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Dissertations / Theses on the topic 'Clinical Results'

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Author: Grafiati

Published: 4 June 2021

Last updated: 20 February 2023

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1

Iwata, Hisashi, Shigeki Yamamura, Hideshi Sugiura, Hidetoshi Kobayashi, Jiro Inagaki, Mitsuru Takahashi, and Hirohisa Katagiri. "Clinical results of nonsurgical treatment for spinal metastases." Thesis, Elsevier, 1998. http://hdl.handle.net/2237/16692.

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2

Lysdahl, Michael. "Rhonchopathy : long-term clinical results after palatal surgery /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-319-8.

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3

Rosenthal, Daniel Todd. "A clinician-mediated, longitudinal tracking system for the follow-up of clinical results." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/33084.

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Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2005.
Includes bibliographical references (p. 36-37).
Failure to follow-up on abnormal tests is a common clinical concern comprising the quality of care. Although many clinicians track their patient follow-up by scheduling follow-up visits or by leaving physical reminders, most feel that automated, computerized systems to track abnormal test results would be useful. While existing clinical decision support systems and computerized clinical reminders focus on providing assistance with choosing the appropriate follow-up management, they fail by not tracking that follow-up effectively. We believe that clinicians do not want suggestions how to manage their patients, but instead want help tracking follow-up results once they have decided the management plan. We believe that a well-designed system can successfully track this follow-up and only require a small amount of information and time from the clinician. We have designed and implemented a complete tracking system including 1) an authoring tool to define tracking guidelines, 2) a query tool to search electronic medical records and identify patients without follow-up, and 3) a clinical tool to send reminders to clinicians and allow them to easily choose the follow-up management. Our tracking system has made improvements on previous reminder systems by 1) using our unique risk-management guideline model that more closely mirrors, yet does not attempt to replicate, the clinical decision process, 2) our use of massive population-based queries for tracking all patients simultaneously, and 3) our longitudinal approach that documents all steps in the patient follow-up cycle. With these developments, we are able to track 450 million pieces of clinical data for 1.8 million patients daily.
(cont.) Keyword follow-up tracking; reminder system; preventive medicine; computerized medical record system; practice guidelines; clinical decision support system
by Daniel Todd Rosenthal.
S.M.

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4

Tat, Lien Thieu. "LASIK clinical results and their relationship to patient satisfaction /." University of Sydney. Faculty of Health Sciences, 2006. http://hdl.handle.net/2123/1607.

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Doctor of Philosophy (PhD) Orthoptics
The aim of this study was to evaluate the safety and efficacy of LASIK as a refractive surgical procedure, using a repeated measures design to assess satisfaction of patients who had LASIK and to correlate clinical outcomes with detailed measures of patient satisfaction to document long-term viability, monitor changes over time and patients’ functional abilities post-operatively. Method In the study 216 post-LASIK subjects were randomly selected from among patients who underwent simultaneous bilateral LASIK using the Chiron Technolas 217C plano-scan excimer laser with the Chiron ACS (Automated Corneal Shaper) and the Hansatome microkeratome. The subjects were recruited from within one centre, and the procedures were performed by any one of three surgeons. The study also included 100 non-LASIK subjects as a control group, to compare and differentiate ocular symptoms and visual difficulties between LASIK and non-LASIK patients. Clinical data documented included visual acuity, subjective refraction, record of glasses and/or contact lenses prescription, corneal topography with EyeSys and Orbscan, slit lamp examination, surgical details, and any pre-existing eye disease/conditions and previous surgery or injury that might prevent the subjects from achieving their desired visual outcome post-operatively. Subjective patient satisfaction evaluation of the treatment group was assessed by subjects completing a survey questionnaire at 3 months, 6 months, 12 months and 24 months post-operatively. The control group subjects completed a comparable questionnaire and were assessed at baseline and 3 months later. Because the control group subjects did not have any surgical alterations, it was unnecessary for them to have more than one follow-up. Results LASIK achieved relatively high patient satisfaction, with only a small number of dissatisfied patients. It was effective in correcting myopia, hyperopia and astigmatism. However, there was some persistent under-correction in myopic spherical and minus cylindrical refractive errors. Hyperopic spherical correction was less effective, as there were more under- as well as over-correction, and the plus cylindrical correction tended to be under-corrected. The LASIK subjects’ post-operative distance uncorrected visual acuity was not as good as their pre-operative best corrected visual acuity, but it did not significantly correlate with patient satisfaction. The findings were consistent with other studies and confirmed the concept that patient satisfaction is not unidimensional and is not related to outcome solely in terms of visual acuity and residual refractive errors. Other contributing factors included problems with glare, rating of unaided distance and near vision, ability to drive at night, change in ability to perform social/recreational, home and work activities, change in overall quality of life, amount of information given prior to surgery, rating of surgery success, and surgery outcome relative to pre-operative expectations. These variables demonstrated distinctive differences between subjects who were satisfied and dissatisfied. Conclusions The findings of this study are consistent with those of earlier studies. However, the repeated measures design and the comparisons between LASIK subjects and the control group revealed some new insights that were previously undocumented. LASIK achieved high patient satisfaction, and factors associated with satisfaction were predictable, but sources of dissatisfaction were more idiosyncratic and contributing factors were identified.

