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1
Poulson, Robert S. „Treatment heterogeneity and individual qualitative interaction“. Diss., Kansas State University, 2011. http://hdl.handle.net/2097/8568.
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Doctor of PhilosophyDepartment of Statistics
Gary L. Gadbury
The potential for high variability in treatment effects across individuals has been recognized as an important consideration in clinical studies. Surprisingly, little attention has been given to evaluating this variability in design of clinical trials or analyses of resulting data. High variation in a treatment’s efficacy or safety across individuals (referred to herein as treatment heterogeneity) may have important consequences because the optimal treatment choice for an individual may be different from that suggested by a study of average effects. We call this an individual qualitative interaction (IQI), borrowing terminology from earlier work - referring to a qualitative interaction (QI) being present when the optimal treatment varies across ‘groups’ of individuals. At least three techniques have been proposed to investigate treatment heterogeneity: techniques to detect a QI, use of measures such as the density overlap of two outcome variables under different treatments, and use of cross-over designs to observe ‘individual effects.’ Connections, limitations, and the required assumptions are compared among these techniques through a quantity frequently referred to as subject-treatment (S-T) interaction, but shown here to be the probability of an IQI (PIQI). Their association is studied utilizing a potential outcomes framework that can add insights to results from usual data analyses and to study design features to more directly assess treatment heterogeneity. Particular attention is given to the density overlap of two outcome variables, each representing an individual’s ‘potential’ response under a different treatment. Connections are made between the overlap quantified as the proportion of similar responses (PSR) and the PIQI. Given a bivariate normal model, the maximum PIQI is shown to be an upper bound for ½ the PSR. Additionally, the characterization of a conditional PSR allows for the PIQI boundaries to be developed within subgroups defined over observable covariates so that the subset contribution to treatment heterogeneity may be identified. The possibility of similar boundaries is explored outside the normal model using the skew normal distribution. Furthermore, a bivariate PIQI is developed along with its PSR counterpart to help characterize treatment heterogeneity resulting from a bivariate response such as the efficacy and safety of a treatment.
2
Johnson, Patrick R. „The cognitive behavioral treatment of chronic headache : group versus individual treatment format /“. The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487260531956491.
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3
Fick, Sarah Johanna. „Consenting to objectifying treatment? Human dignity and individual freedom“. Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20286.
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Thesis (LLM)-- Stellenbosch University, 2012.ENGLISH ABSTRACT: The purpose of this study was to determine whether an individual can and/or should be allowed to consent to objectifying treatment. This necessitated the determination of the meaning of dignity, the meaning of freedom and the relationship between dignity and freedom. It was found that both the right not to be objectified and the right to consent to objectification could be found within human dignity. This is due to the broad definition of dignity in terms of which dignity has two, sometimes contradicting, components. One component safeguards autonomy and the right to choose, which supports consent to objectification, whereas the other promotes individual self-worth by prohibiting objectifying treatment. By investigating the meaning of freedom it was found that freedom as a constitutional value, and possibly also a free-standing constitutional right, could incorporate the right to consent to objectifying treatment. Three possible solutions to this tension between human dignity and freedom were identified and critically analysed. The first was that an individual cannot and should not be allowed to consent to objectification. This solution is primarily based on the notion that dignity is supreme to freedom and that freedom should yield to communitarian dignity. Furthermore, it is contended that consent to objectification is often invalid due to economic coercion and undue influence. The second possible solution was that, although an individual might not be able to validly consent to objectifying treatment, such consent should still be allowed under certain circumstances. The example of invalid consent due to economic coercion introduced in the previous solution was examined in relation to prostitution. The contention regarding this approach is that, since our government is unable to fulfil the socio-economic needs of those who consent due to economic coercion, such consent should be allowed and strictly regulated. The third possible approach was that circumstances do exist in which individuals can give valid consent to objectification and that in these circumstances they should be allowed to do so. In this solution the grounds of the first approach is criticised by contending, for example, that dignity is not supreme to freedom, that a plural society should allow these type of choices and that consent to objectification is already allowed in some instances. The results of this study were that, although there are situations in which genuine consent is not possible, it can be given under certain circumstances. An individual who cannot give genuine consent to objectification should not be allowed to do so, unless transitional measures dictate otherwise. However, an individual who is capable of giving valid consent to objectification should be allowed to do so. Finally, regardless of whether such consent is genuine or not, strict regulation thereof is required.
AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om vas te stel of 'n individu kan toestem en/of toegelaat behoort te word om toe te stem tot objektiverende behandeling. Dit genoodsaak dat die betekenis van menswaardigheid en vryheid, asook verhouding tussen hierdie twee begrippe vasgestel word. Daar is bevind dat beide die reg om nie te geobjektifeer te word nie en die reg om toe te stem tot objektivering gevind kan word binne die begrip van menswaardigheid. Hierdie is te danke aan die breë definisie van menswaardigheid in terme waarvan menswaardigheid uit twee, soms weersprekende, komponente bestaan. Een komponent beskerm outonomie en die reg om te kies, wat toestemming tot objektivering ondersteun, terwyl die ander komponent individuele waarde bevorder deurdat dit objektiverende behandeling verbied. Tydens die ondersoek aangaande die betekenis van vryheid is bevind dat vryheid as 'n grondwetlike waarde, en moontlik ook 'n vrystaande grondwetlike reg, die reg om toe te stem tot objektiverende behandeling kan inkorporeer. Drie moontlike oplossings vir hierdie spanning tussen menswaardigheid en vryheid is geïdentifiseer en krities ontleed. Die eerste is dat 'n individu nie kan toestem en ook nie toegelaat behoort te word om toe te stem tot objektivering nie. Hierdie oplossing is hoofsaaklik gebaseer op die veronderstelling dat vryheid onderworpe is aan menswaardigheid en dat individuele vryheid moet toegee tot die menswaardigheid van die gemeenskap. Verder word dit beweer dat toestemming tot objektivering dikwels ongeldig is as gevolg van die ekonomiese dwang en onbehoorlike beïnvloeding. Die tweede moontlike oplossing was dat, alhoewel 'n individu nie noodwendig instaat is om geldige toestemming tot objektiverende behandeling te verskaf nie, sodanige toestemming onder sekere omstandighede steeds toegelaat behoort te word. Die voorbeeld van ongeldig toestemming as gevolg van ekonomiese dwang wat in die vorige oplossing bekendgestel is, is ondersoek aan die hand van prostitusie. Die bewering ingevolge hierdie benadering is dat, aangesien ons regering is nie in staat is om die sosio-ekonomiese behoeftes van diegene wat toestem tot objektivering as gevolg van ekonomiese dwang te vervul nie, sodanige toestemming toegelaat en streng gereguleer behoort te word. Die derde moontlike benadering is dat daar wel omstandighede bestaan waar individue geldige toestemming kan gee tot objektivering en dat hulle in hierdie omstandighede toegelaat behoort te word om dit te gee. In terme van hierdie oplossing word die gronde waarop die eerste benadering gebaseer is gekritiseer, deur byvoorbeeld te argumenteer dat menswaardigheid nie verhewe is bo vryheid nie, dat in ons huidige diverse samelewing sulke soort keuses aanvaar behoort te word en dat toestemming tot objektivering reeds in sommige geval toegelaat word. Die resultate van hierdie studie was dat, alhoewel daar omstandighede bestaan waaronder geldige toestemming nie moontlik is nie, dit wel onder sekere omstandighede gegee kan word. 'n Individu wat nie daartoe instaat is om geldige toestemming tot objektivering te gee nie, behoort nie toegelaat word om dit te doen nie, tensy oorgangsmaatreëls anders bepaal. Waar 'n individu egter in staat is om geldige toestemming tot die objektivering te gee, behoort dit toegelaat word. Ten slotte is streng regulering van toestemming tot objektiverende behandeling nodig ongeag of sodanige toestemming geldig is of nie.
4
Wong, Hoi-wa Rachel. „Treatment of word reading in a Cantonese dyslexic individual“. Click to view the E-thesis via HKU Scholars Hub, 2003. http://lookup.lib.hku.hk/lookup/bib/B38890811.
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Thesis (B.Sc.)--University of Hong Kong, 2003."A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, April 30, 2003." Includes bibliographical references (p. 29-30) Also available in print.
5
Ndum, Edwin Andong. „Individual treatment effect heterogeneity in multiple time points trials“. Diss., Manhattan, Kan. : Kansas State University, 2009. http://hdl.handle.net/2097/1602.
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6
Wang, Juan. „Estimation of individual treatment effect via Gaussian mixture model“. HKBU Institutional Repository, 2020. https://repository.hkbu.edu.hk/etd_oa/839.
