Dissertations / Theses: 'Clinical Course'

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Vento, Seija. "Nasal polypoid rhinosinusitis : clinical course and etiological investigations." Helsinki : University of Helsinki, 2001. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/vento/.

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Chang, Phoebe. "Clinical Course of Rattlesnake Bite Victims Treated without Antivenom." Thesis, The University of Arizona, 2018. http://hdl.handle.net/10150/626846.

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Stenberg, Maud. "Severe traumatic brain injury : clinical course and prognostic factors." Doctoral thesis, Umeå universitet, Rehabiliteringsmedicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119826.

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Traumatic brain injury (TBI) constitutes a major health problem and is a leading cause of long-term disability and death. Patients with severe traumatic brain injury, S-TBI, comprise a heterogeneous group with varying complexity and prognosis. The primary aim of this thesis was to increase knowledge about clinical course and outcome with regard to prognostic factors. Papers I, II and III were based on data from a prospective multicentre observational study from six neurotrauma centers (NCs) in Sweden and Iceland of patients (n=103-114), 18-65 years with S-TBI requiring neurosurgical intensive care or collaborative care with a neurosurgeon (the “PROBRAIN” study). Paper IV and V were performed on a regional subset (n=37). In Paper I, patients with posttraumatic disorders of consciousness (DOC) were assessed as regards relationship between conscious state at 3 weeks and outcomes at 1 year. The number of patients who emerged from minimally conscious state (EMCS) 1 year after injury according to status at 3 weeks were: coma (0/6), unresponsive wakeful syndrome (UWS) (9/17), minimally conscious state (MCS) (13/13), anaesthetized (9/11). Outcome at 1 year was good (Glasgow Outcome Scale Extended (GOSE>4) in half of the patients in MCS (or anaesthetized) at 3 weeks, but not for any of the patients in coma or UWS. In Paper II, the relationships between clinical care descriptors and outcome at 1 year were assessed. A longer length of stay in intensive care, and longer time between discharge from intensive care and admission to inpatient rehabilitation, were both associated with a worse outcome on the GOSE. The number of intervening care units between intensive care and rehabilitation, was not significantly associated with outcome at 1 year. In Paper III, the clinical course of cognitive and emotional impairments as reflected in the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS) were assessed from 3 weeks to 1 year together with associations with outcomes GOSE and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R) at 1 year. Cognition improved over time and appeared to be stable from 3 months to 1 year. In Paper IV, clinical parameters, the clinical pathways from injury to 3 months after discharge from the NC in relation to outcomes 3 months post-injury. Ratings on the RLAS-R improved significantly over time. Eight patients had both “superior cognitive functioning” on the RLAS-R and “favourable outcome” on the GOSE. Acute transfers to the one regional NC was direct and swift, transfers for postacute rehabilitation scattered patients to many hospitals/hospital departments, not seldom by several transitional stages. In Paper V, an initial computerized tomography of the brain (CTi) and a further posttraumatic brain CT after 24 hours (CT24) were evaluated according to protocols for standardized assessment, the Marshall and Rotterdam classifications. The CT scores only correlated with clinical outcome measures (GOSE and RLAS-R) at 3 months, but failed to yield prognostic information regarding outcome at 1 year. A prognostic model was also implemented, based on acute data (CRASH model). This model predicted unfavourable outcomes for 81% of patients with bad outcome and for 85% of patients with favourable outcome according to GOSE at 1 year. When assessing outcomes per se, both GOSE and RLAS-R improved significantly from 3 months to 1 year. The papers in this study point both to the generally favourable outcomes that result from active and aggressive management of S-TBI, while also underscore our current lack of reliable instruments for outcome prediction. In the absence of an ability to select patients based on prognostication, the overall favourable prognosis lends support for providing active rehabilitation to all patients with S-TBI. The results of these studies should be considered in conjunction with the prognosis of long-term outcomes and the planning of rehabilitation and care pathways. The results demonstrate the importance of a combination of active, acute neurotrauma care and intensive specialized neurorehabilitation with follow-up for these severely injured patients.

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Nakatani, Eiji. "Specific clinical signs and symptoms are predictive of clinical course in sporadic Creutzfeldt-Jakob disease." Kyoto University, 2016. http://hdl.handle.net/2433/217720.

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Andersson, Gerhard. "Clinical Aspects of Tinnitus- Course, Cognition, PET, and the Internet." Doctoral thesis, Uppsala University, Department of Surgical Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-539.

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The purpose of this thesis was to develop novel ways to study tinnitus, to investigate the course of tinnitus, and to study the effects of cognitive-behaviour therapy on tinnitus related distress. Data from 377 tinnitus patients were collected.

A group of 216 patients completed audiological measures and were assessed in a structured interview. The Klockhoff and Lindblom's grading system was used and its inter-rater reliability assessed in a subsample showing a high degree of correspondence. A discriminant analysis showed that a substantial proportion of patients could be correctly classified into grade II or III, by measures of pitch, minimal masking level of tinnitus, avoidance of situations because of tinnitus, and tolerance in relation to onset.

Using tests developed in cognitive psychology, it was found that tinnitus patients had impaired performance. There was no evidence for an attentional bias towards tinnitus related words using a computerized emotional Stroop task, but masking sounds of an "on-and-off" character were more disruptive than constant masking when patients performed the digit-symbol test. It is suggested that tinnitus distress may be increased by the 'changing-state' character of the tinnitus signal, or alternatively by intermittent masking sounds.

In a case-study a patient received an i.v. injection of lidocaine while Positron Emission Tomograpy was conducted. The brain activity associated with tinnitus included the left primary, secondary and integrative auditory brain areas, as well as right paralimbic areas related to negative feelings. The precuneus (Brodmann area 7) might be a brain area involved in the aversiveness associated with tinnitus.

Using a tinnitus questionnaire as the dependent measure it was found that tinnitus maskability at admission predicted distress at follow-up for an average of five years following admission. Some improvement in tinnitus occurred over time, but this was more evident in patients who had received a cognitive-behavioural treatment program.

The effect of an Internet based cognitive-behavioural self-help treatment program for tinnitus was investigated showing a high dropout rate, but with positive results in that the treated patients improved.