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5

Bill-Axelson, Anna. "Localized Prostate Cancer : Results From a Randomized Clinical Trial." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5737.

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6

Bekhali, Zakaria. "Duodenal switch for superobesity - changes in physiology and clinical results." Licentiate thesis, Uppsala, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-428258.

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7

Vironen, Jaana. "How to improve results in rectal cancer surgery a clinical study /." Helsinki : University of Helsinki, 2005. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/vironen/.

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8

Motoca, Luci M. "Treatment Moderation and Secondary Outcomes: Results from a Randomized Clinical Trial." FIU Digital Commons, 2012. http://digitalcommons.fiu.edu/etd/669.

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The present study pursued two objectives in the context of a randomized clinical trial of cognitive-behavioral therapy with parent (CBT/P) and group (GCBT) involvement. The first objective was to examine the variability in treatment outcome. There were three specific aims within the first objective, to evaluate: (1) youth characteristics (age, depressive, and externalizing disorders) as moderators of treatment outcome; (2) the differential outcome of the treatment approaches as a function of youth characteristics; and (3) the relative efficacy of the treatment approaches at each level of the moderators. The second objective was to evaluate the efficacy of anxiety treatments along secondary depressive symptoms and externalizing behaviors. There were five specific aims within the second objective, to evaluate: (1) whether anxiety treatment yields reductions in secondary problems, (2) the efficacy of anxiety treatments in reducing secondary problems as a function of approach and youth characteristics, (3) whether reductions in anxiety symptoms significantly mediate changes in secondary problems, (4) the directionality of change in the hypothesized mediated relations, and (5) whether the hypothesized mediated relations are moderated by treatment approach and youth characteristics. The specific aims were pursued using data collected from 183 youth and their mothers. Research questions were tested using multiple regressions and structural equation modeling. Age, depressive, and externalizing disorders were significant moderators. CBT/P relative to GCBT lowered anxiety more for younger than older youth. GCBT relative to CBT/P lowered anxiety more for older than younger youth. GCBT relative to CBT/P lowered anxiety more for depressed youth than non-depressed youth. GCBT relative to CBT/P lowered anxiety less for externalizing youth than non-externalizing youth. Treatment reduced depressive symptoms and externalizing problem behaviors. Reductions in anxiety mediated changes in depressive symptoms and externalizing problem behaviors. Reversed directionality was found in the relation between social anxiety and depressive symptoms. In CBT/P the direction of change was from depressive to social anxiety. The opposite was true in GCBT. Reductions in social anxiety mediated posttreatment changes in depressive symptoms in GCBT but not CBT/P. The reverse was true at follow-up. Reductions in social anxiety mediated changes in depressive symptoms for girls but not boys.

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9

Drogset, Jon Olav. "Results after surgical treatment of anterior cruciate ligament injuries - A clinical study." Doctoral thesis, Norwegian University of Science and Technology, Department of Neuroscience, 2006. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-969.

