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Solé, Font Laura. "Foetal Stem Cell conversion as a new mechanism of therapy resistance in intestinal cancer." Doctoral thesis, Universitat de Barcelona, 2021. http://hdl.handle.net/10803/672382.
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Current therapy against colorectal cancer (CRC) is based on DNA-damaging agents that eradicate highly proliferative malignant cells. Whether sublethal chemotherapy affects tumour cell behaviour and impacts on patient outcome is primarily unstudied. We now show that sublethal chemotherapy imposes a non-senescent quiescent-like phenotype (TQL phenotype) to TP53 wildtype human CRC patient derived organoids (PDOs) and cell lines. CRC cells displaying this phenotype exhibit tumour-initiating activity comparable to untreated cells but superior metastatic capacity. Thus, re-entry of TQL cells into the cell cycle could be partially responsible of CRC patients’ relapse and metastasis. The TQL phenotype is linked to the acquisition of foetal traits downstream of YAP1, similar to that observed in intestinal regeneration after damage. Importantly, we have uncovered from TQL cells a foetal intestinal stem cell signature (feISC signature) that is also found in untreated human CRC tumours. Notably, nuclear YAP1 accumulation or detection of this signature predict poor prognosis in untreated CRC patients carrying TP53 wildtype tumours. Collectively, our results uncover a potential deleterious effect of chemotherapy and show that detection of nuclear YAP1 or foetal ISC signatures in tumours could be implemented in the clinical practice to inform about patient candidates for closer follow-up or specific pathway-based therapies, such as inhibition of YAP1.La teràpia actual contra el càncer colorectal (CRC) està basada en l’ús d’agents que danyen el DNA, els quals eradiquen específicament les cèl·lules malignes molt proliferants. Actualment es disposa de molt poca informació sobre si el tractament amb quimioteràpia subletal afecta el comportament de les cèl·lules tumorals i si té un impacte en l’evolució del pacient. En el present estudi mostrem que la quimioteràpia subletal imposa un fenotip quiescent no senescent (fenotip TQL) en organoids derivats de pacients (PDOs) amb CRC i en línies cel·lulars amb p53 funcional. Les cèl·lules de CRC que mostren aquest fenotip presenten una capacitat d’iniciació de nous tumors comparable a la de les cèl·lules no tractades i una capacitat metastàtica superior. Per tant, la reentrada de les cèl·lules TQL al cicle cel·lular podria parcialment ser responsable de la recaiguda i la metàstasi dels pacients amb CRC. El fenotip TQL està associat amb l’adquisició de trets fetals depenent de YAP1, similar a l’observat en la regeneració de l’intestí danyat. És important destacar que hem descrit a partir de les cèl·lules TQL una signatura de cèl·lules mare intestinals fetals (signatura feISC) que també es troba en tumors CRC humans no tractats. A més, l’acumulació de YAP1 al nucli o la detecció d’aquesta signatura prediu mal pronòstic en tumors amb p53 funcional de pacients amb CRC no tractats. Col·lectivament, els nostres resultats revelen un nou potencial efecte perjudicial de la quimioteràpia i mostren que la detecció de YAP1 nuclear o de signatures feISC en tumors es podria implementar a la pràctica clínica per informar sobre els pacients candidats a un seguiment més proper o a teràpies dirigides específiques, com la inhibició de YAP1.
La terapia actual contra el cáncer colorectal (CRC) está basada en el uso de agentes que dañan el DNA, los cuales erradican específicamente las células malignas muy proliferantes. Actualmente se dispone de muy poca información sobre si el tratamiento con quimioterapia subletal afecta el comportamiento de las células tumorales y si tiene un impacto en la evolución del paciente. En el presente estudio mostramos que la quimioterapia subletal impone un fenotipo quiescente no senescente (fenotipo TQL) en organoides derivados de pacientes (PDOs) con CRC y en líneas celulares con p53 funcional. Las células de CRC que muestran este fenotipo presentan una capacidad de iniciación de nuevos tumores comparable a la de las células no tratadas y una capacidad metastática superior. Por lo tanto, la reentrada de las células TQL al ciclo celular podría parcialmente ser responsable de la recaída y la metástasis de los pacientes con CRC. El fenotipo TQL está asociado con la adquisición de rasgos fetales dependiente de YAP1, similar a lo observado en la regeneración del intestino dañado. Es importante destacar que hemos descrito a partir de las células TQL una signatura de células madre intestinales fetales (signatura feISC) que también se encuentra en tumores CRC humanos no tratados. Además, la acumulación de YAP1 al núcleo o la detección de esta signatura predice mal pronóstico en tumores con p53 funcional de pacientes con CRC no tratados. Colectivamente, nuestros resultados revelan un nuevo potencial efecto perjudicial de la quimioterapia y muestran que la detección de YAP1 nuclear o de signaturas feISC en tumores se podría implementar en la práctica clínica para informar sobre los pacientes candidatos a un seguimiento más cercano o a terapias dirigidas específicas, como la inhibición de YAP1.
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Lugo, Cheryl A. "Ethical and clinical implications for the field of marriage and family therapy regarding LGBTQI therapeutic approaches." Manhattan, Kan. : Kansas State University, 2010. http://hdl.handle.net/2097/3905.
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Tillewein, Heather. "The Impact of Sexual Orientation Change Efforts on Transgender Individuals." OpenSIUC, 2019. https://opensiuc.lib.siu.edu/dissertations/1764.
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This study investigates the influences for, methods of, and impact of sexual orientation change efforts (SOCE) on transgender individuals. SOCE uses methods such as religious practices, behavioral modification, cognitive reframing, and counseling as ways to change sexual orientation from homosexual to heterosexual (Fjelstrom, 2013). This phenomenological, multiple case study analysis examines individual cases of SOCE to find cross-sectional themes among participants. The study identified participants who were influenced to undergo SOCE due to familial attitudes towards transgender identity. Participants described various methods used to suppress their gender identity during SOCE. They reported being negatively impacted by SOCE, experiencing issues such as loss of faith, interpersonal harm, feelings of inauthenticity, lack of trust, negative self-esteem and sexual dysfunction. This study aims to advocate for policy change regarding SOCE and to bring awareness on the use of SOCE among transgender individuals.
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Santos, Niraldo de Oliveira. "Efeitos do tratamento psicanalítico em pacientes com crises não epilépticas psicogênicas." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-05062014-153641/.
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As crises não epilépticas psicogênicas (CNEP) podem ser definidas como episódios de alteração de movimentos, sensações ou experiência similar à epilepsia causada por processo psicológico e sem associação com descarga elétrica cerebral anormal. Estima-se que o número de casos de pacientes com CNEP seja de 2 a 33 por 100.000 habitantes. O índice de CNEP corresponde ainda a aproximadamente 5% dos pacientes tratados como epilépticos. Os pacientes com CNEP são tratados como possuindo epilepsia refratária, chegando ao limite máximo do tratamento medicamentoso e sem a obtenção de resultados satisfatórios. Objetivos: relatar os efeitos do tratamento psicanalítico individual em pacientes com CNEP. Método: A casuística foi composta por 37 pacientes com diagnóstico prévio de CNEP realizado por meio da monitorização por vídeo-EEG. Foram realizadas sessões individuais de tratamento psicanalítico, com frequência semanal, com duração aproximada de 50 minutos e duração total de 48 sessões em 12 meses. Resultados: Este estudo constatou elevado índice de sucesso no tratamento dos pacientes com CNEP: 29,7% (n=11) de cessação/cura dos sintomas e 51,4% (n=19) redução das crises convulsivas. Foi constatada associação entre cessar ou reduzir as crises e sexo (p < 0,01), religião (p < 0,01) e término do tratamento (p < 0,01). Conclusão: Este estudo apontou a eficácia do tratamento psicanalítico individual realizado com pacientes com CNEP, podendo ser considerada uma forma de assistência essencial para que haja decréscimo ou cessação das crises.Psychogenic non-epileptic seizures (PNES) can be defined as episodes of alteration of movement, feeling or a similar experience to epilepsy caused by a psychological process and with no association with abnormal electrical discharges in the brain. It is estimated that the number of cases of patients with CNEP is from 2 to 33 in 100.000 inhabitants. The number of patients with PNES reaches 5% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum limits. Objectives: to present the effects of individual psychoanalytical treatment in patients with PNES. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. . Psychoanalytical treatment was carried out through 12 months of weekly sessions of around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high success rate in the treatment of PNES patients. 29,7% (n=11) of patients saw cessation or cure of symptoms and 51,4% (n=19) saw a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p < 0,01), religion (p < 0,01) and concluding treatment (p < 0,01). Conclusions: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be considered as an essential form of assistance for the reduction of cessation of episodes. Psychogenic non-epileptic seizures, Conversion disorder, Psychoanalysis, Treatment
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Hynning, Elin. "An Integer Programming Approach to Conversion from Static to Continuous Delivery of Intensity Modulated Radiation Therapy." Thesis, KTH, Optimeringslära och systemteori, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-103805.