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TOMODA, YUTAKA, HIROSHI SAKAIDA, SETSUKO GOTO, SEIJI NOMURA, TORU NAKANISHI, and TOMOMITSU OKAMOTO. "An Unusual Clinical Course after Mole Evacuation: A Case Report." Nagoya University School of Medicine, 1997. http://hdl.handle.net/2237/16752.

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Zhulina, Yaroslava. "Chrohn's disease : aspects of epidemiology, clinical course, and faecal calprotectin." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-49436.

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The overall aim of this thesis was to study epidemiological and clinical changes in the natural history of Crohn’s disease, its phenotype, the need for surgery and pharmacological therapy over time, as well as the role of faecal calprotectin as a biomarker of pathophysiology and disease course. An increased incidence and prevalence of Crohn’s disease was seen in the period 1963-2010. The proportion of patients with non-stricturing, non-penetrating disease behaviour at diagnosis increased, suggesting that either patients with Crohn’s disease are diagnosed earlier in their disease course today or that the Crohn’s disease phenotype is changing. A decrease in complicated disease behaviour, an increased use of immunomodulators, and a reduced frequency of surgical procedures five years after Crohn’s diagnosis was observed. The decrease in surgery at five years seemed to be explained mainly by a decrease in early surgery within three months from diagnosis, likely reflecting an increased proportion of patients with non-stricturing, non-penetrating disease. This suggests that the introduction of new treatment alternatives alone does not explain the reduction in surgery rates, and an increasing proportion of patients with uncomplicated disease at diagnosis may also play an important role. Subclinical mucosal inflammation, mirrored by increased NFkB activity and increased neutrophil activity (i.e. FC and MPO expression), was observed in healthy twin siblings in both discordant monozygotic and discordant dizygotic twin pairs with IBD. These findings strongly support the hypothesis of an ongoing subclinical mucosal inflammation at the molecular level in healthy first-degree relatives of IBD patients. Baseline FC as well as consecutive FC measurements predict relapse in IBD. The doubling of FC value increased the risk of relapse by 101% in the following three months. This increased risk attenuates with time by 20% for every three month period since the sample was obtained.

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Liebrich, Walter. "Expert evaluation of an on-line course in clinical immunology." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96006.

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Thesis (MPhil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: This assignment describes an evaluation by experts of an on-line course in Clinical Immunology offered to medical registrars and scientists as a supplement to a practical rotation. Because of a lack of agreement on what constitutes quality in e-learning and to avoid the customary focus on usability evaluation, an open-ended, interpretivist approach was used here which, while not entirely novel, was unusual in an e-learning environment. For this project it was decided to evaluate both content (subject matter) as well as instructional value using two groups of peers from various academic institutions, clinical immunology experts and e-learning experts. Feedback was obtained through participation in a focus group or in writing. Replies were much easier to obtain from the e-learning group. Five out of seven e-learning experts provided a response, versus three out of twenty subject matter experts. Eventually most of the feedback was obtained from colleagues from the home institution. Both groups made valuable, somewhat overlapping suggestions. Subject matter experts indicated that the course materials were of good quality and adequate on a postgraduate level. E-learning experts expressed concern about the ability of the course to facilitate learning and identified also some usability issues. Some of the findings may well apply to other settings. A number of five evaluators in each group appeared to give a good coverage within an open-ended approach. Expert peer review offered insights that neither student feedback nor self-reflection could. Rather than imposing evaluative criteria on the experts through the use of fixed checklists, the open-ended approach allowed them to cumulatively develop their own framework tailor-made for the course. The choice of subject matter plus e-learning experts may be helpful in similar situations of evaluating on-line courses where dual expertise is not readily available. The open-ended interpretivist approach can be used for formative evaluation only and may work well for courses that are still in development or where an amount of uncertainty about teaching effectiveness exists. Future efforts will likely focus on implementing the recommendations, identifying sustainable ways of quality review for the current course and similar open-ended evaluation of other courses.
AFRIKAANSE OPSOMMING: Die evaluering deur kundiges van ’n aanlyn-kursus in Kliniese Immunologie word in hierdie opdrag bespreek. Hierdie kursus word bykomend tot ‘n praktiese rotasie vir kliniese assistente (medies) en wetenskaplikes aangebied. Aangesien daar nie eenstemmigheid is oor wat gehalte in e-leer behels nie, en om die gebruiklike fokus op die evaluering van gebruiksmoontlikhede te vermy, is ’n interpreterende benadering in hierdie geval gebruik. Alhoewel hierdie benadering nie heeltemal nuut is nie, is die gebruik daarvan ongewoon in die eleer- omgewing. Daar is besluit om vakinhoud sowel as onderrigwaarde in hierdie projek te evalueer. Twee ewe-kniegroepe van verskillende akademiese inrigtings, kundiges in kliniese immunologie sowel as kundiges in e-leer is gebruik. Terugvoer is ontvang deur die deelname aan fokusgroeponderhoude of deur skriftelike terugvoer. Terugvoer is makliker van die e-leergroep verkry. Vyf uit die sewe e-leerkundiges het gerespondeer teenoor drie uit die twintig vakkundiges. Uiteindelik is die meeste terugvoer verkry van kollegas van die tuisinstelling. Beide groepe het waardevolle, maar dikwels oorvleuelende aanbevelings gemaak. Die vakkundiges het aangedui dat die kursusmateriaal van ’n goeie gehalte en geskik op ’n nagraadse vlak is. Die eleerkundiges het hul kommer uitgespreek oor die vermoë van die kursus om leer te fasiliteer en het ook ’n aantal kwessies ten opsigte van bruikbaarheid uitgewys. Sommige van die bevindinge kan moontlik ook in ander kontekste van toepassing wees. Dit het geblyk dat ongeveer vyf evalueerders in elke groep ’n goeie verslag met die oopvrae-benadering gegee het. Vakkundige ewe-kniebespreking het insigte opgelewer wat nie moontlik was met studente-terugvoer of selfrefleksie nie. In plaas daarvan dat evaluerende kriteria deur vaste vraelyste op die kundiges afgedwing is, het die oopvrae-benadering hulle die geleentheid gebied om kummulatief hul eie toepaslike raamwerk vir hierdie spesifieke kursus te ontwikkel. Die keuse van vakkundiges en e-leerkundiges mag nuttig wees in soortgelyke situasies waar aanlynkursusse geëvalueer word en die tweeledige kundigheid nie geredelik beskikbaar is nie. Die oopvraeinterpreterende benadering kan slegs vir formatiewe evaluering gebruik word en mag moontlik goed werk vir kursusse wat nog ontwikkel word en waar daar heelwat onsekerheid oor die doeltreffendheid van die onderrig bestaan. Verdere ontwikkeling sal waarskynlik fokus op die implementering van die aanbevelings, die identifisering van volhoubare maniere van gehalte-beoordeling vir die huidige kursus en soortgelyke oopvrae-evaluering van ander kursusse.

