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1
Steyaert, Johanna M. "Studies on the regulation of conidiation in species of Trichoderma." Lincoln University, 2007. http://hdl.handle.net/10182/544.
Full textAbstract:
A characteristic feature of species of Trichoderma is the production of concentric rings of conidia in response to alternating light-dark conditions. In response to a single burst of light, a single ring of conidia forms at what was the colony perimeter. On the basis of these observations, competency to photoconidiate has been proposed to be due to the age and metabolic rate of the hyphal cell. In this study, conidiation was investigated in five biocontrol isolates (T. hamatum, T. atroviride, T. asperellum, T. virens and T. harzianum) using both a morphological and molecular approach. All five isolates produced concentric conidial rings under alternating light-dark conditions on potato-dextrose agar (PDA), however, in response to a 15 min burst of blue light, only T. asperellum and T. virens produced a clearly, defined conidial ring which correlated with the colony margin at the time of light exposure. Both T. harzianum and T. hamatum photoconidiated in a disk-like fashion and T. atroviride produced a broken ring with a partially filled in appearance. On the basis of these results, it was postulated that competency to photoconidiate is a factor of the metabolic state of the hyphal cell rather than chronological age or metabolic rate. The influence of the source of nitrogen on photoconidiation was assessed on pH-buffered (pH 5.4) minimal medium (MM) amended with glutamine, urea or KNO₃. In the presence of glutamine or urea, T. asperellum and T. harzianum conidiated in a disk, whereas, when KNO₃ was the sole nitrogen source, a ring of conidia was produced. Further, in the presence of increasing amounts of glutamine, the clearly defined photoconidial ring produced on PDA by T. asperellum became disk-like. These results clearly demonstrated that primary nitrogen promotes photoconidiation in these isolates and strongly suggests that competency of a hyphal cell to conidiate in response to light is dependent on the nitrogen catabolite repression state of the cell. The experiments were repeated for all five isolates on unbuffered MM. Differences were apparent between the buffered and unbuffered experiments for T. atroviride. No photoconidiation was observed in T. atroviride on buffered medium whereas on unbuffered medium, rings of conidia were produced on both primary and secondary nitrogen. These results show that photoconidiation in T. atroviride is influenced by the buffering capacity of the medium. Conidiation in response to light by T. hamatum and T. virens was absent in all nitrogen experiments, regardless of the nitrogen source and buffering capacity, whereas both isolates conidiated in response to light on PDA. These results imply that either both sources of nitrogen are required for photoconidiation, or a factor essential for conidiation in these two isolates was absent in the minimal medium. Mycelial injury was also investigated in five biocontrol isolates of Trichoderma. On PDA, all isolates except T. hamatum conidiated in response to injury. On nitrogen amended MM, conidiation in response to injury was again observed in all isolates except for T. hamatum. In T. atroviride, injury-induced conidiation was observed on all medium combinations except the pH-buffered MM amended with glutamine or urea and T. virens conidiated in response to injury on primary nitrogen only, regardless of the buffering capacity. These results have revealed conidiation in response to injury to be differentially regulated between isolates/species of Trichoderma. On unbuffered MM amended with glutamine or urea, conidiation in response to injury occurred at the colony perimeter only in T. atroviride. It was hypothesised that the restriction of conidiation to the perimeter may be due to changes in the pH of the agar. The experiment was repeated and the pH values of the agar under the growing colony measured at the time of light induction (48 h) or injury (72 h). The areas under the hyphal fronts were acidified to below the starting value of the medium (pH 5.4) and the centres of the plates were alkalinised. The region of acidification at the time of stimuli correlated with the production of conidia, which implicates a role for crossregulation of conidiation by the ambient pH. The influence of the ambient pH on injury-induced conidiation was investigated in T. hamatum and T. atroviride on MM amended with glutamine and PDA, pH-buffered from pH 2.8 to 5.6. Thickening of the hyphae around the injury site was observed at the lowest pH values on MM in both T. atroviride and T. hamatum, however no conidia were produced, whereas both Trichoderma species conidiated on pH-buffered PDA in a strictly low pH-dependent fashion. This is the first observation of injury-induced conidiation in T. hamatum. The influence of the ambient pH on photoconidiation was assessed in T. hamatum, T. atroviride and T. harzianum using both buffered and unbuffered PDA from pH 2.8 to 5.2. On buffered PDA, no conidiation in response to light was observed above pH 3.2 in T. hamatum, above 4.0 in T. atroviride and above 4.4 in T. harzianum, whereas on unbuffered PDA it occurred at all pH values tested. It was postulated that conidiation at pH values above 4.4 on unbuffered PDA was due to acidification of the agar. The pH values of the agar under the growing colony were measured at the time of light exposure and in contrast to the MM with glutamine experiments, alkalisation of the agar had occurred in both T. atroviride and T. hamatum. No change in medium pH was recorded under the growing T. harzianum colony. These results indicate that low pH-dependence of photoconidiation is directly related to the buffering capacity of the medium. Recent studies have linked regulation of conidiation in T. harzianum to Pac1, the PacC orthologue. In fungi, PacC regulates gene expression in response to the ambient pH. In these studies pH-dependent photoconidiation occurred only on buffered PDA and on unbuffered PDA conidiation occurred at significantly higher ambient pH levels. It is proposed that the influence of ambient pH on conidiation in the isolates used in this study is not due to direct Pac1 regulation. The T. harzianum isolate used in this study produced profuse amounts of the yellow anthraquinone pachybasin. Production of this secondary metabolite was strictly pH-dependent, irrespective of the buffering capacity of the medium. Studies in T. harzianum have linked Pac1 regulation to production of an antifungal α-pyrone. pH-dependence on both buffered and unbuffered media strongly suggests that pachybasin production may also be under the control of Pac1. Photoconidiation studies on broth-soaked filter paper, revealed rhythmic conidiation in the pachybasin producing T. harzianum isolate. Diffuse rings of conidia were produced in dark-grown cultures and, in cultures exposed to light for 15 min at 48 h, the rings were clearly defined. These results show that conidiation is under the control of an endogenous rhythm in T. harzianum and represent the first report of circadian conidiation in a wild-type Trichoderma. A Free-Running Rhythm (FRR) assay was used to investigate rhythmic gene expression in T. atroviride IMI206040 and a mutant derivative, in which the wc-2 orthologue, blr-2, was disrupted. Over a 3 d period, expression of gpd, which encodes the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase, oscillated with a period of about 48 h. In the Δblr-2 mutant, the gpd rhythm was absent. These results revealed that in T. atroviride, gpd expression is under the control of an endogenous clock and that clock-regulated expression of gpd is associated with a functional BLR complex. Using degenerate primers, a portion of frq, which encodes the N. crassa clock oscillator FREQUENCY, was isolated from T. atroviride and used to probe the FRR assay northern blots. No frq expression was detected at any time point, which suggests that the circadian clock in Trichoderma does not involve FREQUENCY. In a concurrent study, orthologues of rco-1 (rcoT) were isolated and sequenced from T. atroviride and T. hamatum using a combination of degenerate, inverse and specific PCR. RcoT is an orthologue of the yeast global co-repressor Tup1 and in the filamentous fungi, RcoT orthologues have been demonstrated to negatively regulate conidiation. Genomic analysis of all available rcoT orthologues revealed the conservation of erg3, a major ergosterol biosynthesis gene, upstream from rcoT in ascomycetous filamentous fungi, but not in the ascomycetous yeast or in the basidiomycetes. These studies have significantly contributed to our understanding of the regulatory factors controlling conidiation in Trichoderma and have multiple implications for Trichoderma biocontrol; most notable the promotion of conidiation by primary nitrogen and low pH. Incubation conditions can be altered to suit the nitrogen and pH preferences of a biocontrol strain in order to promote cost effective conidial production, however this is not easily achieved in the soil, where the biocontrol strain must perform in a highly buffered environment optimised for plant growth. Successful use of Trichoderma biocontrol strains may involve the screening and targeting of strains to the appropriate pH conditions or the selection of new strains on the basis of capacity to perform under a given range of conditions.
2
Pratap, Kadam Poonam. "Radiometric Calibration of a Hybrid RCWT Imaging Model." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/339045.
Full textAbstract:
The applications of low-light imaging are widespread in areas such as biomedical imaging, remote sensing, ratiometric imaging, lithography, etc. The goal of this work is to develop a radiometrically scaled hybrid RCWT calculator to count the photons detected for such applications. The rigorous computation of different imaging models are discussed. An approach to calibrate the radiometry of the hybrid RCWT model for partially coherent illumination is presented. The diffraction from the object is evaluated rigorously using the hybrid RCWT model. A test bench is set up to validate the radiometrically scaled simulations. In all the cases considered, simulation and experiment agree within a 40% difference.
3
Koudela, Daniela. "Lifshitz transitions in RCo5 (R=Y, La) and in Osmium." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2007. http://nbn-resolving.de/urn:nbn:de:swb:14-1172236213581-34868.
Full textAbstract:
The aim of this thesis was to find anomalies of elastic properties induced by topological changes of the Fermi surface. The latter are called "Lifshitz transitions". Lifshitz transitions are an interesting subject to study because a topological change of the Fermi surface results in a van Hove singularity of the density of states at the Fermi energy, which again induces an anomaly in the free energy and therefore yield anomalies of observable physical quantities. In all cases the question arose, if the corresponding van Hove singularities are large enough to cause anomalies in the elastic properties, which are measurable by nowadays experimental techniques and computable within the accuracy reachable in nowadays computer calculations. The calculations have been done with the Full-Potential nonorthogonal Local-Orbital minimum-basis band-structure code FPLO. To shift the van Hove singularities through the Fermi energy we used hydrostatic pressure, which is mimicked in the computations by decreasing the volume of the unit cell. The materials under consideration had been YCo5 and LaCo5 as examples for magnetic compounds and the element Osmium as an example for a non-magnetic material. All these materials exhibit hexagonal symmetry. In the case of YCo5 our calculations yield a first order Lifshitz transition. Here, an extraordinarily large peak in the spin-up part of the DOS, which is caused by a nearly dispersionless band in the hexagonal plane, crosses the Fermi level under a pressure of about 21 GPa. Thus, the spin-up 3d states become partly depopulated, which results in a drop of the total magnetic moment of 35%. Therefore the transition can be regarded as a transition from strong to weak ferromagnetism. Further, the transition results in a volume collapse of 1.4%. Though the volume collapse is isomorphic, it exhibits the following anisotropy: while the lattice constant in the hexagonal plane is almost smoothly contracting with increasing pressure, the lattice constant in c-direction collapses at the transition-pressure. This volume collapse has been verified in experiment. Analogous calculations have been performed for the compound LaCo5, which is isoelectronic to YCo5. Here as well we predict a first order Lifshitz transition, taking place at a pressure of about 23 GPa. The mechanism of the transition is the same than in YCo5. Again we find a volume collapse under pressure together with a decrease of the magnetic moment. The relative volume change amounts to 1.3%. Like in YCo5, the unit cell dimensions in the hexagonal plane are decreasing almost smoothly with pressure while in c-direction the lattice constant collapses at the transition-pressure. For LaCo5 there are no such experiments done so far to the best of our knowledge. For Osmium we found, that LDA reproduces the ground state volume very well. Furthermore, we could detect three Lifshitz transitions taking place at very high pressures of about 72 GPa, 81 GPa, and 122 GPa. At first, a hole ellipsoid appears at the Gamma-point (V=24.6Å^3, P=72 GPa), then a neck is created at the symmetry-line LH (V=24.2Å^3, P=81 GPa), and finally a hole ellipsoid appears at the L-point (V=23.2 Å^3, P=122 GPa). Due to a degeneracy in the band structure, the hole ellipsoid at the L-point appears at the same pressure when the necks, situated at the symmetry-lines LH merge at L. The corresponding van Hove singularities in the DOS are very tiny and thus no anomalies in the elastic properties could be detected. Furthermore, we showed that the kink in c/a at 25 GPa and at 27 GPa found by Occelli et al. [Occelli et al., Phys. Rev. Lett. 93, 095502 (2004)] and Ma et al. [Ma et al., Phys. Rev. B 72, 174103 (2005)], respectively, is not statistically significant and that (c/a)(P) can be fitted equally well by a smooth function as by piece-wise linear functions as proposed in these referencesDas Ziel dieser Arbeit war es, Anomalien in den elastischen Eigenschaften zu finden, die durch topologische Änderungen der Fermifläche - genannt "Lifschitz Übergänge" - hervorgerufen werden. Lifschitz Übergänge sind ein interessantes Forschungsgebiet, denn die topologische Änderung der Fermifläche führt zu einer van Hove Singularität in der Zustandsdichte, die an der Fermienergie liegt und eine Anomalie in der freien Energie hervorruft und deswegen zu Anomalien in beobachtbaren physikalischen Größen führt. In allen Fällen kam die Frage auf, ob die entsprechenden van Hove Singularitäten groß genug sind, um mit heutigen Methoden meßbare und berechenbare Anomalien in den elastischen Eigenschaften zu verursachen. Die Daten wurden mit dem Computerprogramm FPLO (Full-Potential nonorthogonal Local-Orbital minimum-basis band-structure scheme) berechnet. Um die van Hove Singularitäten durch die Fermienergie zu schieben, verkleinerten wir das Volumen der Einheitszelle, um hydrostatischen Druck zu simulieren. Als zu untersuchende Stoffe wurden YCo5 und LaCo5 als Beispiele für magnetische Verbindungen gewählt und Osmium als Beispiel für ein nicht magnetisches Element. Im Falle von YCo5 fanden wir einen Lifschitz Übergang erster Ordnung. Hier springt ein besonders großer Peak im Spin-auf Teil der Zustandsdichte unter einem Druck von ca. 21 GPa über die Fermienergie. Dadurch werden die Spin-auf 3d Zustände teilweise unbesetzt und das magnetische Moment verringert sich um 35%. Deswegen kann man den Übergang als einen Übergang von starkem Ferromagnetismus zu schwachem Ferromagnetismus bezeichnen. Das Volumen verkleinert sich hierbei um 1.4%. Obwohl dieser Volumenkollaps isomorph ist, zeigt er folgende Anisotropie: während die Gitterkonstante in der hexagonalen Ebene mit zunehmendem Druck mehr oder weniger glatt kontrahiert, kollabiert am Übergangsdruck die Gitterkonstante in c-Richtung. Dieser Volumenkollaps wurde vom Experiment verifiziert. Analoge Rechnungen wurden für die Verbindung LaCo5, die isoelektronisch zu YCo5 ist, durchgeführt. Auch hier sagen wir einen Lifschitz Übergang erster Ordnung voraus, der bei einem Druck von ca. 23 GPa stattfinden wird. Der Mechanismus dieses Übergangs ist der selbe wie in YCo5. Wiederum finden wir einen Volumenkollaps unter Druck zusammen mit einer Verringerung des magnetischen Moments. Die relative Volumenänderung beträgt hier 1.3%. Wie in YCo5 verläuft hier die Kontraktion der Gitterkonstante in der hexagonalen Ebene mehr oder weniger glatt, während die Gitterkonstante in c-Richtung am Übergang kollabiert. Für LaCo5 existieren unseres Wissens hierzu noch keine Experimente. Im Falle von Osmium fanden wir drei Lifschitz Übergänge bei sehr hohen Drücken von ca. 72 GPa, 81 GPa, und 122 GPa. Zuerst bildet sich ein Lochellipsoid am Gamma-Punkt (V=24.6Å^3, P=72 GPa), dann bildet sich ein Hals an der Symmetrielinie LH (V=24.2Å^3, P=81 GPa), und zum Schluß erscheint ein Lochellipsoid am L-Punkt (V=23.2 Å^3, P=122 GPa). Auf Grund einer Entartung in der Bandstruktur taucht das Lochellipsoid am L-Punkt an dem Druck auf, an dem sich auch die Hälse auf der Symmetrielinie LH bei L verbinden. Die entsprechenden van Hove Singularitäten in der Zustandsdichte sind jedoch extrem klein und deswegen können keine Anomalien in den elastischen Eigenschaften detektiert werden. Desweiteren zeigten wir, daß der Knick in c/a, den Occelli et al. [Occelli et al., Phys. Rev. Lett. 93, 095502 (2004)] bei 25 GPa und Ma et al. [Ma et al., Phys. Rev. B 72, 174103 (2005)] bei 27 GPa fanden, statistisch nicht relevant ist und daß (c/a)(P) genauso gut von einer glatten Funktion gefittet wird als von stückweise linearen Funktionen
4
Koudela, Daniela. "Lifshitz transitions in RCo5 (R=Y, La) and in Osmium." Doctoral thesis, Technische Universität Dresden, 2006. https://tud.qucosa.de/id/qucosa%3A23889.