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10

Isenius, Niklas, Sumithra Velupillai, and Maria Kvist. "Initial Results in the Development of SCAN : a Swedish Clinical Abbreviation Normalizer." Stockholms universitet, Institutionen för data- och systemvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-82245.

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Abbreviations are common in clinical documentation, as this type of text is written under time-pressure and serves mostly for internal communication. This study attempts to apply and extend existing rule-based algorithms that have been developed for English and Swedish abbreviation detection, in order to create an abbreviation detection algorithm for Swedish clinical texts that can identify and suggest definitions for abbreviations and acronyms. This can be used as a pre-processing step for further information extraction and text mining models, as well as for readability solutions. Through a literature review, a number of heuristics were defined for automatic abbreviation detection. These were used in the construction of the Swedish Clinical Abbreviation Normalizer (SCAN). The heuristics were: a) freely available external resources: a dictionary of general Swedish, a dictionary of medical terms and a dictionary of known Swedish medical abbreviations, b) maximum word lengths (from three to eight characters), and c) heuristics for handling common patterns such as hyphenation. For each token in the text, the algorithm checks whether it is a known word in one of the lexicons, and whether it fulfills the criteria for word length and the created heuristics. The final algorithm was evaluated on a set of 300 Swedish clinical notes from an emergency department at the Karolinska University Hospital, Stockholm. These notes were annotated for abbreviations, a total of 2,050 tokens. This set was annotated by a physician accustomed to reading and writing medical records. The algorithm was tested in different variants, where the word lists were modified, heuristics adapted to characteristics found in the texts, and different combinations of word lengths. The best performing version of the algorithm achieved an F-Measure score of 79%, with 76% recall and 81% precision, which is a considerable improvement over the baseline where each token was only matched against the word lists (51% F-measure, 87% recall, 36% precision). Not surprisingly, precision results are higher when the maximum word length is set to the lowest (three), and recall results higher when it is set to the highest (eight). Algorithms for rule-based systems, mainly developed for English, can be successfully adapted for abbreviation detection in Swedish medical records. System performance relies heavily on the quality of the external resources, as well as on the created heuristics. In order to improve results, part-of-speech information and/or local context is needed for disambiguation. In the case of Swedish, compounding also needs to be handled.

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11

Nicholls, Alice. "Effort test results : the effect of informed consent in a clinical sample." Thesis, University of Leicester, 2012. http://hdl.handle.net/2381/27639.

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Effort or Symptom Validity Tests (SVTs) are used during neuropsychological assessment to assess for negative response bias. SVT failure can be used as evidence that other test results are invalid and to support a diagnosis of malingering. The positive predictive accuracy of a SVT is dependent on its sensitivity, specificity and the base rate of malingering within the population sampled. The British Psychological Society (BPS, 2009) advises that all clinical patients should be assessed for effort using a SVT. However, there is no available data on the likely base rates of malingering within a UK clinical sample. Furthermore, despite test manual instructions, the BPS also advises that examinees should be informed they will be assessed for effort, potentially invalidating test results. A systematic literature review was conducted to ascertain what is currently known about the base rates of malingering. Studies were only included if they enabled the application of the Slick, Sherman and Iverson (1999) criteria for definite or probable malingering to their sample. Four North American Studies yielded 503 litigating, traumatic brain injured participants of which 24.55% were identified as either probably or definitely malingering. This figure was significantly lower than previous estimates, which have suggested the base rate of malingering may be as high as 40% (Larabee, 2003). In order to investigate whether informing people presenting for a neuropsychological assessment that they would be tested for effort affects their SVT results a multi-site experimental design was employed. Participants were randomly assigned to either informed or uninformed conditions and administered a battery of neuropsychological tests including the Test of Memory Malingering (Tombaugh, 1996). Practical difficulties resulted in small sample size and insufficient statistical power to either accept or reject the null hypothesis. Further data collection, research opportunities and clinical implications are discussed.

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12

Hüttenbrink, Karl-Bernd, Dirk Beutner, and Thomas Zahnert. "Clinical Results with an Active Middle Ear Implant in the Oval Window." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133983.