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Tomioka, Hiromi. "The clinical course and new treatment of idiopathic pulmonary fibrosis." Kyoto University, 2008. http://hdl.handle.net/2433/124326.

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Toshiyuki, Mizota. "The clinical course of anesthetic induction in lung transplant recipients." Kyoto University, 2015. http://hdl.handle.net/2433/202778.

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Champagne, Frances Anne. "Genetic loading and Schizophrenia : relation to course and outcome." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=32739.

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Previous studies have attempted to associate aspects of course and outcome with the schizophrenia genotype. Reliance on a dichotomous familial loading variable as the single indicator of genetic loading has yielded inconsistent results. The goal of the present study was to create a continuous loading variable based on multiple indicators of the schizophrenia genotype (family history of schizophrenia and attention and verbal memory in the 1st degree relatives of the patient) and to determine its association with premorbid adjustment, age at onset, symptoms, and chronicity. Our results suggest that a continuous family history variable predicted problems in premorbid adjustment and an earlier age at onset. Hierarchical regression analysis revealed that verbal memory in the siblings of the patient increased the amount of variance accounted for in premorbid attention problems, over and above that predicted by family history. A "genetic loading" variable based on the incorporation of neuropsychologically impaired siblings into the calculations of family history was significantly correlated with premorbid attention problems.

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Harker, Emil F. "Clinical Homework Directives: A Qualitative Exploratory Study." DigitalCommons@USU, 2000. https://digitalcommons.usu.edu/etd/2717.

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A qualitative study was conducted to better understand how marriage and family therapists use homework directives in their work with couples. Eleven therapists of different marital therapy orientations were interviewed. Remarkably, all of the therapists reported using clinical homework directives in their practice with couples, including those clinicians who primarily identify themselves with psychodynamic models- -models that do not typically include homework in their constructs. Four themes emerged as to why homework is given: (a) to augment or extend the therapy session outside of therapy, (b) to help the clients focus on the therapy process between session, (c) to assess client problems or dynamics for the therapist and the client, and (d) to communicate clients' responsibility for change. Themes concerning the types of homework clients used are (a) behavioral--specific physical actions to do between sessions; (b) communication exercises; (c) writing assignments; and (d) combinations of behaviors, communication exercises, or writing assignments. Results also indicate that most of the therapists in the study subscribe to more than one model of therapy in their clinical work with couples.

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Peterson, Colleen Margaret. "Couple Cohesion: Differences Between Clinical and Non-Clinical Mormon Couples." Diss., CLICK HERE for online access, 1988. http://patriot.lib.byu.edu/u?/MTNZ,10566.

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Miller, Deborah Ann 1952. "Critical Thinking Skills Related to Pre-Clinical Medical School Course Examinations." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc279394/.

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The major purpose of this study was to determine if pre-clinical medical school course examinations reflect critical thinking skills. The entire second year class from a medical school in the southwest made up the population. Student examination results from the first two years as well as scores on the Watson-Glaser Critical Thinking Appraisal were used in this study.

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Kimber, Eva. "Arthrogryposis : causes, consequences and clinical course in amyoplasia and distal arthrogryposis /." Göteborg : Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 2009. http://hdl.handle.net/2077/21079.

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Harbison, Joseph Augustine. "The course, associations and clinical significance of sleep disordered breathing following stroke." Thesis, University of Newcastle upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270779.

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Lundin, Anders. "Mild traumatic brain injury : clinical course and prognostic factors for postconcussional disorder/." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-078-7/.

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Alawneh, Josef. "Infarction of 'asymptomatic' tissue after anterior circulation stroke : impact on clinical course." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610511.

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German, A. A., D. S. Zabarna, Володимир Миколайович Дейнека, Владимир Николаевич Дейнека, and Volodymyr Mykolaiovych Deineka. "Effects of colloidal silver on clinical course of experimental acute intestinal infection." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/32192.

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The role of pseudopathogenic microorganisms (PPM) in infectious diseases is growing. In Ukraine, like in the world, from year to year increases the incidence of acute intestinal infections (AII). When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/32192

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Фадєєва, Ганна Анатоліївна, Анна Анатольевна Фадеева, Hanna Anatoliivna Fadieieva, and N. S. Mazlan. "Clinical features of asthma course in obese patients treated by inhaled steroids." Thesis, Видавництво СумДУ, 2011. http://essuir.sumdu.edu.ua/handle/123456789/15982.

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Van, Diggelen Nicholas Tromp. "Renal disease in systemic lupus erythematosus : correlation of morphology with clinical course." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/25897.

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Patients were selected for the study on the basis of 1: A diagnosis of systemic Lupus Erythematosus according to the 1982 revised American Rheumatology Association criteria47 and 2: An adequate biopsy defined as containing at least six glomeruli. Patients were biopsied at Groote Schuur Hospital during the period 1978 to 1988 and the indications for renal biopsy were clinical based on laboratory results of renal function. Patients were followed between 1 and 120 months with a mean observation period of 34 months. The clinical records were scrutinised and the following pa·rameters were noted at the time of biopsy: age, sex, race, time from diagnosis to biopsy, serum urea, creatinine, creatinine clearence and urinary 24 hour protein. Using the latest serum urea, creatinine, creatinine clearence and / or 24 hour urinary protein where available, outcome was graded as: 1: An improvement in renal function 2: A stable renal function 3: Deterioration in renal function 4: Patient on dialysis 5: Death due to disease

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Mukuddem-Sablay, Zakira. "Adenovirus-associated pneumonia in South African children : presentation, clinical course and outcome." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16697.

