Dissertations / Theses: 'Witch trial'

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Kim, Anne(Anne Y. ). "Optimizing clinical trials with Open Trial Chain." Thesis, Massachusetts Institute of Technology, 2018. https://hdl.handle.net/1721.1/121787.

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Thesis: M. Eng., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2019
Cataloged from student-submitted PDF version of thesis.
Includes bibliographical references (pages 59-64).
The objective of this thesis is to study the challenges of data sharing in healthcare (namely clinical trials), and propose the use of Open Algorithms (OPAL) as a viable solution for research collaboration that allows for access to data without compromising data ownership (data is only used once for the intended purpose, raw data is never leaked, the value generated from the data is transferred to the owner). This thesis surveys the challenges unique to clinical trials, and highlights the various methods for privacy-preserving computation prior to this work. Through the overview of OPAL's solution in the space of privacy-preserving computation, we show the implementation details of how OPAL was applied to clinical trials in a project called Open Trial Chain, a platform for clinical trial data built for analytics, security, and incentivized sharing through technologies like federated learning and blockchain. With motivated examples derived from real-world reported problems in healthcare, we also demonstrate speed, accuracy, and security metrics. In the application, Open Trial Chain can drastically reduce clinical trial costs, reduce error, and increase quality of analysis diversity. Overall, this project shows promise for further extension in other health datasets for compliance in an ever-complicated move towards regulations that reflect for conscientiousness for data security, ownership, and provenance.
by Anne Kim.
M. Eng.
M.Eng. Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science

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Toth, Benjamin. "Clinical trials in British medicine 1858-1948, with special reference to the development of the randomised controlled trial." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364843.

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Bardell, Kirsteen Macpherson. "Death by 'divelishe demonstracion' : witchcraft beliefs, gender and popular religion in the early modern Midlands and north of England." Thesis, Nottingham Trent University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314233.

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Durrant, Jonathan Bryan. "Witchcraft, gender and society in the early modern Prince-Bishopric of EichstaÌˆtt." Thesis, Royal Holloway, University of London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269755.

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Gagnon, Heather Elizabeth. "Scandalous Beginnings: Witch Trials to Witch City." Thesis, Virginia Tech, 1997. http://hdl.handle.net/10919/36535.

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On June 10, 1692, Bridget Bishop was hung as a witch in the community of Salem Village of the Massachusetts colony. Bishop was the first of twenty that died, all of whom professed their innocence. By the end of the madness, more than two hundred persons stood accused of witchcraft. They attempted to prove their innocence or they falsely admitted guilt in order to save their own lives. Citizens did not discuss the episode for many years after the trials were ended. The whole episode was an embarrassing blemish on the history of the state, and there was little atonement for the unjust hangings of those who had proclaimed their innocence. Three hundred years later, Salem, Massachusetts is very different. The image of the witch on a broomstick has been commercialized, and the city has become known as the "Witch City." The city makes over $25 million a year in tourism and is one of the largest tourist attractions in all of New England. This change raises some very important questions, such as how did this change occur? Why did it occur? Is Salem unique? How did perceptions change over time, and why? This thesis attempts to answer these questions by examining a variety of sources. This thesis strives to explain how a tiny New England town that experienced the tragic phenomenon of the witch trials and hangings, evolved into the present-day Witch City.
Master of Arts

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Kilgore, Meredith L. "Effects of trial design on participation and costs in clinical trials : with an examination of cost analysis methods and data sources /." Santa Monica, Calif. : Pardee RAND Graduate School, 2004. http://www.rand.org/publications/RGSD/RGSD179.

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Silwamba, Simon, and n/a. "Inclusive education in Zambia: the Kalulushi trial inclusive program." University of Canberra. Education & Community Studies, 2005. http://erl.canberra.edu.au./public/adt-AUC20061024.115015.

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This qualitative study examined the perceptions of stakeholders (administrators, principals, teachers, students, parents of students with/without disabilities and community members) in the Kalulushi District of Zambia�s Copperbelt province about their views on inclusive education in their district. The study provided a detailed, comprehensive portrait of the views of stakeholders, a view which can serve as a medium through which Zambia can familiarise itself with issues and concerns surrounding inclusion, anticipate problems and plan strategies for success. This study�s primary purpose was to obtain the perceptions of stakeholders in the district regarding a trial of inclusion and to compare their issues and concerns with those encountered in developed countries. The collection of data was conducted over a period of two months and involved interviews, surveys, and focus groups with all stakeholders and analysis of national and local policy. The thesis provided a rich description and detailed analysis of the views of stakeholders regarding issues and concerns about inclusion. Among the findings are that (a) general economic conditions, restructuring programs and medical and social-cultural issues have a huge impact on the implementation of inclusion; (b) schools in the district have few human and material resources to support inclusion; (c) students with/without disabilities and most stakeholders, except teachers, tend to favour inclusion; and (d) the agenda for donor countries complicate educational reform in developing countries.

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Holmqvist, Kalle. "Nordingrå, maj 1675 : en ångermanländsk socken i centrum för trolldomsprocesserna." Thesis, Gotland University, Department of History, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hgo:diva-343.

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In May 1675, the local court in the northern Swedish parish of Nordingrå, which had approximately 1,000 inhabitants, held a preliminary investigation on 113 persons accused of witch-craft and superstition. For the majority of the 113, the main accusation was to have travelled to Blåkulla, a place where witches according to Swedish folklore participated in satanic festivities and rites led by the Devil himself. The preliminary investigation was held at the request of The Royal Witch-craft Commission. Nordingrå belonged to the province of Ångermanland, one of the Swedish provinces with the highest number of witch trials in the 1670s. The trials in Nordingrå have, more or less never been examined before, mainly due to the fact that no sentences or penalties were ever imposed.

The purpose of this paper is to examine social relations and social conflicts in Nordingrå with the records from the witch trial 1675 as the primary source. The theoretical background for the paper is Emmanuel Le Roy Laduries study of the Occitan village of Montaillou along with Hannah Arendts theory on the banality of evil.

One of the paper´s main conclusion is that the relations of power can be traced in the trials, but that they, on the other hand, become less significant the further the trials go. One reasonable interpretation of this fact is that the trials in Nordingrå reflects the tendence of juridical centralization in the 17th century.

The social conflicts in the parish are more obvious in the accusations of superstitions than in the accusations of travels to Blåkulla. For example the conclusion can be drawn that at least a number of inhabitants in Nordingrå had a religion on their own, which did not always match the orthodoxy of the Protestant church. At the same time the accusations of superstition do not play a particularly important role in the trials. The main impression of the trials is, on the contrary, that they do not follow a given pattern regarding who can be put on trial, except for the fact that most of the trialed were women. Against the accused, a number of at least 173 witnesses appeared, most of them children and young people under the age of 24. The witnesses in general did not only tell the court which crimes the accused witches had committed, but also which crimes they had committed themselves.