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In this thesis, we investigate the estimation problem of treatment effect from Bayesian perspective through which one can first obtain the posterior distribution of unobserved potential outcome from observed data, and then obtain the posterior distribution of treatment effect. We mainly consider how to represent a joint distribution of two potential outcomes - one from treated group and another from control group, which can give us an indirect impression of correlation, since the estimation of treatment effect depends on correlation between two potential outcomes. The first part of this thesis illustrates the effectiveness of adapting Gaussian mixture models in solving the treatment effect problem. We apply the mixture models - Gaussian Mixture Regression (GMR) and Gaussian Mixture Linear Regression (GMLR)- as a potentially simple and powerful tool to investigate the joint distribution of two potential outcomes. For GMR, we consider a joint distribution of the covariate and two potential outcomes. For GMLR, we consider a joint distribution of two potential outcomes, which linearly depend on covariate. Through developing an EM algorithm for GMLR, we find that GMR and GMLR are effective in estimating means and variances, but they are not effective in capturing correlation between two potential outcomes. In the second part of this thesis, GMLR is modified to capture unobserved covariance structure (correlation between outcomes) that can be explained by latent variables introduced through making an important model assumption. We propose a much more efficient Pre-Post EM Algorithm to implement our proposed GMLR model with unobserved covariance structure in practice. Simulation studies show that Pre-Post EM Algorithm performs well not only in estimating means and variances, but also in estimating covariance.
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Alldredge, Cameron Todd. „Treatment Failure Rates in Group Versus Individual Treatment Using the OQ-45: An Archival Replication“. BYU ScholarsArchive, 2019. https://scholarsarchive.byu.edu/etd/7471.
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In routine outcome monitoring (ROM), the rate and timing of treatment failure alerts has been related to the success of feedback in past randomized clinical trials. In a recent OQ-45 feedback study, Burlingame and colleagues (2018) found that the rates and timing of not-on-track (NOT) progress alerts in group treatment were different than those reported for individual treatment. Using data from 58 different therapy groups and 374 patients, NOT progress alerts occurred at 186% of the rate reported by Shimokawa et al. (2010) when they examined over 6,000 patients receiving individual therapy at the same clinics. Another significant difference was found on the timing of the first NOT progress alerts with group treatment's first alerts occurring two sessions later than individual treatment. The goal of the current study was to use de-identified archival OQ-45 data from patients receiving group and individual treatment at a comparable clinic to determine if these rate and timing differences were replicable. Data from individual therapy (N = 5,493) and group therapy (N = 146) patients' OQ-45 scores show that the present study duplicated the significant difference found in the rate of NOT alerts between these formats. Relative risk of alerting as NOT at least once in group therapy was calculated to be 1.43 compared to individual therapy (group patients are 143% more likely to alert than individual patients). On the other hand, the present study did not find a significant difference in the timing of first alerts between formats. The implication of these results are significant when considering ROM in group therapy. Patients participating in group therapy are much more likely to flag as not-on-track later during the course of treatment when compared to patients in individual therapy.
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Taylor, Liana. „General Responsivity and Evidence-Based Treatment: Individual and Program Predictors of Treatment Outcomes during Adolescent Outpatient Substance Abuse Treatment“. Diss., Temple University Libraries, 2014. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/308423.
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Criminal JusticePh.D.
Since it was first articulated, the Risk-Need-Responsivity model (RNR; Andrews, Bonta, & Hoge, 1990) has been extensively researched and is regarded as an empirically supported model for providing effective correctional treatment. It is comprised of three core principles: the risk principle, which provides direction for who should receive treatment; the need principle, which identifies intermediate treatment targets; and the responsivity principle, which states how treatment programs should be structured. The RNR model is purported to be relevant for all offender populations, including female offenders (Dowden & Andrews, 1999a), juvenile offenders (Dowden & Andrews, 1999b), violent offenders (Dowden & Andrews, 2000), and sexual offenders (Hanson, Bourgon, Helmus, & Hogdson, 2009). Yet, the majority of RNR research has examined the risk and need principles, and the responsivity principle remains understudied. The responsivity principle includes two sub-principles: general and specific (Andrews, & Bonta, 2010). The current research explored the general responsivity principle, which states that programs should use theoretically relevant models for individual change, specifically cognitive-behavioral and cognitive-social learning models (Andrews & Bonta, 2010). The following techniques are consistent with these models: "role-playing, modeling, repeated practice of alternative behaviors, cognitive restructuring to modify thoughts/emotions, skills building, or reinforcement" (Andrews & Bonta, 2010, p. 50). Despite empirical support, the RNR model has received minimal application to juveniles, and it has not been widely tested in the substance abuse treatment context. Additionally, it is not clear whether adherence to the RNR model is relevant for reducing substance use outcomes in youth. Adolescent substance abuse treatment programs were designed to address substance use among juveniles, and have been widely researched to determine their effectiveness; yet their effectiveness remains understudied among juvenile offenders. These studies include examinations of specific treatment interventions used, such as Multisystemic Therapy. Many of these interventions are considered to be "evidence-based treatment" (EBT), but there is a wide variety of repositories that classify interventions as "evidence-based" with varying criteria used to classify them. The juvenile drug treatment court model (JDTC) was specifically developed to address substance use and crime among juvenile offenders; however, findings from empirical studies have not demonstrated a strong treatment effect. To address these gaps in the literature, secondary analyses were conducted on data collected from 132 adolescent outpatient substance abuse treatment programs (AOPs) and 10 juvenile drug treatment courts nationwide. This research was an application of the general responsivity principle in the AOP and JDTC context to determine the impact of responsivity adherence on the odds of rearrest and substance use severity. The analyses also included an examination of evidence-based treatment (EBT) in both samples to determine the influence of EBT use scores on the odds of rearrests and substance use severity scores. To examine the AOP sample, multilevel models were used to examine the individual- and program-level impact of responsivity adherence and EBT use. To examine the JDTC sample, multivariate analyses were used to examine the individual-level impact of responsivity adherence and EBT use. Overall, responsivity adherence was not significantly associated with rearrests among AOP participants, nor was it significantly associated with substance use severity scores. Additionally, the odds of rearrest were significantly greater among individuals who received interventions with a higher EBT use score; though, there was no association between the average EBT use scores across programs and the odds of rearrest. There was no significant association between individual- and program-level EBT use scores and substance use severity. Among JDTC participants, an increase in responsivity adherence was associated with an increase in the odds of rearrest and substance use severity. A similar association emerged between EBT use scores and both outcomes, wherein increases in EBT use scores were significantly associated with an increase in the odds of rearrest and substance use severity. The results of the analyses suggest the need for further specification of both general responsivity adherence and "evidence-based" treatment for use in future research and theory; specifically, further elaboration of the general responsivity-adherent techniques and clear criteria for classifying interventions as "evidence-based treatment." The findings also imply that certain types of treatment interventions are more compatible with the JDTC model than other interventions. Additional analyses suggest the possibility that general responsivity adherence and evidence-based treatment may not be unique constructs. Future research may benefit through exploring evidence-based treatment as a criterion for adherence to the general responsivity principle.
Temple University--Theses
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Labermaier, Christiana. „Identification of novel candidate genes involved in individual antidepressant treatment response“. Diss., Ludwig-Maximilians-Universität München, 2015. http://nbn-resolving.de/urn:nbn:de:bvb:19-179575.
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10
Donegan, Sarah. „The value of individual patient data for mixed treatment comparison meta-analysis“. Thesis, University of Liverpool, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.570446.
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Numerous treatments can be compared simultaneously using a single mixed treatment comparison (MTC) meta-analysis model that combines all direct and indirect evidence. Three key assumptions underlie MTC methodology: similarity, consistency, and homogeneity. Meta-analysis can be based on individual patient data (IPD) and/or aggregate data. Acquiring IPD will improve the quality of conventional pair-wise meta-analysis in various ways. The value of IPD for MTC meta-analysis is currently unknown. This thesis explores the benefits of using IPD covariate information to assess the underlying assumptions of MTCs. The methodology is illustrated using real IPD from a single multicentre trial that compared artemisinin-based combination therapies (ACTs) for treating uncomplicated malaria in African children. Existing aggregate data MTC meta-analysis models for dichotomous outcomes are extended to allow for patient-level outcomes and covariates. The potential benefits of IPD are evaluated by comparing results from IPD models including treatment by patient-level covariate interactions, with those from aggregate data models including treatment by study-level covariate interactions. The results showed that treatment effects and drug rankings based on IPD, differed from those estimated using aggregate data. The inclusion of patient-level, rather than site-level covariates, produced more precise treatment effects and regression coefficients for the interactions. Therefore, including patient-level covariates was more favourable than including site-level data. A new approach is proposed to determine whether any existing inconsistency is reduced, or explained, following the inclusion of treatment by covariate interactions in the MTC model. The same approach is followed for models involving study-level covariates and models with patient- level covariates. Using aggregate data, results showed that there were too few sites contributing direct evidence to allow consistency to be established when including treatment by covariate interactions. Based on IPD, the regression coefficients for the interactions were estimated from the within-site and across-site interactions and therefore consistency could be determined. Patient- level covariates, rather than site-level data, were clearly beneficial when judging whether inconsistency was reduced by including treatment by covariate interactions in the model. Novel MTC meta-analysis models for a dichotomous outcome are introduced that each combine IPD and aggregate data using a one-stage approach while including treatment by covariate interactions. The methodology is illustrated using the real IPD and a supplementary dataset consisting of aggregate data from a single Cochrane review that also compared ACTs. When MTC models were fitted to the aggregate dataset alone, the results were imprecise and the Markov chain Monte Carlo chains did not convergence. When MTC models were applied to the IPD and when one-stage models were fitted to all data, convergence of the chains was adequate and the credibility intervals for the treatment effects and regression coefficients were much narrower. When exploring treatment by covariate interactions, it was beneficial to obtain IPD, if only for a subset of trials, and to combine the patient-level data with the additional aggregated data in a me ta-analysis model. This thesis has shown that IPD can be extremely valuable in MTC meta-analysis.
