseado em plug-ins para o auxílio no desenvolvimento de aplicações para o monitoramento automático de pessoas em ambientes aplicados a terapias baseadas em jogos – gameterapia, bem como reabilitação motora e exercícios físicos.

In this thesis, we propose a Serious Game (SG) for children with the Autism Spectrum Disorder (ASD) that builds on the concept of LEGO®-Based Therapy that is aimed at improving social and cognitive skills. The proposed SG is composed of building blocks augmented with electronic modules that connect to a computing device that provides visual feedback. We investigate the effects of using the proposed computer SG by comparing it to a non-computer block-game during two empirical studies, one following an unstructured play approach and a second one with structured play by assigning roles to the players. For the first study, the proposed system showed an improvement in social interaction, collaborative play and exercise performance, as well as a decrease in solitary play. For the second study, the proposed system showed an improvement in social interaction, positive vocalizations and exploratory behavior. There was also a marked preference towards the proposed game. Furthermore, we perceived a decrease on the assistance needed when using the proposed system during both studies. Our results suggest that the proposed system can be a useful play therapy tool aimed for young children with ASD.

Sur la plateforme de thèses en lignes Tel on trouve le résumé suivant en français : Cette thèse développe une approche originale de l'interprétation interactive de la théorie de la démonstration en logique linéaire. À l'inverse du cadre joueur/opposant communément associé aux sémantiques des jeux pour la logique, nous proposons un modèle dans lequel les deux joueurs ont des rôles symétriques. Plus précisément, nous passons d'une situation dans laquelle un joueur tente de démontrer un énoncé tandis que l'autre tente de le réfuter à une situation dans laquelle les deux joueurs tentent de démontrer des énoncés contraires. Dans la tradition du calcul vu comme comme recherche de démonstrations, chaque étape de l'interaction est vue comme une étape de deux recherches de démonstrations orthogonales en calcul des séquents. Ce travail contribue dans une certaine mesure à formaliser les liens entre la recherche de démonstrations et la normalisation de démonstrations. Nous présentons d'abord un jeu symétrique simple pour le fragment additif de la logique linéaire, en guise d'introduction à la recherche duale de démonstrations. Nous passons ensuite à un jeu symétrique bien plus complexe pour le fragment additif et multiplicatif de la logique linéaire. Afin d'obtenir un résultat de pleine complétude, nous développons ensuite un troisième jeu à la fois symétrique et concurrent. Enfin, nous étudions quelques extensions de notre modèle
Sur la plateforme de thèses en lignes Tel on trouve le résumé suivant en anglais : This thesis develops an original approach to the interactive interpretation of the proof theory of linear logic. In contrast with the player/opponent dichotomy commonly associated with game semantics for logic, we propose a model in which the two players have symmetric roles. More precisely, we shift from a situation in which a player aims at proving a goal while the other one aims at refuting it to a situation in which the players aim at proving opposite goals. In the tradition of computation-as-proof-search, each step of the interaction is seen as a step in two orthogonal sequent calculus proof searches. To some extent, this work contributes to formalising the connections between proof search and proof normalisation. We first present a simple symmetric game for the additive fragment of linear logic, as a first introduction to dual proof search. We then introduce a much more involved symmetric game accounting for the multiplicative and additive fragment of linear logic. In order to get a full completeness result, we then develop a third, highly concurrent, symmetric game. Finally, we investigate a few extensions of our model

Thesis (MSc (Computer Science))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: The aim of this thesis is to develop a generic 3D virtual environment development platform for autism spectrum disorder (ASD) therapy tools. The potential of using computerised therapy tools for ASD therapy is well known. However, the development of such tools is expensive and time-consuming, and is language and culture speci c. This work intends to alleviate these problems. The design of the platform is based on known game engine designs, but adapted for the requirements of ASD therapy tools. It supports standard features such as 3D rendering, animation and audio output. Speci c features, aimed at ASD therapy tools and educational games, included in our engine are: replays, data capturing, remote monitoring over a network and language localisation. We also implemented an input hardware abstraction layer to allow support for non-standard input peripherals in the future, without modifying existing game implementations. Furthermore, to separate the development of games and tools from the engine, we include wrapper libraries in our engine for Lua and Java. We successfully developed our engine and implemented a number of prototype therapy tools and educational games. These implementations confirmed that the engine works as expected. Some of these programs are currently in use at a local primary school.
AFRIKAANSE OPSOMMING: Die doel van hierdie tesis is om 'n 3D virtuele omgewing en ontwikkelingsplatform vir outistiese spektrum versteuring (OSV) terapiemiddels te ontwikkel. Die gebruik van rekenaargebaseerde terapiemiddels vir OSV terapie is bekend. Om sulke terapiemiddels te ontwikkel is egter duur, tydrowend en is dikwels gerig op spesi eke taal- en kultuurgroepe. Hierdie werk het dit ten doel om hierdie probleme te bowe te kom. Die ontwerp van die platform is gebaseer op die ontwerp van bekende videospeletjie-enjins, maar is aangepas vir die benodigdhede van OSV terapiemiddels. Dit ondersteun standaard funksionaliteit soos 3D uitbeelding, animasie en klank. Ons platform sluit in spesi eke funksionaliteit, wat gerig is op OSV terapiemiddels en opvoedkundige speletjies, naamlik: kykweer, datavaslegging, afstandswaarneming oor 'n netwerk en taal-lokalisering. Verder is 'n abstrakte koppelvlak vir toevoerapparatuur ontwikkel, wat dit moontlik maak om in die toekoms nie-standaard toevoerapparatuur te ondersteun, sonder om bestaande speletjies se implementasies aan te pas. Verder, om die ontwikkeling van speletjies en terapiemiddels te skei van die enjin, is koppelvlakke ontwikkel wat dit moontlik maak om die enjin in Lua en Java te gebruik.

Cette thèse propose des modèles, méthodes et outils destinés aux game designers de jeux thérapeutiques. Le problème de conception le plus fondamental des jeux thérapeutiques est le gameplay, c'est-à-dire des objectifs de jeu et des actions que le joueur doit effectuer pour atteindre ces objectifs. Dans un jeu thérapeutique, le gameplay doit à la fois produire l'effet thérapeutique et motiver le patient à suivre son protocole. Les problèmes sous-jacents de celui-ci sont l'évaluation médicale et ludique du jeu, et l'échange de connaissances entre game designers et experts santé. Nous proposons une méthode de game design de jeu thérapeutique allant de la définition du problème à l'évaluation. Cette méthode intègre les autres solutions que nous proposons, notamment le modèle player/game/therapy et une méthode de formalisation du gameplay
This PhD thesis explores the field of therapeutic games in order to propose methods and tools for the game designer of such games. The most fundamental design problem of therapeutic games is the gameplay, ie. the game objectives and the actions the player does to address the objectives. In therapeutic game, the gameplay must, at the same time, provide the therapeutic effects and motivate the patient to follow his protocol. The sub-problems of this are 1. the two-fold evaluation (medical and motivation), 2. the exchange of knowledge between game designers and health experts. We propose a therapeutic game design method which begins with the problem definition and ends with the two-fold evaluation. This method integrates the other solutions we propose, particularly the player / game / therapy model and a method to formalize the gameplay

Some psychotherapy clients have created video game avatars whose lives in virtual worlds include imaginal material and therefore invite depth psychological consideration. Using hermeneutic, alchemical hermeneutic, and artistic-creative methodologies, this thesis expands the conception of the therapeutic container to include these worlds and characters. The research explores how depth psychology can help Licensed Marriage and Family Therapists integrate their clients’ virtual lives into therapy. A literature review examines the ways computer simulations are different from other activities and describes a postmodern realm where identity is an experiment in a multiplicity of simulations that are both rich and ideological. A multicultural approach is taken in order to treat clients’ avatars and their worlds with dignity and involves an attempt to understand the cultures of technology, digital systems, and video worlds. The author proposes both an overall attitude toward and specific interventions for incorporating the virtual realm into psychotherapy.

Finding the correct therapeutic intervention for a client can be difficult to determine, especially for certain populations like adolescents. The implementation of Table Top Role Playing Games (TRPGs) in therapy is slowly becoming a more widely utilized therapy intervention because of its ability to engage clients who may be apprehensive to engaging in therapy. Having a wide array of interventions in our therapeutic toolbelt is crucial for mental health social workers to flexibly implement interventions, like TRPGs, with clients. Unfortunately, there is little research determining whether this approach is beneficial to therapy or not. This exploratory research study sought to determine the effectiveness of this intervention using qualitative one-on-one interviews with mental health practitioners currently implementing this intervention with their clients. This study revealed certain themes such as: being able to apply TRPGs to clients of any age group, utilization of a client-tailored narrative through TRPGs, applicability of this intervention in a group setting, TRPGs as a form of safe exposure therapy. Certain risks regarding implementation of this intervention were also identified. The data gathered through this study show that TRPGs could prove to be extremely beneficial to therapeutic practices. Further studies into this intervention should be conducted to truly grasp the extent of this interventions benefits or to identify any unidentified drawbacks.