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The aim of this thesis is to generate a starting guess for volumetric modulated arc therapy (VMAT) plan optimization by using data from an intensity modulated radiation therapy (IMRT) plan. We develop a mixed-binary linear programming model, based on choosing segments among a set of predefined segments. The objective is to deliver intensity modulation as similar as possible to the intensity modulation of the IMRT plan. The quality of the solutions is largely dependent on the quality of the predefined segments. However, the model achieves high similarity in intensity modulation when supplied with suitable segments. Unfortunately, high similarity in intensity modulation does not necessarily imply high similarity in dose distribution. In order for the model to generate VMAT plans with acceptable dose distributions the leaf travel between adjacent control points needs to be kept low. The model shows some promising features, but improvements, especially regarding implementation, need to be made in order for the model to be useful.
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Gallo, Maria L. "Nursing advocacy and the accuracy of intravenous to oral opioid conversion at discharge in the cancer patient." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003235.
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Miao, Ran. "Multimetallic Supramolecular Complexes: Synthesis, Characterization, Photophysical Studies and Applications in Solar Energy Utilization and Photodynamic Therapy." Diss., Virginia Tech, 2007. http://hdl.handle.net/10919/26372.
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This thesis describes the study of a series of multimetallic supramolecules containing varied metals and ligands, synthesized by a building block method and characterized by mass spectrometry, electronic absorption spectroscopy, and electrochemistry. Incorporating different functional units into complex systems allowed these multimetallic supramolecules to perform various light activated tasks including DNA cleavage and hydrogen generation from water.
The complex [({(bpy)2Os(dpp)}2Ru)2(dpq)](PF6)12 and [{(bpy)2M(dpp)}2Ru(BL)PtCl2](PF6)6 were synthesized (M = OsII or RuII; BL = dpp or dpq; bpy = 2,2'-bipyridine, dpp = 2,3-bis(2-pyridyl)pyrazine, dpq = 2,3-bis(2-pyridyl)quinoxaline). The building blocks displayed varied electrochemical properties upon complexation. The bridging ligands dpp and dpq display their reduction potentials shifted to less negative values when they changed from monochelating to bischelating. The electronic absorption spectra of the multimetallic systems displayed transitions of each contributing chromophore, with overlapping metal to ligand charge transfer (MLCT) transitions in visible region of spectrum. Spectroelectrochemistry revealed the nature of MLCTs and helped to identify fingerprint features of complex supramolecules. Photophysical measurements include emission spectroscopy with quantum yield measurements and emission lifetime measurements. Photophysical data provided detailed information to aid in developing an understanding of excited state properties of these complexes. Supported by the electrochemical data and spectroelectrochemistry, the hexametallic complex was suggested to have a HOMO localizing in the peripheral Os and a LUMO localizing in the central dpq, separating by a Ru energy barrier. This research systematically investigated photophysical properties of some building blocks and the mixed-metal, mixed-ligand supramolecules constructed by a variety of building blocks coupling light absorbing subunits to a reactive Pt metal center. Preliminary studies suggested [{(bpy)2Ru(dpp)}2Ru(dpq)PtCl2](PF6)6 was a photocatalyst for H2 production from water in the presence of a sacrificial electron donor. The complex [{(bpy)2Ru(dpp)}2Ru(dpq)PtCl2](PF6)6 had been studied for its catalytic ability in generating hydrogen and was found to have 34 product turnovers after 3 h photolysis. Photolysis and gel electrophoresis revealed that the tetrametallic complexes were able to bind to and then photocleave DNA through an oxygen mediated mechanism. The independence of ionic strength variation when [{(bpy)2Ru(dpp)}2Ru(dpp)PtCl2](PF6)6 interacted with DNA, suggested the covalent interaction nature of the complex. These results suggest future work on understanding the excited state properties of supramolecular complexes is suggested. The designs of future photocatalysts for hydrogen production from water and anticancer photodynamic therapy drugs are also proposed.Ph. D.
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Liu, Juan [Verfasser]. "Early detection of the immunophenotyping after conversion to belatacept in comparison to conventional immunosuppressive therapy in renal transplant patients / Juan Liu." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2017. http://d-nb.info/1140486810/34.
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Dhaouadi, Maroua. "Nanoparticules dopées terres rares pour l'imagerie médicale et la thérapie." Phd thesis, Université Pierre et Marie Curie - Paris VI, 2014. http://tel.archives-ouvertes.fr/tel-01037907.
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Ce travail de thèse a été consacré au développement d'un système multicouche constitué de nanoparticules dopées par des ions terres rares (le cœur), entourées d'une première couche cristalline non dopée, permettant de préserver les propriétés optiques du cœur. Une coquille de silice mésoporeuse est ensuite déposée, permettant l'incorporation d'un photosensibilisateur (ZnPc) via les pores de la couche de silice pour une application thérapeutique : la photothérapie dynamique. Différentes matrices ont été étudiées à savoir Y2O3, KY3F10 et NaYF4. Ces matrices ont été codopées Yb3+/Er3+ afin d'obtenir des émissions dans le visible sous l'effet d'une excitation infrarouge (upconversion), le but ultime étant d'exciter le ZnPc in situ. Chacune des matrices a été caractérisée d'un point de vue structural et morphologique dans une première partie, et d'un point de vue spectroscopique dans une deuxième partie. La structure cœur-coquille cristalline renforce l'émission rouge issue du niveau 4F9/2 de l'Er, effet déduit de l'analyse des spectres et de la dynamique de luminescence.La détection de l'oxygène singulet a été réalisée par le protocole de " bleaching " en présence ou pas du ZnPc en évaluant l'intensité de fluorescence de l'ABDA.
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Pethica, Stefania. "Applying conversation analysis to family therapy process research." Thesis, Bangor University, 2018. https://research.bangor.ac.uk/portal/en/theses/applying-conversation-analysis-to-family-therapy-process-research(dc41f1ee-6034-4464-93a9-83926453c64d).html.
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This manuscript explores the application of Conversation Analysis, an empirical approach to the study of naturally occurring everyday interactions, to the field of family therapy process research. Conversation Analysis is claimed to have the potential to benefit family therapy process research by providing evidence of effective therapist-family interactions and producing evidence of in-session change. However, these claims have rarely been substantiated by references to occasions in which this has been the case. This manuscript aims to address these claims in two ways: firstly by reviewing all the literature on family therapy process research that has adopted Conversation Analysis as a methodology of choice; secondly by providing an example of how Conversation Analysis can be used to explore the interactional consequences of a specific therapeutic strategy, psychoeducation, within the context of a feasibility study for a novel family therapy intervention. Finally, this manuscript provides a reflection on future research directions, theoretical developments and the clinical implications of using this methodology, thus providing a comprehensive picture of the application of Conversation Analysis in the field of family therapy process research as well as some evidence of its potential practical utility.
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Black, Christen Anne. "(Re)presenting Art Therapy: A Critical Conversation With Art Education." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1306962321.
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Chrysikou, Vasiliki. "Persuasive argumentation in systemic therapy interaction : a conversation analytic study." Thesis, Loughborough University, 2011. https://dspace.lboro.ac.uk/2134/9131.
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One of the core tasks of systemic therapy is to facilitate change which is largely considered to occur in an affiliative and non-interventionist manner. In this thesis I examine the role of an under-reported practice in the pursuit of 'change' in systemic therapy encounters, by focusing on a therapist's attempts to facilitate change in the client's perspective through persuasive argumentation. An interactional account of argumentation is offered through the means of conversation analysis which is the primary methodological framework for the research. The data consists of 13 hours of recorded and faithfully transcribed interaction between a person living with HIV and a systemic psychotherapist. I report three persuasion mechanisms that the therapist mobilises in the attempt to induce change. In the first,-subsequently to a display by the client of a negative stance the therapist solicits the client's grounds (or strongest grounds) in support of this stance. Pragmatically the move invites a defeasible account which the therapist then challenges or rebuts. In the second, the therapist launches a series of questions which progressively uncover a contradiction in the client's understanding of her lived experience. In the third, the therapist delivers a concession to which she attaches an account or elaboration which in fact opposes the client's trajectory and which renders the concession a tactical one. Based on the findings, I discuss some core characteristics of argumentation in therapy interaction. I also discuss the role of epistemic accessibility in the accomplishment of opposition in systemic therapy practice. Finally, I argue that argumentation in the data arises from the use of habitual systemic therapy techniques which reveals their argumentative potential and the under-theorised role of argumentation in facilitating psychotherapeutic change.
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Viklund, Erika. "Therapy talk and talk about therapy : Client-identified important events in psychotherapy." Licentiate thesis, Linköpings universitet, Psykologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-111919.