11
Sherer, Michelle R. „Individual behavioral profiles and predictors of treatment effectiveness for children with autism /“. Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC IP addresses, 2002. http://wwwlib.umi.com/cr/ucsd/fullcit?p3069223.
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12
Stinson, Jill D. „Is DBT an Effective Treatment for Individuals Convicted of a Sexual Offense?“ Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/8001.
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13
Joy, Adam. „The relationship of individual therapy to depressive symptoms among treatment-seeking homeless men“. Thesis, Pepperdine University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3568592.
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The homeless are a vulnerable group, and research has consistently shown that the homeless experience higher rates of mental disorders, substance abuse, and physical illness than housed persons. Depressive disorders are particularly common among the homeless and have been reported at 2 to 4 times the rate found among housed individuals. The purpose of this study was to examine the relationship of individual therapy to depressive symptoms among treatment-seeking, homeless men attending a residential substance abuse recovery program in an inner-city mission. The participants were 81 men with a mean age of 39.95 years. The sample was ethnically diverse and had a modal educational level of at least some high school. All of the participants had voluntarily sought individual psychological services as an optional component of their substance abuse program in this archival study. Depressive symptoms were measured with the Beck Depression Inventory, Second Edition (BDI-II). De-identified demographic and background information was obtained from the clinical intake form used in this setting. BDI-IIs were administered at intake and following approximately 6 sessions of individual therapy for all participants. Therapy services were provided by clinical psychology doctoral students, under the supervision of licensed psychologists. The sample obtained a mean BDI-II score at intake of 21.68, indicating moderate severity of symptoms; internal consistency reliability was .935. The mean BDI-II score following approximately 6 therapy sessions was 16.36, indicating mild severity; the BDI-II internal consistency reliability at follow-up assessment was .923. As predicted, BDI-II scores were significantly lower at retest. For the men in this study, participation in individual therapy was associated with significant reduction of depressive symptoms. Participants with prominent mood complaints on the clinic intake evaluation form (n = 38) had significantly higher BDI-II scores at intake assessment than individuals with other primary complaints (n = 43), supporting the validity of the BDI-II as a measure of mood symptoms among homeless men. Other findings, clinical implications, limitations, and suggestions for future research are also explored. The results strongly supported the reliability and validity of the BDI-II as a measure of depressive symptoms and psychological distress among treatment-seeking homeless men.
14
Osman, Abdimajid. „Studies on warfarin treatment with emphasis on inter-individual variations and drug monitoring“. Doctoral thesis, Linköping : Linköping University, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med1000s.pdf.
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Cannon, S. „Female breast cancer : The individual experience and social organisation of its diagnosis and treatment“. Thesis, Staffordshire University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384660.
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16
Dahan, Jessica. „Individual Child Cognitive Behavioral Treatment versus Child-Parent Cognitive Behavioral Treatments for Anxiety Disorders in Children and Adolescents: Comparative Outcomes“. FIU Digital Commons, 2013. http://digitalcommons.fiu.edu/etd/963.
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Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers’ use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed.
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Lasher, Michael P., Jon R. Webb, Jill D. Stinson und Peggy J. Cantrell. „Addressing Social Anxiety Concurrently With Prison-Based Sex Offender Treatment: A Case of Individual Needs in an Era of Manualized Treatment“. Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7869.
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Emotional regulation may be an underaddressed therapeutic target in sex offender treatment. This article presents a case report of “Adam,” a Caucasian male referred to a prison-based sex offender treatment program. Adam’s social anxiety was recognized as an antecendent to his sexual offending, and treatment of such, as a critical adjunct to sex offender treatment, is discussed herein. Adam’s individualized treatment included aspects of rational emotive behavior therapy and time-limited dynamic psychotherapy. Adam showed an increased understanding of his anxiety and improvement in his social interactions, both in the context of treatment groups and with female staff, and was willing to continue follow-up care in the community. This case provides support for the individualized treatment of incarcerated offenders as opposed to exclusively utilizing manualized psychoeducational interventions.
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Benjamin, Fatiema. „Exploring the lived experiences of individuals in a substance abuse treatment programme in Cape Town“. University of the Western Cape, 2019. http://hdl.handle.net/11394/7084.
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Magister Artium (Psychology) - MA(Psych)Substance use is a worldwide health concern that has received significant attention as it is often related to deleterious outcomes. Various treatment programmes have been made available to assist people and their families who misuse substances, to aid rehabilitation and equip people with the necessary tools with the aim of preventing possible relapse. The Western Cape Province has been identified as experiencing the highest increase of substance use, with Cape Town being disproportionately affected. Substance use treatment and prevention programmes are therefore an increasingly important means of addressing substance use and related harms. This study aimed to explore the lived experiences of individuals in relation to the treatment they received at a treatment facility in the Cape Town area. As such, the researcher made use of the phenomenological approach as a theoretical framework as it aims to describe the lived experiences of individuals in relation to a particular phenomenon. Furthermore, a qualitative methodological framework was utilised to explore the experiences of individuals who received substance use treatment. Ten participants were purposively selected from an outpatient substance use treatment facility in Cape Town. Focus group discussions were used to collect data and the data were analysed using Interpretive Phenomenological Analysis (IPA). Findings suggest that there were various reasons participants sought treatment. This includes the challenges they experienced in both their personal and occupational lives as well as the realization of the negative effects substance use had on them physiologically. Findings also revealed that the environmental setting individuals were in fostered their treatment; the various aspects of the programme provided by the treatment facility had a significant contribution to their recovery and improved relationships with others; receiving support from family and friends were important in service providers treatment retention as well as individuals ability to identify the changes within themselves since receiving treatment. Overall, results indicate that the treatment programme helped participants in their recovery and enhanced personal relationships, self-perception as well as personal and occupational growth. Findings suggest that there are various reasons as to why people seek treatment and although this may differ, the treatment modality they were provided with contributed substantially to their recovery. Furthermore, this study will contribute to the literature and understanding the ways in which treatment fosters recovery, personal growth and relationships.
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Jones, Elizabeth Murphy. „The Efficacy of Intensive Individual Play Therapy for Children Diagnosed with Insulin-Dependent Diabetes Mellitus“. Thesis, University of North Texas, 2000. https://digital.library.unt.edu/ark:/67531/metadc2636/.
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This study was design to determine the efficacy of intensive individual play therapy as a method of intervention for children diagnosed with insulin-dependent diabetes mellitus. The purpose of this study was designed to study the effectiveness of an intensive play therapy intervention in: a) reducing symptoms of childhood depression in children with IDDM; b) reducing symptoms of anxiety in children with IDDM; c) reducing the overall behavior difficulties in children with IDDM; d) increasing healthy adjustment in children with IDDM; e) increasing diabetic's children's adherence to their diabetic regime; and f) impacting these emotional and behavioral symptoms over time. The 15 children in the experimental group received 12, daily play therapy sessions while attending a summer camp for children with diabetes. The control group, consisting of 15 children who attended the diabetic summer camp, received no play therapy. Children and parents in both groups completed pretest, post-test and three-month follow-up data, consisting of: the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Filial Problems Checklist and the Diabetes Adaptation Scale. Analysis of covariance revealed that the children in the experimental group significantly improved their adaptation to their diabetes following intensive play therapy as reflected by the Diabetes Adaptation Scale. No other hypothesis were retained, although statistical trends noted increased improvement in the experimental group in the areas of behavior difficulties and adherence behavior. Possible explanations for these results include a lack of symptoms reported at the time of pretesting and the validity of these instruments for a chronically ill population. The results of this study indicate that intensive play therapy may be an effective intervention for children diagnosed with IDDM. Qualitative observations and progress noted in therapy reveal that young children with IDDM have the capability to address and resolve issues of anxiety, depression and other emotional issues related to their diabetes in play therapy. Preventative approaches such as play therapy for children with IDDM are particularly important for this population as current behavior patterns and treatment adherence are highly correlated with long-term medical and psychological health.