DESENHO DO ESTUDO: Ensaio Clínico randomizado com avaliador cegado as intervenções. OBJETIVO: foi avaliar os efeitos da realidade virtual como recurso adicional na função dos pacientes com Osteoartrite (OA) de joelho. INTRODUÇÃO: A OA de joelho é uma das doenças ortopédicas mais prevalentes na população idosa, de caráter degenerativo e progressivo que acomete a cartilagem articular, limitando a amplitude de movimento (ADM) articular com rigidez e causando restrições funcionais importantes. A Realidade Virtual (RV) é um dos instrumentos que podem ajudar no processo de reabilitação dos pacientes, motivando e permitindo movimentações e exercícios mais assertivos. MÉTODOS: Noventa pacientes (65 mulheres e 25 homens), entre 50 e 70 anos, com diagnóstico médico de OA em pelo menos um dos joelhos participaram do estudo. Após responderem os questionários Womac e Lequesne, foram avaliados em relação a dor e força muscular. Responderam o Termo de Consentimento e foram divididos aleatoriamente, com envelopes opacos e lacrados, em 3 grupos: Controle que realizou um programa de fisioterapia convencional com exercícios aeróbicos e de fortalecimento muscular; Experimental 1 (Wii) que além do programa convencional fez uso dos jogos do Wii Fit da Nintendo; Experimental 2 (Kinect) que complementou o tratamento convencional com o sistema de vídeo game da Kinect Xbox. RESULTADOS: O estudo revelou redução da dor, melhora da força muscular e função no Questionário Lequesne para todos os grupos após a intervenção (p < .001), entretanto a melhora foi mais acentuada nos grupos Wii e Kinect do que no grupo controle. Quando comparada a dimensão de dor e rigidez, todos os grupos apresentaram reduções significativas no questionário WOMAC A, (p < .001) e somente o Kinect apresentou diferença estatisticamente significante pós intervenção na dimensão CONCLUSÃO: A associação do Vídeo Game no programa de reabilitação de pacientes com OA de joelhos apresenta resultados superiores do que a Fisioterapia convencional. E o recurso Kinect apresentou resultados superiores na função dos pacientes quando comparado ao sistema Wii. Novos estudos, com tecnologias diferentes são essenciais para identificar se os recursos de Realidade Virtual imersiva podem ajudar os pacientes com OA de joelho
STUDY DESIGN: Randomized clinical trial. OBJECTIVE: Evaluate the effects of video games associated with conventional physiotherapy in relation to pain relief, muscular strength, and function. INTRODUCTION: Knee OA is one of the most prevalent orthopedic diseases in the adult and elderly populations, with a degenerative and progressive character that affects the articular cartilage, limiting the articular range of motion (ROM) due to rigidity and causing important functional restrictions. Virtual Reality (VR) is one of the instruments that can help in the rehabilitation process of patients, motivating them and enabling more assertive movements. METHOD: Ninety patients (65 women and 25 men) between 50 and 70 years old, with a medical diagnosis of OA in at least one knee participated in the study. After completing the WOMAC (Western Ontario and McMaster Universities Arthritis Index) and Lequesne questionnaires, they were evaluated for pain (Visual Analogical Scale - VAS) and muscle strength (hand-held dynamometer).The volunteers signed the Consent Term and were then randomly divided, using opaque, sealed envelopes, into 3 groups: Control group - performed a conventional physiotherapy program with aerobic and muscle strengthening exercises; Experimental group 1 (Wii) - in addition to the conventional program used Nintendo\'s Wii Fit games; Experimental group 2 (Kinect) - complemented the conventional treatment with the Xbox Kinect video game system. RESULTS: The findings of the study demonstrated reduced pain and improved muscular strength and function in the Lequesne Questionnaire for all groups after the intervention (p < .001), however the improvement was more pronounced in the Wii and Kinect groups than in the control group. When comparing the pain and stiffness dimensions, all groups presented significant reductions in the WOMAC questionnaire, dimension A (p < .001), and only the Kinect presented a statistically significant difference post-intervention in dimension C. CONCLUSION: The association of Video Games in the rehabilitation program of patients with knee OA presents superior results to conventional physiotherapy. In addition, the Kinect feature demonstrated superior results regarding patient performance when compared to the Wii system. New studies using different technology are essential to identify whether immersive Virtual Reality features can help patients with knee OA

The Kinect device is commonly associated to videogames, but this is not the only purpose of this device. Going into more depth, it could be a powerful tool to accomplish several goals, not only related to simple games. One such example could be Serious Games. Above all, Kinect device is a group of sensors and as such it is an attraction point in order to do experiments and measurements. This thesis tries to understand the potentiality and specifically tries to understand the precision and accuracy in the explicit area of rehabilitation. Taking advantage of the Kinect functionality, the thesis tries to enter in a young area, composed by two principal field of interest: catching and recognizing movements without the help of tool to wear, and the movements in order to do physical therapy. The result of this thesis is that the accuracy and precision of the Kinect device is sufficient for detecting therapeutic movements. Further work is however needed to be able to use Kinect for automatic discrimination of correct and incorrect physical movements.

This case study explores the benefits as well as the challenges of using art therapy with an emotionally disturbed child who was seen in three different settings. The literature reviewed for this case study covers the wide variety of factors affecting the client, including prenatal exposure to drugs, drug abusing parents, neglect in the postnatal environment, difficulty attaching to others, classification as emotionally disturbed (ED), requiring a special education classroom setting, and a diagnoses of Attention-Deficit/Hyperactivity Disorder (ADHD). The findings indicate that the art proved to be a particularly useful tool with which to assess and treat the client. Initially, the client’s reluctance to create art in the session was interpreted by the author as being a reflection of her abilities as an art therapist. By examining her countertransference, the author was able to understand the client’s reluctance as a reflection of his difficulty attaching to the therapist and collaborating with his family. The findings highlight the importance for emerging art therapists to address their countertransference in supervision when working with clients who appear unwilling to make art.

PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO
O objetivo deste trabalho é propor, em uma perspectiva sistêmica construcionista social, um modelo de terapia de casal orientado pelos padrões interacionais do casal em terapia, tomados como marcadores e preditores da formação e dissolução do laço conjugal. É apresentada uma formulação metodológica para a construção do modelo psicoterapêutico que contempla a explicitação dos aspectos epistemológicos, teóricos, morfológicos e técnicos, em relação à inserção nos campos epistêmico, doxológico, axiológico, e no de demanda social. Dentro desta proposta, são revistos estudos sobre temas relevantes para construção deste modelo terapêutico, tais como padrões da conjugalidade na pós-modernidade; características emergentes dos estudos sobre psicoterapia de casal, enfocando a eficácia e eficiência terapêutica; estudos sobre marcadores e preditores da formação e dissolução da conjugalidade; o processo de mudança em psicoterapia, com o aumento da autonomia e complexidade, como produção de novas subjetividades. O modelo apresentado ressalta, além do enfoque sistêmico na relação psicoterapêutica, a construção social da subjetividade e do significado da conjugalidade, sendo que o terapeuta é coparticipante, provocando, através do seu discurso, perturbações que levem a mudanças de segunda ordem, favorecendo aspectos de criatividade na conjugalidade, dentro do espaço social de construção intersubjetiva. Algumas questões técnicas e éticas são apontadas, assim como são sugeridas novas direções de exploração.
The aim of this paper is to propose, in a social constructionism systemic perspective, a model of marital therapy, oriented by couple`s interactional patterns in therapy, as markers and predictors of the conjugal ties formation and dissolution. It is proposed a methodological formulation, for the construction of a psychotherapeutic model that contemplates the explicitness of the epistemological, theoretical, morphological and technical aspects, concerning the insertion in the epistemic, doxological and axiological fields, and of social demand. Within this proposal, studies on subjects relevant to the construction of this therapeutic model, such as conjugality patterns in post-modernity; characteristics emerging from the studies on couple psychotherapy, focused on therapeutic efficiency and efficacy; studies on markers and predictors of the conjugality formation and dissolution; the changing process in psychotherapy like the increase of autonomy and complexity as the production of new subjectiveness are reviewed. The presented model emphasizes, besides the systemic focus on the psychotherapeutic relation, the social construction of subjectivity and the meaning of conjugality, in which the therapist is a co- participant, stimulating, though his speech, disturbances that take to 2nd level changes, favoring creative aspects in the conjugality, within the social space of intersubjective construction. Some technical and ethical issues are pointed out. New directions of exploration are proposed.

This study replicated a mixed-methods, controlled experimental study conducted in 2010, using a game developed for balance rehabilitation and used with a population of survivors of stroke, to gather more data on the strengths and weaknesses of the rehabilitation tool and opinion of its potential effect as an intervention on persons with Spinal Cord Injury, undergoing outpatient treatment at a spinal cord injury center. This data will provide a base for further improvements in the design and use of the tool in therapeutic settings.

People with motor disabilities have a limitation or a loss of capacity carrying out activities considered as normal for human beings. This may incline the relationship with the society and thus it is essential for these people to undergo therapeutic treatments. However, rehabilitation is a tedious process that often fails due to that patients drop treatment. For this reason, this thesis investigates if music in a serious game for rehabilitation can make the experience to become more engaging and, accordingly, whether positive experiences from playing such a game can encourage the rehabilitation process of a patient i.e. to make the rehabilitation process less tedious for the patient. The results, based on a pilot study conducted in a rehabilitation center, indicates that this is the case and further research on the matter is suggested.