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Background: Some patients with chronic middle ear disease and multiple failed revisions, who also need a hearing aid, may benefit from an active middle ear implant. An advantage of an active middle ear implant is that the ear canal is unoccluded. Methods: Following extensive experimental development in temporal bones and investigations of various locations and attachments of a Vibrant Soundbridge transducer, a new titanium clip holder for the vibrant floating mass transducer was developed. This assembly is a total ossicular replacement prosthesis (TORP) that is placed on the stapes footplate. Six patients were implanted with this device. Results: Acoustic results demonstrate significantly improved gain, especially in the high frequencies, which is typically unobtainable by conventional hearing aids. Conclusion: The simple procedure of placing an active TORP assembly on the stapes footplate, similar to the implantation of a passive TORP prosthesis during tympanoplasty, offers promising treatment for cases of incurable middle ear disease
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

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13

Hüttenbrink, Karl-Bernd, Dirk Beutner, and Thomas Zahnert. "Clinical Results with an Active Middle Ear Implant in the Oval Window." Karger, 2010. https://tud.qucosa.de/id/qucosa%3A27554.

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Background: Some patients with chronic middle ear disease and multiple failed revisions, who also need a hearing aid, may benefit from an active middle ear implant. An advantage of an active middle ear implant is that the ear canal is unoccluded. Methods: Following extensive experimental development in temporal bones and investigations of various locations and attachments of a Vibrant Soundbridge transducer, a new titanium clip holder for the vibrant floating mass transducer was developed. This assembly is a total ossicular replacement prosthesis (TORP) that is placed on the stapes footplate. Six patients were implanted with this device. Results: Acoustic results demonstrate significantly improved gain, especially in the high frequencies, which is typically unobtainable by conventional hearing aids. Conclusion: The simple procedure of placing an active TORP assembly on the stapes footplate, similar to the implantation of a passive TORP prosthesis during tympanoplasty, offers promising treatment for cases of incurable middle ear disease.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

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14

Maltez, José Carlos. "Quantitative EEG analysis : temporal variability and clinical applications /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-522-4/.

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15

Udovich, Joshua Anthony. "CONFOCAL MICROENDOSCOPY: CHARACTERIZATION OF IMAGING BUNDLES, FLUORESCENT CONTRAST AGENTS, AND EARLY CLINICAL RESULTS." Diss., The University of Arizona, 2008. http://hdl.handle.net/10150/195003.

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Ovarian cancer is the fifth leading cause of cancer related deaths among women. Early detection improves the chances of survival following diagnosis, and new imaging modalities have the potential to reduce deaths due to this disease. The confocal microendoscope (CME) is a non-destructive in-vivo imaging device for visualization of the ovaries that operates in real-time. Two components of the CME system are evaluated in this paper, and initial results from an ongoing clinical trial are presented.Fiber-optic imaging bundles are used in the CME imaging catheter to relay images over distances of up to 20 feet. When detecting fluorescent signals from investigated tissue, any fluorescence in the system can potentially reduce contrast in images. The emission and transmission properties of three commercially available fiber optic imaging bundles were evaluated. Emission maps of fluorescence from bundles were generated at multiple excitation wavelengths to determine the profile and amount of fluorescence present in bundles manufactured by Sumitomo, Fujikura, and Schott. Results are also presented that show the variation of transmittance as a function of illumination angle in these bundles. Users of high-resolution fiber-optic imaging bundles should be aware of these properties and take them into account during system design.Contrast is improved in images obtained with the CME through the application of topical dyes. Acridine orange (AO) and SYTO 16 are two fluorescent stains that are used to show the size, shape, and distribution of cell nuclei. Unfortunately, little is known about the effects of these dyes on living tissues. This study was undertaken to evaluate the effects of dye treatment on peritoneal tissues in mice. Seventy-five Balb/c mice were split into five groups of fifteen and given peritoneal injections of dye or saline. The proportions of negative outcomes for the control and test groups were compared using confidence intervals and the Fisher's exact test. No significant difference was determined between the groups. These data provide preliminary results on determining the effect of these dyes on living tissues.Preliminary results of a clinical trial are presented showing in-vivo use of the CME for imaging of the ovaries. This is the first portion of a two part study to demonstrate the clinical diagnosis potential of the CME system. A mobile version of the bench-top CME was modified to be used in the clinic. Fluorescein sodium is used as an initial contrast agent in these studies to demonstrate fluorescence imaging. Twenty patients were successfully imaged, and results of this study have allowed progression to a clinical validation study showing the diagnostic capabilities of the CME.