Full textAbstract:
The aim of this thesis was to find anomalies of elastic properties induced by topological changes of the Fermi surface. The latter are called "Lifshitz transitions". Lifshitz transitions are an interesting subject to study because a topological change of the Fermi surface results in a van Hove singularity of the density of states at the Fermi energy, which again induces an anomaly in the free energy and therefore yield anomalies of observable physical quantities. In all cases the question arose, if the corresponding van Hove singularities are large enough to cause anomalies in the elastic properties, which are measurable by nowadays experimental techniques and computable within the accuracy reachable in nowadays computer calculations. The calculations have been done with the Full-Potential nonorthogonal Local-Orbital minimum-basis band-structure code FPLO. To shift the van Hove singularities through the Fermi energy we used hydrostatic pressure, which is mimicked in the computations by decreasing the volume of the unit cell. The materials under consideration had been YCo5 and LaCo5 as examples for magnetic compounds and the element Osmium as an example for a non-magnetic material. All these materials exhibit hexagonal symmetry. In the case of YCo5 our calculations yield a first order Lifshitz transition. Here, an extraordinarily large peak in the spin-up part of the DOS, which is caused by a nearly dispersionless band in the hexagonal plane, crosses the Fermi level under a pressure of about 21 GPa. Thus, the spin-up 3d states become partly depopulated, which results in a drop of the total magnetic moment of 35%. Therefore the transition can be regarded as a transition from strong to weak ferromagnetism. Further, the transition results in a volume collapse of 1.4%. Though the volume collapse is isomorphic, it exhibits the following anisotropy: while the lattice constant in the hexagonal plane is almost smoothly contracting with increasing pressure, the lattice constant in c-direction collapses at the transition-pressure. This volume collapse has been verified in experiment. Analogous calculations have been performed for the compound LaCo5, which is isoelectronic to YCo5. Here as well we predict a first order Lifshitz transition, taking place at a pressure of about 23 GPa. The mechanism of the transition is the same than in YCo5. Again we find a volume collapse under pressure together with a decrease of the magnetic moment. The relative volume change amounts to 1.3%. Like in YCo5, the unit cell dimensions in the hexagonal plane are decreasing almost smoothly with pressure while in c-direction the lattice constant collapses at the transition-pressure. For LaCo5 there are no such experiments done so far to the best of our knowledge. For Osmium we found, that LDA reproduces the ground state volume very well. Furthermore, we could detect three Lifshitz transitions taking place at very high pressures of about 72 GPa, 81 GPa, and 122 GPa. At first, a hole ellipsoid appears at the Gamma-point (V=24.6Å^3, P=72 GPa), then a neck is created at the symmetry-line LH (V=24.2Å^3, P=81 GPa), and finally a hole ellipsoid appears at the L-point (V=23.2 Å^3, P=122 GPa). Due to a degeneracy in the band structure, the hole ellipsoid at the L-point appears at the same pressure when the necks, situated at the symmetry-lines LH merge at L. The corresponding van Hove singularities in the DOS are very tiny and thus no anomalies in the elastic properties could be detected. Furthermore, we showed that the kink in c/a at 25 GPa and at 27 GPa found by Occelli et al. [Occelli et al., Phys. Rev. Lett. 93, 095502 (2004)] and Ma et al. [Ma et al., Phys. Rev. B 72, 174103 (2005)], respectively, is not statistically significant and that (c/a)(P) can be fitted equally well by a smooth function as by piece-wise linear functions as proposed in these references.Das Ziel dieser Arbeit war es, Anomalien in den elastischen Eigenschaften zu finden, die durch topologische Änderungen der Fermifläche - genannt "Lifschitz Übergänge" - hervorgerufen werden. Lifschitz Übergänge sind ein interessantes Forschungsgebiet, denn die topologische Änderung der Fermifläche führt zu einer van Hove Singularität in der Zustandsdichte, die an der Fermienergie liegt und eine Anomalie in der freien Energie hervorruft und deswegen zu Anomalien in beobachtbaren physikalischen Größen führt. In allen Fällen kam die Frage auf, ob die entsprechenden van Hove Singularitäten groß genug sind, um mit heutigen Methoden meßbare und berechenbare Anomalien in den elastischen Eigenschaften zu verursachen. Die Daten wurden mit dem Computerprogramm FPLO (Full-Potential nonorthogonal Local-Orbital minimum-basis band-structure scheme) berechnet. Um die van Hove Singularitäten durch die Fermienergie zu schieben, verkleinerten wir das Volumen der Einheitszelle, um hydrostatischen Druck zu simulieren. Als zu untersuchende Stoffe wurden YCo5 und LaCo5 als Beispiele für magnetische Verbindungen gewählt und Osmium als Beispiel für ein nicht magnetisches Element. Im Falle von YCo5 fanden wir einen Lifschitz Übergang erster Ordnung. Hier springt ein besonders großer Peak im Spin-auf Teil der Zustandsdichte unter einem Druck von ca. 21 GPa über die Fermienergie. Dadurch werden die Spin-auf 3d Zustände teilweise unbesetzt und das magnetische Moment verringert sich um 35%. Deswegen kann man den Übergang als einen Übergang von starkem Ferromagnetismus zu schwachem Ferromagnetismus bezeichnen. Das Volumen verkleinert sich hierbei um 1.4%. Obwohl dieser Volumenkollaps isomorph ist, zeigt er folgende Anisotropie: während die Gitterkonstante in der hexagonalen Ebene mit zunehmendem Druck mehr oder weniger glatt kontrahiert, kollabiert am Übergangsdruck die Gitterkonstante in c-Richtung. Dieser Volumenkollaps wurde vom Experiment verifiziert. Analoge Rechnungen wurden für die Verbindung LaCo5, die isoelektronisch zu YCo5 ist, durchgeführt. Auch hier sagen wir einen Lifschitz Übergang erster Ordnung voraus, der bei einem Druck von ca. 23 GPa stattfinden wird. Der Mechanismus dieses Übergangs ist der selbe wie in YCo5. Wiederum finden wir einen Volumenkollaps unter Druck zusammen mit einer Verringerung des magnetischen Moments. Die relative Volumenänderung beträgt hier 1.3%. Wie in YCo5 verläuft hier die Kontraktion der Gitterkonstante in der hexagonalen Ebene mehr oder weniger glatt, während die Gitterkonstante in c-Richtung am Übergang kollabiert. Für LaCo5 existieren unseres Wissens hierzu noch keine Experimente. Im Falle von Osmium fanden wir drei Lifschitz Übergänge bei sehr hohen Drücken von ca. 72 GPa, 81 GPa, und 122 GPa. Zuerst bildet sich ein Lochellipsoid am Gamma-Punkt (V=24.6Å^3, P=72 GPa), dann bildet sich ein Hals an der Symmetrielinie LH (V=24.2Å^3, P=81 GPa), und zum Schluß erscheint ein Lochellipsoid am L-Punkt (V=23.2 Å^3, P=122 GPa). Auf Grund einer Entartung in der Bandstruktur taucht das Lochellipsoid am L-Punkt an dem Druck auf, an dem sich auch die Hälse auf der Symmetrielinie LH bei L verbinden. Die entsprechenden van Hove Singularitäten in der Zustandsdichte sind jedoch extrem klein und deswegen können keine Anomalien in den elastischen Eigenschaften detektiert werden. Desweiteren zeigten wir, daß der Knick in c/a, den Occelli et al. [Occelli et al., Phys. Rev. Lett. 93, 095502 (2004)] bei 25 GPa und Ma et al. [Ma et al., Phys. Rev. B 72, 174103 (2005)] bei 27 GPa fanden, statistisch nicht relevant ist und daß (c/a)(P) genauso gut von einer glatten Funktion gefittet wird als von stückweise linearen Funktionen.
5
Rossetti, Alessandra. "Analisi del catalogo Europeo-Mediterraneo degli RCMT: 18 anni di dati." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amslaurea.unibo.it/10848/.
Full textAbstract:
L'RCMT (Regional Centroid Moment Tensor), realizzato e gestito dai ricercatori dell'INGV (Istituto Nazionale di Geofisica e Vulcanologia), è dal 1997 il catalogo di riferimento per gli eventi sismici avvenuti nell'area Europea-Mediterranea, ossia nella regione avente longitudine compresa tra 10° W e 40° E e latitudine compresa tra 25° N e 60° N. Tale regione è caratterizzata da un'attività tettonica complessa, legata non soltanto alla convergenza delle placche Euroasiatica ed Africana, ma anche al movimento di altre placche minori (ad esempio, la placca Arabica), che tutte insieme danno origine ad una vasta gamma di regimi tettonici.
Col termine RCMT si indica un particolare tipo di tensore momento sismico, la cui determinazione avviene su scala regionale, per eventi sismici aventi M_w >= 4.5 (M_w >= 4.0 per gli eventi che avvengono nella penisola italica).
Il tensore momento sismico è uno strumento fondamentale per caratterizzare natura ed entità di un terremoto. Da esso, infatti, oltre alla magnitudo momento M_w, si ricava anche il meccanismo focale. Comunemente rappresentato sotto forma di beach ball, consente di individuare il tipo di movimento (distensivo, compressivo o trascorrente, o anche una combinazione del primo o del secondo con il terzo) avvenuto sulla faglia che ha provocato il terremoto. I tensori momento sismico permettono, quindi, di identificare le faglie che si attivano durante una sequenza sismica, di comprendere la loro cinematica e di ipotizzare la successiva evoluzione a breve termine.
Scopo di questa relazione di laurea è stato derivare le relazioni che intercorrono fra le M_w dell'RCMT e le M_w del CMT (Centroid Moment Tensor della Columbia University), del GFZ (Deutsches GeoForschungsZentrum di Postdam) e del TDMT (Time Domain Moment Tensor). Le relazioni sono state ottenute applicando il metodo dei minimi quadrati agli eventi comuni, che sono stati selezionati utilizzando alcuni semplici programmi scritti in Fortran.
6
Montero, Raul Marcio Borjas. "Compensador de reativos tipo RCT controlado por microcomputador." [s.n.], 1987. http://repositorio.unicamp.br/jspui/handle/REPOSIP/259904.
Full textAbstract:
Orientador: Sigmar M. DeckmannDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica
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Resumo: Não informado
Abstract: Not informed.
Mestrado
Mestre em Engenharia Elétrica
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Olsson, Elin, and Frida Bertling. "Mindfulness based stress reduction (MBSR) vid bröstcancer : - en litteraturöversikt." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-34685.