The use of low-cost interactive game technology for balance rehabilitation has become more popular recently, with generally good outcomes. Very little research has been undertaken to determine whether this technology is appropriate for balance assessment. The Wii balance board has good reliability and is comparable to a research-grade force plate; however, recent studies examining the relationship between Wii Fit games and measures of balance and mobility demonstrate conflicting findings. This study found that the Wii Fit was feasible for community-dwelling older women to safely use the balance board and quickly learn the Wii Fit games. The Ski Slalom game scores were strongly correlated with several balance and mobility measures, whereas Table Tilt game scores were not. Based on these findings, the Ski Slalom game may have utility in the evaluation of balance problems in community-dwelling older adults.

The thesis disserts about marketing strategy of the corporation TheRoom. The aim of this thesis is to analyze the company marketing strategy, its marketing activities on the internet, evaluation and to create a list of opportunities, suggestions and recommendation. The theoretical part is dedicated to general meaning of marketing and other specifications of the classical and internet marketing. Practical part deals with corporate environment, including market and competition analyses. The thesis contexts also analysis of marketing communication, SWOT analysis and analysis of database of TheRooms clients. The contribution of the thesis lies in the complex view on the company, its marketing communication and whole market of escape games, which allows to create a comprehensive opinion about the current position and future develop of the company and this sector.

The goal of this study was to explore the potential of using video games with binaural beats as an alternative to regular binaural beat therapy. As previous studies have shown, music therapy, binaural beat therapy, and video games have been used for relaxation purposes to varying success. To prove this, three types of therapies were held in order to test their effectiveness. 16 students participated in the test in which their goal was to partake in one of the three therapy sessions, with two interviews before and after the therapy session. The results showed that a video game therapy with binaural beats could work as an alternative to a standard music therapy session, and that the binaural beats improved the relaxing factor in a video game. However, this area of study is quite new, which means more studies would be needed to ascertain the effectiveness of this kind of therapy.

Det finns övrigt digitalt material (t.ex. film-, bild- eller ljudfiler) eller modeller/artefakter tillhörande examensarbetet som ska skickas till arkivet.

Introdução: O uso de substâncias psicoativas pode afetar o indivíduo, a família e a sociedade. Sabemos que pessoas apresentam problemas sérios relacionados ao uso ou abuso de substâncias psicoativas independente da substância, lícita ou ilícita, prescrita ou não, considerada forte ou fraca, natural ou processada. Uma vez que o desenvolvimento de um transtorno aditivo à drogas possui causas variadas e correlação complexa. Essa complexidade nos faz avaliar constantemente nossa prática em saúde a fim de apoiar os pacientes que buscam atendimento em um Serviço hospitalar. Assim, este trabalho foi elaborado a partir da demanda das pessoas que buscam tratamento, que se propõe a discutir e pensar além dos problemas causados pelo uso de SPAs, mas seus problemas éticos e morais. Problemas identificados pelo próprio sujeito no seu processo de recuperação da função social, na relação com as pessoas próximas, na administração dos riscos para si mesmo e outros, dentre outros aspectos considerados importantes para mudança do estilo de vida. Fundamentação Teórica: Para a compreensão destes problemas apontados pelo grupo dialogamos na área das ciências sociais com Anthony Giddens e Alex Honneth, na área de saúde mental e Tratamento Congnitivo Comportamental Griffith Edwards, Rangé; na área de grupoterapia Sobell e Yallon; para compreender o desenvolvimento moral e comportamental Jean Piaget, Hoffman e Émile Durkheim, a interface da bioética com Potter. Objetivo: desenvolver um jogo de cartas que exemplifique situações rotineiras que se constituem problemas éticos e conflitos morais, vivenciados pelos pacientes quanto às regras básicas de convivência social antes e durante a internação. Métodos: Foi realizado um levantamento dos Descritores da biblioteca virtual em Saúde (BVS): Card Games, Moral Development, Principle-Based Ethics, Adaptation, Psychological; Drug Users, Behavior Therapy, Game Theory, após foram feitas buscas bibliográficas nas bases Medline, Lilacs, NIDA (National Institute on Drug Abuse), ABEAD (Associação Brasileira de Estudos de Álcool e outras Drogas), PubMed, Scielo, ADDICTION e ISI. O delineamento do estudo é qualitativo realizado por meio de consulta em prontuário, entrevistas semi-estruturadas individuais, grupos focais e diário de campo. As sentenças que representam os problemas éticos e morais foram, adaptados do Jogo Sem- Censura: uma questão de princípios. Os dados coletados foram correlacionados com as Regras de Convivência anteriormente elaboradas em oficinas pelos próprios pacientes em conjunto com a equipe. O estudo do material se deu a partir de operação de codificação - recorte dos textos em unidades de registro: um tema. Os resultados brutos foram submetidos a operações estatísticas simples (percentagens) que permitem colocar em relevo as informações obtidas, sendo utilizado o sistema N-vivo. Resultados: Consideramos que houve envolvimento e adesão do grupo na elaboração das sentenças do jogo de cartas. Durante a elaboração do jogo avaliamos que o processo foi rico, lúdico e de simples aplicação para reflexão dos problemas enfrentados na convivência social além dos parâmetros morais do grupo e seus referenciais éticos. A contribuição desta intervenção foi à instituição da cultura em refletir sobre os conflitos éticos e morais identificados pelos pacientes ao longo da sua vida para além dos problemas de convivência na internação. Os problemas identificados pelo grupo foram: a difícil relação com figuras de autoridade (pai, mãe, professor...), preconceito de gênero, percepção de naturalização do crime e a baixa empatia pelas outras pessoas.
Introduction: The use of psychoactive substances can affect the individual, family and society. We know that people have serious problems related to the use or abuse of psychoactive substances regardless of the substance, legal or illegal, prescribed or not, considered strong or weak, natural or processed. Once the development of a disorder, drug additive have different causes, complex correlation. This complexity makes us constantly evaluate our practice in health care to support patients who seek care in a hospital service. This work was developed from the demand of people seeking treatment, which aims to discuss and think beyond the problems caused by the use of PAS, but its ethical and moral problems. Problems identified by the subject in the process of recovery of social function, in relation to people nearby, in managing the risks to yourself and others, among other aspects considered important to change lifestyle. Theoretical Rationale: To understand these problems identified by the group dialogued in the social sciences with Anthony Giddens and Alex Honneth, in the area of mental health and behavioral treatment Congnitivo Griffith Edwards, Rangé; in the area of group therapy and Sobell Yallon; to understand the moral and behavioral development Jean Piaget, Hoffman and Émile Durkheim, the interface of bioethics with Potter. Objective: To develop a card game that exemplifies routine situations that are ethical problems and moral conflicts experienced by patients as the basic rules of social interaction before and during hospitalization. Methods: A survey of Descriptors Virtual Health Library (VHL) was conducted: Card Games, Moral Development, Principle-Based Ethics, Adaptation, Psychological; Drug Users, Behavior Therapy, Game Theory, after literature searches were performed in Medline, Lilacs, NIDA (National Institute on Drug Abuse), ABEAD (Brazilian Association of Studies on Alcohol and other Drugs), PubMed, SciELO, ISI and ADDICTION. The study design is qualitative try been held consultations in medical records, individual field diary semi-structured interviews, and focus groups. Sentences that represent the ethical and moral problems were adapted from Game No- Censorship: a matter of principles. The collected data were correlated with the Rules of Coexistence previously developed in workshops by patients in conjunction with the team. The study material was made from the codification - clipping of text in log units: a theme. The raw results were subjected to simple statistical operations (percentages) that allow you to put in relief the information obtained, the N-vivo system being used. Results: We consider that there was involvement and membership of the group in preparing the sentences of the card game. During the development of the game evaluate the process was rich, playful and simple application to reflection of the problems in social life beyond the moral parameters of the group and its ethical frameworks. The contribution of this intervention was the establishment of the culture to reflect on the ethical and moral conflicts identified by patients throughout their lives beyond the problems of coexistence in the hospital. The problems identified by the group were: a difficult relationship with authority figures (father, mother, teacher ...), gender bias, naturalization perception of crime and low empathy for others.

This thesis is focused on the development of games as a treatment for people who suffer from acrophobia, the fear of being in high-heighted situations. The purpose is to look over the immediate reactions of the players and study what effect first person gaming has on them in a short term. To achieve this, a series of three mini games is employed. Each game corresponds to a level. The first level is a tutorial which makes the player familiar with the game. In the second level, players are required to do a simple task. Finally, in the third level, the task is more pressuring and players need to be quicker to achieve the necessary goals. What is expected from this study is that the full control of the playable character makes the players feel immersed. Additionally, as the game progresses, the players will be more comfortable with heights. Last but not least, it is assumed that fast pace enhances immersion, a major factor of this study. As a result of our experiment, it is demonstrated that the control of the character from the player is a great tactic for immersion. Furthermore, it shows that the players start feeling better with heights even after one session. Finally, the study indicates that the fast pace enhances immersion, but over the time the increase of the pace has lower impact. These statements come as a result from the answers of the experiment‟s participants and will be shown in detail in this paper.