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McBride, Bonnie J. "Promoting instructional interactions : effects of training preschool teachers to use a discrete trial instructional format during classroom activities /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7701.

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Fatima, Kaniz. "Analysis of longitudinal data with ordered categorical response." Thesis, University of Reading, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.239058.

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Mutlu, Bihter. "A trial application of the TEACCH program with Turkish children with autism." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1517.

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Suzuki, Masao. "A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD): the COPD-Acupuncture Trial (CAT)." Kyoto University, 2015. http://hdl.handle.net/2433/202643.

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Baumueller, Eva. "Electromyogram-Biofeedback in Patients with Fibromyalgia A Randomized Controlled Trial." Diss., lmu, 2009. http://nbn-resolving.de/urn:nbn:de:bvb:19-109423.

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Keller, Thomas [Verfasser], and Bernhard [Akademischer Betreuer] Nebel. "Anytime optimal MDP planning with trial-based heuristic tree search." Freiburg : Universität, 2015. http://d-nb.info/1122594054/34.

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McKeag, Nicholas Adam. "A trial of micronutrient supplementation in patients with heart failure." Thesis, Queen's University Belfast, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.602502.

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This thesis describes a randomized, double-blind, placebo-controlled, clinical trial investigating the effect of a multiple micronutrient supplement in patients with stable chronic heart failure. Seventy-nine patients with chronic stable heart failure were recruited and randomized to treatment with a multiple micronutrient supplement or placebo. The primary end-point of the study was left ventricular ejection fraction (LVEF), assessed using cardiovascular magnetic resonance imaging or 3·dimensional echocardiography. The secondary end·points were quality of life (assessed using the Minnesota Living With Heart Failure Questionnaire), physical functioning (assessed using six-minute walk test distance), blood levels of N·terminal prohormone of brain natriuretic peptide, blood levels of Creactive protein, blood • levels of pro· and anti-inflammatory cytokines (tumour necrosis factor alpha. interleukin·6 and mterleukin-10) and urinary levels of a marker of oxidative stress (8· iso·prostagtandin F2 alpha). All end-points were assessed at baseline and after 12 months of treatment with the study medication . Compliance with the study med ication was assessed by measuring blood levels of a number of micro nutrients contained within the multiple micronutrient supplement. There was evidence of good compliance with the study medication in nearly all subjects. With respect to the primary end-point , complete follow-up data were available for 68 subjects (35 patients in th~ placebo group and 33 patients in the multiple micronutrient supplement group). There was no evidence of a significant effect of multiple micronutrient supplementation on LVEF In addition, there was no evidence of a significant effect of multiple micronutrient supplementation on any of the secondary end·points. This study, therefore, provides no evidence to support the routine treatment with a multiple micronutrient supplement of such patients with chronic stable heart failure.

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Duley, Lelia. "The collaborative eclampsia trial : which anticonvulsant for women with eclampsia." Thesis, University of Aberdeen, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318986.

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Objective: To estimate reliably the differential effects of anticonvulsants commonly used for the care of women with eclampsia (magnesium sulphate, diazepam and phenytoin). Design: A multicentre collaborative randomized trial. Setting: Twenty seven hospitals in Africa (Ghana, South Africa, Uganda and Zimbabwe), South America (Argentina, Brazil, Colombia and Venezuela) and India. Subjects: 1687 women with eclampsia. Interventions: In some centres magnesium sulphate was compared with diazepam, other centres compared magnesium sulphate with phenytoin. Main outcome measures: The primary measures were maternal death and recurrence of convulsions. Secondary outcomes were measures of serious maternal morbidity and, for women randomized before delivery, perinatal mortality and morbidity. Results: Of the 1687 women recruited, 910 were entered into the comparison of magnesium sulphate with diazepam and 777 into the comparison of magnesium sulphate with phenytoin. Data are available on 1680 (99.6%) of the women, 99% of whom received the anticonvulsant that they had been allocated. In the diazepam arm of the trial, women allocated magnesium sulphate had a 52% lower risk of recurrent convulsions (95% Cl 64% to 37%) than those on diazepam. In the phenytoin arm, women allocated magnesium had a 67% lower risk of recurrent convulsions (95% Cl 79% to 47%) than those on phenytoin. These reductions in the risk of recurrent convulsions were also reflected in non-significant trends to fewer maternal deaths amongst women allocated magnesium sulphate. Conclusions: There is now compelling evidence in favour of magnesium sulphate, rather than diazepam or phenytoin, for the treatment of eclampsia.

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Rickard, Rory Frederick. "Arterial microanastomosis with size mismatch : a trial of two techniques." Doctoral thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/12777.

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Includes bibliographical references.
Use of perforators as recipient vessels in microvascular reconstruction has led to arterial diameter discrepancy becoming an increasingly common finding. Experimental and clinical evidence confirms that patency rates decrease with increasing diameter mismatch, but no good evidence is available to direct the choice of end-to-end microanastomotic technique where a small-to-large discrepancy exists. A programme of research has been conducted comparing two techniques of endto-end arterial microanastomoses, where a small-to-large diameter discrepancy exists of between 1:1.5 and 1:2.5. These techniques are; 45º oblique section of the smaller vessel, and; invaginating the smaller vessel inside the larger.

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Rorer, Lynette. "An Evaluation of Reinforcement Effects of Preferred Items During Discrete-Trial Instruction." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc801884/.

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This study compared the relative reinforcing efficacy of high-preferred and low-preferred stimuli, as determined by two types of preference assessments, on acquisition rates in three children diagnosed with an Autism Spectrum Disorder (ASD). The study also evaluated the indirect effects of preference on students’ stereotypy and problem behavior during instructional periods. Participants were presented with a task and provided high or low-preferred stimuli contingent upon correct responding. Results showed that acquisition occurred more rapidly in the highly preferred condition for some participants. Higher rates of problem behavior occurred in the low preferred condition for all participants. These results highlight the importance of utilizing preference assessment procedures to identify and deliver high-preferred items in skill acquisition procedures for individuals with ASD.

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Marcus, Alan Rudolph. "Utopia on trial : perceptions of Canadian Government experiments with Inuit relocation." Thesis, University of Cambridge, 1993. https://www.repository.cam.ac.uk/handle/1810/272654.

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Price, David Wayne. "Cotton Mather's cosmology and the 1692 Salem witch trials." Thesis, London Metropolitan University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369396.

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Hyman, Ryan. "The Hartford area witch-hunts : 1647-1683 /." View abstract, 2000. http://library.ctstateu.edu/ccsu%5Ftheses/1590.html.

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Thesis (M.A.)--Central Connecticut State University, 2000.
Thesis advisor: Katherine Hermes. " ... in partial fulfillment of the requirements for the degree of Master of Arts in History." Includes bibliographical references (leaves 80-89).