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Schuller, Kelly L. „The framing effect and breast cancer treatment options do individual characteristics play a role? /“. Morgantown, W. Va. : [West Virginia University Libraries], 2006. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=4629.
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Thesis (Ph. D.)--West Virginia University, 2006.Title from document title page. Document formatted into pages; contains vi, 97 p. : ill. Includes abstract. Includes bibliographical references (p. 56-65).
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Kämppi, A. (Antti). „Identifying dental restorative treatment need in healthy young adults at individual and population level“. Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526209128.
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Abstract Dental caries is one of the most widespread diseases in the world. In the industrialized world the situation improved until the 1990s, after which the good development is claimed to have almost stagnated. One of the aims of this cross-sectional study was to investigate caries prevalence in a young male population. Another aim was to investigate ways to find individuals needing restorative treatment. The hypothesis in this study was that caries prevalence among Finnish young males born in the 1990s was similar or even poorer compared to those born in earlier decades. Polarization of dental caries was still expected to exist. It was also hypothesized that caries prevalence is geographically unevenly distributed in Finland. The Finnish Defence Forces screening protocol was hypothesized to be valid for detecting individuals with restorative treatment need. Finally, it was hypothesized that restorative treatment need at the individual level associates well with a well-chosen set of questions concerning dental symptoms, dental attendance, treatment history and health behaviour. Study material consisted of 255 female and 13,564 male (total n=13,819) conscripts. Anamnestic data, along with information about the socioeconomic status, educational level and place of residence just before military service, were collected with computer-based questionnaire in connection with the oral screening (50 questions and 108 sub-questions). Validity of the screening protocol was evaluated in a sub-population (74 conscripts) examined using both the screening and the ICDAS classification. The screening protocol was validated using the ICDAS criteria and it proved to be well in accord with it considering restorative treatment need at the individual level. The study revealed that on average the conscripts had 1.4 decayed teeth (DT), third molars excluded. The number of decayed, earlier restored or extracted teeth due to caries (DMFT) was 4.1. Ten per cent had about half of the caries lesions and 30% had 90%, suggesting that polarization still exists. It was also found that living in areas with high fluoride content in drinking water, living in urban areas and a Swedish-speaking home municipality were protective factors against dental caries. A positive response to eight questions of a statistically selected set of ten questions reliably predicted restorative treatment need (OR 69.27)Tiivistelmä Karies on yksi maailman laajimmalle levinneistä sairauksista. Menneinä vuosikymmeninä karies väheni merkittävästi aina 1990-luvulle saakka, jonka jälkeen myönteinen kehitys on hidastunut. Tämän tutkimuksen tavoitteena oli tutkia korjaavan hoidon tarpeen määrää nuorten miesten keskuudessa. Tutkimuksen toinen tavoite oli tutkia tapoja erottaa terveistä korjaavan hoidon tarpeessa olevat henkilöt. Tutkimuksen oletuksena oli, että karieksen esiintyvyys 1990-luvun alussa syntyneiden suomalaismiesten joukossa on vastaavalla tai huonommalla tasolla kuin 1970-luvun alussa. Lisäksi oletettiin, että kyseisessä ikäluokassa karies on polarisoitunut. Oletuksena oli myös, että karieksen esiintyvyys on maantieteellisesti epätasaisesti jakaantunut. Tutkimuksessa oletettiin myös, että Suomen Puolustusvoimien käyttämällä suunterveyden seulontamenetelmällä voidaan tunnistaa luotettavasti yksilötasolla korjaavan hoidon tarpeessa olevat yksilöt. Viimeisenä oletuksena oli, että korjaavan hoidon tarve yksilötasolla olisi arvioitavissa seulonnan ja hyvin valitun kysymyspaketin perusteella tutkituissa ikäluokissa. Tämän poikittaistutkimuksen satunnaistettu tutkimusaineisto koostui 13819 varusmiehestä (255 naista ja 13564 miestä) sekä esitietoihin perustuvasta aineistosta joka kerättiin seulonnan yhteydessä tietokonepohjaisella kyselylomakkeella (50 kysymystä ja 108 alakysymystä). Seulonnan tulokset vastasivat hyvin tarkastusta, jossa vauriot diagnosoitiin ICDAS kriteereitä käyttäen. Tutkimus osoitti myös että, keskimäärin yksilöllä oli 1,4 korjaavan hoidon tarpeessa olevaa hammasta viisaudenhampaat pois lukien. Aiemmin korjattujen, karieksen takia poistettujen ja karieksen vaurioittamien hampaiden lukumäärä oli 4,1. Kymmenellä prosentilla tutkimusjoukosta oli puolet kaikista vaurioista ja vastaavasti kolmanneksella tutkituista oli 90 prosenttia kaikista vaurioista. Juomaveden fluoripitoisuus ja asuminen kaupungissa tai ruotsinkielisessä kunnassa olivat suojaavia tekijöitä korjaavan hoidon tarpeen suhteen. Kymmenen esitietokysymystä valittiin tilastollisesti 108 kysymyksen joukosta. Positiivinen, korjaavalle hoidolle altistava, vastaus vähintään kahdeksaan näistä kymmenestä kysymyksestä ennusti luotettavasti (OR 69,27) korjaavan hoidon tarvetta yksilötasolla
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Timmins, Lori L. „Three essays in health economics : determinants of individual health, medical care use, and treatment“. Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/51975.
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This dissertation studies and identifies determinants of individual health. The first chapter analyzes how the supply of medical care affects patient treatment and health outcomes, focusing on how hospitals respond to the loss of a profitable service line. This chapter provides strong evidence that hospital spillovers across service lines are empirically important and that hospitals differentiate treatment by patient payer type. Hospitals practice both revenue augmenting and cost-cutting behavior in other lines of care, targeting specific procedures and payers according to their profitability. Specifically, they increase the number of surgical procedures and perform more marginal surgeries. The effects are concentrated in medical specialties where there are more discretionary surgeries and higher profit margins. Furthermore, hospitals cut back on unprofitable treatment by reducing non-elective admissions and uninsured elective care. Hospitals also increase the intensity of treatment among private payers. The second chapter of this dissertation investigates the demand side of health care, analyzing the role that health insurance plays on primary medical care usage by young American adults. I find office-based physician visits and prescription drugs are not affected by insurance, but dental visits are. There is a small increase in out-of-pocket expenditures caused by insurance loss, concentrated heavily at the top of the distribution. No change in health status or ability to afford care is found. The findings shed light on the expected welfare benefits of recent US health care policies targeting young adults. The final chapter of this dissertation analyzes the extent to which the early childhood environment shapes child health and development outcomes and, specifically, whether universal childcare levels the playing field across children. I analyze the introduction of a universal childcare program in Quebec in 1997, testing its impact on the distribution of child health and development outcomes. I find that there is little heterogeneity in the response to the policy across the distributions of child motor skills and cognitive outcomes. I do, however, find evidence that it led to a reduction in child body weight at the upper end of the distribution.Arts, Faculty of
Vancouver School of Economics
Graduate
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Patterson, Melanie Sian. „Meeting the Learning Needs of Individual Children in the Mainstream Classroom“. Thesis, University of Canterbury. School of Educational Studies and Human Development, 2008. http://hdl.handle.net/10092/2275.
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A teacher in a mainstream classroom identified six children with behaviour difficulties or learning difficulties who were not receiving any assistance outside of the classroom. The teacher was to independently complete a functional assessment of each child to reach a hypothesis about the cause of the difficulty, and then choose and implement an appropriate intervention. Treatment integrity was monitored throughout the interventions to ensure correct implementation. It became apparent that the teacher was unable to complete adequate functional assessments or maintain appropriate interventions because of the time constraints associated with being in a classroom and her lack of specialist knowledge.
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Walby, Gary W. „Associations between individual, social, and service factors, recovery expectations and recovery strategies for individuals with mental illness“. [Tampa, Fla.] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0002203.
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Rogers, Gimel. „Examining therapists' perceptions of barriers to treatment with youth and their families| A mixed methods study“. Thesis, Pepperdine University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3738475.