I framtidens samhälle förväntas äldre utgöra en stor del av befolkningen. Äldre har större risk att drabbas av funktionedsättningar och sjukdomar jämfört med andra grupper i samhället. Studier har visat att äldre definierar hälsa som en upplevelse att vara självständig och känna samhörighet med andra men även frånvaro av symptom och känna sig positiv samt att ha tillräckligt med energi. Arbetsterapi som profession syftar till att möjliggöra aktiviteter som bidrar till hälsa och välmående. Studier har visat att exergames kan vara en effektiv intervention för positiva hälsoeffekter bland äldre personer. Syftet med studien var därför att beskriva äldre personers attityder till och resonemang om exergames. En kvalitativ studie med fokusgruppintervju genomfördes med fyra äldre personer. Data från intervjun analyserades med kvalitativ innehållsanalys. Studiens resultat redogörs med ett tema, två kategorier och fyra underkategorier. Det genomgående temat är ”Betydelsefulla faktorer för äldres vilja att spela exergames”. De två kategorierna är ”förutsättningar att spela” och ”motivation att spela”. Resultatet visade vilka förutsättningar deltagarna ansåg det behövdes för att spela men också hur viktig motivationen var för att spela exergames. Deltagarna ansåg att exergames med många moment och högt tempo upplevdes komplicerade och att det upplevdes meningsfullt att spela exergames om det sker för att träna fysiska och kognitiva förmågor. Slutsats: Äldre uttrycker att det finns många hinder att överkomma för att spela exergames. Genom att underlätta hinder för äldre att spela exergames och med kunskap om meningsfulla spel för äldre kan arbetsterapeuter stödja äldre att uppnå aktivitetsengagemang i exergames.

Cette thèse propose des modèles, méthodes et outils destinés aux game designers de jeux thérapeutiques. Le problème de conception le plus fondamental des jeux thérapeutiques est le gameplay, c'est-à-dire des objectifs de jeu et des actions que le joueur doit effectuer pour atteindre ces objectifs. Dans un jeu thérapeutique, le gameplay doit à la fois produire l'effet thérapeutique et motiver le patient à suivre son protocole. Les problèmes sous-jacents de celui-ci sont l'évaluation médicale et ludique du jeu, et l'échange de connaissances entre game designers et experts santé. Nous proposons une méthode de game design de jeu thérapeutique allant de la définition du problème à l'évaluation. Cette méthode intègre les autres solutions que nous proposons, notamment le modèle player/game/therapy et une méthode de formalisation du gameplay
This PhD thesis explores the field of therapeutic games in order to propose methods and tools for the game designer of such games. The most fundamental design problem of therapeutic games is the gameplay, ie. the game objectives and the actions the player does to address the objectives. In therapeutic game, the gameplay must, at the same time, provide the therapeutic effects and motivate the patient to follow his protocol. The sub-problems of this are 1. the two-fold evaluation (medical and motivation), 2. the exchange of knowledge between game designers and health experts. We propose a therapeutic game design method which begins with the problem definition and ends with the two-fold evaluation. This method integrates the other solutions we propose, particularly the player / game / therapy model and a method to formalize the gameplay

This project explores opportunities in designing hybrid digital/physical smell rehabilitation video games using no unique game peripherals. During a 13-week process, three major iterations were created and externally tested on a small user group. The first two iterations contained five simple minigames that served to explore different types of game concepts. For the final iteration, two minigames were fully developed, a slow- and fast-paced game. The main findings were that slow-paced better-facilitated smell training than fast-paced games; aesthetics increased the player’s focus on small training; not utilising unique game peripherals limited the design opportunities and implementation of smell mechanics.

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s enjoyment and perceived difficulty was also explored. Five children (7 to 10 years) with cerebral palsy (CP) participated in a 6 week, 30 minute intervention 3 times per week, with four preselected balance games. Minimal improvements were found in balance, GV, and hip strength, and participants reported the intervention enjoyable and challenging. Three of five participants had significant increases in activities, as measured by the Activities Scale for Kids (ASK). The second study expanded on pilot study results and included 5 children (5 to 10 years) with different diagnoses. Another non-concurrent multiple baseline design was utilized, and the same measures of balance were used except single leg stance time was substituted for timed up and go. No changes were made to the intensity of intervention, but two games were added to the repertoire. There were minimal changes in balance and hip strength; and no changes were found in the ASK. A majority of participants increased GV, and reported the intervention was enjoyable and challenging. Positive changes were found in the combined results for: center of pressure area with eyes open and closed; time to boundary mean minima with eyes closed in the anterior-posterior direction; and GV. These studies suggest this intervention was insufficient to make improvements in the majority of balance measurements and hip strength for children with DD. Increased activities in children with CP were found in the pilot study. These results suggest video game balance training alone for children with DD was insufficient to demonstrate clinically meaningful change. KEYWORDS: Balance, Developmental Disabilities, Gait Velocity, Hip Strength, Activities and Participation