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Broyles, Donald L. "Triax dome modeling with I-DEAS 4.1." Thesis, This resource online, 1990. http://scholar.lib.vt.edu/theses/available/etd-03032009-041017/.

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Bamias, Christina. "Analysis of clinical trials with rescue medication." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249574.

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Kaur, Geetinder. "Recruitment to randomised controlled trials with children." Thesis, University of Liverpool, 2016. http://livrepository.liverpool.ac.uk/3002903/.

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Recruitment to randomised controlled trials is known to be difficult. Poor recruitment has several adverse consequences. It affects the validity of study findings, is a common cause of trial extensions and may result in premature termination of trials, which is a huge loss in terms of invested funds, resources and lost knowledge. Non-completion or delayed completion of studies maintains the uncertainty about the efficacy and safety of interventions, thereby delaying or preventing the use of effective interventions and prolonging the use of ineffective or potentially harmful treatments. Recruitment of children to randomised controlled trials is thought to be more challenging due to the vulnerability of the population and the fact that consent is provided by another person usually parents. This thesis aims to review the recruitment performance, i.e. comparison of achieved to anticipated recruitment, of randomised controlled trials with children and identify the factors associated with good or poor recruitment. We undertook a pilot systematic review of recruitment and retention in randomised controlled trials with children, in published literature, and found that few studies report recruitment information but those that do, report very high rates of percentage total recruitment achieved (%TR) and consent. It was not possible to obtain unbiased estimates of recruitment performance and consent rate due to the likelihood of selective reporting and/or non-publication of trials with unsuccessful recruitment. We subsequently conducted a review of recruitment of children to randomised controlled trials in the National Institute of Health Research (NIHR) Clinical Research Network (CRN) portfolio and found that under-recruitment and delayed recruitment are common problems in paediatric trials. Having a trial manager or coordinator was found to be significantly associated with successful recruitment. Other factors such as being an IMP (Investigational Medicinal Product) vs. non-IMP trial, trial of acute vs. chronic illness, having CTU (Clinical Trials Unit) involvement, pilot/feasibility study and additional trial demands had no statistically significant association with recruitment success. Since recruitment to a clinical trial can be affected by a number of internal and external factors, we conducted a survey with the clinical teams of a multi-centre randomised controlled trial with children, the MAGNETIC trial, to understand the various facilitators and barriers to recruitment. In order to identify the facilitators and barriers to recruitment and establish the recruitment experience of clinical teams in a systematic manner, we developed an evidence based recruitment survey tool. The survey tool is an online questionnaire that presents a comprehensive evidence based list of facilitators and barriers and free text space for responders to record the strategies applied to overcome these barriers and suggestions for change in organisation of trials to boost recruitment. The survey of clinical teams recruiting to the MAGNETIC trial found that a motivated clinical team with effective communication skills, effective coordination between study team members at site and between sites and CTU, trial management support, research experience of PI, presence of a research nurse and availability of a designated research team were imperative for trial recruitment success. Heavy clinical workload, shift patterns of work, lack of trained staff particularly out of hours, GCP training, local clinical arrangements and parental anxiety about the safety of experimental treatment were recognised as important barriers to recruitment. A trial specific barrier was difficulty faced by the clinicians in seeking consent from the parents of an acutely ill child in the emergency setting and suggestions were made for consideration of deferred consent. We concluded that recruitment to randomised controlled trials with children is challenging and poor recruitment and recruitment delays are a common problem. Reporting of recruitment and consent in paediatric trials is poor and needs improvement. Presence of a dedicated trial manager is significantly associated with successful recruitment and the various generic and trial specific facilitators and barriers to recruitment that have been identified can be used by trialists in planning and conducting future clinical trials with children.

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Nilsson, Erik. "Anaerobic digestion trials with HTC process water." Thesis, Uppsala universitet, Institutionen för geovetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-325289.

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Hydrothermal carbonization (HTC) is a process where elevated temperature and pressure is used in order to convert biomass to hydrochar, a coal-like substance with good dewatering properties and many potential uses. HTC can be used to treat digestate from anaerobic digestion, but the process water that remains after the hydrochar has been recovered needs to be treated further in the wastewater treatment plant. In order to make HTC more competitive compared to other sludge treatments it is important to find a good use for the process water. The main objective of this master thesis was to investigate the effects of recirculating HTC process water to the anaerobic digestion. To achieve the objective, both theoretical calculations and experimental trials were performed. The experimental trials were conducted with an Automatic Methane Potential Test System (AMPTS II) in order to investigate the anaerobic digestion in laboratory scale. In the first trial, three substrates, process water, hydrochar, and primary sludge were tested for their biochemical methane potential (BMP). All substrates were mixed with inoculum. Process water had a BMP of 335 ± 10 % NmL/gvs (normalized CH4 production in mL per g added VS (volatile solids)), hydrochar had BMP of 150 ± 5 % NmL/gvs, and primary sludge had a BMP of 343 ± 2 % NmL/gvs. The methane production was almost the same for process water as for primary sludge i.e. no inhibitory effects could be seen when process water was mixed with only inoculum. In the second trial, a more realistic scenario was tested where process water was co-digested with primary sludge at different ratios. The results from the second trial were not statistically reliable and therefore cannot be used on their own to determine with certainty if the process water could have an inhibitory effect in a full-scale anaerobic digester. However, the combined results from both trials indicate that it is unlikely that the process water would have an inhibitory effect. The possible increase in methane yield, if the digestate from a biogas facility was treated in full-scale implementation of the HTC process, was calculated theoretically. The produced process water would have the capacity to increase the methane production with approximately 10 % for a biogas facility. For the calculations, the BMP for process water was assumed to be 335 NmL/gvs and no synergetic effects was considered.

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Mitchell, Claire. "ReaDySpeech for people with dysarthria after stroke : a feasibility study." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/readyspeech-for-people-with-dysarthria-after-stroke-a-feasibility-study(ecd74ef1-0476-47b3-a561-8487ba42cb44).html.

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Dysarthria describes the impaired speech intelligibility caused by weakness of muscles involved in speech following stroke. This is a common consequence of stroke and can have a detrimental impact on self-confidence leading to social isolation for many. There is limited evidence for dysarthria intervention but we know that research into speech difficulties after stroke is a priority for stroke survivors. An online speech rehabilitation programme was developed, ReaDySpeech, with the potential to offer improved quality of independent practice, increased intensity of practice and the ability to record interaction. The research presented in this thesis aimed to systematically examine the existing evidence base, to carry out some preliminary acceptability work on ReaDySpeech, and implement a feasibility trial. The initial study was a Cochrane systematic review of the effectiveness of interventions for people with non-progressive dysarthria after stroke or other adult-acquired brain injury. This found insufficient evidence to know whether dysarthria intervention is effective or not. This led to a study of early acceptability work for ReaDySpeech and whether there were any technical barriers to use. This found no significant technical barriers other than lack of Wi-Fi and it was acceptable to participants and therapists. This enabled a progression to a feasibility trial following amendments and improvements to the protocol and ReaDySpeech itself. The feasibility trial found recruitment, retention and the intervention were all feasible to carry out during a trial. Further in-depth consideration of the findings indicates more work is needed to widen recruitment and to develop the intervention, comparator and methodology of a future trial for this to be a success with valid clinical implications. This thesis reports this body of work and discusses potential future directions for dysarthria research.