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Includes bibliographical references
Background: Pneumonia is an important cause of morbidity and mortality in children. Viruses have emerged as important aetiological agents in childhood pneumonia. The aim of this study was to document the clinical presentation, severity and outcome of adenoviral-associated pneumonia (AVP) in children and identify risk factors associated with poor outcome. Methods: A retrospective study of laboratory-confirmed AVP cases was conducted between 1 January and 31 December 2011. The medical records of adenovirus PCR positive respiratory tract samples identified through the National Health Laboratory Service (NHLS) database were retrieved. Demographic, clinical and outcomes data of children with AVP were extracted and analysed. Outcome measures were death and development of chronic lung disease (CLD). Results: 1910 respiratory samples were submitted to the NHLS from which 206/1910 (11%) AVP cases were identified. The median age was 12 months (IQR 6-24), 70 (34%) children were malnourished and 14 (7%) HIV-infected. Fever was the commonest presenting symptom occurring in 159 (77%) of cases. Seventy six (37%) required intensive care unit (ICU) admission. There was a high prevalence of co-morbid conditions with 98 (47%) having at least one; cardiac disease was the most common (48 (23%). Twenty nine (14%) developed CLD which was associated with hypoxia at presentation (26/29, 90%, p = 0.01) and admission to ICU (18/29, 62%, p < 0.01). Eighteen (9%) children died. Admission to ICU (OR 8.3, 95% CI 2.3-29.0) and blood stream infection (OR 11.2; 95% CI 2.3-54.1) were independent risk factors for mortality. Conclusion: Adenoviral-associated pneumonia is an important cause of pneumonia and CLD in young children in South Africa. Admission to ICU and blood stream infection were associated with poor outcome

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Househam, Keith Craig. "Epidemiology, clinical features, aetiology and course of acute infectious diarrhoea in infants." Doctoral thesis, University of Cape Town, 1985. http://hdl.handle.net/11427/25736.

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Piccione, Joseph. "Bronchiectasis in Chronic Pulmonary Aspiration: Risk Factors,Time Course and Clinical Implications." University of Cincinnati / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1292360198.

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Kop, Willem Johan. "The predictive value of vital exhaustion in the clinical course after coronary angioplasty." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1994. http://arno.unimaas.nl/show.cgi?fid=7910.

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Nadkarni-DeAngelis, Radha Bhaskar. "Clinical Course of Children with a Depressive Spectrum Disorder and Transient Manic Symptoms." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1242225627.

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Finch, Michelle L. "Emotional intelligence and empathy of nursing students in an immersive capstone clinical course." Diss., NSUWorks, 2016. https://nsuworks.nova.edu/hpd_con_stuetd/39.

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Background. Today’s baccalaureate nursing students need to be prepared to care for patients in an ever-changing, high acuity environment. Many programs offer a capstone immersive clinical experience. However, the benefits of this experience have not been fully explored, and the effect on patient care is unknown. Purpose. The purpose of the study was to determine if there was a change in levels of Emotional Intelligence (EI) and empathy in senior students who completed a capstone immersive clinical experience in the final semester of a baccalaureate nursing program. Theoretical Framework. The theoretical framework for this study was the Mayer and Salovey’s (1997) four-branch model of EI which evaluated EI and empathy of the senior nursing student. Methods. This quasi-experimental study was conducted at a baccalaureate degree program in the Mid-South. A convenience sample was utilized to examine the means of EI and empathy before and after a capstone immersive clinical experience. Results. Significance was found in students’ EI levels after the immersive experience. No significance was found in students’ empathy levels. Significance was not found in students’ EI or empathy with regards to gender and prior health care experience. In students with prior health care experience, empathy declined with increased exposure to clinical experience. Conclusions. EI and empathy along with caring and compassion need to be recognized as important concepts in nursing education. Implementation of EI and empathy in educational activities and evaluation of their effectiveness in nursing curricula will improve students’ preparedness as they complete their education and enter practice.

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Cunningham, Helen 1973. "Environmental factors in the etiology of schizophrenia : relation to course and outcome." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29880.

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Although clinical heterogeneity of schizophrenia has been well established, attempts to account for variance in clinical measures, with environmental risk factors, have been limited. Previous studies failed to examine numerous course and outcome measures within the context of multiple risk factors, within one sample. The goal of this study was to examine the role of three environmental risk factors (birth season, prenatal maternal stress and obstetric complications (OCs)) in explaining heterogeneity in clinical measures in a single sample. Our results suggest the three risk variables are independent of one another. Our findings also consistently implicated summer-fall birth season with poor premorbid adjustment, and with greater negative symptomatology. A causal model with birth season, social problems, onset of prodrome and negative symptoms found both summer-fall birth and earlier onset of prodrome to directly predict greater negative symptoms. Summer-fall birth season also predicted earlier onset of prodrome, via greater childhood social problems.

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Mennenga, Kayla Dawn. "Effects of Positive and Negative Events on Daily Relationship Effect for Clinical Couples: A Daily Diary Study." BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/6047.

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Relationship satisfaction is a popular variable to consider when looking at long-term success for couples. Research indicates positive and negative events have an impact on relationship satisfaction. Considering the influence of the Vulnerability-Stress-Adaptation framework, the present study focuses on the daily impact of positive and negative events that happen outside of therapy on couple relationship satisfaction for couples seeking therapy. Daily diary methods were used to collect data, a first for using this method with clinical couples. Random effects and multilevel models of analysis controlled for days and couples. Results suggest that on any given day, positive events impact both male and female daily relationship satisfaction. Findings also propose that these events outside of therapy tend to occur more frequently in the evening on any given day, specifically for negative events. Understanding these findings, therapists have an opportunity to use therapy as a tool to enhance adaptive processes for couples in order for couples to continue experiencing higher levels of couple satisfaction.