Background: The irradiation of cancer patients with charged particles, mainly protons and carbon ions, has become an established method for the treatment of specific types of tumors. In comparison with the use of X-rays or gamma-rays, particle therapy has the advantage that the dose distribution in the patient can be precisely controlled. Tissue or organs lying near the tumor will be spared. A verification of the treatment plan with the actual dose deposition by means of a measurement can be done through range assessment of the particle beam. For this purpose, prompt gamma-rays are detected, which are emitted by the affected target volume during irradiation. Motivation: The detection of prompt gamma-rays is a task related to radiation detection and measurement. Nuclear applications in medicine can be found in particular for in vivo diagnosis. In that respect the spatially resolved measurement of gamma-rays is an essential technique for nuclear imaging, however, technical requirements of radiation measurement during particle therapy are much more challenging than those of classical applications. For this purpose, appropriate instruments beyond the state-of-the-art need to be developed and tested for detecting prompt gamma-rays. Hence the success of a method for range assessment of particle beams is largely determined by the implementation of electronics. In practice, this means that a suitable detector material with adapted readout electronics, signal and information processing, and data interface must be utilized to solve the challenges. Thus, the parameters of the system (e.g. segmentation, time or energy resolution) can be optimized depending on the method (e.g. slit camera, time-of-flight measurement or Compton camera). Regardless of the method, the detector system must have a high count rate capability and a large measuring range (>7 MeV). For a subsequent evaluation of a suitable method for imaging, the mentioned parameters may not be restricted by the electronics. Digital signal processing is predestined for multipurpose tasks, and, in terms of the demands made, the performance of such an implementation has to be determined. Materials and methods: In this study, the instrumentation of a detector system for prompt gamma-rays emitted during particle therapy is limited to the use of a cadmium zinc telluride (CdZnTe, CZT) semiconductor detector. The detector crystal is divided into an 8x8 pixel array by segmented electrodes. Analog and digital signal processing are exemplarily tested with this type of detector and aims for application of a Compton camera to range assessment. The electronics are implemented with commercial off-the-shelf (COTS) components. If applicable, functional units of the detector system were digitalized and implemented in a field-programmable gate array (FPGA). An efficient implementation of the algorithms in terms of timing and logic utilization is fundamental to the design of digital circuits. The measurement system is characterized with radioactive sources to determine the measurement dynamic range and resolution. Finally, the performance is examined in terms of the requirements of particle therapy with experiments at particle accelerators. Results: A detector system based on a CZT pixel detector has been developed and tested. Although the use of an application-specific integrated circuit is convenient, this approach was rejected because there was no circuit available which met the requirements. Instead, a multichannel, compact, and low-noise analog amplifier circuit with COTS components has been implemented. Finally, the 65 information channels of a detector are digitized, processed and visualized. An advanced digital signal processing transforms the traditional approaches of nuclear electronics in algorithms and digital filter structures for an FPGA. With regard to the characteristic signals (e.g. varying rise times, depth-dependent energy measurement) of a CZT pixel detector, it could be shown that digital pulse processing results in a very good energy resolution (~2% FWHM at 511 keV), as well as permits a time measurement in the range of some tens of nanoseconds. Furthermore, the experimental results have shown that the dynamic range of the detector system could be significantly improved compared to the existing prototype of the Compton camera (~10 keV..7 MeV). Even count rates of ~100 kcps in a high-energy beam could be ultimately processed with the CZT pixel detector. But this is merely a limit of the detector due to its volume, and not related to electronics. In addition, the versatility of digital signal processing has been demonstrated with other detector materials (e.g. CeBr3). With foresight on high data throughput in a distributed data acquisition from multiple detectors, a Gigabit Ethernet link has been implemented as data interface. Conclusions: To fully exploit the capabilities of a CZT pixel detector, a digital signal processing is absolutely necessary. A decisive advantage of the digital approach is the ease of use in a multichannel system. Thus with digitalization, a necessary step has been done to master the complexity of a Compton camera. Furthermore, the benchmark of technology shows that a CZT pixel detector withstands the requirements of measuring prompt gamma-rays during particle therapy. The previously used orthogonal strip detector must be replaced by the pixel detector in favor of increased efficiency and improved energy resolution. With the integration of the developed digital detector system into a Compton camera, it must be ultimately proven whether this method is applicable for range assessment in particle therapy. Even if another method is more convenient in a clinical environment due to practical considerations, the detector system of that method may benefit from the shown instrumentation of a digital signal processing system for nuclear applications
Hintergrund: Die Bestrahlung von Krebspatienten mit geladenen Teilchen, vor allem Protonen oder Kohlenstoffionen, ist mittlerweile eine etablierte Methode zur Behandlung von speziellen Tumorarten. Im Vergleich mit der Anwendung von Röntgen- oder Gammastrahlen hat die Teilchentherapie den Vorteil, dass die Dosisverteilung im Patienten präziser gesteuert werden kann. Dadurch werden um den Tumor liegendes Gewebe oder Organe geschont. Die messtechnische Verifikation des Bestrahlungsplans mit der tatsächlichen Dosisdeposition kann über eine Reichweitenkontrolle des Teilchenstrahls erfolgen. Für diesen Zweck werden prompte Gammastrahlen detektiert, die während der Bestrahlung vom getroffenen Zielvolumen emittiert werden. Fragestellung: Die Detektion von prompten Gammastrahlen ist eine Aufgabenstellung der Strahlenmesstechnik. Strahlenanwendungen in der Medizintechnik finden sich insbesondere in der in-vivo Diagnostik. Dabei ist die räumlich aufgelöste Messung von Gammastrahlen bereits zentraler Bestandteil der nuklearmedizinischen Bildgebung, jedoch sind die technischen Anforderungen der Strahlendetektion während der Teilchentherapie im Vergleich mit klassischen Anwendungen weitaus anspruchsvoller. Über den Stand der Technik hinaus müssen für diesen Zweck geeignete Instrumente zur Erfassung der prompten Gammastrahlen entwickelt und erprobt werden. Die elektrotechnische Realisierung bestimmt maßgeblich den Erfolg eines Verfahrens zur Reichweitenkontrolle von Teilchenstrahlen. Konkret bedeutet dies, dass ein geeignetes Detektormaterial mit angepasster Ausleseelektronik, Signal- und Informationsverarbeitung sowie Datenschnittstelle zur Problemlösung eingesetzt werden muss. Damit können die Parameter des Systems (z. B. Segmentierung, Zeit- oder Energieauflösung) in Abhängigkeit der Methode (z.B. Schlitzkamera, Flugzeitmessung oder Compton-Kamera) optimiert werden. Unabhängig vom Verfahren muss das Detektorsystem eine hohe Ratenfestigkeit und einen großen Messbereich (>7 MeV) besitzen. Für die anschließende Evaluierung eines geeigneten Verfahrens zur Bildgebung dürfen die genannten Parameter durch die Elektronik nicht eingeschränkt werden. Eine digitale Signalverarbeitung ist für universelle Aufgaben prädestiniert und die Leistungsfähigkeit einer solchen Implementierung soll hinsichtlich der gestellten Anforderungen bestimmt werden. Material und Methode: Die Instrumentierung eines Detektorsystems für prompte Gammastrahlen beschränkt sich in dieser Arbeit auf die Anwendung eines Cadmiumzinktellurid (CdZnTe, CZT) Halbleiterdetektors. Der Detektorkristall ist durch segmentierte Elektroden in ein 8x8 Pixelarray geteilt. Die analoge und digitale Signalverarbeitung wird beispielhaft mit diesem Detektortyp erprobt und zielt auf die Anwendung zur Reichweitenkontrolle mit einer Compton-Kamera. Die Elektronik wird mit seriengefertigten integrierten Schaltkreisen umgesetzt. Soweit möglich, werden die Funktionseinheiten des Detektorsystems digitalisiert und in einem field-programmable gate array (FPGA) implementiert. Eine effiziente Umsetzung der Algorithmen in Bezug auf Zeitverhalten und Logikverbrauch ist grundlegend für den Entwurf der digitalen Schaltungen. Das Messsystem wird mit radioaktiven Prüfstrahlern hinsichtlich Messbereichsdynamik und Auflösung charakterisiert. Schließlich wird die Leistungsfähigkeit hinsichtlich der Anforderungen der Teilchentherapie mit Experimenten am Teilchenbeschleuniger untersucht. Ergebnisse: Es wurde ein Detektorsystem auf Basis von CZT Pixeldetektoren entwickelt und erprobt. Obwohl der Einsatz einer anwendungsspezifischen integrierten Schaltung zweckmäßig wäre, wurde dieser Ansatz zurückgewiesen, da kein verfügbarer Schaltkreis die Anforderungen erfüllte. Stattdessen wurde eine vielkanalige, kompakte und rauscharme analoge Verstärkerschaltung mit seriengefertigten integrierten Schaltkreisen aufgebaut. Letztendlich werden die 65 Informationskanäle eines Detektors digitalisiert, verarbeitet und visualisiert. Eine fortschrittliche digitale Signalverarbeitung überführt die traditionellen Ansätze der Nuklearelektronik in Algorithmen und digitale Filterstrukturen für einen FPGA. Es konnte gezeigt werden, dass die digitale Pulsverarbeitung in Bezug auf die charakteristischen Signale (u.a. variierende Anstiegszeiten, tiefenabhängige Energiemessung) eines CZT Pixeldetektors eine sehr gute Energieauflösung (~2% FWHM at 511 keV) sowie eine Zeitmessung im Bereich von einigen 10 ns ermöglicht. Weiterhin haben die experimentellen Ergebnisse gezeigt, dass der Dynamikbereich des Detektorsystems im Vergleich zum bestehenden Prototyp der Compton-Kamera deutlich verbessert werden konnte (~10 keV..7 MeV). Nach allem konnten auch Zählraten von >100 kcps in einem hochenergetischen Strahl mit dem CZT Pixeldetektor verarbeitet werden. Dies stellt aber lediglich eine Begrenzung des Detektors aufgrund seines Volumens, nicht jedoch der Elektronik, dar. Zudem wurde die Vielseitigkeit der digitalen Signalverarbeitung auch mit anderen Detektormaterialen (u.a. CeBr3) demonstriert. Mit Voraussicht auf einen hohen Datendurchsatz in einer verteilten Datenerfassung von mehreren Detektoren, wurde als Datenschnittstelle eine Gigabit Ethernet Verbindung implementiert. Schlussfolgerung: Um die Leistungsfähigkeit eines CZT Pixeldetektors vollständig auszunutzen, ist eine digitale Signalverarbeitung zwingend notwendig. Ein entscheidender Vorteil des digitalen Ansatzes ist die einfache Handhabbarkeit in einem vielkanaligen System. Mit der Digitalisierung wurde ein notwendiger Schritt getan, um die Komplexität einer Compton-Kamera beherrschbar zu machen. Weiterhin zeigt die Technologiebewertung, dass ein CZT Pixeldetektor den Anforderungen der Teilchentherapie für die Messung prompter Gammastrahlen stand hält. Der bisher eingesetzte Streifendetektor muss zugunsten einer gesteigerten Effizienz und verbesserter Energieauflösung durch den Pixeldetektor ersetzt werden. Mit der Integration des entwickelten digitalen Detektorsystems in eine Compton-Kamera muss abschließend geprüft werden, ob dieses Verfahren für die Reichweitenkontrolle in der Teilchentherapie anwendbar ist. Auch wenn sich herausstellt, dass ein anderes Verfahren unter klinischen Bedingungen praktikabler ist, so kann auch dieses Detektorsystem von der gezeigten Instrumentierung eines digitalen Signalverarbeitungssystems profitieren

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clinician to document exercises at home. Several measurements were recorded in one patient with unilateral vestibular hypofunction: The total time of exercise for the week (118 minutes) was documented and compared with expected weekly exercise time (140 minutes). For gaze stabilization exercises, execution time of 60 sec was expected, and observed times ranged from 75-100 sec. An absence of rest periods between each exercise instead of the recommended one minute rest period was observed. Maximum yaw head velocities from approximately 100-350 degrees/sec were detected. A second subject provided feedback concerning the ease of use of the HAMMS device. This pilot study demonstrates, for the first time, the capability to capture the head-motion “signature” of a patient while completing vestibular rehabilitation exercises in the home and to extract exercise regime parameters and monitor patient adherence. This emerging technology has the potential to greatly improve rehabilitation outcomes for individuals completing in-home gaze stabilization exercises 1 .