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Fox, Esther Elizabeth. "The effects of pilates based core stability training in people with MS." Thesis, University of Plymouth, 2015. http://hdl.handle.net/10026.1/3477.

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Background: People with Multiple Sclerosis experience difficulties with balance and mobility. Pilates exercises are often used to address these difficulties. Design: This was a multi-centre, double blind, block randomised, controlled trial. Eligible participants were recruited from seven UK centres. Participants were randomly allocated to either: Pilates based core stability training (Pilates), Standardised Exercise (SE) or Relaxation (placebo). All received face-to-face training sessions over a 12 week period; together with a home exercise programme. Blinded assessments were taken before training, at the end of the 12 week programme and at 16 weeks (follow-up). The primary outcome measure was the 10metre timed walk (10mtw). Secondary outcome measures were the MS walking Scale (MSWS-12), Functional Reach Test (FRT ) (forwards and lateral), a 10 point Visual Analogue Scale (VAS) to determine “Difficulty in carrying a drink when walking”, and the Activities-specific Balance Confidence (ABC) Scale. Effects on deep abdominal muscles were measured with ultrasound imaging (USI) in a subgroup of patients. Independent t-tests were performed to compare groups. Sensitivity analyses were undertaken to confirm the results. A mixed factorial ANOVA analysed the effect of intervention over time upon TrAb and IO upon USI. Results: Of the 100 participants recruited, 13 relapsed leaving 94 for intention to treat analysis. At 12 weeks there were significant differences between: (1) Pilates and Relaxation for walking velocity (p=0.04), forward (p=0.04) and lateral (p=0.04) FRT. (2) SE and Relaxation for all measures (p < 0.05) apart from the VAS. These remained at 16 weeks for 10mtw (p=0.04), LFR (p < 0.01) MSWS-12 (p=0.03) and ABC (p = 0.03). There were no significant interactions (p > 0.05) between groups or over time for TrAb and IO. Conclusions: Participants improved with both Pilates and SE in the short term; with broader and longer-lasting effects in the SE group. USI did not detect any effect of group over time.

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Stockler, Martin Richard. "Validation of the PROSQOLI as an outcome measure for clinical trials in advanced hormone-resistant prostate cancer, assessment of convergent, discriminative and predictive validity with baseline data from a randomised trial." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ51552.pdf.

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Carneiro, JÃssica Rodrigues Mendes. "Randomized clinical trial on the different bleaching protocols with 7,5% hydrogen peroxide." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17433.

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nÃo hÃ
Bleaching is a conservative technique and it much sought after by patients looking for an improvement in smile esthetics. The objective of this study was to evaluate the effectiveness of bleaching treatment, with 7.5% hydrogen peroxide at different time intervals, and evaluate the intensity of related tooth sensitivity. For this, 60 patients were selected and divided into three groups: group PH10 - used the gel for 10 min a day; group PH30 â 30 min; group PH60 â 60 min. The volunteers had the autonomy to stop bleaching when they were satisfied with the result, ranging between 14 and 42 days. Two sensitivity tables (Visual analogue scale and 5-point verbal rating scale) were given to the participants to be filled in daily on the levels of sensitivity. Color assessments were made using the Vitapan Classical Scale and Easyshade spectrophotometer at 14, 21, 28 and 42 days of treatment and 1 month after the end of the bleaching, to evaluate color rebound effect. Degree of patient satisfaction was measured by a questionnaire. For data analysis, Fisherâs exact test compared the percentage of satisfied with unsatisfied participants in each of the three groups (α=0.05). The mean number (Â standard deviation [SD]) of days required to achieve the participant satisfaction in each of the three groups was calculated and statistically analyzed using the ANOVA and t-test (α=0.05). Intensity of sensitivity was evaluated using the Kruskal-Wallis test (α=0.05). To analyze the difference of color of both methods (spectrophotometer and color scale) two tests were used: for the same period in different groups the Kruskal-Wallis test was performed (α=0.05), and for the same group at different time intervals the Friedman test was used (α=0.05). The three methods were effective, with group PH10 being less effective than group PH60 with only the color scale evaluation method in the analysis of tooth 13. One month after the end of the treatment, there was no significant difference with the results found immediately after the treatment period. Group PH10 had a higher mean number of days of gel use, a lesser degree of satisfaction with the end result, and less pain when compared to the others. It can be concluded that the decrease in the daily time-use of 7.5 % hydrogen peroxide had no effect on its effectiveness, and it brought benefit to patients, as well as making the treatment faster, it decreased the discomfort of sensitivity.
O clareamento Ã uma tÃcnica conservadora e bastante procurada por pacientes que buscam uma melhoria na estÃtica do sorriso. O objetivo deste trabalho foi avaliar a efetividade do tratamento clareador, com perÃxido de hidrogÃnio a 7,5% em diferentes tempos, e avaliar a intensidade de sensibilidade dentÃria relacionada. Para isso, foram selecionados 60 pacientes e divididos em trÃs grupos: grupo PH10 - utilizou o gel por 10 min no dia; grupo PH30 â 30 min; grupo PH60 â 60 min. Os voluntÃrios possuÃam autonomia de interromper o clareamento quando estivessem satisfeitos com o resultado, num intervalo entre 14 e 42 dias. Duas tabelas de sensibilidade (escala visual analÃgica e escala de classificaÃÃo verbal de 5 pontos) foram entregues aos participantes para que fossem preenchidas diariamente com os nÃveis de sensibilidade. Foram feitas avaliaÃÃes de cor com Escala Vitapan Classical e espectrofotÃmetro EasyShade aos 14, 21, 28 e 42 dias de tratamento, e 1 mÃs apÃs o fim do clareamento, para avaliar efeito rebote da cor. O grau da satisfaÃÃo do paciente foi medido por um questionÃrio. Para anÃlise dos dados, o teste exato de Fisher comparou os percentuais de participantes satisfeitos com os participantes insatisfeitos em cada um dos trÃs grupos (α = 0,05). Foi feito a mÃdia (Â desvio-padrÃo [DP]) do nÃmero de dias necessÃrios para alcanÃar a satisfaÃÃo dos participantes em cada um dos trÃs grupos e avaliados estatisticamente utilizando-se ANOVA e teste T (α = 0,05). A intensidade da sensibilidade foi avaliada atravÃs do teste Kruskal-Wallis (α = 0,05). Para anÃlise da diferenÃa de cor de ambos os mÃtodos (espectrofotÃmetro e escala de cor) foram utilizados dois testes: para um mesmo perÃodo nos diferentes grupos foi realizado o teste de Kruskal-Wallis (α = 0,05) e para o mesmo grupo em diferentes perÃodos foi feito o teste de Friedman (α = 0,05). Os trÃs mÃtodos foram efetivos, sendo o grupo PH10 menos eficaz que o grupo PH60 apenas para o mÃtodo de avaliaÃÃo com escala de cor na anÃlise do dente 13. ApÃs 1 mÃs do fim do tratamento nÃo houve diferenÃa significativa com o resultado encontrado imediatamente apÃs o perÃodo de tratamento. O grupo PH10 teve uma maior mÃdia de dias de uso do gel, um menor grau de satisfaÃÃo com o resultado final e uma menor intensidade de dor quando comparado aos demais. Pode-se concluir que a diminuiÃÃo do tempo de uso diÃrio do perÃxido de hidrogÃnio 7,5% nÃo influenciou na sua efetividade e trouxe benefÃcio aos pacientes, pois alÃm de tornar o tratamento mais rÃpido, diminui o desconforto da sensibilidade.