Full textAbstract:
Bakgrund: Mindfulness är ett nytt koncept inom omvårdnad. Mindfulness-based stress reduction (MBSR) är ett program som utvecklats från mindfulness inom vården. MBSR har studerats i samband med olika sjukdomar däribland cancer. Bröstcancer är den vanligaste maligna cancern hos kvinnor världen över och att få en cancerdiagnos medför både fysiska och psykiska svårigheter. Syfte: Att beskriva effekter av MBSR på personer med bröstcancer. Metod: Litteraturöversikt baserad på RCT-studier (randomised controlled trials). Datainsamling gjordes via CINAHL, Medline och PsychINFO och tolv RCT-studier granskades med en induktiv ansats. Resultat: Resultatet bygger på tolv RCT studier som jämför MBSR med vanlig behandling (VB) och är indelat i effekter avseende fysiskt välmående, effekter avseende psykiskt välmående, effekter avseende hantering och effekter avseende socialt välmående. Slutsats: Generellt finns kortsiktiga positiva effekter till följd av MBSR-programmet hos personer med bröstcancer. Dock är dessa effekter ofta uppmätta direkt efter interventionen och flera studier visar att dess effekt minskar efter tolv månader. Evidensen för att använda MBSR i vården av personer med bröstcancer är ännu låg och fler studier med längre uppföljning bör göras.Background: Mindfulness is a fairly new concept in nursing. The MBSR-programme (Mindfulness based stress reduction) was developed from mindfulness in healthcare. MBSR has been studied in relation to different healthcare settings and illnesses there among cancer. Breast cancer is the most common cancer amongst women worldwide. To live with cancer entails both psychological and physical issues. Aim: To describe the effects of MBSR on persons with breast cancer. Method: A literature review based on RCT-studies (randomised controlled trials). Data collection was done using CINAHL, Medline and PsychINFO and twelve RCT-studies was examined with an inductive approach. Results: The result is based on twelve RCT-studies comparing MBSR with standard treatment and presented in effects related to: physical wellbeing, psychological wellbeing, coping and social wellbeing. Conclusion: Generally, there are short term positive effects of the MBSR-programme on persons with breast cancer. These effects are often measured directly after the intervention and several studies show that the effects diminish after twelve months. Evidence to use MBSR in healthcare for persons with breast cancer is still low and more studies with longer follow up should be conducted.
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Agbalalah, Tari. "Vitamin D and cardiometabolic disease risk : a RCT and cross-sectional study." Thesis, University of Chester, 2017. http://hdl.handle.net/10034/620602.
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Given the strong evidence for a beneficial role of vitamin D in diabetes and CVD pathogenesis, and the prevalence of vitamin D deficiency, vitamin D supplementation has been advocated for the prevention of cardiometabolic disease. To provide information on the effects of 5,000IU (125µg) vitamin D3 on cardiometabolic risk, a double blind, RCT in a cohort of overweight and obese UK adult males with plasma 25(OH)D concentration < 75nmol/L for a duration of 8 weeks was conducted. To the best of my knowledge, this is the first RCT to investigate the effect of 5,000IU (125µg) vitamin D3 on cardiometabolic markers in vitamin D insufficient, non-hypertensive and non-diabetic overweight and obese adult males.
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Santos, Leonardo Bacelar Lima. "Redes complexas de base territorializada (RCBT): conceito, caracterização e seu potencial de aplicação na modelagem epidemiológica." Instituto Nacional de Pesquisas Espaciais (INPE), 2014. http://urlib.net/sid.inpe.br/mtc-m21b/2014/03.16.04.10.
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A presente tese define Redes Complexas de Base Territorializada (RCBT): grafos com um grande número de vértices, todos de localização espacial conhecida, e regras de conexão que envolvem dependência espacial e que não operam nem de forma regular, nem completamente aleatória. A criação do conceito demanda o desenvolvimento de métodos para tratar dados reais e analisar os resultados do ponto de vista das redes (no formalismo da física estatística) e do fenômeno tratado (sistemas complexos). Ao longo do texto é apresentado um ciclo completo que vai da apropriação dos dados de Origem-Destino à análise dos padrões de circulação e das RCBT construídas com base nesses dados. A visualização em Sistema de Informações Geográficas dos diferentes padrões de circulação e dos atributos das RCBT ajuda a compreender espacialmente o conceito de Espaço de Atividade: conjunto de todos os territórios acessíveis a um indivíduo, desenvolvido como um conceito da geografia humana e hoje fundamental para a modelagem computacional de epidemias, especialmente em escala intraurbana. Em relação aos padrões de circulação, foi apresentada uma inovação para o ajuste gravitacional do fluxo de viagens em função do comprimento efetivo da rota. Pelas RCBT foram obtidas assinaturas clássicas de Sistemas Complexos na abordagem de Redes Complexas: distribuição livre de escala, efeito de pequeno mundo e comportamento hierárquico, simultaneamente à análise geográfica dos resultados.The present thesis defines complex networks of territorialized base (CNTB): graphs with a large number of nodes, all of known spatial location, and connection rules that involve spatial dependence and that do not operate in a regular pattern, nor completely random. The creation of this concept ais o demands the development of methods to treat actual data and analyze the results from the point of view of complex networks (in the formalism of Statistical Physics) and of the phenomena under study (Complex Systems). Throughout the text it is given a original and full cycle that will cover the appropriation of origin-destination data to the analysis of the movement patterns and the CNTB construction based on these data. The visualization, in Geographical Information Systems, of the different patterns of movement, and the attributes of the CNTB, helps understanding the concept of Spatial Activity Space: set of all the territories that are accessible to an individual, developed as a concept of human geography and today fundamental to computational modeling of epidemics, especially in the intraurban scale. Regarding movement patterns, was presented a gravitational adjustment for travei flow as a route's length function. By the use of CNTB, classic signatures were obtained from complex systems using the complex networks approach: scale-free distribution, small-world effect and hierarchical behavior, simultaneously to the geographical analysis of the results.
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Falgin, Hultgren Jonas. "The Acute Metabolic Response of Intermittent Hypoxic Resistance Exercise : A Cross-Over RCT." Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-5791.
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Aim The aim for this present study was to investigate the acute metabolic response from intermittent resistance exercise during hypoxia, with the following research questions: (1) Are blood levels of lactate and glucose different between hypoxia and normoxia? (2) Does hypoxia induce higher lactate accumulation and pH reduction in the human skeletal muscle? (3) Is there a relationship between plasma-, blood- and muscle lactate? Method Eight healthy males (30 ± 2 years) performed 6 sets of unilateral leg extension on each leg (75% of 1RM) with randomized normoxic (20,9% inspired 𝑂2) and normobaric hypoxic (12% inspired 𝑂2) conditions. A total of 5 muscle biopsies was extracted from m. Vastus Lateralis (pre-, post exercise, 90-, 180min and 24h post exercise) during both normoxia and hypoxia trials, separated by one week for all participants. Blood samples were repeatedly taken with 20 min intervals. Heart Rate (HR) and saturation (𝑆𝑝𝑂2) were measured by a pulsoximeter during resistance exercise. Results No significant main effect was observed for blood lactate and glucose levels as well as the muscle lactate accumulation and pH between normoxia and hypoxia. However, pH in muscle showed a trend between the conditions post exercise where hypoxia reached lower levels in total (P=0.08). Significant correlations were observed for blood- and plasma lactate, where hypoxia showed a stronger relationship than normoxia (r=0.98 compared to r=0.87). Equal findings for the correlation of muscle- and plasma lactate showed an even greater coefficient value for hypoxia compared to normoxia (r=0.860 compared to r=0.59). Conclusion Summarized data indicated that no significant difference between hypoxia and normoxia was evident. Nonetheless, tendencies illustrate that hypoxia may alter the metabolic response slightly. However, further research is needed to draw a conclusion between the conditions.Syftet med denna studie är att undersöka kroppens akuta metabola svar från intermittent styrketräning under hypoxi, med följande frågeställningar: (1) Skiljer sig nivåerna av laktat och glukos i blodet mellan hypoxi och normoxi? (2) Skapar hypoxi större laktatansamling och pH reduktion i människoskelettmuskeln? (3) Finns det en relation mellan plasma-, blod- och muskellaktat? Metod Åtta friska män (30 ± 2 år) deltog där deltagarna utförde 6 set unilateral benextension för varje ben (75% 1RM). Intermittent styrketräning randomiserades med hypoxi som utfördes med 12% syrgas och normoxi som bibehöll normal syrgasnivå (20,9% syrgas). Under två testdagar togs 5 muskelbiopsier från m. Vastus Lateralis (före-, efter träning, 90-, 180min och 24h efter träning) på vartannat ben per testdag. Hjärtfrekvensen och 𝑆𝑝𝑂2 mättes via pulsoximeter under träningen. Resultat Ingen signifikant huvudeffekt påvisades mellan hypoxi och normoxi för blodlaktat samt glukos, såväl som laktatackumulationen och pH värdet i muskeln. Muskel pH visade en trend där hypoxi efter styrketräning nådde lägre totalnivå än normoxi (P=0,08). Vidare observerades hypoxi att ha starka relationer mellan blod- och plasmalaktat jämfört med normoxi (r=0,98 vs. r=0,87). Större skillnad framgick för korrelationen mellan muskel- och plasmalaktat där hypoxi-försöket utgav starkare koefficient jämfört med normoxi (r=0,86 vs. r=0,59). Konklusion Sammanfattad data visar att hypoxi inte skapar större metabolisk respons vid intermittent styrketräning. Trots detta framkom tendenser som illustrerar att hypoxi kan påverka den metabola stressen under styrketräning. Däremot krävs vidare forskning för att kunna säkerställa effekten av hypoxi på kroppens metabola svar.
Ingår i Marcus Mobergs projekt: ”Resistance exercise under hypoxia and the acute molecular effects in human skeletal muscle
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Beringer, Danielle Nicole. "An Exploratory Study Investigating the Time Duration of Slip-Induced Changes in Gait." Thesis, Virginia Tech, 2013. http://hdl.handle.net/10919/23079.
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The biomechanics of slips are commonly studied in laboratory settings in an effort to improve the understanding of slip mechanisms for the advancement of slip and fall prevention strategies and risk assessment methods. Prior studies have shown changes in gait after slipping, and these changes can reduce the external validity of experimental results. As such, most researchers only slip participants one time. The ability to slip participants more than once, after allowing gait to return to a natural baseline, would improve the experimental efficiency of these studies. Therefore, the goal of this study was to determine the time duration of slip-induced changes in gait. The required coefficient of friction (RCOF), a parameter highly predictive of risk of slipping, was measured on thirty-one young male adults during level gait on three separate days before slipping, immediately (<10 minutes) after slipping, and either one, two, four, or six weeks later. On average, the RCOF decreased 12% from its baseline value (0.20) after slipping, indicating the adoption of a protective gait with a decreased risk of slipping. The RCOF data trended toward baseline values 4-6 weeks after the slip experience, but remained statistically different from baseline. This indicates that the slip-induced gait alterations have long-lasting effects, enduring up to six weeks after the slip experience.Master of Science
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Walid, Rania. "Impact Evaluation in Post-conflict Environments : A Critical Appraisal of Randomised Controlled Trial (RCT)." Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-104816.
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Impact evaluations in development interventions has been growing in recent years. The increasing demand for evidence-based outcomes has led to a debate of what methodology is best to evaluate the impact of development interventions. Accordingly, Randomised Controlled Trial (RCT) has been labeled as a gold standard for impact evaluations. The RCT method functions in a unique way, as it removes the selection bias and ensure high validity of a study. The aim of this research study is to critically assess the RCT as an alternative approach for impact assessment in relation to post-conflict countries; whether this claim holds in a conflict-affected environment or that the context-specific factors of post-conflict countries challenge the implementation of an RCT. This study implements mixed method approach by using simple descriptive statistics and semi-structured interview to answer the research questions. The findings of this study indicate that context-specific factors of post-conflict environments pose challenges on the implementation of an RCT. As a result, these challenges threaten the quality of the RCT method which lies in reliability, internal validity and external validity. The findings also indicate that feasibility of RCT which lies in ethics, logistics and security, cannot be addressed individually, as the feasibility has a direct impact on the quality of the RCT method.
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Hedén, Lena. "Distressing Symptoms in Children with Cancer in General; During Needle Procedures in Particular." Doctoral thesis, Uppsala universitet, Pediatrik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-172905.
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The main aims of this thesis were to investigate the effect of distraction, midazolam and morphine on fear, distress, and pain during needle procedures, and to longitudinally describe parents’ perceptions of their children’s symptom burden during and after cancer treatment. The design in Study I-III was that of a randomized controlled trial (RCT) conducted in a medical setting; Studies II-III were placebo controlled. Study IV has a longitudinal design, and data were collected at three times during treatment and three times after the end of successful treatment. Participants in Study I were children aged 1 to 7 (n=28), in Study II children aged 1 to 19 (n=50), in Study III children aged 1 to 19 (n=50), and in Study IV parents (n=160) of children aged 1 to 19. Blowing soap bubbles or having a heated pillow reduces children’s fear and distress in connection with needle procedures. Low-dose oral midazolam 0.3mg/kg body weight is effective in reducing fear and distress, especially in younger children. Interestingly, oral morphine at a dose of 0.25mg/kg body weight does not reduce fear, distress or pain. These studies have evaluated interventions that may be of help for the most frightened children during needle procedures. We suggest that the first-line intervention against procedural fear, distress, and/or pain should be standard care (i.e. EMLA) in addition to distraction interventions when needed, and only when this is insufficient to add pharmacological interventions. According to parents, feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms in their children, whereas less hair than usual is the most prevalent symptom during treatment. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout treatment. The child’s symptom burden, as reported by parents, decreases over time. Information about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during and after cancer treatment.