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The present study identified and quantified five main barriers to treatment categories, deducted first from the qualitative dataset, then consolidated with the results of the quantitative dataset. Clinicians (N=36) that worked with youth and their families participated. The main findings suggested five parent themes (practical obstacles, poor alliance with the therapist, therapist’s perceptions, socioemotional, and cultural ) and seven concept groups (transportation, financial, logistical, attendance, therapeutic relationship, lack of communication, and lack of engagement ). Implications provide strategies to ratify some of these barriers, such as gathering data on youth clients and their families. For the purposes of this study, the terms children, adolescentss, and youth will be used interchangeably and will be defined as any individual under the age of 18.
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Hendryx, Maggie. „A Further Evaluation of Individual and Synthesized Contingencies within Functional Analysis Methods“. Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1505235/.
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A functional analysis (FA) is the most commonly used assessment methodology for identifying maintaining variables influencing problem behavior. However, if an FA does not produce clear differentiation, researchers and practitioners often then modify procedures to include additional individualized variables. The interview-informed synthesized contingency analysis (IISCA) provides a marked departure from FA methodology and aims to include individualized factors at the initiation of the assessment in order to more rapidly produce differentiation and clear results. We sought to further evaluate and compare the outcomes of two different functional analysis methods: the single-contingency functional analysis (FA) and the interview-informed synthesized contingency analysis (IISCA) to determine the function of problem behavior and evaluate the subsequent function-based treatment determined from the functional analysis results with two children diagnosed with autism spectrum disorder (ASD). Both participants engaged in problem behavior maintained by single-contingencies of reinforcement identified within the single-contingency FA and emphasized by the effectiveness of each single-contingency function-based treatment.
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Lo, Yi-Ping. „A new individual-based modelling framework for bacterial biofilm growth applied to cold plasma treatment“. Thesis, Loughborough University, 2013. https://dspace.lboro.ac.uk/2134/12311.
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Biofilms are colonies of bacteria attached to the surface at a solid-fluid interface. Bacteria in biofilm produce exopolysaccharides (EPS) that form a gel-like matrix in which the bacteria are embedded. Biofilms have numerous consequences in industrial and medical settings, both positive (bioreactors, digestion) and negative (blocking, as corrosive damage of materials/devices, food contamination, clinical infection). The use of antibiotics or mechanical clearing can be effective at removing biofilms, but such treatments are not always effective or appropriate in all situations. Recently, non-thermal atmospheric plasma treatments have been proposed as an alternative (or complementary) form of treatment, that can target sites of infection with minimal damage to the surroundings (e.g. host cells in a clinical setting). These plasmas generate a multitude of chemical species, most of which are very short lived, that can infiltrate and diffuse into the biofilm killing the bacteria within. The aim of this thesis is to develop a multi-dimensional mathematical model to investigate the effect of a non- thermal plasma on biofilms in time and space and to identify key factors that determine effectiveness of the treatment. Most of the chemical products of cold plasmas are too short lived, or too reactive, to be effective in killing the biofilms, it is the longer live species, e.g. ozone, hydrogen peroxide, acid species, that penetrated the biofilm and do the most damage. However, the EPS in biofilms is an effective barrier against ozone and hydrogen peroxide. No published biofilm model combines multi-dimensional growth with a detailed description of EPS production, hence a new mathematical model is developed and applied to simulating plasma treatment. The thesis is split broadly into two parts. The first part presents a new biofilm model framework that simulates growth in response to any number of substrates (e.g. nutrient, oxygen). The model combines an Individual based model (IbM) description of bacteria (individuals or clusters) and substrates are described as a continuum. Novel features of the framework are the assumption that EPS forms a continuum over the domain and the explicit consideration of cellular energy (ATP). Simulations of this model demonstrate the contrast between biofilm grown with topical nutrient sources (forming irregular, bumpy biofilm) and basal nutrient source with topical oxygen such as biofilm grown on agar (forming regular spatially uniform biofilms). The former is in broad agreement with experiments whilst the latter, to our knowledge, has been the subject of very little experimental study. The second part extends the modelling framework to consider the effect of the plasma species. The simulations demonstrate that penetration is a key factor in their effectiveness, for which EPS plays a key role in preventing spread within and beyond the plasma treated zone. The simulations provide estimates of the timescale of equilibration of the main plasma species, predict the effect of combining these species and demonstrate how the constituents of the biofilm can change following treatment. A number of recommended suggestions for future theoretical and experimental study are discussed in the conclusions.
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Hodes, Matthew. „The family treatment of adolescent anorexia nervosa : changes in the individual and parental expressed emotion“. Thesis, King's College London (University of London), 2003. https://kclpure.kcl.ac.uk/portal/en/theses/the-family-treatment-of-adolescent-anorexia-nervosa--changes-in-the-individual-and-parental-expressed-emotion(1d361af2-59a4-4820-b02f-e4045e2e2c2c).html.
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Warnqvist, Anna. „Feeling the zeros : Modeling individual responses, measured against time, to treatment of chronic myeloid leukemia“. Thesis, Uppsala universitet, Statistiska institutionen, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-323855.
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In this paper response curves of patients with chronic myeloid leukemia are modeled using one and two-level censored models. Two-level models (also called mixed models) allow random effects and censored models are used to account for the large amount of values too small to be detected. The curves are observed from start of medication to a maximum of 36 months (9 measurement points). The data set is divided into two: "excellent responders" and "other". The "excellent responders" are modeled with a simple cubic censored model, and only one of the background variables measured at time zero ("blasts"), is found to be significant in explaining variation in the change curves, and even this with certain reservations. "Other" are modeled with a cubic two-level censored model and hemoglobin and eosinophile levels, as well as amount of blasts, are significant in explaining variation in this group.
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Temoteo, Rayrla Cristina de Abreu. „Adesão ao tratamento da tuberculose: Aspectos da vulnerabilidade individual e social“. Universidade Estadual da Paraíba, 2015. http://tede.bc.uepb.edu.br/tede/jspui/handle/tede/2319.
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The Directly Observed Treatment objective of strengthening TB treatment adherence, reducing cases of abandonment and increasing the likelihood of cure. The individual and social vulnerability elements can interfere with adherence to this treatment, contextualized in the environment in which the patient is inserted. OBJECTIVE: Analyze the adhesion potential to tuberculosis treatment related to aspects of individual and social vulnerability, in Campina Grande - Paraíba. MATERIAL AND METHOD: Descriptive and analytical study with cross-cut with a quantitative approach. Held in Campina Grande, Paraiba, 2015. They were included as research participants tuberculosis cases treated, diagnosed from September 2014 to February 2015. Performed descriptive analyzes (absolute frequencies, relative rather boxplot graphics), to view the dispersion of data and factor analysis of multiple correspondence, to highlight similarities between data. RESULTS: The lower potential for adherence to tuberculosis treatment evidenced by unfavorable answers to questions such as: impact of tuberculosis on work, conception of causality of health-disease and work process (employment status). Established diagnosis in more than 30 days lack of support treatment at work (or unemployment), negative reaction to the diagnosis, negative impact on the life and lack of family support, were also aspects which have worsened the vulnerability to non-adherence to treatment tuberculosis. CONCLUSIONS: The success of this treatment is conditional on the complexity of each case, considering the family, professional and social (individual and social vulnerabilities). The intersectoral actions aimed at finding facilities in the resolution of this problem.
Elementos de vulnerabilidade individual e social podem interferir na adesão ao tratamento da tuberculose (TB), contextualizados no ambiente o qual o doente está inserido. Os marcadores de adesão, por sua vez, detectam precocemente vulnerabilidades na adesão ao tratamento de doentes com TB, por meio de escores, apresentando forte potencialidade para o monitoramento dessa adesão no âmbito da Atenção Primária à Saúde (APS), aprimorando a vigilância de pessoas com TB. OBJETIVO: Verificar aspectos de vulnerabilidade individual e social relacionados ao diagnóstico e a potencialidade de adesão ao tratamento da tuberculose, em Campina Grande – Paraíba. MATERIAL E MÉTODO: Estudo descritivo, com recorte transversal, de abordagem quantitativa realizado com 39 doentes com tuberculose, em tratamento há no mínimo 30 dias, no município de Campina Grande, no ano de 2015. Foram incluídos como participantes da pesquisa casos de tuberculose em tratamento, diagnosticados no período de setembro de 2014 a fevereiro de 2015. Realizadas análises descritivas (frequências absolutas, relativas, e gráficos boxplot), para visualizar a dispersão dos dados e análise fatorial de correspondência múltipla, para evidenciar similaridades entre os dados. RESULTADOS: O menor potencial para adesão ao tratamento da tuberculose foi evidenciado por respostas desfavoráveis a quesitos como: impacto da tuberculose sobre o trabalho, concepção sobre a causalidade do processo saúdedoença e trabalho (condição empregatícia). Diagnóstico estabelecido em período superior a 30 dias, falta de apoio ao tratamento no trabalho (ou desemprego), reação negativa diante do diagnóstico, impacto negativo sobre a vida e falta de apoio familiar, foram também aspectos que podem potencializar a vulnerabilidade a não adesão ao tratamento da tuberculose. CONCLUSÃO: O sucesso do tratamento está condicionado à complexidade de cada caso, considerando o ambiente familiar, profissional e social (vulnerabilidades individual e social). A intersetorialidade das ações visa encontrar facilidades na resolução dessa problemática. A utilização do instrumento foi importante para evidenciar marcadores em baixo potencial de vulnerabilidade à adesão ao tratamento da tuberculose, evidenciando quais deles necessitam de intervenção, recomendando-se sua utilização na APS para o monitoramento da adesão ao tratamento da TB.