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Keller, Stephanie M. "Depression Symptom Discontinuities over the Course of Treatment for Chronic Posttraumatic Stress Disorder." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1315432490.

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Ansong, J. Y. "Case study of toxoplasmosis chorioretinitis in young woman: clinical course and effectiveness of treatment." Thesis, Буковинський державний медичний університет, 2012. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/1439.

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Savka, S. D. "Characteristics of clinical manifestation and the course of mental disorders and concomitant cardiovascular diseases." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18747.

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Полов`ян, Катерина Сергіївна, Екатерина Сергеевна Половьян, Kateryna Serhiivna Polovian, and E. L. Lihweuli. "Effects of nanosilver on clinical course of acute intestinal infections, intestinal microflora and cytokines." Thesis, Видавництво СумДУ, 2011. http://essuir.sumdu.edu.ua/handle/123456789/15968.

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Ellman, Lauren Mindy. "Pre and perinatal factors in the neurodevelopmental course of schizophrenia neurocognitive and clinical outcomes /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1475173691&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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Kotsch, Janeen S. "EXPLORING STUDENTS’ EXPERIENCES OF CONCEPT-BASED LEARNING IN AN ASYNCHRONOUS ONLINE PHARMACOLOGY COURSE: AN INTERPRETIVE STUDY." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent161787487052164.

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Vesco, Anthony Thomas. "Examining the Course of Cyclothymic Disorder and Comparing it to Dysthymic Disorder and Other Bipolar Spectrum Disorders in Children." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1364907946.

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Washychyn, Jill. "Symptom-Specific and Nonsymptom-Specific Factors in Eating Disorders: A Comparison of Bulimics, Dieters, and Normals." W&M ScholarWorks, 1990. https://scholarworks.wm.edu/etd/1539625648.

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Holcombe, Andrea Lee. "Selected health implications of low body mass: determinants and health outcomes." Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6592.

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While the role of obesity in health outcomes has been well described, the role of low body mass index (BMI), body weight relative to height, has largely been ignored. Those with low BMI are commonly excluded completely or combined with the normal BMI category in BMI studies. However, there have been some studies indicating poorer health outcomes among those with lower BMI, particularly that of increased risk of mortality. The purpose of this study is to explore the role of low BMI throughout the lifespan. Data from the Health and Retirement Study was used to evaluate 1) the association between childhood health and socioeconomic status (SES) exposures and low BMI in midlife adulthood, 2) the association between low BMI and health related outcomes in midlife adulthood (ages 50 to 65), and 3) the association between low BMI in midlife and health related outcomes, including mortality, over a longer follow-up (maximum of 20 years). To increase sample size, two low BMI definitions were used: the traditional Few significant results were found. Low BMI status was consistently associated with older age and female gender as well as current smoking status. Childhood exposure of respiratory disease and greater SES disadvantages was more common among those with low BMI in adulthood. In midlife adulthood, low BMI status was associated with increased difficulties with activities of daily living with either definition of low BMI. Increased risk of fracture was associated with a low BMI definition of <18.5. Increased risk of lung disease and decreased risk of high blood pressure was associated with a low BMI definition of ≤20. An analysis of those 30 years old or older found low BMI to be associated with increased risk of mortality and decreased risk of diabetes regardless of low BMI definition. When low BMI was defined as <18.5, those with low BMI were also more likely to experience difficulty with one or more activities of daily living. When low BMI was defined as ≤20, low BMI status was associated with greater risk of lung disease and decreased risk of high blood pressure. Further research is needed to fully characterize the role of low BMI on health outcomes as well as the role of SES on low BMI. Additionally, there is a need for greater understanding of the potential biological mechanisms of low BMI for health outcomes. Currently, there are few studies evaluating health outcomes and SES of low BMI. Limiting studies to the extreme upper end of the BMI spectrum limits the overall understanding of the role of BMI in health and may overlook unique characteristics and challenges those with low BMI may face.

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MIYAKE, KOJI, NOBUYUKI HAMAJIMA, TATSURO MURASE, TAKAO SAKATA, and MUNEHISA TAKASHI. "Grade 3 Bladder Cancer with Lamina Propria Invasion (pT1): Characteristics of Tumor and Clinical Course." Nagoya University School of Medicine, 1991. http://hdl.handle.net/2237/17514.

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Hess, Cecilia. "Enrolled bridging course learners’ perspectives related to factors influencing their learning in the clinical environment." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71633.