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Ren, Zhen. "Exploration of medical applications of electrical capacitance tomography." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/exploration-of-medical-applications-of-electrical-capacitance-tomography(57a537b3-4836-4e36-8c7b-a8c35224eb7d).html.
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With the advantages of low cost, high imaging speed, non-intrusive and non-invasive, electrical capacitance tomography (ECT) becomes one of most maturely developed industrial tomography modalities. However, ECT had not been considered for medical applications before this work. This thesis is to explore medical applications of ECT, especially for root canal treatment (RCT) and revision total hip replacement (THR).A dental ECT system based on impedance analyser has been designed for RCT for two purposes: (1) to visualise the tooth surface in real time and (2) to determine the position of an endodontic file. To adapt the limited space in oral cavity, a miniature two–plate dental ECT sensor with either 2×2 or 2×3 array has been designed and fabricated. The sensor has a similar performance to the conventional ECT sensor and can provide good image quality. By registering and fusing with the radiograph based on a Major-axis method, a real-time image with high resolution can be obtained. A piecewise linear function has been used to locate the axial position of the apex of an endodontic file. The results show that high accuracy can be achieved near the ‘End Point’ as it is one of the reference points, determined by the sudden change in capacitance when a grounded metallic file touches the root apex (conductive media or solution).For revision THR, a conventional 8-electrode single plane sensor has been used, generating real-time 3D images of a metallic rod using a model based method. By this method, the 3D image reconstruction is simplified to estimate the cross-sectional and axial potions of the rod in the sensing area and to draw an image of the rod with prior knowledge. A high accuracy can be achieved with the maximum absolute error of 0.13 cm in estimating cross-sectional position using a weighted mean method and 0.4 cm in estimating axial position by the linear function based on the relative change in capacitance between file and electrodes. A preliminary experiment has been carried out to generate an electrical impedance tomography (EIT) image of a metallic object in conductive solution with high permittivity. Using the impedance analyser based system, the EIT image can be obtained with a conventional ECT sensor and the result is promising, providing the possibility of obtained a real-time EIT 3D image of a milling/drilling tool during revision THR.
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Madaro, Matteo. "La terapia manuale e l’esercizio terapeutico nella persona con spalla congelata: una revisione di RCT." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amslaurea.unibo.it/16901/.
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Background: la Spalla Congelata (o Capsulite Adesiva) è una condizione clinica caratterizzata da dolore e riduzione della mobilità del distretto articolare della spalla che causa disturbi del sonno e marcate limitazioni dell’attività. Ad oggi, gli approcci fisioterapici volti al miglioramento di dolore, ROM e funzione sono molteplici, ma non è ancora chiaro quale di questi sia di miglior efficacia rispetto agli altri.
Obiettivo: questa Revisione di RCT ha lo scopo di verificare l’efficacia della Terapia Manuale e dell’esercizio terapeutico nel migliorare dolore, ROM, funzione e forza muscolare nelle persone con Spalla Congelata.
Metodi di ricerca: sono state consultate le banche dati elettroniche CENTRAL, CINAHL, MEDLINE, PEDro e PubMed. La ricerca è iniziata nel Giugno 2018 e si è conclusa il 26 Settembre 2018. Sono stati inclusi solo RCT che trattassero di Terapia Manuale ed esercizio terapeutico nelle persone con Spalla Congelata.
Risultati: sono stati individuati 7 RCT. Le misure di outcome prese in esame sono relative a: ROM, dolore, funzione e forza muscolare.
Coclusioni: aggiungere Terapia Manuale ad un programma di esercizi terapeutici e terapie strumentali genera un miglioramento maggiore di ROM, dolore e funzione. Allenare i soggetti ad eseguire le ADL genera miglioramenti della funzione e può anche influenzare miglioramento di ROM, dolore e forza. Esercizi di rinforzo della cuffia dei rotatori migliorano la forza muscolare più efficacemente rispetto a Terapia Manuale e terapie fisiche strumentali. Il mantenimento prolungato di posizioni che pongono in allungamento le strutture articolari e peri-articolari della spalla è più efficace in termini di funzione e ROM rispetto a Terapia Manuale e terapie strumentali. Sono necessari ulteriori studi di elevata qualità metodologica, con campioni di grandi dimensioni e che valutino gli effetti a lungo termine (follow-up) di questi approcci fisioterapici nella riabilitazione della persona con Spalla Congelata.
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Martin, Thomas [Verfasser]. "Sulkusdarstellung und parodontale Gesundheit nach unterschiedlichen Verfahren zum Weichgewebsmanagement bei gesunden Probanden (RCT) / Thomas Martin." Ulm : Universität Ulm. Medizinische Fakultät, 2014. http://d-nb.info/1062610733/34.
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Salman, Mayla. "Détection et signalisation du monoxyde de carbone chez des bactéries aérobies - Hémo-senseur RcoM-2 et réponses mycobactériennes au CO." Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLX076.
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Le gaz toxique CO peut agir à faibles quantités comme molécule de signalisation ; détectée par les protéines senseurs à base d’hème.La première partie de ce travail concerne le régulateur de transcription bactérien CO-dépendant RcoM-2, qui possède une affinité extrêmement élevée pour le CO, tout en étant insensible à l'O₂. RcoM-2 se lie à son ADN cible seulement lorsque du CO est lié à l’hème. Nous avons caractérisé l'interaction hème-CO dans la protéine entière RcoM-2 et l'avons comparée à l’hémo-domaine isolé RcoMH-2. RcoM-2 peut lier du CO avec une affinité effective plus faible que RcoMH-2. Le CO se dissocie avec un taux 20 fois plus élevé par rapport à RcoMH-2, où la liaison du CO est quasi irréversible. Une petite fraction du CO peut échapper de la protéine, ainsi permettant RcoM-2 à agir comme senseur du CO. La présence du domaine de liaison à l'ADN influence les propriétés de fixation du CO à l'hème. Les études sur l'origine moléculaire précise des propriétés dynamiques doivent attendre la structure 3D de RcoM-2.La détection du CO est cruciale pour Mycobacterium tuberculosis, l’agent infectieux de la tuberculose, qui doit répondre aux mécanismes de défense de l'hôte, dont le CO. Le gène cor (rv1829) pourrait y jouer un rôle. Nous avons démontré que Cor est un dimère très stable, capable de lier un hème de façon stoechiométrique, suggérant ainsi une fonction potentielle de senseur direct du CO. Un résidu histidine a été identifié comme ligand potentiel de l’hème. La dynamique interne du CO est très similaire de celle d’autres senseurs à CO bactériens. Cor présente une activité de liaison à l'ADN dépendante de l'hème et du CO, qui est aboli dans le mutant H70A. Nos études ont également montré que le régulateur de transcription mycobactérien Rv0081, induit en réponse aux changements gazeux, peut se lier sur la région régulatrice prédite de cor. La création d’une souche Δcor dans le modèle non-pathogène M. smegmatis se poursuit et constituera un premier pas vers des futures analyses transcriptomiquesThe toxic gas CO can act in low quantities as signaling molecule; detected by heme-based sensor proteins.The CO-dependent transcription factor RcoM-2 has a very high affinity for CO, while being insensitive to O₂. RcoM-2 binds to DNA only when CO is bound to heme. We characterized the heme-CO interaction in full-length RcoM-2 and compared it with the isolated heme domain RcoMH-2. RcoM-2 can bind CO with lower effective affinity than RcoMH-2. CO dissociates with a 20-fold higher rate than in RcoMH-2, where CO binding is almost irreversible. A small fraction of CO can escape from the protein, thus allowing RcoM-2 to act as CO sensor. The presence of the DNA binding domain influences the binding properties of CO to heme. Identification of the precise molecular origin of the dynamic properties must await the 3D structure RcoM-2.CO detection is crucial for Mtb, the infectious agent of tuberculosis that must overcome the host's defense mechanisms, including CO. The gene cor (rv1829) has been implicated in these processes. We have shown that Cor is a highly stable dimer that is able to stoichiometrically bind a heme cofactor, suggesting a potential function as direct CO sensor. A histidine residue was identified as potential heme ligand. The internal CO dynamics is very similar to other bacterial CO sensors. Cor exhibits DNA binding activity that depends on the presence of heme and CO, which is abolished in the H70A mutant. Our studies also showed that the transcriptional regulator Rv0081, induced in response to gaz changes, can bind to the predicted regulatory region of cor. The creation of a Δcor strain in the non- pathogenic model M. smegmatis continues and will be a first step towards transcriptomic analyzes
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Hrusa, Michael [Verfasser]. "Sulkusdarstellung und parodontale Gesundheit nach unterschiedlichen Verfahren zum Weichgewebsmanagement bei parodontal erkrankten Probanden - RCT / Michael Hrusa." Ulm : Universität Ulm. Medizinische Fakultät, 2014. http://d-nb.info/1053381344/34.
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Littleton, Heather, Amie E. Grills, Katherine D. Kline, Alexander M. Schoemann, and Julia Dodd. "The From Survivor to Thriver Program: RCT of an Online Therapist-Facilitated Program for Rape-Related PTSD." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7326.
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This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist-facilitated cognitive-behavioral program for rape-related PTSD. Eighty-seven college women with rape-related PTSD were randomized to complete the interactive program (n = 46) or a psycho-educational self-help website (n = 41). Both programs led to large reductions in interview-assessed PTSD at post-treatment (interactive d = 2.22, psycho-educational d = 1.10), which were maintained at three month follow-up. Both also led to medium- to large-sized reductions in self-reported depressive and general anxiety symptoms. Follow-up analyses supported that the therapist-facilitated interactive program led to superior outcomes among those with higher pre-treatment PTSD whereas the psycho-educational self-help website led to superior outcomes for individuals with lower pre-treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape-related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency.
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Yusuf, H. "Preventing obesity by reducing soft drinks consumption among young people attending dental practices : a feasibility cluster RCT." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1470597/.
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Background: In England, 70% of young people consume soft drinks on a regular basis which increases the likelihood of obesity and dental caries. Many young people often visit the dentist; however primary dental care has been an underutilised research setting for delivering and evaluating dietary interventions. Motivational Interviewing (MI) has been shown to be effective in behaviour change. Therefore, this study provides an opportunity to assess an obesity intervention to reduce soft drinks consumption among young people attending NHS dental practices. Aims: To conduct a feasibility trial of an MI intervention to reduce soft drinks consumption among young people attending primary dental care practices in North Central London (Camden, Islington, and Haringey). Methods: The initial developmental phase explored dental teams’ attitudes, behaviours and perceived barriers in delivering prevention, using a mixed methods approach (focus groups followed by a questionnaire survey). A purposive sample of 11 out of 22 dental practices was selected from the study area for the four focus groups (two with dentists and two with dental care professionals). A cross-sectional survey of all NHS dentists was also conducted using a self-complete questionnaire. Descriptive analysis of the questionnaire data was undertaken and differences by the age and sex of the sample were assessed. A cluster feasibility trial with embedded process evaluation was then undertaken in the second phase of the study. Participants: Ten randomly allocated NHS dental practices recruited 39 overweight or obese young people (11-16 years). Intervention: 3-4 MI sessions. The three main outcomes were: mean daily consumption of sugary soft drinks using a 24 hour dietary recall, body mass index (BMI) and waist circumference. Outcomes were measured at baseline and at 6 month follow-up. Process evaluation outcomes: Recruitment, retention, fidelity and acceptability of the intervention were assessed using mixed methods. MI Fidelity was assessed using the Motivational Interviewing Treatment Integrity Code (MITI). Thematic analysis was used to analyse the qualitative data and descriptive analysis for the quantitative data. The study was approved by the local Ethics Committee (10/H0722/2). Results: Of the 300 eligible respondents, 164 questionnaires were returned (response rate: 54.7%). In Phase I, there were broad similarities in the themes that emerged from the four focus groups and the questionnaire survey. The majority of respondents strongly agreed that NHS dentists had a role to play in smoking cessation counselling, diet and alcohol advice. For dentists, prevention was viewed to be part of their ethical obligation. A high proportion of respondents 95.7% delivered oral hygiene advice, 85.4% provided diet advice, and 76.7% offered smoking cessation advice always or frequently. Barriers to delivering prevention included organisational factors (lack of adequate remuneration, bureaucracy), patient-related factors (motivation and compliance), and clinician-related factors (lack of training and resources). There was significant variation in providing prevention by the age and sex of dentists with female and younger dentists more likely to provide certain aspects of preventive care. Phase II- 10 dental practices were recruited (5 control and 5 intervention). Out of 149 potential participants, 39 (26.2%) conformed to the eligibility criteria, 5 (12.8%) withdrew from the study, and 3 (7.6%) were lost to follow-up, resulting in a retention rate of 79.5%. Facilitators of study implementation included the use of a screening questionnaire, support from the research team and incentives for young people and dental teams. In terms of acceptability, participants reported that the study had a positive impact on their knowledge or behaviours. At follow-up, soft drinks consumption decreased. Dental teams valued being involved in research. They recognised the challenges in recruiting young people and employed varying mechanisms to overcome them. Intervention fidelity revealed the MI practitioners to be proficient in MI and there was little variation in proficiency among the practitioners. Conclusions: Dentists in the study area were actively involved and had a generally positive attitude towards delivering prevention in primary dental care. The intervention was acceptable and feasible among dental teams and young people. MI is a feasible tool for reducing sugary soft drinks consumption among overweight young people attending dental practices. Further research is required to assess its effectiveness in primary dental care.
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Kim, Sukwon. "Relationships between Hamstring Activation Rate and Biomechanics of Slip-induced Falls among Young and Older Adults." Thesis, Virginia Tech, 2003. http://hdl.handle.net/10919/43308.