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Peters, Michael S. „Social cognitive skills in socio-emotional and marital adjustment following the diagnosis and treatment of breast cancer“. Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/280641.
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The main purpose of this study was to examine the role of specific social cognitive skills in psychosocial and relational adjustment to a chronic illness. The particular chronic illness investigated in this study was female breast cancer, and 30 married heterosexual couples facing the onset and treatment of breast cancer volunteered to be participants. The study was founded on the premise that chronic illness often presents as much of a social and relational challenge as it does a physical challenge. Based on this premise, the study's central argument was that persons equipped with relatively more sophisticated interpersonal communication skills would receive higher ratings of their communication functioning by their partners, express higher levels of marital satisfaction, and (in the case of wives) exhibit better psychosocial adjustment than would persons with less sophisticated communication skills. A significant association was revealed between participants' construct differentiation and message design logic. Contrary to predictions, no relationship was found between participants' social cognitive skills and partners' ratings of participants' communication functioning, or between participants' social cognitive skills and partners' assessments of global relationship satisfaction. A positive trend for wives and a significant positive association for husbands were found for the predicted relationship between participants' assessments of their partners' communication functioning and their own global relationship satisfaction. Partial support was provided for the predicted associations between wives' social cognitive skills and their own psychosocial adjustment to breast cancer, and between wives' social cognitive skills and their assessments of partners' communication functioning. Additional analyses revealed that wives' global relationship satisfaction was significantly associated with time since diagnosis and disease stage, whereas husbands' global relationship satisfaction was significantly associated with time since diagnosis only. Supplemental analyses also indicated several hypothesis-disconfirming negative associations between participants' social cognitive skills and participants' assessments of partners' communication functioning, global relationship satisfaction, and wives' psychosocial adjustment to breast cancer. These associations were found, however, only for couples wherein partners had highly discrepant construct differentiation scores. Despite providing only mixed support for the study's central argument, the study's results present several interesting findings that warrant further investigation. Intervention implications are also identified.
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Labermaier, Christiana [Verfasser], und Mathias [Akademischer Betreuer] Schmidt. „Identification of novel candidate genes involved in individual antidepressant treatment response / Christiana Labermaier. Betreuer: Mathias Schmidt“. München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2015. http://d-nb.info/1067752439/34.
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Erickson, Christine Johnson. „The effectiveness of functional family therapy in the treatment of juvenile sexual offenders“. [Bloomington, Ind.] : Indiana University, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3330801.
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Thesis (Ph.D.)--Indiana University, Counseling and Educational Psychology Dept., 2008.Title from PDF t.p. (viewed on Jul 23, 2009). Source: Dissertation Abstracts International, Volume: 69-10, Section: B, page: 6409. Adviser: Thomas L. Sexton.
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Tucker, Chamise N. „Examining the effects of individual counseling treatment on a depressed woman who has experienced childhood sexual abuse“. DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1997. http://digitalcommons.auctr.edu/dissertations/1401.
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Previous research has concluded that depression is viewed as the most long-term effect of childhood sexual abuse in combination with selfdestructive behaviors, feelings of isolation, and low self-esteem. A major limitation of the previous research is that there is lack of attention given to the role interventions can play in alleviating depression among women who have experienced childhood sexual abuse (CSA). This study examined the effects of individual counseling treatment on depression in a woman who experienced childhood sexual abuse. This study sought to decrease levels of depressive episodes in a woman who had been victimized during her childhood.
An A/B Single System Design was used to test the effectiveness of individual counseling treatment on depression. To collect data on depression the Costello-Comrey Depression Scale was used and administered to a woman who was recruited by the researcher. The results of the analysis showed that depression was significantly lowered during the intervention phase. Implications for research and social work practice are discussed.
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Oldenburg, Catherine E. „HIV Treatment and Prevention in KwaZulu-Natal, South Africa: Individual, Couple, and Household Effects of Antiretroviral Therapy“. Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27201745.
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In 2015, the World Health Organization (WHO) announced revised guidelines for the treatment of HIV, recommending immediate initiation of antiretroviral therapy (ART) for all HIV-infected individuals worldwide. This recommendation was based on the results of several landmark randomized controlled trials of immediate ART initiation that documented substantial decreases in HIV transmission within couples and improvements in clinical outcomes in individuals. However, the degree to which global scale-up of immediate ART initiation will result in reductions in HIV transmission and gains in life expectancy depends on real-world effectiveness. Outside of trials, a large proportion of HIV-infected individuals do not know their status and resource constraints can affect the supply of ART.
Using the Africa Centre for Population Health’s demographic and HIV surveillance program, a population-based open cohort that has been conducting annual surveillance since 2000, this dissertation evaluates the effectiveness of ART in a real-world setting at multiple levels, including for individuals, within couples, and in households. First, this dissertation analyzes the effect of ART uptake in serodiscordant couples in the risk of HIV acquisition by the uninfected partner. Second, the effectiveness of immediate eligibility for ART on household-level HIV acquisition is assessed. Finally, the effect of immediate ART eligibility and uptake on survival in HIV-infected individuals is examined using two causal modeling approaches.
ART was found to be highly effective at preventing new infections and reducing mortality in a hyperendemic region of rural KwaZulu-Natal. In serodiscordant couples, the use of ART was associated with a 77% reduction in HIV acquisition in this cohort, a dramatic decrease in HIV transmission despite the severe resource constraints of the area. As expected, the effect in households where not all members are sexual partners was less pronounced, with a 53% reduction in HIV transmission. Finally, the use of ART led to a 35-40% decrease in all-cause mortality. Taken together, these results indicate a strong protective effect of ART outside of a tightly controlled clinical trial setting. The scale-up of immediate ART eligibility and initiation in Sub-Saharan Africa likely will lead to significant reductions in the HIV epidemic and in the survival of HIV-infected individuals.
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Austin, Ashley. „Treatment attrition among racial/ethnic minority adolescents participating in a brief motivational intervention for substance use problems : the influence of individual, social, cultural, and treatment factors“. FIU Digital Commons, 2007. http://digitalcommons.fiu.edu/etd/1337.
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The present study has the primary aim of examining the predictors of treatment attrition among racial/ethnic minority adolescents with substance use problems. This study explores the potential differential influence of specific individual, social, cultural, and treatment factors on treatment attrition within three racial/ethnic subgroups of adolescents. Participants: A unique feature of the study is the use of a racial/ethnic minority sample (N=453), [U.S.-born Hispanics (n = 262), Foreign-born Hispanics (n = 117), and African- Americans (n = 74)]. Multivariate logit analyses were used to examine the influence of specific factors on treatment attrition among the full sample of adolescents, as well as within each racial/ethnic subgroup. Consistent with expectations, multivariate logit analyses reveal that, the specific factors associated with attrition varied across the three racial/ethnic subgroups. Having parents with problem substance use, being on the waitlist, and being court mandated to treatment emerged as predictors of attrition among the US-born Hispanics, while only Conduct Disorder was significantly associated with greater attrition among foreign-born Hispanics. Finally, among African-Americans, parental crack/cocaine use, parental abstinence from alcohol, and being on the waitlist were predictive of attrition. Multiple factors were associated with treatment attrition among racial/ethnic minority adolescents with specific factors differentially predicting attrition within each racial/ethnic subgroup. African-American youth were more than twice as likely as their Hispanic counterparts to leave treatment prematurely. It is critically important to understand the predictors of attrition among racial/ethnic minority youth in order to better meet the needs of youth most at risk of dropping out.
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Trottier, Haley C. „THE EFFECT OF SPEECH THERAPIST PRESENTATION STYLE ON RATINGS OF SATISFACTION WITH THERAPIST AND LIKELY ADHERENCE TO TREATMENT“. Ohio University Honors Tutorial College / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1461332893.
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Salaminiou, Evangelia Eva. „Families in multiple family therapy for adolescent anorexia nervosa : response to treatment experience and family and individual change“. Thesis, King's College London (University of London), 2005. https://kclpure.kcl.ac.uk/portal/en/theses/families-in-multiple-family-therapy-for-adolescent-anorexia-nervosa--response-to-treatment-experience-and-family-and-individual-change(0821fff6-e4d4-4111-b843-6a0aa6bff85c).html.