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Thesis (MCurr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Exposure to the clinical learning environment forms an essential part of nursing education. Being a nurse lecturer in the private sector, the researcher observed that bridging course learners do not always perform academically as satisfactorily as they should. For the purpose of the current study, the researcher investigated enrolled bridging course learners’ perspectives related to factors influencing their learning in the clinical environment. The study focused on bridging course learners in the private sector. The objectives of the study were to determine whether the following was valid for the population under consideration: - a shortage of staff is a barrier to learning in the clinical environment; - an orientation programme has been implemented for bridging course learners in the clinical environment; - bridging course learners in the clinical environment have to take charge of wards; - the attitude of staff members is a barrier to the learners’ learning experience. - there is a learner/mentor relationship in the clinical environment; - opportunities to gain practical competence exist in the clinical environment. An exploratory descriptive design with a predominantly quantitative approach was applied. The population for the study consisted of bridging course learners at the three private nursing colleges in the Cape metropolitan area (N = 89). Due to the small size of the population, all available learners who voluntarily gave consent were included in the study. The sample size for this study constituted 62% (n = 55) of the target population. A semi-structured questionnaire was used to collect data, and both open and closed ended questions were used. Reliability and validity were assured by means of a pilot study and the use of experts in the field of nursing education and statistics. Data were collected personally by the researcher. Ethical approval was obtained from the Committee for Human Science Research at the Faculty of Medicine and Health Sciences at Stellenbosch University. Statistical associations were determined using the Spearman and Mann-Whitney U tests. The results of this study are presented in percentages and tables. The majority (n = 46/84%) of the participants disagreed that the staffing in units was sufficient. Most (n = 40/73%) participants disagreed with the statement that working conditions were conducive to learning. Qualitative analysis revealed that the participants perceived the clinical environment to be hostile, and the majority (n = 47/85%) of the participants agreed that staff members had a negative attitude towards them. Furthermore, only five (n = 5/9%) participants indicated that they always spent time with their mentor, and the majority (n = 36/65%) of the participants disagreed with the statement that they could achieve specific outcomes before moving to another ward. A shortage of staff, being placed in charge of wards in the absence of a registered nurse, negative attitudes of staff members, and the lack of a mentor–learner relationship were identified as factors that impacted negatively on learning in the clinical environment. Several recommendations, grounded in the study findings, were identified, including: - Sufficient staff should be on duty to improve the learning environment, in order for learners to achieve their outcomes according to the curriculum. - Learners should receive adequate supervision and support. - Sufficient time should be allocated for practical procedures, such as releasing learners on practical days to practise procedures. Factors influencing enrolled bridging course learners’ learning experiences in the clinical environment were identified. Strategies to address these factors may improve their clinical experiences and ultimately their clinical competence.
AFRIKAANSE OPSOMMING: Blootstelling aan kliniese leer omgewing is ’n grondliggende deel van verpleegonderrig. As ’n verpleeglektrise in die privaat sektor, het die navorser tot die gevolgtrekking gekom dat oorbruggingsleerders nie akademies na wense presteer nie. Vir die doel van hierdie studie het die navorser die faktore geëvalueer wat die kliniese onderrig van oorbruggingsleerders gedurende hul plasing in die kliniese omgewing beïnvloed. Die ondersoek konsentreer op oorbruggingsleerders wat in die privaat sektor werk. Die oogmerke van die studie was om te bepaal of: - ’n personeeltekort onderrig in die kliniese omgewing belemmer; - daar ’n oriënteringsprogram vir oorbruggingsleerders bestaan; - oorbruggingsleerders die bevel oor eenhede moet oorneem; - leerders personeelgesindhede as ’n hindernis ervaar; - daar ’n leerder/mentor-verhouding in die kliniese omgewing is; - geleenthede vir praktiese onderrig geskep word. ’n Beskrywende, verkennende studie met ’n oorwegend kwantitatiewe benadering is uitgevoer. Die studiebevolking was oorbruggingsleerders (N = 89) wat die drie privaat verpleegkolleges in die Kaapse metropool verteenwoordig. As gevolg van die klein populasie het alle leerders wat vrywillig hul toestemming verleen het, aan die studie deelgeneem. Gevolglik is ’n steekproef (n = 55/62%) van die teikenpopulasie geneem. Die navorser het ’n semi-gestruktureerde vraelys gebruik om data in te win en beide oop en toe vrae was gevra. Betroubaarheid en geldigheid is deur middel van ’n proefstudie sowel as die gebruik van deskundiges op die gebied van verpleegonderrig en statistiek verseker. Die navorser het die data persoonlik ingesamel. Etiese goedkeuring is van die Gesondheidsnavorsingsetiekkomitee van die Fakulteit Geneeskunde en Gesondheidswetenskappe van die Universiteit Stellenbosch verkry. Statistiese korrelasies is met behulp van die Spearman- en Mann-Whitney-U-toetse ondersoek. Die resultate van die studie word in die vorm van persentasies en tabelle aangebied. Die meeste deelnemers (n = 46/84%) reken daar is nie voldoende personeel in die sale nie. Voorts dink die meeste (n=40/73%) ook dat werksomstandighede nie onderrig bevorder nie. Kwalitatiewe ontleding toon dat die deelnemers die kliniese omgewing as bedreigend beskou, en die meeste (n = 47/85%) is dit ook eens dat personeel ’n negatiewe houding teenoor hulle openbaar. Slegs vyf deelnemers (n = 5/9%) het aangedui dat hulle altyd tyd saam met hulle mentor deurbring, terwyl die meeste (n = 36/65%) erken dat hulle nie hulle studie-uitkomste bereik alvorens hulle na ’n ander saal oorgeplaas word nie. Die studie bevind dat ’n personeeltekort, om in bevel van eenhede geplaas te word in die afwesigheid van ‘n geregistreerde verpleegkundige, personeel se negatiewe houding, en die gebrek aan ’n mentor/leerder-verhouding van die faktore is wat onderrig in die kliniese omgewing benadeel. Verskeie aanbevelings word op grond van die studiebevindinge gedoen. Dit sluit die volgende in: - Daar behoort genoegsame personeel aan diens te wees om die onderrigomgewing vir leerders te verbeter en hulle sodoende in staat te stel om hul studie-uitkomste volgens die kurrikulum te behaal. - Behoorlike toesig oor leerders moet verseker word. - Leerders behoort op praktiese dae van ander werk vrygestel te word ten einde hul prosedures te voltooi. Faktore wat die leer ervaring van oorbruggings leerders in die kliniese omgewing beinvloed was identifiseer. Strategieë wat hierdie faktore adresseer, kan hulle kliniese ervaring asook hul kliniese vaardigheid verbeter.

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Demierre, Stanislas. "Correlation between the clinical course and mast cell infiltration in the canine granulomatous meningoencephalomyelitis (GME) /." [S.l.] : [s.n.], 2000. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Pryor, Jason, Piyush Singh, Nilesh Dankhara, Stacy D. Brown, and Darshan Shah. "Correlation of Newborn’s Clinical Course with Cord Blood Levels of Buprenorphine, Methadone, and Their Metabolites." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5277.