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30

Familusi, Mary Ajibola. "Analysis of clustered competing risks with application to a multicentre clinical trial." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23763.

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The usefulness of time-to-event (survival) analysis has made it gain a wide applicability in statistically modelling research. The methodological developments of time-to-event analysis that have been widely adopted are: (i) The Kaplan-Meier method, for estimating the survival function; (ii) The log-rank test, for comparing the equality of two or more survival distributions; (m) The Cox proportional hazards model, for examining the covariate effects on the hazard function; and (iv) The accelerated failure time model, for examining the covariate effects on the survival function. Nonetheless, in time-to-event endpoints assessment, if subjects can fail from multiple mutually-exclusive causes, data are said to have competing risks. For competing risks data, the Fine and Gray proportional hazards model for sub-distributions has gained popularity due to its convenience in directly assessing the effect of covariates on the cumulative incidence function. Furthermore, sometimes competing risks data cannot be considered as independent because of a clustered design; for instance, in registry cohorts or multi-centre clinical trials. The Fine and Gray model has been extended to the analysis of clustered time-to-event data, by including random-centre effects or frailties in the sub-distribution hazard. This research focuses on the analysis of clustered competing risks with an application to the investigation of the management of pericarditis clinical trial (IMPI) dataset. IMPI is a multi- centre clinical trial that was carried out from 19 centres in 8 African countries with the principal objective of assessing the effectiveness and safety of adjunctive prednisolone and Mycobacterium indicus pranii immunotherapy, in reducing the composite outcome of death, constriction or cardiac tamponade, requiring pericardial drainage in patients with probable or definite tuberculous pericarditis. The clinical objective in this thesis is therefore to analyse time to these outcomes. In addition, the risk factors associated with these outcomes were determined, and the effect of the prednisolone and M. indcus pranii was examined, while adjusting for these risk factors and considering centres as a random effect. Using Cox proportional hazards model, it was found that age, weight, New York Heart Association (NYHA) class, hypotension, creatinine, and peripheral oedema show a statistically significant association with the composite outcome. Furthermore, weight, NYHA class, hypotension, creatinine and peripherial oedema show a statistically significant association with death. In addition, NYHA class and hypotension show a statistically significant association with cardiac tamponade. Lastly, prednisolone, gender, NYHA class, tachycardia, haemoglobin level, peripheral oedema, pulmonary infiltrate and HIV status show a statistically significant association with constriction. A value of 0.1 significance level was used to identify variables as significant in the univariate model using forward stepwise regression method. The random effect was found to be significant in the incidence of composite outcomes of death, cardiac tamponade and constriction, and in the individual outcome of constriction, but this only slightly changed the estimated effect of the covariates as compared to when the random effect was not considered. Accounting for death as a competing event to the outcomes of cardiac tamponade or constriction, does not affect the effect of the covariates on these outcomes. In addition, in the multivariate models that adjust for other risk factors, there was no significant difference in the primary outcome between patients who received prednisolone, and those who received placebo, or between those who received M. indicus pranii immunotherapy, and those who received placebo.

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31

Hanson, Christine. "A Randomized-Controlled Trial of Working Memory Training in Youth with ADHD." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1363969480.

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32

Vondran, Jodi C. "A two pan feeding trial with companion dogs: considerations for future testing." Thesis, Kansas State University, 2013. http://hdl.handle.net/2097/15891.

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Master of Science
Food Science
Edgar Chambers IV
Palatability of pet foods is judged by the use of animals in colonies. Pet food manufacturers would like to understand how palatable a food is compared to another food. This generally is accomplished by a two pan test where a pet has the opportunity to freely choose between two foods. Preference is evaluated through the use of an intake ratio, the ratio of the amount of test food consumed divided by the total amount of the foods consumed. Although this is easy to do in laboratories, another option would be to do such studies with animals in more ‘real-life’ home environments. The purpose of this study was to develop, and test a method to capture feeding information from a study of canines in the home environment and analyze the results of the palatability tests. Individual dog owners were screened for information on the household and pets. Twenty-five dogs of different ages, breeds and sizes were selected to participate on the in-home panel. Seven different palatability tests were performed using the in-home panel with four of those tests being replicated; a total of 11 comparative tests. These dogs were tested using a proprietary computer-based technology that collected information about intake of each food for each individual dog for a duration of seven days for each of the 11 comparative studies. Data was analyzed and resulted in showing that differences between foods can be found. Statistical analyses compared initial day one data to subsequent day data collected during each study to determine whether a full seven day test was needed. In addition, comparisons were made to compare the impact of prior foods eaten to subsequent preferences of the dogs. Results of the in-home panel were the same on day one as for all seven days of testing. Also, previous exposure to a food did not alter subsequent preference for that food. Such data has implications for pet food manufacturers related to timing and cost of testing.

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Sweeney, Jennifer Jean. "A Systematic Replication of the Effectiveness of Group Discrete Trial Teaching with Students with Autism." Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1271693679.

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Konyar, Grace Elizabeth. "Empowering Popularity: The Fuel Behind a Witch-Hunt." Ohio University Honors Tutorial College / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1490710757496863.

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35

Peirce, Catherine. "Effectiveness of two different occupational therapy interventions with individuals with multiple sclerosis : a randomized controlled trial." Diss., NSUWorks, 2001. https://nsuworks.nova.edu/hpd_ot_student_dissertations/24.