Pacientes que sofrem de doenças na tireoide, como hipertireoidismo causado pela doença de Graves, ou câncer de tireoide, têm como principal forma de tratamento a chamada terapia por radioiodo. Este tratamento consiste na ingestão de um radionuclídeo, no caso, o isótopo de massa atômica 131 do iodo (131I). A terapia utilizando radioisótopos é aplicada em uma variedade de tumores e, por se tratar de um material radioativo que o paciente recebe por via venosa ou oral, certa quantidade de radionuclídeos chegam a órgãos e tecidos diferentes do esperado e mesmo o acúmulo de material radioativo na região de interesse contribui para dose em tecidos sadios. Logo, é necessário um planejamento prévio. Em 80% dos planejamentos, a atividade a ser administrada no paciente é calculada através de valores pré-determinados, como peso, idade ou altura. Apenas cerca de 20% das terapias são realizadas com um planejamento personalizado, específico para cada paciente. Levando essas informações em consideração, este trabalho tem como objetivo realizar um estudo dosimétrico através de imagens para que no futuro seja utilizado em rotinas clínicas para planejamento de iodoterapia individualizado para cada paciente. Neste trabalho foram adquiridas imagens tomográficas (SPECT-CT) de um fantoma de tireoide preenchido com 131I. O fantoma foi construído com base na literatura, reproduzido de maneira fidedigna, e aperfeiçoado, permitindo a inserção de dosímetros termoluminescentes (TLD) em pequenas cavidades. As imagens foram inseridas no software GATE, baseado na ferramenta GEANT4, que permite a simulação da interação da radiação com a matéria pelo método Monte Carlo. Essas imagens foram convertidas em formato reconhecível pelo GATE e através da elaboração de um script de comandos, foram realizadas simulações com o intuito de estimar a dose em cada região da imagem. Uma vez que o dosímetro permanecia exposto ao material radioativo por alguns dias, para evitar um dispêndio de tempo computacional muito grande e estimar o valor final da dose no mesmo período de tempo em que o dosímetro ficou exposto através da simulação, foi necessário extrapolar uma equação e calcular a dose para este tempo. Foram realizadas duas aquisições diferentes, a primeira com uma distribuição não homogênea da fonte e a segunda com distribuição homogênea. Para a distribuição não homogênea, a comparação dos resultados da simulação com resultados obtidos por TLD mostram que ambos possuem a mesma ordem de grandeza e variam proporcionalmente em relação à distância que se encontram da fonte. A diferença relativa entre eles varia de 1% a viii 39% dependendo do dosímetro. Para a distribuição homogênea, os valores possuem a mesma ordem de grandeza, mas estão muito abaixo do esperado, com uma diferença relativa de até 70% e os valores da dose simulados estão, em sua maioria, duas vezes menores que o real. A técnica ainda não está pronta para ser implementada na rotina clínica, mas através de estudos de fatores de correção e novas aquisições, essa técnica pode, em um futuro próximo, ser utilizada.
Radio-iodine therapy is the main form of treatment for patients with diseases on the thyroid, such as hyperthyroidism caused by Graves\' disease or thyroid cancer. This treatment consists in the intake of a radionuclide, the iodine isotope of atomic mass 131 (131I). The radioisotope therapy is applied in a variety of tumors and since the patient receives it intravenously or orally, certain amount of radionuclide reaches different organs and tissues than the ones expected. Even the radioactive material accumulated in the region of interest contributes to the energy deposition on healthy tissues. Therefore, it is necessary a treatment planning. However, 80% of nuclear medicine therapy the administered activity is based in quantity as patients weight, age or height. The patient-specific therapy planning occurs in less than 20% of applications in nuclear medicine. Considering that information, this work aims to conduct a dosimetric study based on images so that in the future could be used in clinical routines for patient-specific radioiodine therapy. Were acquired tomographic images (SPECT-CT) of a thyroid phantom filled with 131I. The phantom was consistently reproduced according to the literature, with some improvements allowing the placement of thermoluminescent dosimeters into small cavities. Such phantom was used for the acquisition of SPECT-CT images. The images were inserted into the GATE software, based on GEANT4 tool, which allows the simulation of radiation interaction with matter, through the Monte Carlo method. Those images were converted into acceptable format for GATE and through the development of a command script, the simulations were performed in order to estimate the dose in each region of the image. Since the dosimeter remained exposed to the radioactive material for a few days, to reduce computational time and estimate, by simulation, the dose over the same period of time which the dosimeter has been exposed, it was necessary to extrapolate the equation and calculate the dose for this time. Two images acquisitions were made, the first with an inhomogeneous source distribution and the second with a homogeneous distribution. For the inhomogeneous acquisition, the simulation and TLD values have the same magnitude and both of them vary in proportion to the source distance. The relative difference ranges from 1% to 39% depending on the dosimeter. For the homogeneous one, despite being in the same magnitude either, the values are much lower x than expected, with a difference of up to 70%, and the simulated data, in general are half the TLD values. The technique is not yet ready to be implemented in clinical routine, but through studies of correction factors and new acquisitions, this technique may in the near future, be used.

The purpose of this study was to test whether video game use is associated with more problems with spending time together among married couples, whether problems with time together are associated with relationship quality, and whether attachment behaviors can moderate the association between time together as a problem and relationship quality. Previous studies have found a negative association between excessive video game use and couple relationship outcomes. Excessive video game use may negatively impact relationships by taking away from time spent on shared leisure and relationship maintenance activities. The Double ABCx model provided a theoretical framework for understanding how attachment behaviors such as accessibility, responsiveness, and engagement may act as protective factors that buffer the stress created by video game use and perceiving time together as a problem on couple relationships. A sample of 415 married couples who took the Relationship Evaluation Questionnaire between 2011 and 2013 and indicated that one or both partners played video games was used. Results indicated that there was a negative indirect effect of women's sports and music game use on women's relationship quality via women's reports of time together as a problem in the relationship. There was also a positive indirect effect of women's exercise game use on relationship quality. There was also a negative association between men's and women's reports of time together as a problem on own relationship quality. Men's attachment behaviors moderated the association between women's reports of time together as a problem and women's relationship quality. Clinical implications include more thoroughly assessing why video game use may be a problem in the relationship and fostering healthy attachment behaviors.

Conceptualization psychotherapy as an interpersonal influence process emphasizes how a therapist is perceived by a client. Factors affecting a client's early impressions of a therapist could influence therapeutic interactions since first impressions are relatively stable. The study investigated effects of nonverbal behavior and gender during a simulated initial meeting between a therapist and client. Undergraduates (N = 466) viewed a male or female therapist interviewing with a new female client. Therapist gaze .(100%, 80%, 40%) and smiling (high, low) were manipulated. After subjects viewed one of 12 videotapes, they completed questionnaires rating therapist expertness, trustworthiness, attractiveness, masculinity and femininity. A comparison of the therapist with subjects' expectations of a therapist in general was obtained by pre- and post-testing utilizing a measure of client expectations. MANOVAs were performed on all ratings except expectation scores, where an ANCOVA was utilized. Main effects for therapist gender indicated the female therapist was rated as significantly more expert, attractive, trustworthy and feminine than the male (ps < .81). For ratings of masculinity, subject gender interacted with therapist gender (p < .001). Wain effects showed that high smiling was rated as more attractive and more feminine (ps < .01). Smiling and level of gaze interacted on ratings of trustworthiness, expertness and masculinity (ps < .04). The 100 per cent and 80 per cent gaze levels increased expertness, trustworthiness and masculinity ratings. Smiling affected expertness at the 80 per cent level, and trustworthiness and masculinity at the 40 per cent level. Analysis of the expectation scores resulted in a three-way interaction between subject gender, smiling and gaze (p < .02). The results suggested that female subjects expected more responsive therapist behavior. The results suggested that the ratings of the male and female therapist reflected both the use of sex stereotypes and the influence of the therapist role. Based on the nonverbal behavior manipulation, several recommendations for therapist behavior were suggested.

Hadron Therapy is an advanced radiotherapy technique for cancer treatment. It offers a better irradiation ballistic than conventional techniques and therefore requires appropriate quality assurance procedures. In this work, we upgraded the GEANT4-based GATE Monte Carlo platform in order to recalculate the TPS dose distributions in view of further benchmarking. In a first step, we selected an appropriate simulation environment (physics models and parameters) in order to produce accurate and efficient simulations. GATE simulations were validated using measurements and other Monte Carlo codes for depth-dose and transverse profiles. While a good agreement was found for depth-dose profiles, larger discrepancies were pointed out for transverse profiles. In a second step, we developed a modeling method to simulate active scanning beam delivery systems, which does not require to simulate the components of the treatment nozzle. The method has been successfully applied to an IBA proton therapy system and validated against measurements for complex treatment plans. Interfaces have also been developed in order to link DICOM RT ION PLAN and DICOM RT DOSE with GATE. Finally, we compared in a third step the TPS and Monte Carlo dose distributions in homogeneous and heterogeneous configurations. The beam models of both dose engines were in satisfactory agreement, allowing further evaluation of clinical treatment plans. A two-field prostate plan has been evaluated, showing a satisfactory agreement between the TPS and Monte Carlo, and demonstrating the novel capabilities of the platform for the evaluation of the TPS. To summarize, we selected an appropriate simulation environment for proton therapy, proposed a modeling method for active scanning systems and presented a method to compare the TPS and Monte Carlo dose distributions. All tools developed in GATE were or will be publicly released. A detailed validation stage of the system including absolute dosimetry is still necessary, in order to quantitatively evaluate its accuracy in various homogeneous and heterogeneous configurations. In this thesis, we have demonstrated that the GATE Monte Carlo platform is a good candidate for the simulation of active scanning delivery systems, allowing further TPS benchmarking. Moreover, the GATE platform also handles imaging applications, such as PET or prompt-gamma imaging towards online treatment monitoring and paves the way of interdisciplinary research advances.