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Purpose In recent years, there has been a significant increase in opioid-related drug use among pregnant mothers, specifically Methadone, Subutex (Buprenorphine) and Suboxone (Buprenorphine and Naloxone) resulting in increased neonatal intensive care unit (NICU) admissions for treatment of neonatal abstinence syndrome (NAS). Standard tests such as urine, meconium, and cord stat blood samples have not been shown to accurately demonstrate maternal abuse of these medications or predict the clinical course of NAS. This study aims to correlate and compare clinical symptoms of NAS with cord/ placental blood concentrations of Buprenorphine, Methadone and their metabolites. Another goal is to demonstrate the ability to correctly identify maternal abuse and concentrations of these medications. Methods The design was an observational study where cord/placental blood samples were obtained from eligible subjects. In addition to the standard cord stat test done by state, samples were analyzed using liquid chromatography mass spectrometry (LC-MS/MS) to quantify the metabolites of Buprenorphine, Norbuprenorphine and Methadone. Investigators performing the LC-MS/MS were blinded. Infants were treated on attending physician’s discretion according to clinical course. All infants were followed until discharge. Demographics and clinical course, including NICU stay, were recorded. Results A total of 19 mothers were enrolled, out of which, 15 (78.9%) mothers were on Subutex, 2 (10.5%) on Suboxone and 2 (10.5%) on Methadone. Data analysis was performed only on subjects with exposure to Subutex due to low sample size for Suboxone and Methadone subjects. Cord stat performed by the state lab was negative in 33.3% of subjects; however, 100% of the cord blood samples tested by LC-/MSMS were positive. The percentage of neonates transferred to NICU for NAS was 60% of which 67% received replacement therapy. Length of stay in NICU for treatment of NAS did not have any correlation to the concentration of the metabolites in cord blood. Pearson’s correlation coefficient (r) between duration of NICU stay and Norbuprenorhine concentration was r = -0.07 (p-value = 0.40); Buprenorphine concentration was r = -0.30 (p-value = 0.14); Norbuprenorphine-glucoronate concentration was r = -0.05 (p-value = 0.43); Buprenorphine-glucoronate concentration was r = -0.31 (p-value = 0.13). No correlation was found after adding the concentrations of all the above metabolites with NICU stay r = -0.24 (p-value = 0.19). Conclusion The cord stat result is inferior to cord/placental blood levels of drug metabolites using LC-MS/MS for diagnosing maternal substance abuse in at risk infants. No correlation was found between the concentrations of metabolites and length of stay in NICU or duration of replacement therapy. This study was limited by a small sample size.

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Brodman, Douglas M. "Depressive and externalizing comorbidity and the relations to child anxiety treatment response time-course." Diss., Temple University Libraries, 2015. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/351770.

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Psychology
Ph.D.
Objective: The present study examined the potential roles of externalizing and depressive co-occurring psychopathology on the time-course to anxiety treatment response among youth receiving different treatment conditions. Method: Participants were 488 youth (aged 7-17 years) who received either Cognitive-Behavioral Therapy (CBT) (N = 139), sertraline (SRT) (N = 133), CBT+sertraline (COMB; N = 140), or pill placebo (PLB; N = 76) in the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008). Results: Findings did not demonstrate a significant relation of comorbid psychopathology with treatment response time-course. Participants in CBT and SRT had significantly different overall treatment response trajectories, though comorbid psychopathology did not significantly relate to the observed treatment response trajectories. Exploratory analyses revealed that parental treatment assignment reaction to CBT was positively associated with more favorable treatment response time course, whereas parental treatment assignment reaction to SRT did not significantly relate to treatment response time course. Conclusions: Our results are consistent with the notion that current interventions (CBT, SRT) produce improvements that generalize across co-occurring depressive and externalizing psychopathology. Clinical implications for the treatment of anxious youth with regard to comorbidity and contextual factors are discussed and suggestions for future research are offered.
Temple University--Theses

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Jodkowski, Jakub [Verfasser]. "Primary Pan-CT is associated with improved clinical course and outcome in polytrauma patients / Jakub Jodkowski." Greifswald : Universitätsbibliothek Greifswald, 2013. http://d-nb.info/1035043726/34.

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Gostoli, Sara <1982&gt. "The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5839/.

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Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.
Obiettivi: Lo scopo della presente tesi di dottorato è stato valutare l’impatto della Riabilitazione Cardiologica (RC) sulla modificazione di stili di vita, qualità di vita, psicopatologia, distress e benessere psicologico, considerando il possibile effetto moderatore di disturbi depressivi, ansiosi e sindromi psicosomatiche sul cambiamento degli stili di vita. È stata inoltre valutata l’influenza della RC su morbilità e mortalità cardiaca. Metodi: Il gruppo sperimentale (N=108), sottoposto a RC, è stato confrontato con un gruppo di controllo (N=85), composto da pazienti cardiopatici non sottoposti a RC, sia alla baseline che a 1 mese, 6 e 12 mesi. L’assessment ha incluso: la Structured Clinical Interview for DSM-IV, l’intervista strutturata basata sui Diagnostic Criteria for Psychosomatic Research (DCPR), il questionario GOSPEL sugli stili di vita, il Pittsburgh Sleep Quality Index, la Morisky Medication Adherence Scale, il MOS 36-Item Short Form Health Survey, il Symptom Questionnaire, la Psychological Well-Being Scale e la 14-items Type D Scale. Risultati: La RC, rispetto alla condizione di controllo, è risultata associata a: mantenimento dei livelli di attività fisica, aumento dei comportamenti alimentari corretti e della capacità di gestione dello stress, miglioramento della qualità di vita e del sonno; diminuzione delle diagnosi psichiatriche e psicosomatiche più frequentemente riscontrate alla baseline. Al contrario, non è risultata associata a: stile alimentare sano, perdita di peso e miglioramento dell’aderenza farmacologica. Inoltre, non sono stati riscontrati effetti rilevanti riguardo a benessere e distress psicologico sub-clinico, fatta eccezione per la crescita personale e lo scopo nella vita (PWB). La RC non ha inoltre svolto un ruolo protettivo sul decorso clinico. La presenza di sindromi psicosomatiche e disturbi depressivi ha influenzato l’andamento di specifici stili di vita. Conclusioni: I risultati evidenziano l’importanza di una valutazione psicologica integrata in riabilitazione cardiologica, allo scopo di identificare e gestire fattori potenzialmente associati al decorso clinico della patologia cardiaca.

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El-Najjar, Inas. "Prognostic factors and the clinical course of follicular lymphoma in the FDG-PET and rituximab era." Thesis, Queen Mary, University of London, 2012. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8504.