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Supported by a research grant from the Multiple Sclerosis Foundation, this randomized controlled trial was designed to compare the effectiveness of two occupational therapy interventions and a social activity intervention on the lives of people with multiple sclerosis. A multi-group pretest-posttest control group design was used to test the hypothesis that there would be a difference in impact between an occupational therapy rehabilitation intervention, a social activity intervention, and an occupational therapy wellness intervention on the occupational performance, quality of life, and general health status of people with MS. Multiple sclerosis affects approximately 350,000 Americans. It potentially limits occupational engagement in activities, roles, and meaningful participation in society. The economic impact both to the individual and to society is estimated to be 6 billion dollars annually. The literature described traditional occupational therapy (OT) practice for this population and highlighted some limitations of studies measuring the outcomes of traditional rehabilitation approaches. The literature suggested that health promotion and wellness approaches hold promise to improve health and quality of life for people with MS. Therefore, in an effort to contribute to evidence-based occupational therapy practice, two different occupational therapy interventions were developed: one based on the rehabilitation and biomechanical frames of reference and the Model of Human Occupation (MOHO) and the other, a wellness intervention, based on the Person Environment Occupational Performance Model (PEOPM) and the MOHO. Participants were recruited from MS membership organizations. Those who met the inclusion criteria and who elected to participate in the study were randomly assigned to one of the two occupational therapy interventions or to a social activity control group. The Occupational Self Assessment, the SF-36, and the Quality of Life Inventory were administered at the beginning and upon completion of 10 sessions held weekly. The results suggest that both of the occupational therapy interventions used in this study can have a positive impact on the health and well-being and quality of life of people with MS, as compared to a social activity group. The researcher concluded that further occupational therapy research is needed that addresses quality, of life outcomes for people with MS and that other methods of assessing occupational performance outcomes need to be explored. A number of theoretical frameworks and models both within and outside the occupational therapy profession are recommended to guide the development of occupational therapy practice and outcome studies for this population.

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Hackl, Peter. "Optimal Design for Experiments with Potentially Failing Trials." Department of Statistics and Mathematics, WU Vienna University of Economics and Business, 1994. http://epub.wu.ac.at/68/1/document.pdf.

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We discuss the problem of optimal allocation of the design points of an experiment for the case where the trials may fail with non-zero probability. Numerical results for D-optimal designs are given for estimating the coefficients of a polynomial regression. For small sample sizes these designs may deviate substantially from the corresponding designs in the case of certain response. They can be less efficient, but are less affected by failing trials. (author's abstract)
Series: Forschungsberichte / Institut für Statistik

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37

Julious, Steven Anthony. "Designing clinical trials with uncertain estimates of variability." Thesis, University College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429292.

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Sinha, Ian. "Outcomes in clinical trials in children with asthma." Thesis, University of Liverpool, 2011. http://livrepository.liverpool.ac.uk/3193/.

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The selection of outcomes is a critically important decision when designing randomised controlled trials (RCTs). Informed clinical decisions can only be based on the results of RCTs that have measured outcomes of importance to both clinicians and patients. It can be difficult to know which outcomes should be measured in RCTs. Some groups advocate core outcome sets, which are a minimum set of outcomes that should be measured, and reported, in all clinical trials in a given condition. These increase the likelihood that important outcomes are measured, reduce nonuniformity between studies, and reduce the risk of outcome reporting bias. We systematically reviewed studies that determined which outcomes to measure in clinical trials in children, and found that such work had been conducted in only few conditions, and the quality of existing work was variable. Few studies used structured consensus techniques to reach agreement about which outcomes to measure in trials, and parents were seldom involved. No studies included children. One condition in which there were no robust recommendations about which outcomes to measurein RCTs was childhood asthma, which is a condition of considerable global importance. We subsequently aimed to assess whether the absence of a core outcome set for RCTs of children with asthma meant that certain outcome domains were measured less frequently than others, and whether there was nonuniformity between studies in terms of outcomes selected. We conducted a systematic review of RCTs of children with asthma, published between January 1988 and December 2007, and found that the included studies focussed on short-term disease activity, but quality of life, functional status, and long-term outcomes were infrequently measured. Certain outcomes were measured and reported in various ways. We recommended that a core outcome set should be developed for childhood asthma, using structured consensus techniques, such as the Delphi process. In order to aid the development of such a core set, we first systematically reviewed studies that used the Delphi process to determine which outcomes to measure in clinical trials. We observed variations in the methodology used, identified potential sources of bias, and provided recommendations about how such studies could be conducted and reported. In order to develop a core outcome set for childhood asthma, we used a Delphi process to ascertain the views of 46 clinicians, and around 100 parents and young people, about which outcomes are most important and relevant from their perspective, when making shared decisions about regular therapies which control asthma. The most important outcomes were symptoms, exacerbations, and quality of life. Although consensus still needs to be reached amongst other groups of individuals involved in clinical trials, we conclude that these outcomes should be measured, and reported, in all RCTs that aim to evaluate the effectiveness of regular therapies for children and young people with asthma.

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Weißer, Steffen Verfasser], and Sergej [Akademischer Betreuer] [Rjasanow. "Finite element methods with local Trefftz trial functions / Steffen Weißer. Betreuer: Sergej Rjasanow." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2012. http://d-nb.info/1052551254/34.

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Sheppard, Sasha. "A randomised controlled trial comparing hospital at home with in-patient hospital care." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.284587.

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41

Li, Chi-ming, and 李志明. "Statistical analysis of a phase IV clinical trial in patients with allergic rhinitis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31970084.

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42

Mosleh, Sultan. "Improving attendance at cardiac rehabilitation : a cohort study with nested randomised controlled trial." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=203472.

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43

Seretny, Michael Lee. "Field trial with the Ball State diagnostic inventory based on the Feighner criteria." Virtual Press, 1988. http://liblink.bsu.edu/uhtbin/catkey/560297.

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This study examined the Ball State Diagnostic Inventory. First, the construct validity of the measure and the 14 corresponding psychiatric diagnoses was considered. Secondarily, the investigation considered the psychiatric epidemiology of a college-age population.A review of the literature was presented with an emphasis on psychiatric syndromes, the Neo-Kraepelinian tradition, and the development of empirically based diagnostic criteria. The construction of the Ball State Diagnostic Inventory was placed in the historical context of the assessment of empirically based descriptive diagnostic criteria.One thousand and twenty-two undergraduate and graduate students from four U.S. universities volunteered to complete the Ball State Diagnostic Inventory. Participants were screened for prior psychiatric treatment or a course of psychotrophic medication. The mean chronological age of the subjects was 20.6 years (SD = 1.25) with a range of 18 to 28. The Ball State Diagnostic Inventory is a 218-item measure of adult psychopathology as reflected in the diagnostic criteria of the Diagnostic Inventory Schedule.The results showed the epidemiological point prevalence rates for this college age sample to correspond to other estimates. The 14-factor solution provided evidence of grouping of symptoms into traditionally defined diagnostic categories. Moreover, derived factors were similar to previous factor analytical studies with major psychiatric syndromes.The results were discussed in terms of their support for the utility of empirically based diagnostic criteria. Further investigations with the Ball State diagnostic Inventory were explored.
Department of Educational Psychology

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44

Li, Chi-ming. "Statistical analysis of a phase IV clinical trial in patients with allergic rhinitis." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23295314.