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Capturing and studying the moments in psychotherapy that clients find most important can help us understand more about how psychotherapy works, what the curative ingredients are, and by what processes they are mediated. Qualitative research in this area has, so far, mainly focused on describing, and categorizing clients’ experiences of important factors and events. The methods employed to analyse the data have been rather limited in variation and are usually based on a realist epistemology, according to which data are basically treated as reflections of the clients’ actual experiences. This entails a risk of overlooking and obscuring other aspects of therapy and the therapy process that are equally important to explore, for example the microprocesses of interaction within important events, or how clients’ accounts of their experiences are shaped and limited by the context in which they are produced. The overall aim of this licentiate thesis was to explore client-identified important events in psychotherapy with a focus on studying therapy talk and talk about therapy from a social constructionist point of view, which would allow a closer exploration of the understudied areas mentioned above. In Study I, Conversation Analysis was used to explore the interaction taking place between seven client-therapist dyads in 16 client-identified important events collected from their third sessions. The analysis identified that 12 of the events contained clients’ expressions of disagreement. Three different ways that the therapists handled the disagreement were discerned: The first, and most common, way was to orient to the client’s cues of disagreement by inviting the client to elaborate on his or her point of view and to establish a shared understanding acceptable to both participants. The second way was to orient to the client’s disagreement cues but define the therapist’s own point view as more relevant than the client’s, and the third way was a single case in which the therapist did not in any way orient to the client’s disagreement cues. In Study II, two qualitative methods based on different epistemologies were used to analyse the same set of eight clients’ accounts of 18 important events. The aim was to first identify what types of events clients describe as important, and then explore how their accounts of these events were contextually shaped and organized, and the consequences of this. The first analysis, a content analysis, yielded descriptions of five different types of events, which were similar to the ones found in previous research on important events. The second analysis, a discourse analysis, demonstrated how clients’ accounts were not only influenced by the participants’ ability to accurately remember and report their experience, but also by what was sayable within the context of the research interview. In conclusion, the two studies demonstrate how qualitative methods based on a socialconstructive perspective can contribute to our understanding of clientidentified important events by highlighting and describing participants’ use of language in interaction, and its forms and functions within therapy sessions and in research interviews. The findings point out the need to broaden the range of qualitative methods used in psychotherapy research in general and indicate the potential value of methods like CA and DA to psychotherapy process research and research on important events in particular.
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Mastache, Martinez Claudia I. "A discursive study of therapy talk : the collaborative approach to therapy." Thesis, Loughborough University, 2004. https://dspace.lboro.ac.uk/2134/7707.
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The main goal of this thesis is to describe what happens in the collaborative approach to therapy from a conversation and discursive analytical perspective. The data we worked with are part of collaborative therapy sessions in Mexican Spanish Dialect. Chapter 1 is an introduction to two of the main social constructionist approaches to therapy, the `reflecting team approach' and the `collaborative approach' to therapy. This sets out the theoretical environment in which the therapy was done. Chapter 2 is a review of the state of the art in conversation and discourse studies on therapy talk and related fields, illustrating the type of analysis done up to now. Chapter 3 describes aspects of Mexican population that were part of the context in which the data originated; some notes on translation issues are included here. Chapter 4 is the first analytic chapter and it describes the dynamics in conversation of the English particle `okay' as found in Spanish therapeutic interaction. It shows both the work okay is doing when found in the therapists' discourse and what it is doing when found in the clients' discourse. Chapter 5 presents the analysis of instances of informality that were found in the data, arguing that aspects of an `egalitarian therapeutic stance' can be displayed in the participants' talk. Chapter 6 is a study on questions and therapy, more specifically it shows the questions that can be asked by the clients in therapy talk and the conversational job this is doing. Chapter 7 is an example of research done when taking as a starting point a category that is relevant for therapy and counselling: active listening. In reading through this thesis, the reader will find aspects of the therapeutic approach as displayed in talk. Examples of this are the displays in talk of the philosophical stance, such as being egalitarian in an institutional setting. Besides describing how theoretical assumptions can be displayed in talk, this work describes in detail several aspects of therapy talk.
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Fox, Sarah. "A case series examination of interaction-focused therapy for aphasia." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/a-case-series-examination-of-interactionfocused-therapy-for-aphasia(c1452d19-7649-4b00-8a2e-da65d81a3bcd).html.
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This study reports the application and outcomes of Conversation Analysis (CA)-motivated interaction-focused therapy for a case series of eight couples managing the impact of aphasia on their conversations. It builds on previously reported interaction-focused therapy case studies (e.g. Lock, Wilkinson, & Bryan, 2001, Wilkinson, Bryan, Lock & Sage, 2010; Wilkinson, Lock, Bryan & Sage, 2011). Therapy was individualised for each couple, based on CA findings, but taking account of language, cognitive and self-reported disability assessments, and the couples' own observations during informal interviews. The participating couples were beyond the spontaneous recovery period for aphasia and presented with different types (e.g. Wernicke's, Broca's, Anomic) and severities of aphasia. Each couple video-recorded at least 80 minutes of baseline conversation at home, over eight recordings of ten minutes or more. Another eighty minutes were recorded immediately post-therapy, and again three months later. Results were evaluated by comparing pre- and post-therapy data, with the maintenance data used to evaluate whether changes were sustained three months after therapy ended. The findings indicated that four couples implemented behavioural changes following interaction-focused therapy. There was no systematic evidence of change in the other four couples' data. Reasons for successful and unsuccessful outcomes are hypothesised, including resistance to changing adaptations that mask aphasic difficulties, despite the loss of communicative effectiveness these adaptations may cause. Preliminary analysis of linguistic and cognitive assessment data has not revealed any patterns that can be related to response to therapy, but more work is warranted to further explore this data. New findings include two interaction-focused therapy targets: 1) eye gaze by people with aphasia to stall/mobilise help with repair from their partners, and 2) facilitating the person with aphasia to gain the floor more regularly by beginning a turn in the partner's turn space. Other new findings are the use of CA to assess aphasic comprehension impairments, the effectiveness of environments of possible occurrence (Schegloff, 1993) as a measure for evaluating success in interaction-focused therapy studies, and benign pedagogics. The study identified some areas for future research, including the development of an interview to elicit attitudes and beliefs about managing aphasia, as these seemed to influence response to therapy. Clinical applications have been suggested in terms of when this form of therapy may be relevant and for whom it might be expected to prove beneficial.
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Herbert, Ruth Elizabeth. "Therapy for word-finding in aphasia : effects on picture naming and conversation." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446711/.
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Therapy for word finding deficits in aphasia have taken two forms: semantic and phonological, with relatively more examples of the former in the literature. Criticisms levelled against such therapies focus on the fact that in most reported cases treatment effects are limited to treated items, and there is very little evidence of real functional change in terms of improvement in everyday speech for the person with aphasia. Behaviour in conversation can vary and for this reason it is important to establish reliability and stability of the aspects of conversation under scrutiny. This was carried out in the work reported here in order to identify aspects of conversation which might be used as outcome measures for therapy. The analysis of inter and intra-rater reliability and of test retest stability produced a measure which was used to identify the effects of two forms of therapy. The two forms of therapy were presented consecutively to three people with aphasia. In the first phase phonological and orthographic cues were used. In the second phase participants were encouraged to use the set of treatment words in speech situations, ranging from naming to definition to use in conversation. The effect of each form of therapy on picture naming and on conversation was measured. The results showed a positive effect of the phonological and orthographic cues for two of the participants in terms of gains in picture naming. For the third participant this therapy was ineffective. The second phase of therapy was effective for all three in terms of gains in items only treated in that phase of therapy. The analysis of the conversation data showed unstable baselines for a number of aspects for all three participants. Nevertheless there were some aspects which were stable for a given individual and some evidence of positive changes after therapy.
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Garcia, Samira Y. "Enhancing the Couple Alliance and Developing a Dyadic Orientation in Discursive Couples Therapy: A Conversation Analysis of Therapists'." NSUWorks, 2016. http://nsuworks.nova.edu/shss_dft_etd/21.
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The purpose of this study is to develop an interpretative understanding of how discursive therapists’ linguistic actions enhance the couple alliance. Additionally, this study includes an exploration of whether these models hold up to a common factors conversation in the practice of couples therapy. The couple alliance is the central relationship in couples therapy. Previous research suggests that therapists’ actions might have an effect on enhancing this alliance by creating a dyadic orientation. In postmodern/discursive models of practice, therapists’ actions have gone mostly unexplored, leaving therapists with little understanding of what is done in the process of couples therapy that enhances the couple alliance and creates a dyadic orientation. Results from a Conversation Analysis of couple’s cases in Narrative Therapy, Solution-Focused Brief Therapy, and Collaborative Language Therapy suggest the linguistic actions of discursive therapists appear mostly congruent with the claims they make regarding couples therapy. These actions may produce an enhanced couple alliance based on the empirically supported characteristics of a strong couple alliance. Findings also support model-dependent common factors of discursive couples therapy. In all three approaches the couple alliance appears to be enhanced by: (a) developing a symmetrical structure of the dialogue, (b) developing a contextual understanding of the self and the partner, (c) expanding the changes to the larger system, and (d) using thematic summaries. These findings have implications for practice and training in discursive couples therapy. Recommendations for future research include utilizing deductive reasoning in outcome studies to explore the effectiveness of a discursive couples therapy common factors approach to enhance the couple alliance.
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Parker, Nikki. "'What d'you think?' : a discursive analyis of psychology in therapy talk." Thesis, Loughborough University, 2003. https://dspace.lboro.ac.uk/2134/7685.