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Follicular lymphoma (FL) is classically described as an incurable disease characterised by a distinctive clinical course, with repeated relapses and remissions. A progressive shortening of the duration of each remission and an increased relapse rate after each response is typically described. Major recent developments in the management of patients with FL have been the introduction of haematopoietic stem cell transplant (HSCT) and of rituximab treatment, resulting in a significant improvement in the overall survival of patients diagnosed with FL in the recent era. Another major advance in the 21st century is the introduction of 18-fluoro-deoxyglucose positron emission tomography (FDG-PET) for the staging of patients with lymphoma, which has proven to be more accurate than standard computer tomography. A new prognostic score, the Follicular Lymphoma International Prognostic Index 2 (FLIPI2) has been designed in the setting of these innovations. The aim of this thesis is to examine how the introduction of such advances has impacted on the management and on the clinical course of patients with FL. It will specifically address the impact that FDG-PET has on the staging, management and prognosis of FL and it will compare the recently designed FLIPI2 in newly diagnosed FL patients with the pre-rituximab prognostic score (FLIPI). As mentioned, the introduction of rituximab and HSCT has contributed to the significant improvement in the outcome of patients with FL. This thesis will demonstrate how these developments have changed not only the outcome but also the clinical course of patients with FL and will assess the impact that prior treatment with rituximab has on the outcome of patients undergoing a HSCT.

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De, Villiers Adele. "The development, implementation and evaluation of a short course in Objective Structured Clinical Examination (OSCE) skills." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6697.

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Thesis (MPhil)--University of Stellenbosch, 2011.
Introduction: Objective Structured Clinical Examination (OSCE) examiner training is widely employed to address some of the reliability and validity issues that accompany the use of this assessment tool. An OSCE skills course was developed and implemented at the Stellenbosch Faculty of Health Sciences and the influence thereof on participants (clinicians) was evaluated. Method: Participants attended the OSCE skills course which included theoretical sessions concerning topics such as standard-setting, examiner influence and assessment instruments, as well as two staged OSCEs, one at the beginning and the other at the end of the course. During the latter, each participant examined a student role-player performing a technical skill while being video recorded. Participants‟ behaviour and assessment results from the two OSCEs were evaluated, as well as the feedback from participants regarding the course and group interviews with student role players. Results: There was a significant improvement in inter-rater reliability as well as a slight decrease in inappropriate examiner behaviour, such as teaching and prompting during assessment of students. Furthermore, overall feedback from participants and perceptions of student role-players was positive. Discussion: In this study, examiner conduct and inter-rater reliability was positively influenced by the following interventions: examiner briefing; involvement of examiners in constructing assessment instruments as well as viewing (on DVD) and reflection, by examiners, of their assessment behaviour. Conclusion: This study proposes that the development and implementation of an OSCE skills course is a worthwhile endeavour in improving validity and reliability of the OSCE as an assessment tool.

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Liakhovych, O. D. "Some features of the clinical course of osteoarthritis in patients with comorbid nonalcoholic steatohepatitis and obesity." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19619.

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Geppert, Leanne Michele. "The Impact of Amphetamine and Cannabis Use on the Symptoms and Clinical Course of Early Psychosis." Thesis, Griffith University, 2008. http://hdl.handle.net/10072/365510.

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Amphetamines and cannabis are the most commonly used illicit substances in Australia and are associated with a range of severe mental health problems, including psychosis. While a number of studies have previously examined the symptom profiles of amphetamine users and cannabis users with psychosis, it remains unclear whether these patients experience differences in the severity and clinical course of their symptoms and behaviour compared to non-using patients with psychosis. This thesis examined the demographics, psychiatric and family history, premorbid adjustment, clinical symptoms, and disturbed behaviours of 98 inpatients admitted to hospital with an early psychosis. The TimeLine Follow Back method was used to determine substance use in the 30 days prior to admission, allowing participants to be categorised according to the following drug classes: amphetamines, cannabis, amphetamines + cannabis, none. Participants were assessed at admission and then weekly until discharge (or for a maximum of eight weeks) with the Brief Psychiatric Rating Scale (positive symptoms, negative symptoms, mania symptoms, depression-anxiety symptoms) and the Disturbed Behaviour Rating Scale. Multi-level modelling (MLM) was used to determine statistically significant differences between each of the substance-using groups and their respective non-using groups on the severity of their symptoms and behaviour at admission and over the course of their hospitalisation. Importantly, MLM also allowed for these groups to be compared on the rate of symptom and behaviour change during the first eight weeks of hospitalisation, providing evidence of any differences in clinical course.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Psychology
Griffith Health
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Bender, Rachel. "Kindling of Life Stress in Bipolar Disorder: Comparison of Sensitization and Autonomy Models and Integration with Emerging Biopsychosocial Theories." Diss., Temple University Libraries, 2012. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/191985.

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Psychology
Ph.D.
Most life stress literature in bipolar disorder (BD) fails to account for the possibility of a changing relationship between psychosocial context and episode initiation across the course of the disorder. The kindling hypothesis states that over the longitudinal course of recurrent affective disorders, there is a weakening temporal relationship between major life stress and episode initiation (Post, 1992). This process could reflect either a progressive sensitization or a progressive autonomy (i.e., insensitivity) to life stress. The present study aimed to test the kindling model in BD by examining the effect of lifetime mood episodes on the relationship between proximal life events and prospectively assessed mood episodes. Polarity-specific tests of the model were conducted across the continuum of event severity, with respect to both impact and frequency of life events. Moreover, examination of the kindling hypothesis was embedded in the context of two emerging biopsychosocial theories of BD: the expanded Behavioral Approach System Dysregulation Model and the Circadian and Social Rhythm Theory. Data from 278 participants (146 bipolar spectrum participants and 132 normal control participants) were collected as part of the Temple-Wisconsin Longitudinal Investigation of Bipolar Spectrum Project. Hypotheses were polarity- and event-type specific and were in line with a stress sensitization model of bipolar spectrum disorders (BSD), rather than a stress autonomy model. Results partially supported a sensitization model: there was a decreased frequency and an increased impact of major events, and an increased frequency and impact of minor events. However, results for specific polarities and event types were not fully consistent with a stress sensitization model. Implications of these findings are addressed, followed by a discussion of study strengths, limitations, and promising directions for future research.
Temple University--Theses

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Dissertations / Theses on the topic 'Clinical Course'

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