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Ballard, Jaime Elizabeth. „Cost-Effectiveness of Treating Pervasive Developmental Disorders: A Comparison by Treatment Modality“. BYU ScholarsArchive, 2013. https://scholarsarchive.byu.edu/etd/3925.
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This study examined the costs of pervasive developmental disorder (PDD) treatment in a large healthcare organization. When compared to individual therapy and mixed therapy, family therapy had significantly fewer sessions, fewer episodes of care, and better cost-effectiveness. Individual therapy had significantly shorter treatment length than mixed therapy. There were no differences in treatment length or number of episodes by license, but dropout and cost-effectiveness were significantly different. Medical doctors had the highest dropout and best cost-effectiveness, while Marriage and Family Therapists had the lowest dropout and Masters of Social Work had the poorest cost-effectiveness. Children had significantly higher dropout than other age groups. An autism diagnosis was associated with fewer sessions but additional episodes of care when compared to PDD. Having a comorbid diagnosis is associated with longer treatment length but slightly fewer episodes of care. A regression model to predict number of episodes of care by intensity of treatment, provider type, and modality, intensity of treatment explained only 6% of the variance.
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Gadon, Lisa Alexandre. „Identification and management of prodromal symptoms in bipolar affective disorder : the role of individual, disorder, and treatment-related factors“. Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5712.
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Background: Traditional psychosocial treatments have been adapted for use with individuals with bipolar affective disorders due to the limited prophylactic nature of pharmacotherapy and the recognition of the role of psychosocial factors in the course of this disorder. Psychosocial interventions that include a prodromal monitoring and management component have been empirically shown to be an effective adjunct to medication for the treatment of bipolar disorder. Aims: There is a deficit of quantitative research that examines the impact of individualrelated (e.g. age, self-efficacy), disorder-related (e.g. time since diagnosis, experience of prodromal symptoms) and treatment-related (e.g. level of psychosocial input) factors on individuals’ ability to manage this disorder via the use of prodromal monitoring. The current research aimed to investigate factors that are associated with the identification and management of prodromal symptoms. Method: Participants completed five self-report measures in order to provide information on their experience of prodromal symptoms, current mood state, general self-efficacy, view of social support from significant others, and demographic and clinical-related variables. The data were collected from 101 participants, 58 of whom were female. The sample consisted of individuals with a diagnosis of bipolar disorder type I and II. Results: Univariate and bivariate analyses were used to explore the relationship between individual, disorder, and treatment-related variables associated with participants’ experience of bipolar disorder. Variables that were significantly associated with participants’ perception of their ability to identify and manage prodromes were further investigated using ordinal logistic regression analyses. The results indicated that general self-efficacy and prodromal-specific help from significant others were associated with an increase in participants’ perception of their ability to identify manic and depressive prodromal symptoms. General self-efficacy was also associated with participants’ view of their ability to manage cognitive and behavioural prodromes. Experience of prodromal symptoms (e.g. consistency of symptoms experienced, type of prodrome experienced) was associated the participants’ perception of their ability to identify and manage prodromes. In general, disorder-related variables (e.g. time since diagnosis, mood state, diagnosis type, and number of episodes experienced) were not significantly associated with the participants’ view of their ability to identify and manage prodromal symptoms. Individual-related variables such as gender and age, however, were associated with prodromal identification. Conclusion: The results indicated the need to consider constructs such as general selfefficacy and experience of prodromal symptoms (e.g. consistency of symptoms, types of prodromes experienced, and ability to recognise prodromes when they first present) when helping patients to learn how to identify and manage prodromal symptoms. In addition gender differences and the role of help from significant others were highlighted as variables that should be considered when using prodromal monitoring approaches with patients with bipolar disorder. Limitations of the research are reviewed in relation to the methodology used. Clinical implications and directions for future research are considered.
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Hagey, Derek Willis. „Collaborative treatment of erectile dysfunction: thoughts from the membership of the Sexual Medicine Society of North America“. Diss., Kansas State University, 2012. http://hdl.handle.net/2097/13791.
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Doctor of PhilosophyDepartment of Family Studies and Human Services
Sandra Stith
Recent years have seen a rise in the medicalization of treatments for erectile dysfunction (ED). While there has been a divide between the medical and psychological communities, some have called for a more collaborative relationship. Little research has been done on the collaboration between medical professionals and psychotherapists in treating ED. This study seeks to increase current knowledge about medical professionals’ referral practices and communication post-referral. An online survey was developed and distributed to the members of the Sexual Medicine Society of North America (SMSNA) (N = 541). Survey questions inquired as to the factors that increased participants’ willingness to refer ED patients, the form of communication participants currently desire to have with psychotherapists and the participants’ desired level of communication with psychotherapists to whom they might refer. Less than ten percent of the medical professionals invited to participate in the study completed the survey (n=50). Those who did complete the survey were primarily male, specialized in urology and practiced in the U.S. Almost half the respondents were employed in an academic setting while just over half of respondents worked in hospital-based, group, or solo practices. Just over half of the survey participants practiced in urban areas. Although the number of medical professionals who completed the survey was small, findings indicated that those who completed a sexual medicine fellowship and who had a larger percentage of their patient population being seen for ED were more likely to refer patients to psychotherapists. Participants who have referred ED patients to psychotherapists reported little-to-no communication between them and the psychotherapists to whom they refer. The study participants expressed a desire to refer patients to psychotherapists who are experienced in working with both sexual and couples issues. Questions about the desires and experiences of medical professionals who have not referred to psychotherapists were not able to be answered because of the limited number of these individuals in the data set. Although the number of participants who completed the survey limits the generalizability of the data, this study demonstrates that most medical professionals who responded to the survey are willing to refer ED patients to psychotherapists.
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Romano, Elisa. „Evaluation of a multi-component individual treatment intervention for adult males with histories of sexual abuse : a multiple-baseline approach“. Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0006/NQ41624.pdf.
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West, Aimee Michelle. „Child behavioral severity and parents' perceptions of the effectiveness and likelihood of seeking behavioral health treatment“. Thesis, Kent State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1555280.
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Objective: Although externalizing behavior problems are the most common problems in childhood, most remain untreated. Identifying factors related to treatment use can help close the gap between need and utilization. This study examined how the severity of a child's behavioral symptoms moderates the relationship between parents' perceptions of treatment effectiveness and the likelihood of using offered treatments.
Method: Participants were 182 parents of three to eight year old children attending primary care pediatric visits in five Midwestern community-based practices. Parents completed questionnaires rating the perceived effectiveness of the treatment, likelihood of utilizing the treatment, and the Pediatric Symptom Checklist.
Results: Separate linear regressions were conducted for four treatment types. Child behavior moderated the relationship between parental perceived effectiveness and likelihood to use prescription medication, p < .05. Parents of children with more severe behavior problems were more likely to use prescription medication than parents of children without severe behavior problems, and likelihood to use prescription medication had a weaker relationship with believing it will work than for other parents. For parents of children with less severe behavior problems, belief in the effectiveness of prescription medication was positively associated with likelihood to use. All other regressions were not significant.
Discussion: The impact of perceived effectiveness of prescription medication on likelihood to use it varies depending on the severity of a child's behavioral symptoms. Parents of children without a clinically-significant behavior problem need to believe in prescription medication's effectiveness in order to increase their likelihood to use it.
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Deavers, Frances. „Modeling Risk for Sexually Transmitted Infections in Women in a Court-Ordered Substance Treatment Program“. Master's thesis, University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6264.
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Developing a comprehensive model of Sexually Transmitted Infection (STI) risk factors and their inter-relationships is vital to improving methods of risk identification and treatment delivery. The CDC posed three general categories that may serve as a framework for such a model: sexual network, individual behavior, and social/ structural risk. None of the extant risk models incorporate measures from all three categories. Additionally, none of these models, generally focused on individual behavior, use medical data on infection as their outcome variable. This is problematic because the ultimate outcome of infection is also influenced by sexual network and social/ structural variables, in addition to individual behaviors. Therefore the current study aimed to develop a comprehensive model of risk incorporating sexual network, individual behavior, and social/ structural risk variables, using medical data on infection status as the outcome variable. The sample consisted of 506 women in a court-ordered substance treatment program. An Exploratory Factor Analysis provided preliminary evidence for a three factor model corresponding to the CDC framework. However, a Confirmatory Factor Analysis failed to confirm this model. Additionally, a logistic regression suggested that this model has limited clinical utility for this sample. Future studies may more conclusively determine the importance of various STI risk variables, the relationships between them, and whether they mirror the CDC theoretical framework. With rates of infection still high in the United States, and even increasing among women for certain STIs, this is a critical public health issue that should continue to be examined.M.S.