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This study was conducted to investigate whether hamstring muscle activation rate could potentially serve as an indicator for slip-induced falls, particularly for older adults. Kinematics (heel contact velocity, walking velocity, slip distance, and step length), kinetics (friction demand), and electromyography (EMG) while walking over a slippery surface were collected and examined in the study. Normalized EMG data were examined in term of activation rate and compared to heel contact velocity. Twenty-eight subjects from two age groups (14 young and 14 elderly) walked across a track with embedded force platforms while wearing a fall arresting harness attached to an arresting rig for safety. In order to obtain realistic unexpected slip-induced fall data, the slippery surface was hidden from the subjects and unexpectedly introduced. The primary objective of the study was to evaluate if hamstring activation rate could be a valid indicator for the initiation of slip-induced falls. The results suggested that hamstring activation rate in younger adults was higher than older adults, whereas, younger adults’ heel contact velocity was not different from older adults. These results suggested that heel contact velocity in younger adults was sufficiently reduced before the heel contact phase of the gait cycle. This could be due to the outcome of higher hamstring activation rate in younger adults in comparison to older adults. However, an equal number of falls in two age groups, in spite of older adults’ slower walking velocity, lower RCOF, shorter slip distance, and slower peak sliding heel velocity, suggested that the recovery phase of the slip-induced fall accidents should be studied further.Master of Science
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Callesen, Pia. "Efficacy of metacognitive therapy." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/efficacy-of-metacognitive-therapy(45a1662f-61f4-4c0f-a734-b4e2b8e82710).html.
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This PhD investigated the efficacy of individual therapies for depression and went on to test metacognitive therapy (MCT) for major depressive disorder (MDD) in individual therapy and in transdiagnostic groups consisting of a range of disordersStudy 1 included a systematic review of meta-analyses comparing the effects of individual therapy for MDD across studies. The findings show small to moderate effect sizes between g=0.25 to d= 0.69 and recovery rates 34% to 47.9% for ITT analyses. However, studies are biased and lack objective definitions of recovery, remission and clinically meaningful change which makes comparisons across studies challenging. Study 2 aimed to test MCT in a single case study with four depressed Danes in an outpatient setting. Three out of four patients reached recovery levels (BDI-II smaller or equal to 8) in only five to eleven sessions and all four patients were recovered at 6-months follow-up. Study 3 involved a large randomised clinical trial (n= 153) in which the effect of MCT was compared to cognitive behaviour therapy (CBT) for MDD. Patients were allocated to up to 24 sessions of treatment and were assessed at pre, post and 6 months follow-up on primary and secondary measures. The mean number of sessions were significantly lower for MCT (5.5; SD = 2.4 versus 6.7; SD = 4.7) and MCT showed a higher completion rate (73.6% versus 65.4%). Both treatments were associated with significant improvements in depression measured with the HDRS and BDI-II. MCT was superior in its effects on the BDI-II and on secondary measures, showing a clear advantage of MCT. . Large ES were detected in both MCT and CBT. Using Jacobson and Truax (1991) criteria revealed that 76% reached recovery levels at post-treatment in MCT whereas 54% reached recovery in CBT. These findings were maintained for both conditions at 6-months follow-up. Study 4 evaluated the effect of MCT in a 6-week treatment protocol for mixed groups of diagnosis in an open trial (n= 131). Significant improvements were observed in outcomes and 85% of patients were reliably improved at post-treatment as measured on the HADS. These findings were maintained at follow- up and the treatment appeared effective in both anxious and depressed cases. In conclusion existing treatments for depression are effective but there is much room for increasing efficacy. MCT appeared more effective than a current treatment of choice; CBT in depression. MCT was also associated with significant improvement in anxiety and depression in patients in a transdiagnostic group setting. The results support the future study and implementation of MCT as an effective treatment option.
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Turner, David T. "Psychological interventions for psychosis : a meta-analysis of social skills training followed by a randomised controlled experimental study assessing the impact of meta-cognitive training addressing the jumping-to-conclusions bias on capacity." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/22967.
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Background There now exist a range of efficacious options for the treatment of psychosis in mental healthcare. The importance of recovery, empowerment, dignity and choice among patients with severe mental health diagnoses are important topics in contemporary research and practice. This thesis presents a meta-analytic review followed by a randomised controlled experimental study. These address distinct but related questions which aim to further our understanding of the choices available for intervention in psychosis and whether intervention may improve the ability of psychosis patients to make those choices. Aims The first objective aimed to offer a comprehensive review of the effectiveness of social skills training (SST), which is a psychological intervention for psychosis. SST has fallen out of favour in the UK and is not widely implemented in practice. We hypothesised that SST would demonstrate superiority for the negative symptoms of psychosis. The second objective was to determine whether decision-making capacity regarding treatment among psychosis patients could be improved by the application of a brief psycho-educational intervention targeting the jumping-to-conclusions (JTC) bias, which is a commonly observed cognitive bias in psychosis. We hypothesised that the intervention would improve decision-making capacity. Methods Firstly, a series of 70 meta-analyses are presented in a systematic review assessing the efficacy of social skills training across a number of psychosis outcome domains: positive symptoms, negative symptoms, general symptoms, overall symptoms and social functioning outcomes. Secondly, a randomised controlled experimental study is presented in which 36 psychosis patients in NHS Lanarkshire and 1 in NHS Dumfries & Galloway were allocated to receive either a brief meta-cognitive training (MCT) intervention or an non-specific control presentation lecture. Capacity was assessed at baseline and post-treatment while the impact of the intervention upon capacity was estimated by ANCOVA. Mediation analyses assessed whether changes in the JTC bias mediated outcome. Findings In the meta-analytic review, SST demonstrated superiority over treatment as usual (TAU. g=0.3), active controls (g=0.2-0.3) and comparators pooled (g=0.2- 0.3) for negative symptoms; and over TAU (g=0.4) and comparators pooled (g=0.3) for general psychopathology. In the randomised controlled study, MCT demonstrated large effects on two capacity outcomes; overall capacity (d=0.96, p < .05) and appreciation (d=0.87, p < .05). Exploratory analyses suggested a mediating effect of JTC (d=0.64, p < .05). Interpretation SST demonstrates a magnitude of effect for negative symptoms similar to those commonly reported for CBT for positive symptoms and may have potential for wider implementation in mental healthcare settings. The randomised controlled study suggests that psycho-educational interventions targeting capacity have clinical utility and may be developed for implementation. Limitations included lack of blinding, no fidelity checks and inclusion based on clinical diagnosis therefore a larger randomised controlled trial addressing these limitations is warranted.
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Nwosu, Ann. "Sensitivity Analyses of the Effect of Atomoxetine and Behavioral Therapy in a Randomized Control Trial." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492475391440277.
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Sembi, Sukhdev. "Mums4Mums : structured telephone peer-support for women experiencing postnatal depression : a pilot RCT to test its clinical effectiveness." Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/114368/.
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Background: Postnatal Depression (PND) is experienced by around 13% of women, who suffer a range of disabling symptoms that can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later mental health. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. This study aimed to evaluate the impact of telephone peer-support for women experiencing PND. Methods/Design: A pilot RCT was conducted in which women who screened positive for postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS > =10) were randomised to receive telephone-based support from peers who had recovered from PND, or standard care. Primary outcome measures included depressive symptomatology measured post-intervention and at six-months using the EPDS, and parent-infant interaction using the CARE-Index. Secondary outcome measures included anxiety and depression, dyadic adjustment, parenting stress, and self-efficacy. Maternal perceptions of the telephone peer-support were being assessed using semi-structured interviews. Quantitative and qualitative data was also collected from the peer-supporters to assess the impact on them of delivering the intervention. Results: Participants: twenty-eight participants were recruited to the study, and there was a fifty-percent dropout rate (intervention group n=6, control group n=8). While there were no differences in EPDS scores between the two groups at post-intervention, the intervention group continued to improve at six-month follow-up, whereas the control group showed signs of relapse. The intervention had no impact on mother-infant interaction. In-depth interview data show that women valued the support that was provided. Peer-Supporters: nineteen peer-supporters were recruited, of whom five left before supporting a participant, and eight left after supporting only one participant. The quantitative results showed a significant non-clinical increase in anxiety at post intervention. The qualitative results indicated that the peer-supporters found the majority of calls challenging, and that delivering the intervention had had a deleterious impact on some peer-supporters. Conclusion: While these findings suggest a positive impact of telephone-based peer-support, further research into ways of improving mother-infant interaction are urgently required. Research is also required into providing effective support for the peer supporters.
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TRAN, ANNIE. "Dosage de l'activite cofacteur de la ristocetine du facteur willebrand, vwf : rco, a l'aide d'un agregametre multivoies informatise." Lille 2, 1992. http://www.theses.fr/1992LIL2M330.
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Braun, Cora, Tom Bschor, Jeremy Franklin, and Christopher Baethge. "Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder." Karger, 2016. https://tud.qucosa.de/id/qucosa%3A70596.
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Background: It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during longterm use. Methods: We carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). Sources were obtained from 5 review articles and by searches of MEDLINE, PubMed Central and a hand search of bibliographies. We meta-analyzed placebo-controlled antidepressant RCTs of at least 3 months’ duration and calculated suicide and suicide attempt incidence rates, incidence rate ratios and Peto odds ratios (ORs). Results: Out of 807 studies screened 29 were included, covering 6,934 patients (5,529 patient-years). In total, 1.45 suicides and 2.76 suicide attempts per 1,000 patient-years were reported. Seven out of 8 suicides and 13 out of 14 suicide attempts occurred in antidepressant arms, resulting in incidence rate ratios of 5.03 (0.78–114.1; p = 0.102) for suicides and of 9.02 (1.58–193.6; p = 0.007) for suicide attempts. Peto ORs were 2.6 (0.6–11.2; nonsignificant) and 3.4 (1.1–11.0; p = 0.04), respectively. Dropouts due to unknown reasons were similar in the antidepressant and placebo arms (9.6 vs. 9.9%). The majority of suicides and suicide attempts originated from 1 study, accounting for a fifth of all patient-years in this meta-analysis. Leaving out this study resulted in a nonsignificant incidence rate ratio for suicide attempts of 3.83 (0.53–91.01). Conclusions: Therapists should be aware of the lack of proof from RCTs that antidepressants prevent suicides and suicide attempts. We cannot conclude with certainty whether antidepressants increase the risk for suicide or suicide attempts. Researchers must report all suicides and suicide attempts in RCTs.
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Cairns, Melinda Claire. "A pragmatic RCT comparing specific spinal stabilisation exercises and conventional physiotherapy in the management of recurrent low back pain." Thesis, Coventry University, 2002. http://curve.coventry.ac.uk/open/items/11bbd169-8b0e-ab44-fc10-bfbf23e97b8b/1.
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Background: Altered muscular function of the deep abdominal and back muscles has been implicated as a factor in the development and continuation of low back pain (LBP) and small-scale studies, on specific subgroups of LBP patients, have reported favourable outcomes when these dysfunctions are addressed using specific exercise training. However, these techniques are increasingly being incorporated into treatment packages for non-specific LBP in the UK despite little evidence of their effectiveness in this patient group. A multi-centered, pragmatic, randomized clinical trial, with 12-month follow-up, was therefore designed to investigate the effectiveness of incorporating specific spinal stabilisation exercises within a physiotherapy treatment package in the management of recurrent LBP patients. Methods: Following ethical approval, consenting patients with recurrent LBP, without significant levels of distress (as measured by the distress risk assessment method {DRAM}), were randomized to two groups; 'conventional' physiotherapy and the provision of an advice booklet (Cl) and 'conventional' physiotherapy, the provision of an advice booklet with the addition of specific spinal stabilisation exercises (SSSE). Randomisation was stratified for laterality, duration of symptoms and initial functional disability level {Roland Morris Disability Questionnaire—RMDQ} using a minimization procedure. Functional disability (RMDQ) was the main outcome, and generic, disease-specific and psychological measures were also collected. The trial was powered to detect a 5-point difference between groups using 90% power. A total of 221 patients were screened for entry into the trial and 97 were recruited from three metropolitan physiotherapy departments within the UK between May 1999 and September 2000. Results: All patients were between the ages of 19 and 60 years (mean 38.6, SD: 10.5) and had an average duration of symptoms of 8.7 (8.1) months. Over 30% of the patients screened for entry to the trial were excluded as they showed evidence of psychological distress. Both groups demonstrated improved functioning, reduced pain intensity and an improvement in the physical component of quality of life. Mean change (95% Cl) for RMDQ scores between baseline to 12-month follow-up were —4.5 (-6.2 to —3.6) for the SSSE group and -5.2 (-6.7 to —3.6) for the CT group. No statistically significant differences between the two groups were demonstrated for any of the outcome variables. Patients in the spinal stabilisation group received a slightly greater mean number of treatment sessions over a longer period than the conventional physiotherapy treatment group (7.5 (2.5) over 11 weeks compared to 5.9 (2.3) over 8 weeks respectively). Exploration of the content of each treatment package revealed a combination of treatments was used, most frequently active exercise and manual therapy, with little use of electrotherapy or mechanical lumbar traction. Discussion and Conclusion: This trial represents the largest to date investigating the effects of specific spinal stabilisation exercises, and the first examining their use in a recurrent LBP population. Results indicate that physiotherapy is effective in reducing functional disability and to a lesser extent pain intensity, with improvements maintained at one year following completion of treatment, but that the addition of spinal stabilisation exercises to conventional physiotherapy and an advice booklet, does not provide any obvious additional benefit in terms of functional disability or pain intensity. These findings are of importance as they support the ongoing use of physiotherapy treatment packages in the management of recurrent LBP patients, without significant levels of distress, but challenge the assumption that stabilisation training provides an additional benefit in this particular group of LBP patients.