This PhD represents my attempt to make sense of my personal experiences of depression through the form of cabaret. I first experienced depression in 2006. Previously, I had considered myself to be a happy and optimistic person. I found the experience of depression to be a shock: both in the experience itself, and also in the way it effected my own self image. These personal experiences, together with my professional history as a songwriter and cabaret performer, have been the motivating force behind the research project. This study has explored the question: What are the implications of applying principles of Michael White’s narrative therapy to the creation of a cabaret performance about depression and bipolar disorder? There is a 50 percent weighting on the creative work, the cabaret performance Mind Games, and a 50 percent weighting on the written exegesis. This research has focussed on the illustration of therapeutic principles in order to play games of truth within a cabaret performance. The research project investigates ways of telling my own story in relation to others’ stories through three re-authoring principles articulated in Michael White’s narrative therapy: externalisation, an autonomous ethic of living and rich descriptions. The personal stories presented in the cabaret were drawn from my own experiences and from interviews with individuals with depression or bipolar disorder. The cabaret focussed on the illustration of therapeutic principles, and was not focussed on therapeutic ends for myself or the interviewees. The research question has been approached through a methodology combining autoethnographic, practice-led and action research. Auto ethnographic research is characterised by close investigation of assumptions, attitudes, and beliefs. The combination of autoethnographic, practice-led, action research has allowed me to bring together personal experiences of mental illness, research into therapeutic techniques, social attitudes and public discourses about mental illness and forms of contemporary cabaret to facilitate the creation of a one-woman cabaret performance. The exegesis begins with a discussion of games of truth as informed by Michel Foucault and Michael White and self-stigma as informed by Michael White and Erving Goffman. These concepts form the basis for a discussion of my own personal experiences. White’s narrative therapy is focused on individuals re-authoring their stories, or telling their stories in different ways. White’s principles are influenced by Foucault’s notions of truth and power. Foucault’s term games of truth has been used to describe the effect of a ‘truth in flux’ that occurs through White’s re-authoring process. This study argues that cabaret is an appropriate form to represent this therapeutic process because it favours heightened performativity over realism, and showcases its ‘constructedness’ and artificiality. Thus cabaret is well suited to playing games of truth. A contextual review compares two major cabaret trends, personal cabaret and provocative cabaret, in reference to the performer’s relationship with the audience in terms of distance and intimacy. The study draws a parallel between principles of distance and intimacy in Michael White’s narrative therapy and relates these to performative terms of distance and intimacy. The creative component of this study, the cabaret Mind Games, used principles of narrative therapy to present the character ‘Jo’ playing games of truth through: externalising an aspect of her personality (externalisation); exploring different life values (an autonomous ethic of living); and enacting multiple versions of her identity (rich descriptions). This constant shifting between distance and intimacy within the cabaret created the effect of a truth in ‘constant flux’, to use one of White’s terms. There are three inter-related findings in the study. The first finding is that the application of principles of White’s narrative therapy was able to successfully combine provocative and empathetic elements within the cabaret. The second finding is that the personal agenda of addressing my own self-stigma within the project limited the effective portrayal of a ‘truth in flux’ within the cabaret. The third finding presents the view that the cabaret expressed ‘Jo’ playing games of truth in order to journey towards her own "preferred identity claim" (White 2004b) through an act of "self care" (Foucault 2005). The contribution to knowledge of this research project is the application of therapeutic principles to the creation of a cabaret performance. This process has focussed on creating a self-revelatory cabaret that questions notions of a ‘fixed truth’ through combining elements of existing cabaret forms in new ways. Two major forms in contemporary cabaret, the personal cabaret and the provocative cabaret use the performer-audience relationship in distinctive ways. Through combining elements of these two cabaret forms, I have explored ways to create a provocative cabaret focussed on the act of self-revelation.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Due to the development of computer technology and its presence in the daily routine of professionals and students, more resources have emerged with the aim of providing an efficient way to transmit and enhance knowledge in all fields of science. In medical and therapeutic offices, is commonplace to note the existence of computer tools such as visualization applications, games and simulators that enable therapeutic methods based on information technologies and communication. Due to the fact that Speech Pathology is a profession in constant development, this study proposes describing and demonstrating the importance of using technology in speech-language therapies. Thus, it was necessary to conduct a field survey for lifting the profile of professionals of speech pathology on the use of technology in their clinical practice as well as a literature search on existing applications in general healthcare and in speech therapy. Later, it was proposed the building of an application to support rehabilitation processes. It was noticed that there is need for research directed to the field of Speech-therapy concerning to the use of assistive technology for speech-language therapies. Although there are specific computer programs for rehabilitation, little is known about the evaluation and validation of these software in scientific literature. It was developed a game as a way to assist in the treatment of atypical swallowing. The game, called MOtrilha, can support therapeutic techniques for the correction of atypical swallowing. It is one more tool to help professionals and to motivate patients.
Em virtude do desenvolvimento da tecnologia computacional e sua presença no dia-adia de profissionais e estudantes, mais recursos tem surgido com o objetivo de proporcionar uma forma eficaz de transmitir e aprimorar conhecimentos em todas as áreas das ciências. Nos consultórios médicos e terapêuticos, é comum observar a existência de ferramentas computacionais como aplicativos de visualização, jogos e simuladores que possibilitam métodos terapêuticos baseados em tecnologias da informação e comunicação. Sendo a Fonoaudiologia uma profissão em constante desenvolvimento, o presente estudo propõe-se a descrever e apresentar o uso de tecnologias em terapiasfonoaudiológicas. Para tanto, foi necessária a realização de uma pesquisa de campo para o levantamento do perfil de fonoaudiólogos quanto à utilização de tecnologias na sua prática clinica, assim como uma pesquisa bibliográfica sobre os aplicativos existentes na área da saúde em geral e em Fonoaudiologia. Posteriormente, foi proposta a construção de um aplicativo para o auxílio à reabilitação fonoaudiológica. Percebeu-se que há necessidade de pesquisas direcionadas ao campo da Fonoaudiologia concernentes ao uso de tecnologias de apoio a terapias fonoaudiológicas pois, embora existam programas computacionais específicos para a reabilitação, pouco se sabe a respeito da avaliação e validação dos mesmos respaldados na literatura científica. Foi realizada a construção do jogo MOtrilha como forma de auxiliar nos tratamentos de Deglutição Atípica. O jogo visa contribuir na facilitação e melhor aproveitamento das técnicas terapêuticas para a correção da Deglutição Atípica, sendo uma ferramenta a mais para o auxílio do profissional e motivação dos pacientes.

What key design features can be identified in creating a tool/game for helping children open up about sexual abuse through the collaboration with health care professionals? In today’s society, sexual abuse of children is a real and common occurrence. This research will explore what role interactive media can play in helping children open up about abuse as well as identify 11 key design features for designing such a tool. To do so, the participatory method (Simon 2010) will be utilized throughout the design process, based on the collaboration with health care professionals to ensure as relevant and applicable design features as possible. The result of this study are the first iterations of designing this tool as well as the 11 key features that were identified with the help of health care professionals’ expertise.

In many South African schools where English is used as the language of instruction learners with a different mother tongue are accepted, yet they may experience many challenges. In this research study I investigated whether group music therapy sessions can have a positive impact on such learners in relation to particularly two of these difficulties. The first difficulty is social interaction and integration. The second difficulty is their negative attitude towards English, the school and their school work. This difficulty develops because of their weak competency in the language. The paradigm in which this study falls is interpretive and a qualitative approach was used. A case study design was utilised. Ten music therapy sessions were offered to a group of nine grade eight boys from three different linguistic backgrounds: three English home language speakers, three Portuguese home language speakers and three siSwati home language speakers. Music therapy offers a non-threatening environment in which group members can creatively interact. I made use of an array of techniques including improvisation, movement, song writing and musical games where group members had opportunities to express themselves in an unconventional way. Three different sources of naturally-occurring data were used. Questionnaires were filled in by all participants before the commencement of the sessions, five video excerpts were selected from the music therapy group sessions and a focus group was held with all participants after the last session. Data was analysed according to Ansdell and Pavlicevic’s (2001) qualitative content analysis. Responses from the questionnaires and focus group and thick descriptions from the selected video excerpts were coded and categorised according to Gibb’s (2007) proposed technique of open coding. Results generated from the analysed data indicated that, through the opportunities afforded to the group in music therapy sessions, social interaction was experienced in a novel way and integration was enhanced. Findings also indicated that, through this unique way of interacting, the attitude of some members towards English improved. There were also indications that improvement was not across the board and individuals reacted differently to the process. A much longer process could hold far more convincing results.
Dissertation (MMus)--University of Pretoria, 2013.
lmchunu2014
Music
unrestricted