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This thesis is an investigation of talk in a therapeutic setting. It takes discursive psychology as the main influence theoretically, and also draws on the rigorous analytical techniques of conversation analysis (CA). The data was collected in various family therapy settings in the U.K., both residential and non-residential videotapes made during those sessions These recordings were made by therapists for their own use initially, and were not produced especially for this project. Videotapes were transcribed according to standard CA conventions, and subsequently analysed. One of the primary research questions has been to examine empirically mental state language as used in the therapeutic setting. Secondly, it has been to examine accounting practices and the production of versions of events as 'fact'. Thirdly, the aim has been to consider the practical implications of asymmetry as a participants' concern. As a unifying and over-arching analytic interest the use of reported speech in each of these other aspects has been investigated to assess its role in their production. The conclusions of the thesis demonstrate that participants themselves orient to one another's minds as accessible and reportable entities, and that speech is treated as reflective of inner thought. Furthermore, where speech is reported in the therapeutic setting, it is frequently used to validate and to evidence claims about other people's 'psyche'.
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Janoski, Clare N. "The Influence of Siblings' Language Status on Maternal Conversation-Eliciting Strategies." Bowling Green State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1555691232099618.
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Ozaki, Nozomu. "A Conversation Analysis of Therapist-Client Interactional Patterns in Single Session Therapy: A Researcher's Interpretation." Diss., NSUWorks, 2017. https://nsuworks.nova.edu/shss_dft_etd/45.
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In response to the growing awareness of the issue of accessibility to mental health services (World Health Organization, 2013), single session therapy (SST) has been implemented in various settings throughout the world. (Hoyt &Talmon, 2014b; Miller, 2008; Miller & Slive, 2004; Talmon, 2014). Although there has been much advancement in the knowledge and application of SST, an understanding of therapist-client interactional patterns that enfold in SST is extremely scarce. In this study, I investigated how therapists collaboratively improved the talk in SST turn by turn in such a way that promoted therapeutic improvement. I utilized conversation analysis (Sacks et al., 1974) to analyze a video-recording of a SST consultation within a single instrumental case study format (Stake, 2005). The findings of this study provide an interactional understanding of the collaborative practice, valued in SST literature (e.g., Campbell, 2012; Miller & Slive, 2004; Slive et al., 2008). Specifically, the therapists’ collaborative manner is exemplified in how the therapists oriented to the moment-to-moment interaction with the client within and across various interactional practices to coordinate their interaction, form and maintain the therapeutic relationship with the client, invite therapeutic change, and negotiate advice with the client. The findings of this study offer SST therapists and supervisors a potential interactional repertoire that they can utilize in their SST consultations and SST trainings. This study also presents a method of psychotherapy research that can address the research-practice gap (Strong & Gale, 2013).
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Roan, Robert. "Depth and Digital in Conversation| Practicing Marriage and Family Therapy Directly With Video Game Avatars." Thesis, Pacifica Graduate Institute, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10261875.
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Some psychotherapy clients have created video game avatars whose lives in virtual worlds include imaginal material and therefore invite depth psychological consideration. Using hermeneutic, alchemical hermeneutic, and artistic-creative methodologies, this thesis expands the conception of the therapeutic container to include these worlds and characters. The research explores how depth psychology can help Licensed Marriage and Family Therapists integrate their clients’ virtual lives into therapy. A literature review examines the ways computer simulations are different from other activities and describes a postmodern realm where identity is an experiment in a multiplicity of simulations that are both rich and ideological. A multicultural approach is taken in order to treat clients’ avatars and their worlds with dignity and involves an attempt to understand the cultures of technology, digital systems, and video worlds. The author proposes both an overall attitude toward and specific interventions for incorporating the virtual realm into psychotherapy.
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Ilic, Dragana. "Conversation Analysis of Michael White’s Decentered and Influential Position." NSUWorks, 2017. http://nsuworks.nova.edu/shss_dft_etd/25.
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The relationship between the therapist and the client is an important consideration for most models of therapy, with all models of therapy emphasizing the importance of establishing a positive therapeutic relationship. Quantitative and qualitative studies have shown that the relationship between the therapist and the client is a predictor of positive outcomes. However, different models define the preferred therapeutic relationship differently. This study was a qualitative exploration of a decentered and influential position of the therapist in narrative therapy. A video of a one-session narrative therapy case conducted by Michael White was analyzed using conversation analysis to answer the following research question: How, if at all, can White be seen to take a decentered and influential position in narrative therapy? The findings of this study provide more knowledge about White’s decentered and influential stance in narrative therapy. It is expected that this knowledge could be useful for education and training purposes, as well as for the improvement of clinical practice.
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Sutton, Julie Patricia. "'The invisible handshake' : an investigation of free musical improvisation as a form of conversation." Thesis, University of Ulster, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369986.
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Gulick, Eleanor. "Developing discourse structure analysis for use on conversations that include people with aphasia." Bowling Green State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1594159643173734.
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Bitter, James Robert, Oscar C. Christensen, Frank O. Main, and William G. Nicoll. "An Interrupted Conversation: An Interview with Dr. Oscar C. Christensen." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/5205.
Full textAbstract:
This interview with Dr. Oscar Christensen was conducted mostly by email over several years, starting in 2003. The original purpose of the interview was to clarify the values and beliefs that were the foundation for Dr. Christensen's work as an Adlerian family counselor with the intent of developing a book on Adlerian family therapy in the future. The interview process was interrupted when Dr. Christensen became terminally ill.
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Bergmann, Amelia. "EXAMINATION OF THE CONVERSATION PARTICIPATION RATING SCALE." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1398991717.
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Rivera-Walter, Iliamaris. "Love as Dialogue: Finding Human Connection In Conversation." Diss., NSUWorks, 2017. https://nsuworks.nova.edu/shss_dft_etd/29.
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Dialogue is a conversation situated in a view of existence as relational (Bakhtin, 1981; Buber, 1970). As a result, it evokes love—love as the constant companion to human experience that allows for collaboration, co-existence, and evolution (Maturana & Verden-Zöller, 2008). Dialogue, and its potential to generate love, offers persons the ability to understand how love can be activated within relationships and in daily encounters as a result of dialogical engagement. It also holds implications for the field of family therapy, including the nature and purpose of therapy, as well as training and practice. In order to understand how love and dialogue evoke one another, each was explored as a concept. Dialogism, the foundational philosophy of dialogue as articulated by its principle contributors, Mikhail Bakhtin (1981) and Martin Buber (1970), provides a relational, ontological context for dialogue as a conversation. Love, as an experience of shared humanity—as a “bumping into” humanity’s “collective consciousness” (Gumbrecht, Maturana, & Poerksen, 2006), initiates, fuels, and emerges within dialogue. Love and dialogue are foundational to human existence and therefore cannot be separated. This recognition results in an acceptance of love-as-dialogue. Love-as- dialogue presents individuals with a way of living that orients them toward engagement. It also invites family therapists into a conversation about therapy as a meeting of human beings and therefore as being situated in love.
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Du, Plooy Corne Wilhelmus. "A premarital pastoral conversation - a wedding of stories a narrative approach /." Thesis, Pretoria : [S.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-03062006-100436.
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Jeffrey, Sarah Kathering. "Questioning the importance of being earnest : a conversation analysis of the use and function of humour in the serious business of therapy." Thesis, University of Hertfordshire, 2010. http://hdl.handle.net/2299/4538.
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This thesis explores the long-standing debate in the field of psychotherapy around the use of humour in psychotherapy and the shift from outcome to process research in psychotherapy research. In line with the social constructionist framework of this study, the researcher’s position is outlined. The literature review describes the link between language and the construction of both the therapeutic relationship and humour. The functions of humour in psychotherapy are outlined, and the contribution that Conversation Analysis (CA) can make in this evolution. CA, with its focus on the social action of talk, is employed on three audio-tapes of psychotherapy within this research to identify the resources drawn upon by interactants, and to examine the sequential environments in which humour arises and the responses to humorous utterances. Linguistic devices used to create humour included hyperbole, irony in conveying contrasting incongruent frames of reference, repetition, empathic self-disclosure, sarcasm, facetiousness, normalising statements, humorous impersonation and anthropomorphic personification. Humour emerged in the sequential environment of repeating and elaborating on diverging viewpoints outside of therapy. Humour in the context of persuasion and resistance functioned to dismantle client resistance and contrast their competing perspectives. Humour made in the context of uncertainty exaggerated pre-existing conversational disruption, allowing a move into repair. Humour was used to contrast new and old ways of viewing situations in the process of therapeutic change. Therapists used humour strategically to move into therapeutic tasks such as formulation, reinterpretation, lexical substitution, invitation to express emotion, praise for following an intervention and empathy. Results are discussed in relation to humour's potential place in pertinent areas of therapy such as the therapeutic relationship, empathy and emotional connectedness, unconditional positive regard, congruence, resistance, uncertainty and change. Clinical implications are summarised drawing on these concepts. Strengths and limitations of the project are outlined, future research suggested and reflections by the researcher conclude this thesis.