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Acharya, Dev Raj. "Measuring the effectiveness of teaching sex education in Nepalese secondary schools : an outcome from a Randomised Controlled Trial (RCT)." Thesis, Aberystwyth University, 2014. http://hdl.handle.net/2160/7aed061b-668e-4789-879e-b30ba401b6c6.
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This study aimed to identify the effectiveness of delivering sex education in secondary schools in Hetauda (Nepal) by exploring the sexual health knowledge and understanding of young people, and parents' and teachers' views on sex education, in order to place the findings in the wider social, cultural and educational context of modern Nepal. The research selected four secondary schools pupils of diverse sociobackground characteristics in Hetauda municipality, central Nepal. This study was conducted by undertaking an intervention in control (2 schools) and experiment (2 schools) groups, and as such constituted the quantitative method. Semi-structured Key Informant Interviews (KIIs) with 14 key stakeholders (6 parents and 8 teachers) and 8 Focus Group Discussions (FGDs) with 78 pupils constituted the qualitative method. Quantitative and qualitative data were analysed separately by utilising statistical software (SPSS, 19) and thematic analysis, respectively. Outcomes were compared, combined and discussed. This study relies on a multiple theory platform (cognitive constructivism, social constructivism and social cognitive theory) to evaluate the effectiveness of sex education delivery in schools. The conventional teacher in the control school delivered the sex education programme in a didactic approach. The result had less impact on pupils' sexual health knowledge and understanding. In contrast, the health facilitator-led experimental schools used a participatory approach which showed a reasonable knowledge increment around sexual health. However, the pupils were still confused and uncertain about how to obtain sexual health information from relatives of a similar age and their family members. Many parents lacked the knowledge, iv confidence and skills to offer meaningful support to their children. This study noted four main important influential sexual health attitudes and behaviours of the pupils: ambiguous social roles leading to confusion; increased sexual awareness and curiosity about sex; significant gaps in knowledge and behaviour; and limited parental input. This study suggested several possible approaches that could be developed to improve sex education in Nepal. Young people need more information on the risk of Sexually Transmitted Infections (STIs) and unwanted pregnancies. This could encourage them to gain more sexual health knowledge which in turn could lead to increased engagement in safer sexual health practices. In particular, more young girls should be provided with access to sexual health knowledge and services in order to achieve real improvements in pupils' sexual health. Furthermore, attention needs to be given to rigorous research and appropriate sex education interventions in school. Integrating sex and relationship education, both in formal and informal education, could help to improve young people's sexual and reproductive health status.
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Heinrich, Stephanie. "Deutsche Adaptation der \"Resources for Enhance Alzheimer\'s Caregiver Health II\": Eine randomisierte kontrollierte Studie." Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-209135.
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Abstract:
Hintergrund: In Deutschland leben derzeit über eine Million Menschen mit Demenz, welche vorrangig von ihren Angehörigen versorgt werden. Diese Pflege und Betreuung ist für den pflegenden Angehörigen mit erheblichen Belastungen insbesondere auf der psychischen, physischen und sozialen Ebene verbunden. Daher ist es notwendig geeignete Interventionen zur Stärkung und Entlastung der pflegenden Angehörigen zu etablieren und diese in die Versorgungslandschaft zu implementieren.
Ziel der Untersuchung: Ziel der Arbeit war es, zu überprüfen, ob sich durch eine zugehende Multikomponentenintervention für pflegende Angehörige von Menschen mit Demenz, im Vergleich zum Angebot der Regelversorgung, die subjektiv empfundene Belastung der pflegenden Angehörigen verbessern lässt. Als Intervention wurde das amerikanische REACH II Programm (Resources for Enhance Alzheimer‘ Caregivers Health II) adaptiert.
Methode: Die Studie wurde als prospektive randomisiert kontrollierte Studie mit einer Interventions- und einer Kontrollgruppe konzipiert. Rekrutiert wurden pflegende Angehörige von Menschen mit Demenz im Raum Leipzig, die gemeinsam in einem Haushalt wohnten. Die Interventionsgruppe erhielt über einen Zeitraum von sechs Monaten eine zugehende Multikomponentenintervention (DeREACH), welche neun Hausbesuche und drei telefonische Kontakte einschließt. Die Kontrollgruppe wurde im Rahmen der Regelversorgung behandelt. Das primäre Ergebnismaß bezog sich auf die Veränderung der Belastung der pflegenden Angehörigen nach sechs Monaten, gemessen anhand des Zarit Burden Interview.
Ergebnisse: In die Studie wurden 92 pflegende Angehörige aufgenommen (Interventionsgruppe n=47, Kontrollgruppe n=45). Für das primäre Ergebnismaß konnten 82 Teilnehmer analysiert werden. Die Belastung reduzierte sich in der Interventionsgruppe nach sechs Monaten um 0,42 (SD=8,42) Skalenpunkte und verstärkte sich in der Kontrollgruppe um 7,05 (SD=8,09) Skalenpunkte. Die zusammengefasste Mittelwertdifferenz beträgt -7,47; KI95% (-11,11; -3,82) und ist zugunsten der Interventionsgruppe statistisch signifikant (p<0,000). Weitere signifikante Effekte zugunsten der Intervention bestehen für die sekundären Zielkriterien Somatisierung und psychische Gesundheit.
Schlussfolgerung: Für die Intervention DeREACH bestätigt sich ein Nutzen in Bezug auf das Belastungserleben pflegender Angehöriger von Menschen mit Demenz. Die Intervention konnte in die Leipziger Versorgungslandschaft implementiert werden und wurde von den pflegenden Angehörigen sehr gut angenommen.
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Shen, Haiqing. "New candidate gene involved in reverse cholesterol transport (RCT) : the case for phospholipid transfer protein (PLTP): interactions with dietary factors /." Thesis, Connect to Dissertations & Theses @ Tufts University, 2004.
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Thesis (Ph.D.)--Tufts University, 2004.Adviser: Jose Ordovas. Submitted to the School of Nutrition Science and Policy. Includes bibliographical references (leaves 136-137). Access restricted to members of the Tufts University community. Also available via the World Wide Web;
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Walpole, Beverly. "Motivational Interviewing to Enhance Self-Efficacy and Promote Weight-loss in Overweight and Obese Adolescents: A Randomized Controlled Trial." Thesis, A portion of this thesis was published: Beverly Walpole, Elizabeth Dettmer, Barbara A. Morrongiello, Brian W. McCrindle, and Jill Hamilton. "Motivational Interviewing to Enhance Self-Efficacy and Promote Weight Loss in Overweight and Obese Adolescents: A Randomized Controlled Trial." in J. Pediatr. Psychol. first published online May 13, 2013 doi:10.1093/jpepsy/jst023 (10 pages), 2013. http://hdl.handle.net/10214/7261.
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Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of motivation to maintain adherence to healthy behavior changes. The current investigation was a randomized controlled trial examining the efficacy of Motivational Interviewing (MI) as an intervention for promoting self-efficacy and weight-loss in a sample of overweight and obese youth. Participants (N = 42) ages 10-18, were randomly assigned to a control (social skills training) or treatment (MI) group. Both groups received individual therapy (~30 minutes/month) in addition to usual care of diet/exercise counseling. Pre and post (at 6 months follow-up) variables included measures of self-efficacy and anthropometrics. Results indicated that while significant between-group differences were not found, individuals in the MI group attended more sessions. Overall, participants in both groups showed significant increases in self-efficacy and a trend of decreased BMI z-scores. Though health benefits from participation in individual therapy may have been accrued, specific benefits attributable to MI were limited. Findings from the current study suggest that more than one type of counseling intervention (i.e., MI and social skills training) may be beneficial when providing integrative treatment for obese youth.Canadian Institutes of Health and Research (CIHR)
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Jones, Mark A. "An evaluation of the effectiveness of the Lidcombe program of early stuttering intervention." University of Sydney, 2005. http://hdl.handle.net/2123/977.
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Philosophy(PhD)This thesis presents a randomised controlled trial of the Lidcombe Program of Early Stuttering Intervention. The Lidcombe Program was developed for the treatment of stuttering in preschool-age children. The effectiveness of the Lidcombe Program was compared to a control group in a parallel group randomised controlled trial with blinded outcome assessment. A number of supplementary studies were conducted in support of the trial; two literature reviews, two retrospective file audits and a statistical simulation study. A review of randomised studies of treatments for stuttering showed that there have been 27 such studies published in English language journals. Of these only one was devoted to a treatment for early stuttering and that was the Lidcombe Program. The randomised study showed that 3 months of this treatment was associated with a lower level of stuttering compared to a control group who received no treatment. However, with a sample size of 23, this study lacked power and the children did not receive a full course of treatment. Despite these limitations, this study provided evidence that a medium to large effect size could be anticipated in an adequately powered and properly conducted randomised controlled trial. The second review was of sample size and power in stuttering research studies that had been published in two speech pathology journals; the Journal of Speech, Language and Hearing Research (Vol 39, No. 1 to Vol 40, No, 4) and the Journal of Fluency Disorders (Vol 21, No. 1 to Vol 22, No, 3). Results suggested that the majority (73%) of the 26 studies reviewed were insufficiently powered to detect even large effects. However it was acknowledged that it is very difficult to recruit even moderate sample sizes of people who stutter. It was concluded that one way to help improve this situation is collaboration of multiple research centres or, in the case of a randomised controlled trial, inclusion of multiple recruitment sites in one study. This strategy was adopted in the randomised controlled trial reported in this thesis. Two retrospective file audit studies of children treated with the Lidcombe Program were conducted in Australia and Britain. One purpose of these file audits was to obtain information relevant to the design and conduct of the randomised controlled trial. Data from the case reports on more than 300 children from the two sites were included in a meta-analysis. Results showed that a median of 11 weekly clinic sessions were required for children to attain the criteria for low levels of stuttering for completion of Stage 1 of the Lidcombe Program. Approximately 90% of children had achieved those criteria within 6 months of beginning treatment and almost all children had achieved them within 1 year. In addition two variables were found to be associated with longer treatment duration: more severe pre-treatment stuttering and shorter times from onset of stuttering to the start of treatment. The latter was apparent in the meta-analysis but not for the individual cohorts. As a result of these findings, pre-treatment stuttering severity was stratified along with other relevant variables in the randomised controlled trial and follow up for participants was a minimum of 9 months. A simulation study was conducted prior to analysis of data from the primary outcome measure of the randomised controlled trial: percentage of syllables stuttered (%SS). The distribution of %SS scores is positively skewed. Nonetheless, simulation showed t-test to be an appropriate analysis for this primary outcome measure. There were two treatment sites for the randomised controlled trial: the University of Canterbury (Christchurch, New Zealand) and the Stuttering Treatment and Research Trust (Auckland, New Zealand). A total of 54 preschool-age children were recruited: 29 to the Lidcombe Program and 25 to the control group. Half the proposed sample size was achieved due to slower than anticipated recruitment. This occurred because, as the trial progressed, treatment with the Lidcombe Program became common knowledge among parents in New Zealand and they became increasingly reluctant to agree to have their child randomised to the trial. Analysis with t-test showed a highly statistically significant difference (p = 0.003) at 9-months post-randomisation. The mean percentage of syllables stuttered (%SS) at 9-months post-randomisation was 1.5 (SD = 1.4) for the Lidcombe Program group compared to 3.9 (SD = 3.5) for the control group, resulting in a treatment effect of 2.3 %SS (95% confidence interval: 0.8-3.9). This treatment effect was more than double the minimum clinically worthwhile difference specified in the trial protocol. These results show that the Lidcombe Program is significantly more effective than natural recovery for reducing stuttering levels in preschool children. The Lidcombe Program is the first early stuttering treatment to be shown to be more effective than natural recovery in a randomised controlled trial.
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Imai, Takumi. "Exploratory assessment of treatment-dependent random-effects distribution using gradient functions." Doctoral thesis, Kyoto University, 2021. http://hdl.handle.net/2433/264638.
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京都大学新制・論文博士
博士(社会健康医学)
乙第13422号
論社医博第16号
新制||社医||11(附属図書館)
京都大学大学院医学研究科社会健康医学系専攻
(主査)教授 佐藤 俊哉, 教授 藤渕 航, 教授 黒田 知宏
学位規則第4条第2項該当
Doctor of Public Health
Kyoto University
DFAM
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Woodford, Joanne. "Development and feasibility randomised controlled trial of guided Cognitive Behavioural Therapy (CBT) self-help for informal carers of stroke survivors." Thesis, University of Exeter, 2014. http://hdl.handle.net/10871/17401.
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Background: One-in-three carers of stroke survivors experience depression with no psychological treatments tailored to meet their needs, such as barriers to attending traditional face-to-face psychological services. A cognitive behavioural therapy (CBT) self-help approach may represent an effective, acceptable solution. Methods: Informed by the MRC framework (2008) for complex interventions, six studies informed development, feasibility and piloting of a CBT self-help intervention for depressed carers of stroke survivors: Study One: Systematic review and meta-analysis of psychological interventions targeting depression and anxiety in carers of people with chronic health conditions; Study Two: Interviews to understand difficulties experienced by depressed and anxious carers; Study Three: Interviews to understand positive coping strategies used by non-depressed and non-anxious carers; Study Four: Drawing on results of Studies One to Three, iterative modelling to develop the CBT self-help intervention; Study Five: Feasibility randomised controlled trial to examine methodological and procedural uncertainties for a Phase III definitive trial; Study Six: Updated systematic review and meta-analysis. Results: Study One: 16 studies identified for inclusion yielding small and medium effect sizes for depression and anxiety respectively, with trends for individually delivered treatments over shorter session durations to be more effective for depression. Six additional studies were included in Study Six, replicating Study One results; Study Two: Depressed and anxious carers experience difficulties adapting to the caring role, managing uncertainty, lack of support and social isolation; Study Three: Non-depressed and non-anxious carers utilise problem-focused coping strategies to gain balance and adapt to caring role, use assertiveness, seek social support and positive reinterpretation; Study Four: Developed a theory-driven CBT self-help intervention; Study Five: Recruited 20 informal carers in 10-months, representing 0.08% of invited carers randomised with high attrition in the intervention arm. Lack of GP recognition, gatekeeping and barriers to accessing psychological support identified as reasons for poor recruitment. Conclusions: A greater appreciation is required concerning barriers experienced by informal carers of stroke survivors to accessing support for depression and type of acceptable psychological support.