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16

Isokangas, J. M. (Juha-Matti). "Endovascular treatment of 467 consecutive intracranial aneurysms in Oulu University Hospital:angiographic and clinical results." Doctoral thesis, University of Oulu, 2006. http://urn.fi/urn:isbn:9514283112.

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Abstract The purpose of the study was to analyze the angiographic and clinical results of endovascularly treated intracranial aneurysms in Oulu University Hospital, Finland. The study population consisted of 416 consecutive patients (467 aneurysms, 332 ruptured), who were referred for endovascular treatment of intracranial aneurysm(s) between December 1993 and July 2004. Technical failures were analyzed for an assesment of technical feasibility. Angiographic results were assessed using modified Raymond Classification. Clinical results were analyzed from patient files using the Glasgow Outcome Scale (GOS). Patient, aneurysm, and procedure related variables were tested with an intention to find the predictors of the angiographic and clinical outcome. The clinical effects on presenting symptoms were analyzed for a subgroup of patients with a symptomatic unruptured aneurysm (n = 30). The mean results on technical feasibility, complications, and angiographic results were separately assessed for three time periods (1993–1997, 1998–2000 and 2001–2004) to demonstrate potential significant changes in outcome. Endovascular treatment of saccular aneurysms was technically feasible in 91.4% of the treatments. Initially, 25.7% of the aneurysms were completely occluded, 57.9% had a neck remnant, and 16.3% remained incompletely occluded. In follow-up, the rates for complete occlusions, neck remnants and incomplete occlusions were 37.6%, 49.7% and 12.7%, respectively. Small aneurysm size predicted complete aneurysm occlusion, while a wide aneurysm neck and location in the posterior circulation predicted incomplete occlusion. In follow-up (mean 38.2 months), 78.1% of the patients with a ruptured aneurysm and 92.3% of the patients with an unruptured aneurysm had resumed independent life (GOS 4-5). The predictors of good outcome were young age, good preprocedural clinical condition, small amount of blood in CT scan, and uncomplicated procedure. Ten of the treated aneurysms involved intracranial bleeding in follow-up, and the annual risk for bleeding after endovascular treatment was 0.95% among the patients with ruptured aneurysms and 0.33% among those with unruptured aneurysms. The risk of bleeding was associated with larger aneurysm size and lower occlusion grade. In the subgroup of symptomatic unruptured aneurysms, 53.4% of the patients showed either resolution or improvement of the symptoms after treatment. The rates of procedural complications, morbidity, and mortality were 16.5%, 6.7%, and 1.7%, respectively. The risk for procedural complications was higher when the balloon remodeling technique was used and lower in retreatments. Technical feasibility (85.6%, 90.6%, and 95.7%, respectively) and the percentage of complete occlusions (initially 16.5%, 23.0%, and 32.9%, respectively) were significantly improved by increased experience, while no statistical difference was detected in the total procedural complication rates (15.4%, 15.7%, and 18.3%, respectively) or the combined procedural morbidity and mortality rates (8.0%, 8.3%, and 9.1%, respectively). All six dissecting aneurysms treated with parent artery occlusion or the stent remodeling technique resulted in complete occlusions. The present results confirmed endovascular treatment of intracranial aneurysms as a feasible, safe, and effective method in preventing further bleeding of aneurysms. Increased experience in a single center improved the feasibility of the treatment as well as the angiographic results.

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17

Svensson, Michael. "The clinical, radiographic, histological and ultrastructural results after anterior cruciate ligament reconstruction using autografts /." Göteborg : Dept. of Orthopaedics, Institute of Surgical Sciences, Sahlgrenska Academy at Göteborg University, Göteborg, 2008. http://hdl.handle.net/2077/8437.

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18

Poon, Tung-chung Jensen, and 潘冬松. "Laparoscopic colorectal resection: the impacton clinical outcomes & strategies to further optimize its results." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45205711.