L'objectif de cette thèse est de développer et de valider une méthode de calcul de dose indépendante afin de soutenir le travail de mise en service intense d'une installation de traitement par faisceaux d'ions légers (LIBT) et de valider le calcul de dose du système de planification de traitement (SP). Le travail porte sur les traitements de protonthérapie et est organisé en collaboration entre le laboratoire CREATIS (Lyon, France) et le centre de thérapie ionique MedAustron - Vienna - Austria (Wiener Neustadt, Autriche). Chez MedAustron - Vienna - Austria, afin d’exploiter une pénombre latérale aiguë du faisceau de protons et d’améliorer la précision des algorithmes de calcul de la dose TPS, l’intervalle entre la fenêtre de la tête de traitement et le patient est réduit en déplaçant le patient vers la tête de traitement. Par conséquent, les traitements non isocentriques doivent être pris en compte avec précision lors de la modélisation ainsi que lors de la phase de validation, car l'éloignement de la cible de l'isocentre de la pièce peut réduire la précision du traitement. Dans cette étude, la paramétrisation du faisceau de crayons à protons suit les recommandations de Grevillot et al. (2011), mais comprenant une description complète de la buse. Un soin particulier est apporté à la modélisation des propriétés du faisceau de crayon dans des conditions non isocentriques, y compris l'utilisation d'un Range Shifter (RaShi). La caractérisation du faisceau de crayon est basée uniquement sur les profils de fluence mesurés dans le profil de dose d’air et de profondeur acquis dans l’eau. De plus, le modèle présenté est calibré en dose absolue sur la base d'un nouveau formalisme produit-zone-dose présenté dans Palmans et Vatnitsky (2016). Finalement, une validation détaillée est effectuée dans l'eau, pour les distributions de doses tridimensionnelles de forme régulière. Plusieurs paramètres couramment exploités en dosimétrie des protons, tels que la distance parcourue, la pénombre distale, la modulation, la taille des champs et la pénombre latérale pour la dosimétrie protonique sont évalués à des fins de validation. Le modèle optique à faisceau de crayon a atteint une précision de l'exigence clinique de 1 mm / 10% et il n'est pas affecté par la complexité des traitements non isocentriques ni par l'utilisation d'un RaShi. Les plages sont reproduites entre 0,2 et 0,35 mm (déviation maximale) sans et avec le décaleur de plage, respectivement. La différence de dose dans les conditions de référence est de 0,5%. La validation de l'administration de la dose en 3D dans l'eau était à 1,2% maximum. La concordance des paramètres distaux et longitudinaux est généralement meilleure que 1 mm. Les résultats obtenus serviront de référence pour la future mise en œuvre clinique du système de calcul de dose indépendant MedAustron - Vienna - Austria
The goal of this PhD is to develop and validate an independent dose calculation method in order to support the intense commissioning work of a Light Ion Beam Therapy (LIBT) facility, and to validate the Treatment Planning System (TPS) dose calculation. The work focuses on proton therapy treatments and is held as a collaboration between the CREATIS laboratory (Lyon, France) and the MedAustron - Vienna - Austria Ion Therapy Center (Wiener Neustadt, Austria). At MedAustron - Vienna - Austria, in order to exploit a sharp lateral penumbra for the proton beam as well as to improve the accuracy of the TPS dose calculation algorithms, the air gap between the treatment head window and the patient is reduced by moving the patient towards the treatment head. Therefore, non-isocentric treatments have to be accurately taken into consideration during modeling as well as validation phase as moving the target away from the room isocenter may lead to reduced treatment accuracy. In this study, the parametrization of the proton pencil beam follows the recommendations provided in Grevillot et al. (2011), but including a full nozzle description. Special care is taken to model the pencil beam properties in non-isocentric conditions, including the use of a Range Shifter (RaShi). The characterization of the pencil beam is based solely on fluence profiles measured in air and depth dose profile acquired in water. In addition, the presented model is calibrated in absolute dose based on a newly formalism in dose-area-product presented in Palmans and Vatnitsky (2016). Eventually, a detailed validation is performed in water, for three-dimensional regular-shaped dose distributions. Several parameters commonly exploited in proton dosimetry such as range, distal penumbra, modulation, field sizes and lateral penumbra for proton dosimetry are evaluated for validation purposes. The pencil beam optics model reached an accuracy within the clinical requirement of 1mm/10% and it is not affected by the complexity of non-isocentric treatments and the use of a RaShi. Ranges are reproduced within 0.2 and 0.35 mm (max deviation) without and with range shifter, respectively. The dose difference in reference conditions is within 0.5%. The 3D dose delivery validation in water was within 1.2% at maximum. The agreement of distal and longitudinal parameters is mostly better than 1 mm. The obtained results will be used as a reference for the future clinical implementation of the MedAustron - Vienna - Austria independent dose calculation system. As an example of the potential clinical outcome of the presented work, the patient specific quality assurance measurements performed in water have been successfully reproduced within the clinical requirement of 5% accuracy for a few patients

La planification de traitement en radiothérapie nécessite un calcul précis de la dose délivrée au patient. La méthode la plus fiable pour y parvenir est la simulation du transport des particules par technique Monte Carlo. Cette thèse constitue la première étude concernant la validation de la plateforme de simulation Monte Carlo GATE (GEANT4 Application for Tomographic Emission), basée sur les librairies de GEANT4 (GEometry ANd Tracking), pour le calcul de la dose absorbée déposée par des faisceaux d'électrons. L'objectif de cette thèse est de montrer que GATE/GEANT4 est capable d'atteindre le niveau d'exigences requis pour le calcul de la dose absorbée lors d'une planification de traitement, dans des situations où les algorithmes analytiques, actuellement utilisés dans les services de radiothérapie, n'atteignent pas un niveau de précision satisfaisant. L'enjeu est de prouver que GATE/GEANT4 est adapté pour la planification de traitement utilisant des électrons et capable de rivaliser avec d'autres codes Monte Carlo reconnus. Cet enjeu a été démontré par la simulation avec GATE/GEANT4 de faisceaux et des sources d'électrons réalistes utilisées en radiothérapie externe ou en radiothérapie moléculaire et la production de distributions de dose absorbée en accord avec les mesures expérimentales et avec d'autres codes Monte Carlo de référence pour la physique médicale. Par ailleurs, des recommandations quant à l'utilisation des paramètres de simulation à fixer, assurant un calcul de la distribution de dose absorbée satisfaisant les spécifications en radiothérapie, sont proposées.

La radiothérapie externe représente une part importante du traitement conservateur du sein. Le calendrier classique consiste à délivrer une dose totale de 50 Gy en 25 fractions sur 5 semaines. Pour certaines catégories de femmes, une radiothérapie de 5 à 6 semaines, avec des transports longs et fréquents est parfois difficile à réaliser. La radiothérapie peropératoire (RIOP) permet de prévenir le risque de récidive locale dans le lit tumoral, et ne nécessite que quelques jours d’hospitalisation. Cette étude se concentre sur l’utilisation d'une source de rayons X miniaturisée de faible énergie (50kV). Après résection chirurgicale de la tumeur, un applicateur est inséré dans le lit tumoral et le système délivre une dose unique de 20 Gy à sa surface. Cependant, il n'y a pas de prescription personnalisée ni d'information sur la dose délivrée et ce point est contestable, car un texte officiel recommande une optimisation de la dose individuelle. Dans ce contexte, un calcul Monte Carlo permet d'évaluer avec précision la dose délivrée à la patiente en simulant le transport des particules. Cette thèse propose d'évaluer ce critère de dose absorbée le plus justement possible à partir d'une modélisation réaliste de la source de rayons X et de calculs de dose individuels à l'aide de simulations de Monte Carlo en prenant en compte les hétérogénéités tissulaires du sein. Des mesures dosimétriques in vivo viennent également confirmer les résultats de simulations
External radiation therapy is an important part of breast conservative treatment. The conventional calendar is to deliver a total dose of 50 Gy in 25 fractions over 5 weeks. For certain categories of women, 5 to 6 weeks of radiotherapy, with long and frequent transport is sometimes difficult to achieve. Intra-operative radiotherapy (IORT) helps to prevent the risk of local recurrence in the tumor bed, and only requires a few days of hospitalization. This study focuses on the use of a miniaturized low energy X-ray source (50kV). After surgical resection of the tumor, an applicator is inserted into the tumor bed and the system delivers a single dose of 20 Gy on its surface. However, there is no custom prescription and this is questionable since an official text recommends optimizing the individual dose. In this context, a Monte Carlo calculation makes it possible to accurately assess the dose delivered to the patient by simulating the transport of particles. This thesis proposes to assess the absorbed dose criterion as accurately as possible from a realistic model of the X-ray source and individual dose calculations using Monte Carlo simulations taking into account the tissue heterogeneities of the breast. In vivo dosimetric measurements also confirm the results of simulations

Introdução: A psicoterapia infantil mediada com o computador pode tornar os pacientes mais colaborativos e motivados, diminuir o estigma de ir à terapia, aproximar e melhorar a relação com o terapeuta, facilitar a compreensão de conceitos terapêuticos fundamentais dentro da abordagem cognitivo-comportamental, melhorando suas habilidades de resolução de problemas além de estruturar as sessões de terapia. Objetivo: Criar um protocolo computadorizado para tratamento psicoterápico de crianças denominado Projeto Transformador. Avaliar o projeto para saber de sua viabilidade e utilidade como instrumento terapêutico. Método: Foram realizados dois estudos, um com as crianças e outro com os terapeutas. Os dois estudos foram abertos e utilizaram métodos quantitativos e qualitativos. O primeiro ensaio (A), foi realizado com 10 crianças com transtornos de ansiedade, que responderam a escalas de avaliação e a questionários. No segundo estudo (B), 12 terapeutas usaram o Projeto Transformador em sua prática clínica e sua experiência foi ouvida e analisada. Resultados: Os dados coletados mostraram que as crianças e os terapeutas ficaram satisfeitos com o programa computadorizado Projeto Transformador e este mostrou-se útil motivando a execução de um ensaio clínico randomizado
Introduction: Computer-mediated child psychotherapy can make patients more collaborative and motivated, decrease the stigma of going to therapy, closen and improve the relationship with the therapist, facilitate the understanding of fundamental therapeutic concepts within the cognitive-behavioral approach, improving their problem solving skills, as well as structure therapy sessions. Objective: To create a computerized protocol for psychotherapeutic treatment of children called Projeto Transformador. To assess the project\'s feasibility and usefulness as a therapeutic instrument. Method: Two studies were performed, one with children and one with therapists. Both studies were open and used quantitative and qualitative methods. The first study (A) was conducted with ten children with anxiety disorders who responded to evaluation scales and questionnaires. In the second study (B), twelve therapists used Projeto Transformador in their clinical practice and their experiences were heard and analyzed. Results: The data collected showed that both children and therapists were satisfied with the computerized program Projeto Transformador and that the program proved to be useful, motivating the implementation of randomized clinical tests