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Ramos, Carlos Armando. "Context-Enriched Conversation Analysis of Relational Hypnotherapy with a Client Diagnosed with a Phobia of Blood and Needles." Diss., NSUWorks, 2018. https://nsuworks.nova.edu/shss_dft_etd/37.
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Although clinical hypnosis has been studied in a variety of ways, most of the research has focused on individual and evidence-based approaches; few have examined relational or systemic models. Influenced by Milton Erickson’s hypnosis methods and Gregory Bateson’s systemic concepts, relational hypnotherapists value the importance of both the intra- and interpersonal context in the treatment of problems, accentuating the significance of the mind and body connection (or relationship) in inviting non-volitional therapeutic change. The author of this research explored how Douglas Flemons, the developer of relational hypnosis, facilitated an enduring non-volitional shift with a client, “Grace,” who desired to have a baby but could not see or talk about blood, needles, or medical procedures without fainting. Using context-enriched conversation analysis (CECA), the author embraced his theoretical understanding of relational hypnosis as a guide to examine multiple sources of data, which included selected audio-recorded excerpts from Douglas and Grace’s hypnotherapeutic sessions; Grace’s descriptions of change in her email correspondence with Douglas; and Douglas’s case notes. Although there were a total of eight sessions, the author’s analysis revealed that the most influential and significant moments occurred during the first two sessions. Douglas’s initial interventions, or as he would say, intraventions, laid the foundation for a shift in Grace’s identity, which helped her embrace a variety of resourceful skills and attributes to overcome her problem. The author also discussed the clinical and research implications for relational hypnosis, brief and family therapy, and psychotherapy in general.
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Chang, Wan-Zu Diana. "Effects of Memory Aids on the Conversations of Elderly Chinese Persons." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1306180580.
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Wright, Bridget M. "Children with Autism Spectrum Disorder and Their Siblings as Co-Recipients of a Comic Strip Conversation Intervention: An Exploratory Study." Ohio University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1585561598507285.
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Todd, Celia Anne. "The role of communication partners in conversations with people with learning difficulties." Thesis, University of Exeter, 2012. http://hdl.handle.net/10036/4519.
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This study looks at what happens in informal conversations between three people with learning difficulties (intellectual impairment) and a range of non-disabled partners. It takes a participatory approach using data collected by the participants with learning difficulties who chose their communication partners; these partners included family and staff who were paid to support them. The study uses descriptive statistics to highlight areas where there was apparent asymmetry in the conversations. Conversation Analysis combined with features taken from Systemic Functional Linguistics is then used to look in detail at some of these aspects. Important features identified include turn design, repair, and the use of evaluative language and the contribution of non-verbal aspects in particular eye gaze, gesture and the use of artefacts. The study highlights possible strategies for assessing and supporting more effective and equitable interaction for those with learning difficulties and communication impairment and identifies features that should be considered when training professionals working in the field of learning difficulties.
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Wolson, Shane. "In conversation with a gay man a deconstruction of autobiographical documents /." Diss., Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-09182007-121756/.
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Cantwell, Sarah. "Talk about what might be helpful : relating meta-therapeutic dialogue to concrete interactions and exploring the relevance for therapeutic practice." Thesis, University of Roehampton, 2018. https://pure.roehampton.ac.uk/portal/en/studentthesis/talk-about-what-might-be-helpful(52f0cea4-63dc-4619-a986-3db5bfc53729).html.
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This thesis investigated how clients and therapists discuss the means by which clients can work towards their therapeutic goals. Cooper et al. (2016) termed such discussions meta-therapeutic communication or meta-therapeutic dialogue and Cooper and McLeod (2011) recommend carrying them out since outcomes are robustly related to whether the client accepts the therapeutic strategy as appropriate for their needs (e.g. Horvath et al., 2011). This thesis undertook the first discovery-oriented, Conversation Analysis (CA) study of how clients and therpaists actually carry out meta-therapeutic discussions. It represents a sustained attempt to bridge the practice-research gap and highlights the conceptual and practical challenges in doing so. 42 audio-recorded pluralistic therapy sessions were sampled across seven therapist-client pairs. Before carrying out the CA study proper, it was necessary to conceptually link broad descriptions of meta-therapeutic dialogue to participants’ concrete actions in therapy sessions. This involved a review of related concepts (Chapter Two), as well as a detailed conceptualization of how therapists’ stocks of interactional knowledge (SIKs) (Peräkylä & Vehviläinen, 2003) regarding meta-therapeutic dialogue might demonstrably link with their concrete actions as described by CA findings (Chapters Three through Five). Therapists’ questions to clients about what might be helpful were selected as a likely site for meta-therapeutic dialogue and were subjected to an in-depth CA investigation of the practical issues participants themselves treated as important in their interactions around these questions (Chapters Six through Eight). Findings show how some apparent opportunities for meta-therapeutic dialogue are less facilitative of clients’ independent input, and can sometimes be interactionally coercive. There is evidence that facilitating dialogical opportunities for talking about what might be helpful may require the therapist to move back-and-forth between opposing positions, such as treating the client as potentially unknowing but still also holding open a space for their contribution. These findings extend existing SIKs regarding meta-therapeutic dialogue by specifying some concrete considerations therapists orient to during such endeavours. Some practical similarities between meta-therapeutic dialogue and problem-solving/solution-focused approaches are also highlighted.
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Johansson, Eva. "A portfolio of academic, therapeutic practice and research work : including a conversation of how emotion is dealt with in the practice of Beckian cognitive therapy." Thesis, University of Surrey, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.604331.
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This portfolio contains work which was submitted as part of the Practitioner Doctorate (PsychD) in Psychotherapeutic and Counselling Psychology at the University of Surrey.1t consists of three dossiers which reflect the academic, clinical and research work undertaken as part of this degree. The academic dossier contains three essays. The first essay explores a Winnicottian perspective on how depression can be conceptualised and worked with therapeutically. The second essay examines the variation within the CBT tradition with respect to how emotion is attended to and worked with in clinical practice. With specific reference to depression, the third essay explores the possibility of a second-wave CBT approach to practice that would be more compatible with the principles of counselling psychology than the standard CBT treatments which have adopted the medical model of distress. The therapeutic practice d6ssier gives an overview of my clinical practice during my training. This dossier contains descriptions of the clinical placements I have undertaken, and also includes my final clinical paper which provides a reflective account of my journey toward becoming a counselling psychologist. Finally, the research dossier contains a literature review and two empirical research studies. The review explores the historical context of contemporary theory of emotion within psychotherapy, by examining the theories of emotion within influential philosophical works from the history of Western thought. The first empirical piece is a Foucauldian discourse analysis of how emotion is constructed in contemporary CBT self-help literature. The second empirical piece is a conversation analysis of the recordings of therapy sessions conducted by A. T. Beck, seeking to illuminate how emotion is dealt with in the practice of Beckian cognitive therapy.
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Berry, Caitlin Ann. "Effectiveness of communication partner training program for employees working with persons with aphasia." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523401040148992.
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Cutshall, Jessica. "Psychoeducational Mental Health Counseling Video Intervention: Patients’ Attitudes, Knowledge, and Conversations with Provider about Mental Health Counseling." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586883515772007.
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Yeh, Yea-Wen, and 葉雅雯. "Diagnostic value of neopterin for detecting tuberculosis in rheumatoid arthritis patients with QuantiFERON conversion during biologic therapy." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/89589998105549264858.
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碩士國立中興大學
生命科學院碩士在職專班
103
Frequent QuantiFERON-TB-Gold In Tube (QFT-GIT) conversion was observed in rheumatoid arthritis (RA) patients receiving biologic therapy. We aimed to evaluate the diagnostic utility of plasma cytokines and chemokines for identifying active tuberculosis (TB) in RA patients with QFT conversion. We prospectively evaluated 187 patients who received biologic therapy and serial QFT-GIT assays. QFT-GIT was performed by measuring IFN-γ levels in whole blood treated with TB-specific antigens. Levels of TB-related cytokines and chemokines at the time of QFT-GIT assays were determined by multiplex assay using the Milliplex MAP Human Cytokine/ Chemokine Panel and enzyme-linked immunosorbent assay. QFT conversion was observed in 54 (28.9%) of 187 RA patients, 54 RA patients with QFT conversion at baseline, 7 patients developed active TB (RA-TB) during the period of biologic therapy. Neopterin levels assessed at the time of active TB were higher in RA-TB patients than in RA non-TB subjects. The optimal cut-off neopterin level for detecting active TB using ROC curve analysis was 5045 pg/ml. RA patients with QFT conversion during the period of biologic therapy should be carefully evaluated and stimulated levels (TB-specific antigens) of neopterin may provide an useful information for identifying active TB.
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"Optical characterization of samarium-doped fluorophosphate glass for x-ray dosimetry for microbeam radiation therapy at the Canadian Light Source." Thesis, 2012. http://hdl.handle.net/10388/ETD-2012-06-486.