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19

Cunningham, Shona H. "['1'3'1I]-meta-iodobenzylguanidine treatment of neuroblastoma : experimental evaluation of strategies to improve clinical results." Thesis, University of Glasgow, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364088.

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20

Khaschuk, V. S. "Experience with results of adhesive disease’s treatment in children at children’s clinical city hospital." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17673.

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21

Zahnert, Thomas, Hubert Löwenheim, Dirk Beutner, Rudolf Hagen, Arneborg Ernst, Hans-Wilhelm Pau, Thorsten Zehlicke, et al. "Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results." Karger, 2016. https://tud.qucosa.de/id/qucosa%3A70599.

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Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warbletone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up. All patients had previously undergone failed reconstruction surgeries (up to 5 or more). In a subset of patients, additional speech tests at 12 months postoperatively were used to compare the aided with the unaided condition after implantation with the processor switched off. An established quality-of-life questionnaire for hearing aids was used to determine patient satisfaction. Results: Postoperative bone conduction remained stable. Mean functional gain for all couplers was 37 dB HL (RW = 42 dB, OW = 35 dB, Bell = 38 dB, CliP = 27 dB). The mean postoperative Freiburger monosyllable score was 71% at 65 dB SPL. The postimplantation mean SRT 50 (speech reception in quiet for 50% understanding of words in sentences) improved on average by 23 dB over unaided testing and signal-to-noise ratios also improved in all patients. The International Outcome Inventory for Hearing Aids (IOI-HA) quality-of-life questionnaire was scored very positively by all patients. Conclusion: A significant improvement was seen with all couplers, and patients were satisfied with the device at 12 months postoperatively. These results demonstrate that an active implant is an advantage in achieving good hearing benefit in patients with prior failed reconstruction surgery.

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Hse, Mei-yin Kitty, and 許美賢. "Clinical evaluation of compomer, a polyacid-modified composite resin, in primary teeth: 1 year results." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31954029.

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23

Lundberg, Elena. "Growth hormone responsiveness in children : results from Swedish multicenter clinical trials of growth hormone treatment." Doctoral thesis, Umeå universitet, Pediatrik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-134569.

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The general aims of the thesis were to study GH responsiveness by estimation of pharmacokinetics and bioavailability of injected recombinant human GH (rhGH), of growth response as gain in heightSDS during childhood and puberty, and IGF-I response as change in circulating IGF-ISDS and IGFBP3SDS. Methods Short children were recruited during 1988–1999 into two national randomized multicentre clinical trials on growth until adult height. A group of 117 GHD patients who had been treated from prepuberty with a single GH dose of 33μg/kg/day for at least 1 year were randomized at onset of puberty either to remain on this dose regimen or to an increased dose, GH67μg/kg/day, administered once daily or divided into two doses, GH33x2μg/kg/day. Data on IGF-ISDS and IGF binding protein 3 (IGFBP3)SDS were available from 111 patients and analysed as stated below. The 151 short prepubertal non-GHD patients were randomized into three groups: untreated controls, GH33 or GH67μg/kg/day. A subpopulation from both trials, 128 patients examined annually in Gothenburg, formed the study sample on GH uptake. They received sc GH injections to obtain 16–24 hour GH curves and the GH pharmacokinetics and bioavailability was calculated. Results: A dose-dependent effect on Cmax was found with great intra- and inter-individual variability. Of the Cmax variability, 43% was explained by the rhGH dose and proxies for injection depth. Median bioavailability of the injected dose was 71%, with great variation, mainly dependent on injection depth. In the IGHD group a dose-dependent difference in pubertal gain in heightSDS was found, with mean of 0.8 for the GH67 group and 0.4 for GH33, p<0.01. The mean total gain in heightSDS during treatment was 1.9 for GH67 and 1.4 for GH33, p<0.01. A dose-dependent pubertal ΔIGF-ISDS was 0.5 vs −0.1, p=0.007, correlating to pubertal gain in heightSDS, p=0.003; and was the most important variable to explain the variation in pubertal gain in heightSDS. In the non-GHD group the ΔIGF-ISDS from baseline to mean study level was dose-dependent 2.07 vs 1.20, p=0.001; and correlated negatively with baseline values of IGF-ISDS, rho= -0.56 for GH67, p=0.001, vs rho= -0.82 for GH33, p=0.0001, and correlated positively with gain in heightSDS in both GH-treated groups, rho= 0.42, p<0.001. In multivariable regression analyses, ΔIGF-ISDS was always an important explanatory variable for long-term growth response from the prepubertal period until adult height, while the IGF-ISDS study level per se was not. Conclusion: Growth response to GH treatment was dose dependent with great variability between patients. More pubertal growth was attained by an increased rhGH dose, mimicking the physiology of healthy children, in whom GH secretion rate increases during puberty. This resulted in a gain in IGF-ISDS closely correlating to pubertal gain in heightSDS in both IGHD and non-GHD patients. A broad range in GH responsiveness was found for both growth and IGF response in both diagnostic groups, but lower in the non-GHD group. Higher uptake of a given GH dose was observed after a deep injection and a higher GH concentration. These results are clinically applicable for individuals who remain short close to onset of puberty; by identifying and deeply injecting a rhGH dose that accounts for individual responsiveness, we can stimulate an increment in IGF-ISDS that correlates to gain in heightSDS during puberty.