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Morais, Guilherme Loss de. "Caracterização filogenética das proteínas inativadoras de ribossomos (RIPs) de mamona (Ricinus communis L.) e análise da expressão dos genes Rcom RIPs durante o desenvolvimento da semente." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/21430.
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As Proteínas Inativadoras de Ribossomos (RIPs) compreendem uma família de enzimas que inibem a síntese protéica através da depurinação de uma adenina específica do RNA ribossomal. Os membros desta família são classificados como RIPs do tipo I, quando possuem somente o RNA-N-Glicosidase e RIPs do tipo II quando além do domínio glicosidase, também apresentam um domínio de lectina. As RIPs foram mais estudadas em plantas, onde a ricina e a aglutinina, ambas RIP do tipo II de mamona (Ricinus communis), estão entre as primeiras descritas. O presente trabalho teve o objetivo de identificar parálogos da ricina e aglutinina, bem como RIPs do tipo I de mamona e analisar as suas relações filogenéticas. Além disso, validar o uso de 14 potenciais genes de referência para qRT-PCR em cinco estádios do desenvolvimento da semente de mamona. O padrão de expressão gênica por RT-qPCR de todas RIPs de mamona identificadas, também foram analisados nestes mesmos estádios. Um total de 18 genes de RIPs foi identificado em mamona (Rcom RIPs), dos quais 10 foram classificados como do tipo II e 8 do tipo I. As topologias das árvores filogenéticas sugerem que as Rcom RIPs foram originadas a partir de múltiplos eventos de duplicação gênica. Dois modelos evolutivos foram propostos para a radiação das Rcom RIPs, baseados em processos de fusão gênica associado ou não a eventos de duplicação parcial. Os genes Act 2/7, EF β, Ubi, TIP e UBC foram os que apresentaram perfil de expressão mais estável e foram selecionados para subsequente normalização dos dados de expressão das Rcom RIPs. Os genes que codificam as Rcom RIPI 3, 4, 5, 7 e 8 e as Rcom RIPII 1, 2, 4, 5, 6 e 8 são transcritos em sementes, sendo que a Rcom RIPII 1 (ricina) e a Rcom RIPII 2 (aglutinina) foram as mais expressas. O presente trabalho apresenta um modelo evolutivo das Rcom RIPs, o qual pode ser extrapolado para outras espécies de plantas. Este trabalho também demonstra o primeiro esforço para a padronização de genes de referência para RT-qPCR em mamona e o primeiro que apresenta a expressão outras Rcom RIPs, além da ricina e aglutinina.Ribosome inactivating proteins (RIPs) comprise a family of enzymes that inhibit protein synthesis, after depurination of an adenine-specific ribosomal RNA. The members of this family are classified as type I RIPs, which have a RNA-Nglycosidase domain and type II RIPs encompassing a RNA-N-glycosidase and a lectin domain.The RIPs were more studied in plants, where ricin and agglutinin, both type II RIP of castor bean (Ricinus communis), were the first to be described. This work aimed to: 1) identifine paralogous of ricin and agglutinin, as well as the type I RIPs of castor bean; 2) analyze their phylogenetic relationships; 3) validate the use of 14 potential housekeeping genes for qRT-PCR for five developmental stages of R. communis seeds; 4) analyze the pattern of gene expression by RTqPCR of all RIPs castor identified in these same stages. A total of 18 genes that encode RIPs were identified in castor bean (Rcom RIPs), 10 of which were classified as type II and 8 as type I. The phylogenetic trees topologies suggest that Rcom RIPs were originated from multiple events of gene duplications. Two evolutionary models have been proposed for the radiation of Rcom RIPs based on gene fusion processes associated or not to events of partial duplication. The genes Act 2/7, EF β, Ubi, TIP and UBC presented the more stable expression profile and were selected for further RT- qPCR normalization experiments. The Rcom RIPI 3, 4, 5, 7 and 8 and Rcom RIPI 1, 2, 4, 5, 6 and 8 genes are actively transcribed in seeds, whereas the Rcom RIPI 1 (ricin) and Rcom RIPI 2 (agglutinin) were the most expressed. This paper presents an evolutionary model of Rcom RIPs, which can be extrapolated to other plant species. Also, corresponds to the first effort to standardize housekeeping genes for RT-qPCR in castor bean and the first that shows the expression Rcom RIPs, other than ricin and agglutinin.
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Downs, M., A. Blighe, R. Carpenter, A. Feast, K. Froggatt, S. Gordon, R. Hunter, et al. "A complex intervention to reduce avoidable hospital admissions in nursing homes: a research programme including the BHiRCH-NH pilot cluster RCT." Programme Grants for Applied Research, 2021. http://hdl.handle.net/10454/18485.
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YesBackground: An unplanned hospital admission of a nursing home resident distresses the person, their family and nursing home staff, and is costly to the NHS. Improving health care in care homes, including early detection of residents’ health changes, may reduce hospital admissions. Previously, we identified four conditions associated with avoidable hospital admissions. We noted promising ‘within-home’ complex interventions including care pathways, knowledge and skills enhancement, and implementation support. Objectives: Develop a complex intervention with implementation support [the Better Health in Residents in Care Homes with Nursing (BHiRCH-NH)] to improve early detection, assessment and treatment for the four conditions. Determine its impact on hospital admissions, test study procedures and acceptability of the intervention and implementation support, and indicate if a definitive trial was warranted. Design: A Carer Reference Panel advised on the intervention, implementation support and study documentation, and engaged in data analysis and interpretation. In workstream 1, we developed a complex intervention to reduce rates of hospitalisation from nursing homes using mixed methods, including a rapid research review, semistructured interviews and consensus workshops. The complex intervention comprised care pathways, approaches to enhance staff knowledge and skills, implementation support and clarity regarding the role of family carers. In workstream 2, we tested the complex intervention and implementation support via two work packages. In work package 1, we conducted a feasibility study of the intervention, implementation support and study procedures in two nursing homes and refined the complex intervention to comprise the Stop and Watch Early Warning Tool (S&W), condition-specific care pathways and a structured framework for nurses to communicate with primary care. The final implementation support included identifying two Practice Development Champions (PDCs) in each intervention home, and supporting them with a training workshop, practice development support group, monthly coaching calls, handbooks and web-based resources. In work package 2, we undertook a cluster randomised controlled trial to pilot test the complex intervention for acceptability and a preliminary estimate of effect. Setting: Fourteen nursing homes allocated to intervention and implementation support (n = 7) or treatment as usual (n = 7). Participants: We recruited sufficient numbers of nursing homes (n = 14), staff (n = 148), family carers (n = 95) and residents (n = 245). Two nursing homes withdrew prior to the intervention starting. Intervention: This ran from February to July 2018. Data sources: Individual-level data on nursing home residents, their family carers and staff; system-level data using nursing home records; and process-level data comprising how the intervention was implemented. Data were collected on recruitment rates, consent and the numbers of family carers who wished to be involved in the residents’ care. Completeness of outcome measures and data collection and the return rate of questionnaires were assessed. Results: The pilot trial showed no effects on hospitalisations or secondary outcomes. No home implemented the intervention tools as expected. Most staff endorsed the importance of early detection, assessment and treatment. Many reported that they ‘were already doing it’, using an early-warning tool; a detailed nursing assessment; or the situation, background, assessment, recommendation communication protocol. Three homes never used the S&W and four never used care pathways. Only 16 S&W forms and eight care pathways were completed. Care records revealed little use of the intervention principles. PDCs from five of six intervention homes attended the training workshop, following which they had variable engagement with implementation support. Progression criteria regarding recruitment and data collection were met: 70% of homes were retained, the proportion of missing data was < 20% and 80% of individuallevel data were collected. Necessary rates of data collection, documentation completion and return over the 6-month study period were achieved. However, intervention tools were not fully adopted, suggesting they would not be sustainable outside the trial. Few hospitalisations for the four conditions suggest it an unsuitable primary outcome measure. Key cost components were estimated. Limitations: The study homes may already have had effective approaches to early detection, assessment and treatment for acute health changes; consistent with government policy emphasising the need for enhanced health care in homes. Alternatively, the implementation support may not have been sufficiently potent. Conclusion: A definitive trial is feasible, but the intervention is unlikely to be effective. Participant recruitment, retention, data collection and engagement with family carers can guide subsequent studies, including service evaluation and quality improvement methodologies. Future work: Intervention research should be conducted in homes which need to enhance early detection, assessment and treatment. Interventions to reduce avoidable hospital admissions may be beneficial in residential care homes, as they are not required to employ nurses.
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 2. See the NIHR Journals Library website for further project information.
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Relton, Clare. "A new design for pragmatic randomised controlled trials : a 'Patient Cohort' RCT of treatment by a homeopath for menopausal hot flushes." Thesis, University of Sheffield, 2009. http://etheses.whiterose.ac.uk/6644/.
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There is debate regarding the effectiveness of homeopathy and its continuing provision in the NHS, and despite 150+ clinical trials there are conflicting opinions as to what can be concluded from these trials. This thesis addresses the question: “What type of clinical trial design can provide the information needed to make decisions about the provision of homeopathy in a publicly funded healthcare system?” A critique of the methods used in existing clinical trial designs was undertaken which identified twelve key criteria for appropriate clinical trial design; methods from existing standard and alternative clinical trial designs were adapted in order to derive a new clinical trial design that has the potential to meet all twelve key criteria (the ‘Patient Cohort’ RCT design). A current clinical question was identified: ‘What is the clinical & cost effectiveness of treatment by a homeopath for women with menopausal hot flushes?” and a population based survey confirmed the importance of this question. The ‘Patient Cohort’ RCT design was piloted in an NHS setting in order to address this current clinical question. Seventy ‘with need’ women were recruited to the Hot Flush Cohort of whom forty-eight were eligible for the treatment, a proportion of whom were randomly selected to be offered the treatment. 70.8% of those offered treatment accepted the offer and completion of outcome measures was high (93.7%). The results indicate that a full trial of this treatment for this condition may be worthwhile conducting. A full RCT using this design would be an appropriate clinical trial design to provide answers as to the provision of homeopathy and other clinician delivered interventions in publicly funded healthcare system such as the NHS. The ‘Patient Cohort’ RCT design can be usefully applied to clinical questions that require very pragmatic approaches yet need the scientific rigour of randomisation.
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Jones, Jenny. "The acute (immediate) specific haemodynamic effects of reflexology." Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/9845.
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Reflexology is one of the top six complementary therapies used in the UK. Reflexologists claim that massage to specific points of the feet increases blood supply to referred or 'mapped' organs in the body. Empirical evidence to validate this claim is scarce. This three-phase RCT measured changes in haemodynamic parameters in subjects receiving reflexology treatment applied to specific areas of the foot which are thought to correspond to the heart (intervention) compared with reflexology applied to other areas on the foot which are not (control).
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Sadicario, Jaclyn S. "PREDICTORS OF EXPERIMENTAL AND CONTROL GROUP ATTENDANCE: FINDINGS FROM AN HIV/STD PREVENTION RCT WITH PREGNANT WOMEN AT RISK FOR SUBSTANCE USE." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5703.
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Efforts to improve inclusion in research have included mandating the recruitment of ethnic minorities and women into NIH funded studies. However, little research has been completed on who attends such interventions. This is particularly worrisome in populations for which attendance to interventions can have dire consequences. HIV is a public health concern for pregnant women in substance using communities, as pregnant women are much less likely to use condoms during intercourse to prevent HIV. Group modular HIV prevention interventions have long been the standard for HIV prevention. However, little attention in research on HIV prevention interventions RCTs has been focused on attendance to these interventions. This study examined predictors of intervention and control group attendance in a randomized controlled trial comparing a 5-session Safer Sex Skill Building (SSB) intervention to a 1-session HIV education control group in a sample of pregnant women at risk for prenatal substance use. This study identified psychosocial and mental health variables associated with both 1 session control group and 5-session SSB intervention attendance as well as endeavored to identify the number of sessions necessary to attend to achieve an adequate dose in treatment. Findings include younger age and marital status as being predictive of participation in the one session HE control group and having a trade, skill, or profession as being predictive of participation in the five session SSB intervention group. Further research is needed to understand what factors may impact five-session SSB group attendance.
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Miti, Elvis Joseph. "An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16603.