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45

Vermöhlen, Vanessa, Petra Schiller, Sabine Schickendantz, Marion Drache, Sabine Hussack, Andreas Gerber-Grote, and Dieter Pöhlau. "Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO)." Sage, 2018. https://tud.qucosa.de/id/qucosa%3A35527.

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Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54). Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

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46

Cruz, Sarai. "CONDUCTING A TRIAL-BASED FUNCTIONAL ANALYSIS WITH ADULTS IN A DAY PROGRAM SETTING." OpenSIUC, 2013. https://opensiuc.lib.siu.edu/theses/1190.

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AN ABSTRACT OF THE THESIS OF Sarai Cruz, for the Master's of Science degree in Behavior Analysis and Therapy, presented on June 21, 2013, at Southern Illinois University Carbondale. TITLE: CONDUCTING A TRIAL-BASED FUNCTIONAL ANALYSIS WITH ADULTS IN A DAY PROGRAM SETTING MAJOR PROFESSOR: Dr. Joel Ringdahl Functional analysis is an assessment that is used to identify the functional contingences in a variety of settings. The present study describes a trial-based functional analysis conducted in a day program setting, with two adult participants with intellectual disabilities that engaged in inappropriate touching. This study extended similar procedural methodology as outlined by Sigafoos and Saggers (1995) of conducting 1-min components (test and control) and 20 trials under three test conditions (demand, tangible, and attention). Results indicated a clear pattern of responding for both participants. For the male participant, the result suggest the problem behavior was maintained by multiple sources of reinforcement. For the female participants, the results suggest the problem behavior was maintained by access to attention. These results propose that a trial-based functional analysis is a viable options to determine maintaining contingences when conducted in a day program setting. Future research should be conducted to further establish trial-based functional analysis in applied natural settings to increase its use outside of contrived, clinical environments. Key words: Trial-based functional analysis, intellectual disabilities, day program

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47

Griffin, Brandon J. "Efficacy of a Self-forgiveness Workbook: A Randomized Controlled Trial with University Students." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3318.

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Insofar as forgiveness of oneself enables one to responsibly manage the consequences of wrongdoing, the practice of self-forgiveness may be essential to the preservation of one’s physical, psychological, relational, and spiritual health. In the present thesis, an intervention wait-list design was employed to investigate the efficacy of a 6-hour self-directed workbook designed to promote self-forgiveness. University students (N = 204) who reported perpetrating an interpersonal offense and who experienced some sense of remorse were randomly assigned to either an immediate treatment or wait-list control condition, and assessments were administered on three occasions. Participants’ self-forgiveness ratings increased in conjunction with completion of the workbook, and the effect of treatment depended upon self-administered dose and baseline levels of dispositional self-compassion in some cases. In summary, the workbook appeared to facilitate the process of responsible self-forgiveness among perpetrators of interpersonal wrongdoing, though replication trials are needed in which lower rates of attrition reduce the possibility of biased results.

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48

Cheung, Yip-ling Maria. "Working with triad affiliated youths a descriptive study of the outreaching workers' practice experience /." Click to view the E-thesis via HKUTO, 1985. http://sunzi.lib.hku.hk/hkuto/record/B31974363.

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49

Cavalcante, Ana Augusta Monteiro. "Enteral nutrition supplemented with l-glutamine and its action on the inflammatory process, the glycolytic metabolism, the immune system and the oxidative stress of patients with systemic inflammatory response syndrome." Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5260.