Masters
Psychology
Sciences
Clinical Psychology
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Cully, Laura Marie. „Predictors of Intimate Partner Violence among Women Seeking Treatment for a Substance Use Disorder“. The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu152267976367848.
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Rich, Benjamin. „Optimal dynamic treatment regime structural nested mean models: improving efficiency through diagnostics and re-weighting and application to adaptive individual dosing“. Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114179.
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Dynamic treatment regimes are common in medicine, for example in the treatment of chronic diseases. As information about a patient is gathered over time, it is desirable to make use of this accumulating information to make treatment decisions that are specifically tailored to the individual patient, or to base decisions on dynamically evolving observations. Dynamic treatment regimes have been the topic of much recent work in the area of causal inference. In particular, semi-parametric methods for estimating a "best" or "optimal" treatment rule or strategy from observational data have been developed. One such method proposed by Robins is the optimal dynamic treatment regime structural nested mean model (ODTR-SNMM) and associated g-estimation procedure. Of significant concern when applying this methodology are the modelling assumptions involved. In this work, checking of modelling assumptions using residual and influence diagnostics as is typically done in a traditional regression setting is extended to the ODTR-SNMM. The methodology is evaluated on simulated data under different model specification settings. These ideas are also applied to real data from a breastfeeding cessation study. Subsequently, partially misspecified models, which give rise to consistent though inefficient estimation of the parameter of interest due to misspecification of a nuisance model, are considered. In addition to the possibility of addressing partial misspecification through the proposed diagnostic techniques, re-weighting is considered as a means of improving the efficiency of estimators under these modeling assumptions. A re-weighting approach based on sample influence is proposed and studied with simulations. Finally, the application of optimal dynamic treatment regimes estimation to adaptive dosing strategies for drugs with narrow therapeutic windows and highly variable dosing is considered. Using oral anticoagulation therapy as a motivating example, a simulation is designed using realistic pharmacokinetic (PK) and pharmacodynamic (PD) models to generate the data. A modelling approach for ODTR-SNMM with continuous dosing is proposed and applied to the PK/PD simulated data. The performance of various models under different settings is compared.Les régimes de traitement dynamiques sont utilisés fréquemment en médecine. Nous les retrouvons, par exemple, dans le traitement des maladies chroniques. Alors que l'information obtenue chez un patient est récupérée dans le temps, il est souhaitable d'utiliser cette information afin de pouvoir faire des décisions de traitement qui sont adaptées à chaque patient, ou de pouvoir baser des décisions de traitements sur des observations qui évoluent. Les régimes de traitement dynamiques ont fait le sujet de travaux récents dans le domaine de l'inférence causale. Plus particulièrement, des méthodes semi-paramétriques ont été développées pour estimer, à partir de données non expérimentales, la règle de traitement ou la stratégie la meilleure ou optimale. Une de ces méthodes, proposée par Robins, est le modèle moyen structurel emboîté pour régime de traitement optimal dynamique (Optimal Dynamic Treatment Regime Structural Nested Mean Model : ODTR-SNMM) et la procédure g-estimation associée. Les suppostitions impliquées dans la modèlisation sont une préoccupation importante lors de l'application de cette méthodologie. Dans cette thèse, la vérification des suppositions de modélisation en utilisant les diagnostics résiduels et d'influence, normalement réalisée dans une analyse de régression traditionelle, est étendue à l'approche ODTR-SNMM. La méthodogie est évaluée en utilisant des données simulées, obtenues à partir de différents réglages de simulation. L'approche est aussi mise en application dans une étude d'arrêt d'allaitement. Par la suite, nous considérons des modèles partiellement mal spécifiés qui engendrent une estimation cohérente mais inefficace du paramètre d'intérêt en raison de la mal spécification du modèle de nuisance. En plus de la possibilité de traiter les mal spécifications partielles par les méthodes de diagnostic proposées, la repondération est considérée comme façon d'améliorer l'efficacité des estimateurs sous ces suppositions de modélisation. Une méthode de repondération basée sur l'influence des échantillons est proposée et étudiée par simulations. Finalement, nous considérons l'application de l'estimation des régimes de traitement dynamiques optimaux sur les stratégies de dosage adaptatifs pour les médicaments ayant une marge thérapeutique étroite et un dosage hautement variable. Utilisant l'anticoagulothérapie orale en exemple, nous concevons une simulation dans laquelle les données sont réalisées à partir de modèles pharmacocinétique (PK) et pharmacodynamique (PD) réalistes. Une technique de modélisation pour l'ODTR-SNMM avec dosage continu est proposée et appliquée aux données PK et PD simulées. Nous comparons la performance de plusieurs modèles utilisant différent réglages.
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Mattei, Stephanie Beth. „Attachment theory as a model for developing new therapeutic strategies and interventions in the individual treatment of sexual abuse in children“. View full text, 2001.
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Mickelson, Bryan K. „Client Change in Multi-Model Treatment: A Comparison of Change Trajectories in Group, Individual, and Conjoint Formats in a Counseling Center“. Diss., CLICK HERE for online access, 2008. http://contentdm.lib.byu.edu/ETD/image/etd2758.pdf.
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Edwards, Emily A. „GROUP COGNITIVE BEHAVIORAL THERAPY OVER INDIVIDUAL COGNITIVE BEHAVIORAL THERAPY? A META-ANALYSIS OF EFFECTIVE TREATMENT OF ANXIETY DISORDERS IN MIDDLE CHILDHOOD“. CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/236.
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Anxiety is a commonly diagnosed disorder in middle childhood that affects many aspects of the child’s life. Effective treatment is needed so that children are able to experience fewer or no symptoms of anxiety and to manage anxiety. Cognitive behavioral treatment (CBT) is widely used as a treatment for children with anxiety. CBT can either be facilitated in an individual or group format but there are inconsistencies in the literature regarding which modality is most effective. A meta-analysis was conducted to compare the effectiveness of individual CBT (ICBT) and group CBT (GCBT) in treating school-aged children with anxiety disorders. Eligible studies focused on the Coping Cat program for ICBT or GCBT programs such as FRIENDS. Participants from the selected studies were between the ages of 5-12 years and were treated by either ICBT or GCBT. Effect sizes were calculated from post-intervention measures and combined to examine group differences. It was found that ICBT was associated with a very large effect size (1.05) and GCBT (0.54) had a large effect size. This suggests that ICBT is the superior treatment modality as children who received individualized treatment reported a greater reduction or elimination of anxiety symptoms. Individual treatment allows opportunity for the therapist to work with the child and their families whereas in GCBT, there is less time to create treatment plans that are uniquely tailored. A proposed ICBT program is outlined that addresses a richer family component and social skills training.
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Gilbert, Alexandra Jane. „Optimising individual treatment regimes and patient outcomes through the use of patient-reported toxicity assessments in patients treated with pelvic radiotherapy“. Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/13268/.
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The primary objectives of this thesis are to develop a systematic method for patients to self-report pelvic radiotherapy adverse events (AE) using electronically collected patient reported outcomes (PROs) in clinical practice and to evaluate patient-reported toxicity in association with radiotherapy dosimetric data and clinical factors. Before testing the research objectives in two observational studies, important practical and methodological issues were addressed. Analysis from systematic and literature reviews, content analysis of three validated PRO systems and interviews with health professionals found the European-Organisation-for-Research-and-Treatment-of-Cancer-Quality-of-Life-Questionnaires (EORTC-QLQ) C30 and cancer-specific modules to have the most effective coverage of acute and late AE for patient treated with radiotherapy for anal, rectal, endometrial and cervical cancer. Qualitative analysis of patient cognitive interviews found the EORTC-QLQ system was acceptable to patients and revealed discrepancies in toxicity grading between patient and clinician (using the Common-Terminology-Criteria-of-Adverse-Events (CTCAE)) might be due to inherent differences in the grading descriptions between the scoring systems. Electronic methods for collection and presentation of PRO data were developed alongside technology to improve clinical data capture from electronic health records (EHR). A pilot study of 31 patients proved it was feasible to collect electronic and paper PRO data and integrate results into individual EHRs. A protocol for organ at risk (OAR) contouring and methods used for dose-volume-histogram (DVH) export were developed. The cross sectional (n=315) and prospective studies (n=129) found bowel urgency and sexual dysfunction to be the late AE most commonly reported by patients. The cross sectional study piloted the application of principal component analysis to describe DVH data from patients treated with multiple radiation techniques and demonstrated associations between PRO late toxicity and dosimetric and clinical data. The prospective study interim analysis found resolution of many treatment-related symptoms by six-months and provided encouraging findings for the use of longitudinal PRO collection in routine practice.