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Microbeam Radiation Therapy (MRT) is an experimental form of radiation treatment which has the potential to improve the treatment of many types of cancer. In MRT, the radiation is applied as a grid by passing the collimated X-ray beam from a synchrotron through a microplane collimator, which is a stack of parallel plates of two materials with dramatically different X-ray transparencies. The peak-to-valley dose ratio (PVDR) is the difference between the dose in the microbeams and the dose delivered between the beams. It is the PVDR that is of biological importance in MRT. Therefore a dosimeter for MRT requires a combination of a large dynamic range for dose response into the kilo-Gray regime, and high spatial resolution on the micron scale. This project characterizes fluorophosphate glasses doped with trivalent samarium ions as a potential valency conversion dosimeter for MRT using the conversion of Sm3+→Sm2+ to measure the delivered dose. Samples irradiated at the Canadian Light Source synchrotron showed X-ray induced conversion that could be optically characterized by changes in the photoluminescence emission spectra to obtain irradiation dose. The conversion efficiency depends almost linearly on the irradiation dose up to 150 Gy and saturates at doses exceeding 1500 Gy. The conversion shows a strong correlation with an observed increase in absorbance of the glass in the range of 200-750 nm. The absorbance increases with X-ray dose and is related to the formation of phosphorous-oxygen hole centers (POHC) and POn electron centers. The presence of these defects within the irradiated glass was determined by examination of the induced optical absorbance and electron paramagnetic resonance (EPR) spectra. The formation of these hole centers along with the conversion of Sm3+→Sm2+ under X-ray irradiation suggests that the X-rays cause the formation of electron-hole pairs in the glass. The electrons are then primarily captured by the Sm3+ ions, becoming Sm2+ ions, with some of the electrons being captured by POn electron centers. The holes are captured by the POHCs. This process can be represented chemically as Sm3+ + e-→ Sm2+ and PO + h+→POHC. The stability of the Sm conversion under illumination was examined using photoluminescence spectra and the stability of the X-ray induced defects was examined via the induced optical absorbance and EPR spectra.
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CHEN, YU-LING, and 陳幼玲. "A Study of The Facilitating and Conversion--Taking The Reconciliation of Expressive Art Therapy and Chinese Family Constellation as Example." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/7a3q5m.
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碩士南華大學
生死學系碩士班
106
This study explored the transformation of the catalytic and familial arrangement of small solutions through the expression of artistic treatment techniques, Help the client willing to express his or her true feelings (usually unfair feelings of negative and repressive), As well as how to guide the parties to make their own subjective values can be adjusted. This study, based on the expressive art therapy techniques, takes the small settlement of Chinese families as an example to explore the research on the expression and treatment of catalytic therapy and the transformation of family arrangement. The research purpose and question to be answered are as follows: 1、How to use ( Lifeline/ Projection/ Hypnosis ) skills to catalyze parties to express and vent negative emotions with Expressive art therapy. 2、Usually people's emotional inner psychology has produced negative twists and turns, How small reconciliation experiences can catalyze and translate negative perceptions. 3、How the Expressive art therapy and small reconciliation experience help parties convert psychological distress into spiritual growth. This study adopts a compromise approach to choose activities from different orientations. It can do self-exploration to express itself, help to detect the hidden parts of the mind, clarify the feelings of internal confusion, release attacks and get angry, and help the parties to expand their self-understanding and self. Findings of the study: The researchers analyzed the effect of the expressive artistic media and the help of family arrangement in assisting the conversion of life attitude. They found that anxiety has an impact on the individual's life and life: fear of anxiety reproduction; Life; three, fear of separation anxiety; four, fear of death anxiety; and five, afraid of fear of anxiety and other five to do to explore; after the family arrangement of self-awareness is: to help stop the obstacles to experience life preview, experience Conversion causation, awareness of love is the door of life meaning, to help love the rooted spiritual transformation.
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TSAI, MING-YAN, and 蔡明燕. "Conversion to Insulin Therapy of Patients with Type 2 Diabetes - A Quasi-experimental Study of a Medical Center in Southern Taiwan." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/37470208984440192338.
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碩士國立臺灣師範大學
健康促進與衛生教育學系在職進修碩士班
98
The main purpose of this study was to investigate the influence and short-term effects of the insulin treatment and health education on patients with type 2 diabetes concerning their diabetes knowledge, attitudes of insulin treatment, and satisfaction degrees of diabetes treatment. The subjects were type 2 diabetic patients in a medical center in southern Taiwan, a total of 68, experimental group 37, control group 31. The experimental group received health education of insulin treatment and conversion to insulin treatment, with three months of tracking. There were six withdrawing from the study. A total of 62 completed pretest and posttest questionnaires. The results are as follows: 1. Patients of different education levels are significantly different on their awareness of diabetes treatment. Awareness of the illiteracy level is significantly lower than that of the elementary, junior high and senior high school, college / university and above education levels. Awareness of the elementary level is lower than that of the college / university and above education levels. 2. Regarding awareness of diabetes treatment, the subjects perform better in the part of prevention of diabetes complication and the hypoglycemia part, but show insufficient awareness of insulin. 3. For insulin treatment, type 2 diabetic patients show a common sense of self-failure and anxiety of self-injection. The majority of diabetic patients think that "the use of insulin indicates that my diabetes has become worse", and secondly that "the use of insulin indicates that control of my diabetes with diet and oral hypoglycemic agents has failed" and worry that "I fear injecting myself with a needle." Married people have lower psychological resistance to insulin treatment. 4. Insulin treatment and health education can improve knowledge of diabetes treatment of the subjects, and reduce their negative attitude toward insulin treatment with an obvious attitude change in their sense of failure, fear of injection, life limitation, and fear of hypoglycemia. After turning to the insulin therapy, the satisfaction degrees of diabetes treatment have been raised. The patients are more satisfied than they were in the past in their diabetes treatment and their individual condition. Insulin treatment and health education intervention can reduce the negative attitude toward insulin therapy. However, it is necessary to understand the patients’ feelings, accept their negative emotion and attitude, to reduce their psychological resistance against insulin therapy when providing related health education.
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"Synthesis, Stability and Characterization of Indirect Conversion Materials for the Measurement of Dose at a Synchrotron Biomedical Imaging and Therapy Beamline." Thesis, 2012. http://hdl.handle.net/10388/ETD-2012-07-581.
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Novel dosimetric materials to ensure properly calibrated x-ray beam profiles are required to facilitate the implementation of Microbeam Radiation Therapy in cancer treatment. Indirect conversion dosimetric materials are explored for possible future applications in Microbeam Radiation Therapy devices. The indirect conversion materials barium borophosphates, barium fluorophosphates with sodium ion modifier, and barium aluminosilicates were synthesized and studied. Each synthesized compound was also doped (or additionally co-doped) with a rare-earth compound. The rare-earth compounds used for doping included samarium (III) oxide, and samarium (III) fluoride. Codoping was explored with the compound erbium (III) chloride. Synthesized samples were x-ray irradiated at the Biomedical Imaging and Therapy beamline of the Canadian Light Source and also at the University of Saskatchewan. Experimental characterization methods of dosimetric material samples included x-ray luminescence, photoluminescence, electron spin resonance, Raman spectroscopy, absorbance spectroscopy, x-ray diffraction, differential scanning calorimetry, and modulated differential scanning calorimetry. The materials are experimentally characterized and determined for their merit in further research and development. All materials were found to scintillate, and some were found to function as x-ray storage phosphors as well. The barium borophosphates and also the barium fluorophosphates with sodium ion modifier possessed x-ray storage functionality according to photoluminescence spectra. An absorbance peak was observed after x-ray irradiation for barium fluorophosphates. Electron spin resonance data suggest that x-ray irradiation forms two similar types of paramagnetic defects for barium borophosphates. It appears that these defects are oxygen hole centres, which form during the indirect conversion process of samarium dopant cations. Indirect conversion involves samarium cation valency change from the 3+ to 2+ oxidation state, occurring when an electron is captured by the cation. Thermal analysis of the barium fluorophosphates by differential scanning calorimetry and modulated scanning calorimetry indicate preferential properties and moderate glass forming ability for manufacturing processes. It is concluded that barium fluorophosphates are best suited for dosimetric detectors, and secondly, barium borophosphates. Finally, future studies on materials for dosimetry in Microbeam Radiation Therapy are recommended.
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"Optical and thermal properties of samarium-doped fluorophosphate and fluoroaluminate glasses for high-dose, high-resolution dosimetry applications." Thesis, 2014. http://hdl.handle.net/10388/ETD-2014-10-1780.