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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico
The Systemic Inflammatory Response Syndrome (SIRS) is characterized by an excessive release of inflammatory mediators as a systemic inflammatory response to a serious clinical injuries. The use of glutamine in nutraceutical doses has been studied as a strategy in tissue protection and preservative of tissue metabolic function in stressful situations, helping to improve the immune response of patients. The effects of enteral glutamine supplementation in nutraceutical doses on the inflammatory markers, of glycolytic metabolism, of immune system and of oxidative stress were studied in adult and elderly patients with SIRS in a prospective, clinical, randomized, controlled, double-blind crossover study. Thirty six moderately severe patients admitted to the Intensive Care Unit were selected according to pre-defined criteria, diagnosis of SIRS and the APACHE II score (>10<20), distributed into two groups and submitted to the supplementation with 1 litre of enteral nutrition with addition of 30g of L-glutamine or calcium caseinate or 1 litre of enteral nutrition with addition of 30g of calcium caseinate or L-glutamine for two days, pause for one day only with diet, followed by four days of supplementation. Blood samples were collected before (T0) and after (T1) each supplementation. For evaluation blood parameters (hematocrit, leukocytes, lymphocytes, monocytes, prealbumin, blood urea nitrogen, creatinine, glucose, lactate, C-peptide and insulin), IL-1, IL-6, IL-10 and TNFα were also assayed. Glutathione, TBARS, and glutamine and glutamate amino acids were measured. Six patients died during the study. Thirty patients finished the study, 16 men (53%) and 14 (47%) women, median age 74.4 years (30-92 years) in moderately severe state of health (APACHE II 13.1 - range 10-19). All patients developed SIRS and were given enteral nutrition supplemented with L-glutamine or calcium caseinate, 1464kcal/day (range 792-1914kcal/day). The use of L-glutamine in nutraceutical dose of 30g/day showed no changes in blood parameters. All laboratory parameters remained within normal values except the blood urea [Calcium Caseinate T1=47.0mg/dL (range 34.0-69.0 mg/dL) versus Glutamine T1=50.0mg/dL (36.75-75.0mg/dL); p=0.030]. Creatinine concentrations were not statistically different. There was no statistically significant difference in assessment of inflammatory parameters (IL-1, IL-6, IL-10 E TNFα). Leukocytes count decreased significantly in both groups [Calcium Caseinate T0=13.650 1/mm3 (10.148-18.250 1/mm3) versus T1=11.500 1/mm3 (8.050-29.100 1/mm3); p=0,019] and [Glutamine T0=12.850 1/mm3 (11.155-15.550 1/mm3) versus T1=11.000 1/mm3 (9.200-16.325 1/mm3); p=0.046]. There was increase statistically significant difference in lymphocytes count between groups [Calcium Caseinate T1=1085 1/mm3 (range 805-1363 1/mm3) versus Glutamine T1=1916 1/mm3 (1301-2517 l/mm3); p<0.0001] and Calcium Caseinate group decreases [T0=1288 1/mm3 (range 834-2209 1/mm3) versus T1=1085 1/mm3 (range 805-1363 1/mm3); p=0.0324] and Glutamine group increases [T0=954 1/mm3 (range 785-1442 1/mm3) versus T1=1916 1/mm3 (range 1301-2517 l/mm3); p<0.0001]. Blood concentration of TBARS decreased significantly in both groups [Calcium Caseinate T0=20.56mol MDA/ml (range 13.64-20.56mol MDA/ml); p=0.001] and [Glutamine T0=17.67 mol MDA/ml (range 8.11-34.98 mol MDA/ml) versus T1=16.52 mol MDA/ml (range 5.41-21.86 mol MDA/ml); p=0.020]. The blood concentrations of Gluthatione showed a statistically significant reduction in caseinate group (T0=486.0mol/ml (range 486.0Â165.8mol/ml versus T1=451.0Â167.4mol/ml; p=0.047) and no statistically significant difference in the glutamine group, nor between groups. However, there were no differences between groups. Glutamine and glutamate were not statistically different. Enteral nutrition supplemented with glutamine in nutraceutical doses of 30g/day increase lymphocyte count, helps to reduce lipid peroxidation and maintains the antioxidant glutathione capacity, interfering beneficially modulating the inflammatory response and stress, but present no effect upon cytokines concentrations or glycolytic parameters.
A SÃndrome da Resposta InflamatÃria SistÃmica (SRIS) caracteriza-se por uma liberaÃÃo excessiva de mediadores inflamatÃrios a uma sÃrie de situaÃÃes clÃnicas graves. A utilizaÃÃo da glutamina em doses nutracÃuticas tem sido estudada como uma estratÃgia de proteÃÃo tecidual e metabÃlica em situaÃÃes de estresse, melhorando a resposta imune de pacientes. Os efeitos da nutriÃÃo enteral suplementada com 30g/dia de glutamina sobre os marcadores inflamatÃrios, do metabolismo glicolÃtico, da funÃÃo imune e do estresse oxidativo foram estudados em pacientes adultos e idosos com SRIS. Foi realizado estudo clÃnico prospectivo, randomizado, controlado, duplo-cego, cruzado. Trinta e seis pacientes internados em Unidade de Terapia Intensiva foram selecionados pelos critÃrios do estudo, diagnÃstico da SRIS e score APACHE II (>10<20), distribuÃdos em dois grupos e submetidos Ã suplementaÃÃo com 1 litro de dieta enteral suplementada com 30g de L-glutamina ou caseinato de cÃlcio ou 1 litro de dieta enteral suplementada com 30g de caseinato de cÃlcio ou L-glutamina por dois dias, intervalo de um dia somente com dieta, perfazendo quatro dias de dieta com suplementaÃÃo. Amostras de sangue foram coletadas antes (T0) e apÃs (T1) cada suplementaÃÃo. Foram realizadas anÃlises do hematÃcrito, leucÃcitos, linfÃcitos, monÃcitos, prÃ-albumina, urÃia, creatinina, glicose, lactato, peptÃdeo-C e insulina, das IL-1, IL-6, IL-10, TNFα, glutationa, TBARS e dos aminoÃcidos glutamina e glutamato. Seis pacientes foram a Ãbito durante o estudo e trinta pacientes concluÃram o estudo, sendo 16(53%) homens e 14(47%) mulheres, mediana de idade 74,4 anos (30-92 anos), moderadamente graves, mediana de APACHE II 13,1 (10-19) e mediana de ingestÃo calÃrica de 1464kcal/dia (792-1914kcal/dia). O uso L-glutamina em dose nutracÃutica de 30g/dia nÃo mostrou alteraÃÃes nos parÃmetros hematolÃgicos. Houve aumento da urÃia [Caseinato T1=47,000mg/dL (34,000-69,000mg/dL) versus Glutamina T1=50,000mg/dL (36,750-75,000mg/dL); p=0,030] na comparaÃÃo intergrupos, mas nÃo houve diferenÃa estatisticamente significante de creatinina em nenhum dos grupos. NÃo houve alteraÃÃo estatisticamente significante nos parÃmetros inflamatÃrios (IL-1, IL-6, IL-10 e TNFα). A contagem de leucÃcitos diminuiu significantemente em ambos os grupos [Caseinato T0=13.650 1/mm3 (10.148-18.250 1/mm3) versus T1=11.500 1/mm3 (8.050-29.100 1/mm3); p=0,019] e [Glutamina T0=12.850 1/mm3 (11.155-15.550 1/mm3) versus T1=11.000 1/mm3 (9.200-16.325 1/mm3); p=0,046]. Houve aumento estatisticamente significante na contagem de linfÃcitos na comparaÃÃo intergrupos [Caseinato T1=1.085 1/mm3 (805-1.363 1/mm3) versus Glutamina T1=1.916 1/mm3 (1.301-2.517 l/mm3); p<0,0001], uma diminuiÃÃo estatisticamente significante no grupo Caseinato [T0=1.288 1/mm3 (834-2.209 1/mm3) versus T1=1.085 1/mm3 (805-1.363 1/mm3); p=0,0324] e aumento no grupo Glutamina [T0=954 1/mm3 (785-1.442 1/mm3) versus T1=1.916 1/mm3 (1.301-2.517 l/mm3); p<0,0001]. Observou-se reduÃÃo estatisticamente significante na dosagem do TBARS na comparaÃÃo intragrupos [Caseinato T0=20,56mol MDA/ml (13,64-20,56mol MDA/ml) versus T1=15,08 mol MDA/ml (13,64-20,56 mol MDA/ml); p=0,001] e [Glutamina T0=17,67 mol MDA/ml (8,11-34,98 mol MDA/ml) versus T1=16,52 mol MDA/ml (5,41-21,86 mol MDA/ml); p=0,020], mas nÃo houve diferenÃas intergrupos. A concentraÃÃo sanguÃnea de glutationa apresentou uma reduÃÃo estatisticamente significante no grupo Caseinato (T0=486,00mol/mlÂ165,80mol/ml) versus T1=451,00Â167,40mol/ml; p=0,047) e nÃo houve diferenÃa no grupo Glutamina, tampouco entre os grupos. Glutamina e glutamato nÃo demonstraram diferenÃas estatisticamente significantes. Conclui-se que a nutriÃÃo enteral suplementada com glutamina em dose nutracÃutica de 30g/dia em pacientes moderadamente graves promove um aumento dos linfÃcitos, contribui para reduzir a peroxidaÃÃo lipÃdica e mantÃm a capacidade antioxidante da glutationa, interferindo de forma benÃfica na modulaÃÃo da resposta inflamatÃria e do estresse, mas nÃo apresenta nenhum efeito sobre a concentraÃÃo de citocinas ou parÃmetros glicolÃticos.

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Peacock, Michelle Ann Nezu Christine M. "Mental illness as a mediator of competent behavior in persons with mental retardation /." Philadelphia, Pa. : Drexel University, 2005. http://dspace.library.drexel.edu/handle/1860/471.

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