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Includes bibliographical referencesAim: Evidence shows high burden of psychosocial problems among orphaned children with HIV. Intervention studies have generally been conducted in developed countries. This mixed methods study aimed to determine whether Memory Work (MWT) Therapy 1 week group intervention improves outcomes for this complex population, in terms of their self-esteem, coping and psychological wellbeing compared to standard care, and to establish mechanisms of action. Method/Issue: An RCT Phase II of 48 Adolescents aged 14-18, full-orphaned AIDS on ART in Tanzania, with a waitlist control. Following (T0) baseline interviews, random allocation was for either intervention experimental condition (EC), or Control Condition (CC). All participated in second round of data collection (T1) at two weeks, and a final (T2) a month later. The EC children and caregivers participated in a focus group at T2. The CC then received the intervention 4 months later. Four questionnaires used, Brief Symptom Inventory (BSI), Rosenberg Self Esteem Scale (SES), Strengths and Difficulties Questionnaire (SDQ), and Self Efficacy Questionnaire (SEQ). Groups were compared at each time-point using multivariable linear regression controlling for baseline characteristics and group as independent variable, with change score as dependent variable. Qualitative data were subjected to thematic analysis to describe the experience of the intervention and how to refine it. Results/Comments: Significant differences favoured the EC at T1: BSI P<0.001, B=44.985, CI=25.5, 64.4), SDQ P=0.010, B=4.811, % CI 1.226, 8.396), SEQ both social scale P=0.015, B=-4.539, % CI-8.161,-0.918) and emotional scale P=0.002, B=-5.803 % CI-9.434, 2.171) (no effect for SES). At T2 we found these effects persisted: BSI P=0.001, B=46.668 %CI=21.541, 71.835), SDQ P=0.002, B=5.218 % CI 1.960, 8.476), SEQ both social scale P=<0.001, B=-7.791, % CI-11.320,-4.262) and emotional scale (P=<0.001, B=-9.007, % CI-12.032,-5.983). Additionally, at T2 found an EC effect for SES P<0.001, B=-4.392, %CI=-6.738,-2.046). The children recalled and described enjoying specific tasks within the intervention memory book, (such as "hero book" and the "tree of life") and described becoming "resilient" people. Discussion: The trial demonstrates improved outcomes in all measures for a complex population, i.e., bereaved children on treatment. Importantly, the effect did not attenuate and indeed self-esteem improved over time. The intervention should now be replicated in a fully powered trial.
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Malherbe, Lodewicus Francois. "Cataract surgery and non-attendance: RCT to determine the effect of a SMS reminder system and financial impact in a developing country." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27434.
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AIMS: Missed cataract surgical appointments are an important cause of inefficiency, with delays in appropriate treatment, loss of continuity of care, and wasted resources. This study was conducted to determine if an SMS reminder system will reduce the failure to attend (FTA) rate by our patients who are booked for cataract surgery. METHODS: A randomised controlled trial was conducted at Groote Schuur Hospital between June 2015 and June 2016. Eligible patients were randomised into one of two study groups: either the "NO reminder control group "or the "SMS reminder intervention group". Patients in the SMS reminder group were entered into a secure web platform from which the automated SMS reminder system dispatched an SMS reminder one month, four days and one day pre-operatively between 10am and 12am. The message contained the following: "Dear "Mr/Mrs name", this is to confirm your cataract surgery at Groote Schuur Hospital, booked for "date". Please phone 021 404 3541 if any queries." RESULTS: 234 patients were enrolled into this study, and 15 patients were excluded. Of the remaining 219 patients, 111 were randomised into the NO reminder group (control) and 108 into the SMS reminder group (intervention). SMS reminders reduced the FTA rate by 52.6% from 11.7% to 5.6% (p=0.11). Transport problems were identified as the most common reason for non-attendance. CONCLUSION: An SMS reminder system aids in the reduction of non-attendance for booked cataract surgery. With an estimated cost of only 54 cents for three SMS reminders, this affordable intervention results in an improved efficiency of clinical service delivery.
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Tobin, Derek. "An RCT comparison of advice versus usual care in low back pain patients classified as low risk with the start-back tool." Thesis, Glasgow Caledonian University, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.726788.
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Kerr, Lisa Marie. "Predicting maternal mental health and pre-school child development in a high-risk first pregnancy cohort that includes a nested preventative RCT." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/31220.
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This thesis is concerned with a 31/2 year follow up of mothers (n = 114) and their first born children (n = 116, including 2 sets of twins). When pregnant with these children the mothers participated in a randomised controlled trial (RCT) of a psychosocial intervention known as Preparing for Parenthood (PFP), which was designed to prevent maternal depression. This follow-up is the latest of seven main stages of the PFP research programme: (1) women were screened for sub-clinical depression (n = 1300), those who screened positive were thereby identified as at high risk of maternal depression (n = 400); and (2) underwent baseline assessments (n = 292); (3) the women were randomised (n = 209) to continue standard antenatal care or, in addition, randomised women were followed-up at 3 months after childbirth (n = 190); (6) also, at 12 months after childbirth (n = 180) at which point, their first born children were followed-up (n=182, including 2 sets of twins). In this seventh stage of the research programme, the aims were to: (1) evaluate the long-term effectiveness of the intervention, testing the hypotheses that the intervention will determine maternal mental health and child development, as well as positively influence maternal social support and personal problem solving; (2) test the hypothesis that antenatal depression will be a substantial predictor of maternal depression. The results refuted the hypothesis. It was concluded that the intervention did not determine maternal mental health and child development, or positively influence maternal social support and personal problem solving. It was also concluded that antenatal depression was not a substantial predictor of maternal depression at 31/2 years after childbirth.
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Spieth, Peter Markus, Anne Sophie Kubasch, Ana Isabel Penzlin, Ben Min-Woo Illigens, Kristian Barlinn, and Timo Siepmann. "Randomized controlled trials - a matter of design." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-215848.
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Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.
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Iversen, Hanne Moe, and Ingrid Sirevåg Olsen. "Betydningen av fellesfaktorer og behandlingsformat i terapi : En undersøkelse av faktorene allianse, kompetanse, etterlevelse og behandlingsformat i en RCT-studie av generalisert angstlidelse." Thesis, Norges teknisk-naturvitenskapelige universitet, Psykologisk institutt, 2013. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-23610.
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I klinisk forskning har det lenge vært en debatt om betydningen av fellesfaktorer og spesifikke faktorer i terapi. Forskerne strides fremdeles om hvilke faktorer som i størst grad kan tilskrives den ubestridte virkningen av terapeutisk behandling. I dette studiet undersøkes den relative betydningen av faktorene allianse, kompetanse, etterlevelse og behandlingstformat for utfall i terapi for generalisert angstlidelse (GAD). Behandlingsformatene som undersøkes er kognitiv atferdsterapi (CBT) og metakognitiv terapi (MCT). For å undersøke effekten av allianse, kompetanse og etterlevelse kodes disse faktorene i videofilmede terapisesjoner. Terapisesjonene er hentet fra en randomisert kontrollert (RCT) studie på GAD (n = 59), hvor de samme seks terapeutene behandlet klienter med både CBT og MCT. Statistiske analyser viste at allianse, kompetanse og etterlevelse var av liten betydning for behandlingsutfall. Behandlingsformat var den eneste faktoren som viste seg å være av signifikant betydning for utfall av terapi (t = -2.38, p < 0.05). MCT hadde en høyere effektstørrelse i behandling enn CBT (MCT d = 2.16, CBT d = 1.53). Funnene er viktige bidrag i debatten om optimalisering og effektivisering av psykoterapeutisk behandling for klienter med GAD.
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Vandini, Chiara. "L'efficacia dell'action observation training nel migliorare la funzionalita e l'uso spontaneo dell'arto superiore nei bambini con paralisi cerebrale infantile: una revisione di RCT." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amslaurea.unibo.it/21917/.
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Introduzione: sulla base delle evidenze del coinvolgimento dei neuroni specchio nell'apprendimento motorio, è stato ipotizzato un ruolo dell'Action Observation Training (AOT) nella riabilitazione delle paralisi cerebrali infantili (PCI). L’AOT, già applicata con successo negli adulti per il recupero motorio nel Parkinson, post ictus o chirurgia ortopedica, in età evolutiva può favorire l’apprendimento motorio e migliorare la funzionalità degli arti superiori tramite l’osservazione e la successiva esecuzione di azioni. Obiettivo:indagare le più recenti e valide evidenze sull’efficacia dell’AOT nel migliorare la funzionalità e l’uso spontaneo dell’arto superiore nei bambini con PCI. Metodi:La ricerca è stata svolta sulle principali banche dati ed ha incluso studi pubblicati negli ultimi 10 anni. Sono stati inclusi studi clinici randomizzati controllati in cui l’AOT, guidato da fisioterapisti, venisse proposto a bambini con PCI e che ponessero come outcome l’effetto dell’AOT sulla funzionalità, uso spontaneo e motricità dell’arto superiore. Risultati:sono stati selezionati 5 studi, valutati con la scala PEDro. 4 studi su 5 hanno mostrato effetti positivi e miglioramenti della funzionalità, della motricità e dell’uso spontaneo dell’arto superiore in seguito al trattamento con l’AOT. Tale approccio riabilitativo sembra attivare maggiormente i neuroni specchio, ovvero aree della corteccia coinvolte nell’apprendimento per imitazione.Conclusioni:l’AOT sembra utile affiancata alla fisioterapia convenzionale, nel migliorare la funzionalità dell’arto superiore in attività di vita quotidiana, con risvolti sulla qualità di vita. L'AOT potrebbe essere eseguito a casa dai genitori. È auspicabile proseguire la ricerca con trial clinici con campioni di ampiezza maggiore, multicentrici. Futuri studi potrebbero approfondire i fattori d’influenza sulla risposta al trattamento e analizzare l’efficacia dell’AOT sulla precisione dei movimenti e su altri compiti motori nei bambini con PCI.
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Rothmayr, Judith [Verfasser], Winfried [Gutachter] Banzer, and Johannes [Gutachter] Fleckenstein. "Kurzwirksame Effekte von Akupunktur und Stretching bei Myofaszialen Triggerpunktschmerzen im Nackenbereich: eine verblindete, placebo-kontrollierte RCT / Judith Rothmayr ; Gutachter: Winfried Banzer, Johannes Fleckenstein." Frankfurt am Main : Universitätsbibliothek Johann Christian Senckenberg, 2018. http://d-nb.info/1175471062/34.
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Cheung, Lok-ka Lily, and 張樂嘉. "Premorbid functioning : correlations with social functioning and clinical symptoms in first-episode psychosis, using baseline data from the JCEP 4-year RCT study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192976.
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The current study analysed baseline data from the Jockey Club Early Psychosis (JCEP) 4-year RCT study (still underway). The aims were to (1) examine whether the correlations between premorbid functioning and the outcome variables of social functioning and clinical symptoms were significant in baseline measurements of the JCEP study, and (2) pave the way for the examination of the persistence of these correlations at 4 year follow-up, after the completion of the JCEP study.
360 first-episode adult-onset psychosis patients with schizophrenia-spectrum disorders were recruited from all inpatient and outpatient psychiatric units in Hong Kong since 2009. Premorbid functioning was measured by the Premorbid Adjustment Scale (PAS). Social functioning was measured by the Role Functioning Scale (RFS) and Social and Occupational Functioning Assessment Scale (SOFAS). Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), and Scale for Assessment of Positive Symptoms (SAPS).
Premorbid adjustment was significantly correlated with social functioning and negative symptoms; patients with poorer premorbid adjustment had worse social functioning and more severe negative symptoms. Positive symptoms were not significantly correlated with premorbid adjustment. There were no gender differences in premorbid adjustment. The majority of patients had a pattern of good premorbid adjustment (adequate to good levels of premorbid adjustment across all age-specific time periods). There were no significant differences in the outcome variables between the premorbid adjustment patterns. The current study findings have important clinical implications, in terms of advising the use of more effective and personalized interventions and treatment regimens on patients. In addition, the examination of premorbid adjustment facilitates early detection and identification of high risk psychosis individuals, which may help to reduce the duration of untreated psychosis.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
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CORREIA, NEVES MARGARIDA. "Les interactions rct/cmh et leur role dans le choix de la differentiation des thymocytes vers la voie cd4 ou la voie cd8." Université Louis Pasteur (Strasbourg) (1971-2008), 1999. http://www.theses.fr/1999STR13116.
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On distingue principalement deux familles de lymphocytes t : les cellules cd4 + exprimant un recepteur (rct) qui reconnait des peptides antigeniques presentes par les molecules de classe ii du complexe majeur de histocompatibilite (cmh) et les cellules cd8 + dont le recepteur interagit avec des molecules de classe i du cmh. Ces cellules ont un precurseur commun qui se differencie en choisissant la voie de differenciation cd4 ou la voie cd8. On sait que les interactions rct/cmh sont necessaires pour que ce choix ait lieu ; cependant, on ne sait pas a quel point cette interaction determine specifiquement la decision. D'autre part, les bases moleculaires expliquant la preference des rct pour une certaine classe de cmh sont tres peu connues. Afin de mieux comprendre les bases moleculaires de la restriction au cmh, nous avons etudie la repartition des membres de la famille v2 parmi les cellules t cd4 + ou cd8 +. Puis, pour analyser le role des interactions rct/cmh dans le choix de la voie de differenciation cd4/cd8, nous avons cree une lignee de souris transgenique pour un rct dont la variabilite est restreinte au cdr3 de la chaine : la souris variable. Le repertoire de rct restreint de la souris variable ainsi que l'utilisation d'un marqueur de voie de differenciation (la lignee cd4-gal) nous ont permis de suivre le choix entre voie cd4 et voie cd8 ainsi que les etapes suivantes de differenciation de cellules selon le rct specifique qu'elles expriment. Nos resultats montrent que la preference du rct pour une certaine classe de cmh est determinee par des residus de diverses regions du rct. L'etude sur le choix de voie de differenciation cd4/cd8 suggere que c'est bien l'interaction rct/cmh-peptide qui specifiquement dicte le choix de cette voie ; en revanche, elle renforce l'idee qu'il n'y a pas de correlation directe entre la voie de differenciation choisie et la preference du rct pour une certaine classe des molecules du cmh.