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Microbeam radiation therapy (MRT) is an experimental form of radiation treatment which causes less damage to normal tissue in comparison with customary broad-beam radiation treatment. In this method the synchrotron generated X-ray beam is passed through a multislit collimator and applied to the tumor in the form of an array of planar microbeams. MRT dosimetry is an extremely challenging task and no current detector can provide the required wide dynamic rang and high spatial resolution. In this thesis, fluorophosphate (FP) and fluoroaluminate (FA) glass plates doped with trivalent samarium (Sm3+) are characterized towards developing a potential X-ray detector suitable for MRT dosimetry. The detection is based on the difference in the photoluminescence signatures of Sm3+ ions and Sm2+ ions; the latter are formed under X-ray irradiation. This valency conversion is accompanied by the formation of defects including hole centers (HCs) and electron centers (ECs) in the glass structure which absorb light in the UV and visible regions (induced absorbance). Both FP and FA glasses show promising dynamic range for MRT and may be used as a linear sensor up to ~150 Gy and as a nonlinear sensor up to ∼2400 Gy, where saturation is reached. X-ray induced defects saturate at the same dose. The optimum doping concentration is in the 0.001˗ 0.2 at.% range. Doping with higher concentrations will decrease the conversion efficiency. The glass plates also show a very promising spatial resolution (as high as a few microns) for recording the dose profile of microbeams which is readout using a confocal fluorescence microscopy technique. These plates are restorable as well and the response is reproducible. The effects of previous X-ray exposure including samarium valency conversion as well as induced absorbance may be erased by annealing at temperatures exceeding the glass transition temperature Tg while annealing at TA < Tg enhances the response. This enhancement is explained by a thermally stimulated relaxation of host glass ionic matrix surrounding X-ray induced Sm2+ ions. Optical erasure is another practical means to erase the recorded data. Nearly complete Sm2+ to Sm3+ reconversion (erasure) is achieved by intense optical illumination at 405 nm. While, existing X-ray induced bands would be only partially erased. Electron spin resonance (ESR) and optical absorbance spectroscopy are used to investigate the nature of X-ray induced defects and their correlation with Sm valency conversion. A model based on competition between defect center formation and the Sm3+ ⇆ Sm2+ conversion successfully explains the different processes occurring in the glass matrix under X-ray irradiation.
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Dubberley-Habich, Patricia A. "Conversation analysis : ritual in experimental systemic couples therapy involving alcohol dependence." Thesis, 1992. http://hdl.handle.net/2429/2899.
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This study was intended to fulfill three goals which will be described. Its
method, subjects, results, and limitations will also be discussed.
Following Gale's (1989) lead, the first goal, was to contribute to application
of the ethnomethodological technique of conversation analysis to the field of family
therapy, specifically experiential systemic couples therapy.
The second goal was to discover themes emergent from the data. These
characterized the process of therapeutic change, particularly with an alcoholinvolved
couple. This was achieved by noting details of conversational interaction,
both verbal and nonverbal, between the members of the therapeutic system.
The third goal, was to highlight the nature of a ritual through the
separation, liminal, and integration stages. The couple's problems were
externalized, experienced, and resolved in the present through ritually burning
symbols.
Conversation analysis was conducted on one session with an alcoholinvolved
couple. The session was videotaped, audiotaped, and then transcribed
for intensive analysis. All other sessions with the couple and therapist were
reviewed to add context to the interview on which this study focussed.
Twelve themes emerged from the analysis. These were the central theme
of ritualization and its constitutive subthemes of personal and family myths,
symbolization, experiential, externalization, intensification, contextual/systemic,
constructivist meaning shifts, therapist empathy, therapist genuineness,
collaboration, and therapist artistry. Each was discussed and supported with
quotes from the transcript. These quotes demonstrated both positive or successful
exemplars and deviant or unsuccessful examples.
Possible limitations which might be ameliorated by adding related studies
to this line of research involve several points. These include the degree of
representativeness of the participants, lack of random sampling, small sample
size, reactivity to videotaping, and researcher biases.
In summary this investigation used conversation analysis with an alcoholinvolved
couple participating in ritualization in experiential systemic therapy. It
has as its goal to add to the research regarding each of these topics so as to guide
researchers and therapists in conceptualizing change through therapeutic
interventions.
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McFee, Alexandra. "Efficacy of group conversation intervention in individuals with severe profiles of aphasia." Thesis, 2018. https://hdl.handle.net/2144/30934.
Full textAbstract:
The present study examines the efficacy of group conversation intervention for Individuals with Severe Aphasia (IWSA) in a preliminary case study of five participants. IWSA are particularly marginalized from society as a result of profound communication deficits. Current efficacious treatment strategies for IWSA are compensatory in nature however, IWSA have the same goals of less severe profiles with regard to rengagement in social and community life. IWSA are commonly excluded from research regarding participation based treatment due to their complex profiles. Aims of the study were to determine if IWSA improved in discrete linguistic measures, functional and quality of life measures and targeted elements of discourse production as a result of 20 total hours of group conversation therapy. Results of evaluations conducted at pre-treatment, post-treatment and maintenance intervals revealed significant improvements on standardized linguistic measures from pre to post treatment for two of the five participants. Group analysis of functional measures showed no change across testing intervals, however when individual clinically significant change scores were calculated on one measure, three of five participants demonstrated clinically significant increase in self-reported communicative effectiveness at maintenance testing. Results of discourse analysis were variable by participant and dependent on targeted outcome measures/individualized goals. Overall, results should be interpreted with caution, due to the variability in the participant’s profiles, lack of a standard measurement tool for narrative samples and small sample size. Patterns in results prompt further research regarding efficacy of conversation therapy for IWSA.
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Mackintosh, Carolyn, N. B. Bowles, and Alison Torn. "Nurses' communication skills: an evaluation of the impact of solution-focused communication training." 2001. http://hdl.handle.net/10454/3149.
Full textAbstract:
NoThis paper describes the evaluation of a short training course in solution-focused brief therapy (SFBT) skills. This evaluation examined the relevance of SFBT skills to nursing and the extent to which a short training course affected nurses¿ communication skills. Nurses¿ communication skills have been criticized for many years, as has the training in communication skills that nurses receive. The absence of a coherent theoretical or practical framework for communication skills training led us to consider the utility of SFBT as a framework for a short training course for qualified nurses, the majority of them are registered nurses working with adults. Quantitative and qualitative data were collected: the former using pre- and post-training scales, the latter using a focus group conducted 6 months after the training. Data were analysed using the Wilcoxon signed-rank test and content analysis. Quantitative data indicated positive changes in nurses¿ practice following the training on four dimensions, and changes in nurses¿ willingness to communicate with people who are troubled reached levels of significance. Qualitative data uncovered changes to practice, centred on the rejection of problem-orientated discourses and reduced feelings of inadequacy and emotional stress in the nurses. There are indications that SFBT techniques may be relevant to nursing and a useful, cost-effective approach to the training of communication skills. Solution focused brief therapy provides a framework and easily understood tool-kit that are harmonious with nursing values.
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Leaman, Marion C. "Establishing Psychometrically-Sound Measures of Linguistic Skills in People With and Without Aphasia During Unstructured Conversation and Structured Narrative Monologue." Thesis, 2020. https://doi.org/10.7916/d8-jtx3-3n79.
Full textAbstract:
The body of work contained in this dissertation consists of seven studies investigating conversational skills in people with aphasia (PWA). The predominant focus is on establishing reliable measures of language skills in unstructured conversation in PWA. Overall, ten measures are investigated, and much of the work is concerned with establishing interrater reliability and test-retest stability. These measures are needed to determine generalization of aphasia intervention to conversation, to inform treatment decision-making, and to develop future interventions that have the capacity to improve language abilities at a conversation-level.
The initial work focused on microlinguistic skills (i.e., word and sentence-level language; Leaman & Edmonds, 2019a; 2019c), and then evolved to include macrolinguistic skills (discourse-level language) with a focus on global coherence (Leaman & Edmonds, in press) and topic initiation (Leaman & Edmonds, 2020). In addition, questions emerged regarding: a) the relationship of language production in monologue and in conversation (due to the predominance of monologue testing, as opposed to conversation, in clinical environments; b) normative data for the measures in monologue and in conversation; c) the sensitivity of the measures as treatment outcome measures. Research questions regarding items a and b are addressed in the novel research conducted for the dissertation (reported in the last two manuscripts in this document, i.e., Dissertation Studies 1 and 2 (DS1 and DS2)), and item c is addressed in Obermeyer et al., (in press).
In addition, a related outcome of this research is a methodology, The Conversation Collection Protocol (CCP). The CCP was developed to consistently collect unstructured conversations that would have similar interactional features that could be used as language samples. The protocol is based on conversational interactions in typical speakers, and is primarily informed by the Conversation Analysis literature (for an overview see Schegloff, 2007). The CPP was piloted to train SLP conversation partners to use typical, familiar, social, adult-style interactions during the conversations (rather than traditional therapy or instructional behaviors) in the first study (Leaman & Edmonds, 2019a). The protocol was further developed prior to data collection for the dissertation studies. In this development phase, the systemized training protocol was expanded to include excerpted readings from literature regarding conversational interaction, and a post-training quiz for the partners. In addition, a session fidelity protocol was developed and implemented.
Use of the CCP in all of the studies contributed to achieving similarity in the SLP partners’ interactional styles across conversational dyads, allowed fostering of social conversations which were desired (i.e., as opposed to interview-style conversations often used in the literature), and promoted the PWA to direct their own communication decisions and topics of discussion which in typical therapy interactions may be drastically limited by the clinician (Simmons-Mackie & Damico, 1999). The CCP resulted in high session fidelity (98-99%) across the 27 SLPs who participated in the two dissertation studies. The CCP training also resulted in a corpus of conversations that are similar in content and complexity (measured by mean length of utterance and type-token ratio), with similar topics and an equitable distribution of topic-initiating utterances between the PWA and the partners (Leaman & Edmonds, 2019a; DS1).
This research agenda is motivated by a clinical need and vision for a dramatic shift in aphasia intervention, which moves away from structured, decontextualized therapy tasks and towards use of everyday conversation as the primary vehicle of intervention. Prerequisite to development of such an intervention is development of outcome measures capable of capturing real-world changes in conversation. Without such measures, it is not possible to determine whether treatment has the intended effects on conversation.
Because conversation is a complex, multi-modal, and contextually-bound phenomenon, treatment that improves everyday conversation could potentially affect many aspects of communication. Change in conversation can be realized by treatment focused on verbal skills, nonverbal skills, compensatory strategies, participation, and/or partner training, and ideally should combine all of these communication parameters. Currently, measures and scales exist for each of these areas, except for in the area of language ability in conversation. It is this clinical and research gap, the lack of reliable measures to evaluate language in its most commonly used context, conversation, that fuels this line of research.
The publications, in press manuscripts, and two manuscripts resulting from the dissertation research are presented in their order of publication. Conclusions, clinical implications, and future directions are presented in each. However, in brief summary, the primary findings of this body of work are:
1. Reliability and Stability of Language in Conversation
Measurement of language production skills in PWA can be accomplished with a high-level of reliability and stability for all measures investigated except for: a) the measure of behavioral manifestations of lexical retrieval (LEXoth; Leaman & Edmonds, 2019a); and b) referential cohesion (REF), which demonstrated variability that precluded test-retest stability in two studies (Leaman & Edmonds, 2019a; DS1). The clinical implication is that language in unstructured conversation, for certain measures, is reliable and stable.
2. Language Production Relationships in Monologue and Conversation
Language production in monologue does not tend to parallel language production in unstructured conversation, thus performance during monologue therapy tasks cannot reliably predict conversational language production for most measures investigated (DS2). Consequently, language findings based on a monologue task (this research used a story narrative monologue) cannot be extrapolated for understanding of conversational language skills for most of the measures investigated. Thus, if the desired outcome of treatment is impact at a conversation level, evaluation of the effectiveness of the intervention to achieve this aim cannot be estimated with use of a story narrative monologue language sample. Further, development of intervention relevant to language needs in conversation cannot be adequately developed based on a story narrative monologue. Further investigation is needed regarding the relationship between single picture description tasks and conversation in terms of language production skills.
3. Topic Initiation Mechanisms in PWA and Their Partners
PWA often use similar mechanisms to alert listeners that a new topic is being initiated as their communication partners without aphasia, such as waiting for an old topic to end, or using a marker like “oh, and by the way…”. In interactions between individuals without communication disorders, these mechanisms are often layered and used simultaneously. However, the findings of this research demonstrate that as aphasia severity increases, individuals use fewer simultaneous mechanisms to introduce topics. In addition, for people with moderate to severe aphasia, the fewer topic initiation mechanisms they use, the less successful they are during their topic initiating utterances (Leaman & Edmonds, 2020). This work provides a broader analysis of topic initiating behaviors in PWA with a larger sample size (n=10) than had been previously available. In addition, it established a needed methodology for locating the beginning and end of topic locations in unstructured conversation. This ability to reliably locate topics within conversation is also key to the subsequent research regarding global coherence in conversation, which depends on analysis of each utterances coherence to the overall topic being discussed (Leaman & Edmonds, in press; DS1). An important clinical implication suggests that explicit teaching PWA to use simultaneous methods of topic initiation may have therapeutic benefit to support a greater level of successfulness when they initiate new topics during conversation. Further, teaching both PWA and their regular partners about mechanisms of topic initiation may facilitate improved awareness of these mechanisms with positive therapeutic effect in conversation.
4. Sensitivity of Linguistic Measures as Post-Treatment Outcomes
Evidence of stability and sensitivity of linguistic measures in conversation is provided in an intervention case study (Obermeyer et al., in press). As a case study, this research suggests preliminary evidence that a discourse-level intervention (Attentive Reading and Constrained Summarization -Written) can affect change in conversation, and that measures investigated in the research presented here may be sensitive to such change.
5. Development and Use of the CCP to Train SLPs as Conversation Partners
Although not addressed as a research question, the CCP appears to be effective as a systematic method to collect unstructured conversations suitable for language analysis. Further, the CCP training is brief (less than an hour), and a large group of SLPs (27) demonstrated learning and adherence to the protocol, as evidenced by high session fidelity and resulting conversations that are similar in terms of vocabulary use frequency, mean length of utterance, type-token ratio, and even distribution of topic-initiating turns between the PWA and their partners, and similar topical content across the conversations (Leaman & Edmonds, 2019a; DS1). Further, in the dissertation research over 90 conversations were collected using the CCP training (some were not analyzed due to subsequent ineligibility of the participant), and no conversation resembled an interview or traditional didactic therapy interaction. The clinical implication is that SLPs can be efficiently and effectively trained as conversation partners to collect unstructured (social) conversational samples for the purpose of assessment.
Next steps in this line of research are detailed in the conclusion of each of the seven articles and manuscripts. In addition, a summary of the findings and future directions based on the entire body of work are included in the Epilogue of this dissertation.
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Mohammadi, Paria. "LouLou : An exploration in the role of physical objects in the two-dimensional world of therapy." Thesis, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:konstfack:diva-7340.
Full textAbstract:
The world health organization has predicted that by 2030, depression will cause more early deaths and disability than cancer, stroke, or accidents. The number of burnouts has been increasing during the past years since we are so focused on our materialistic needs, educating ourselves in managing our devices. Meanwhile, we have not learned how to manage our own emotions. In our Swedish society today, we have people from different backgrounds and linguistic skills that find it difficult to talk about their emotional states and ask for help. At the same time, most of the methods used in therapy are done verbally or in writing that can be hard, even for those who speak the same language. In my project, I have interviewed psychotherapists and individuals who have attended therapy sessions. Speaking to a therapist, I realized the lack of physical objects in this field where almost everything is communicated verbally or on paper. During my process, I have learned about the importance of three-dimensional objects for a patient and how these objects can be used as aids to help one open up and express emotions. In this area, I have explored the following question: Whether or not emotions would abstract into forms? Can we describe our mixed emotions by using shapes, objects, and colors? What can I, as a designer, contribute to the two-dimensional world of therapy and mental health? Based on the results from several workshops and studying Robert Putchik’s theory of emotions, I created a set of tools. These aiding tools help the patient to open up about mixed feelings and break them down into primary emotions. These tools aim to help the patient to address and categorize emotions and easily communicate with the therapist.Världshälsoorganisationen har förutspått att vid 2030 kommer depression att orsaka mer tidiga död och funktionshinder än cancer, stroke eller olyckor. Antalet utbrändhet har ökat under de senaste åren eftersom vi är så fokuserade på våra materialistiska behov, lär oss att hantera tekniken men vi har inte lärt oss hur vi ska hantera våra egna känslor. Detta är aktuell idag i det svenska samhället där folk med olika bakgrund som har språksvårigheter lyckas inte uttrycka deras känslomässiga tillstånd för att få det hjälp det behöver. Samtidigt, de flesta metoderna som används i terapi sker muntligt eller skriftligt, vilket kan vara svårt även för dem som pratar samma språk. I mitt projekt har intervjuat psykoterapeuter och individer som har varit på terapisessioner. Under processens gång har jag insett betydelsen som ett tredimensionellt objekt kan ha för patienten och hur detta kan användas som hjälpmedel och stöd. Inom detta område har jag bearbetat följande frågor: Huruvida skulle känslor abstraheras i former? Kan vi beskriva våra blandade känslor med hjälp av objekt? Vad kan jag som designer bidra till den tvådimensionella världen av terapi och psykisk hälsa?
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Steyn, Lynette. "Empowering young people through narrative." Diss., 2001. http://hdl.handle.net/10500/16119.
Full textAbstract:
Dominant discourses on power, childhood and gender lead to power inequalities in social relationships in families and schools, allowing abuses of power (the subjugation and marginalisation of women and young people). These dominant structures of belief are often disrespectful of young people's experiences, stories and knowledges. This research attempted to respond to dilemmas in child relationships, to challenge belief structures that construct relationships between adults/young people, and to empower young people to stand up for their beliefs and make their voices heard. The research was guided by a post-modern, narrative pastoral approach. To deconstruct
discourses that restrict young people within social institutions, social construction discourse, feminist post-structuralism, narrative theology and feminist theology were used. Narrative practices were used to look at depression, guilt, trouble and anger. Re-authoring conversations were used to construct preferred stories about young people's identities and to explore alternative stories and the not-yet-said on drugs.Philosophy, Practical & Systematic Theology
M. Th. (Practical Theology (Pastoral Therapy))