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Hse, Mei-yin Kitty. "Clinical evaluation of compomer, a polyacid-modified composite resin, in primary teeth 1 year results /." Hong Kong : Faculty of Dentistry, The University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19902232.

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25

Phelps, Emma. "Exploring patients' experience of viewing their own 3D medical imaging results during a clinical consultation." Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/90841/.

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Background: Patients can struggle to comprehend and recall medical information, hindering their ability to participate in their own care. Research suggests that images may aid comprehension of medical information. Available for use in clinical practice, 3D medical images are relatively easy to interpret and could benefit lay people. However, little is known about patients’ experience of viewing them. Aim: The aim was to understand the role of a patient’s own 3D image in a clinical consultation. Four objectives were explored, to: (i) understand the impact for patients viewing their 3D image; (ii) understand how 3D images are incorporated into consultations; (iii) compare the experience of viewing 3D images, 2D images and no image alongside a diagnosis and (iv) understand whether informing participants of the occurrence of errors within image interpretation affects their trust in a diagnosis. Methods: A multi-method approach was adopted. Fourteen patients and four clinicians from a tertiary care orthopaedic outpatient clinic participated in semi-structured interviews and 10 clinical consultations were video-recorded. Additionally, 31 volunteers participated in focus groups and 252 volunteers participated in psychology laboratory experiments. Results: Patients considered their 3D images to be evidence, describing them to be truthful and authoritative. 3D images were used to explain diagnoses and treatments to patients during consultations. Participants showed better recall of the diagnosis when it was accompanied by 3D and 2D images compared to no image. Additionally, participants reported greater understanding and trust when the diagnosis was accompanied by 3D images compared to 2D images or no image. There was no significant difference in trust between participants who were informed of the potential for error within image interpretation and those who were not. Conclusion: Patients trust 3D images, perceiving them to provide authoritative knowledge. They may be a powerful resource for patients, increasing patient understanding, trust, and recall.

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Pobi, Shibendra. "A study of machine learning performance in the prediction of juvenile diabetes from clinical test results." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001671.

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Hedman, Katarina. "Pooling Data from Similar Randomized Clinical Trials Comparing Latanoprost with Timolol; Medical Results and Statistical Aspects." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3392.

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Blázquez, Navarro Arturo. "Towards personalized medicine in kidney transplantation: Unravelling the results of a large multi-centre clinical study." Doctoral thesis, Humboldt-Universität zu Berlin, 2020. http://dx.doi.org/10.18452/21322.

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Trotz Fortschritte in den letzten Dekaden ist das Langzeitüberleben von Nierentransplantaten unzureichend. Die Personalisierung der Behandlung kann dabei zu erheblichen Verbesserungen führen. Vor diesem Hintergrund wurde eine Kohorte von 587 Patienten im ersten Jahr nach der Transplantation untersucht und ein breites Spektrum von Markern zur langfristigen Prognose etabliert. In dieser Dissertation beschreibe ich in vier Manuskripten und zwei Kapiteln meine Arbeit zur personalisierten Transplantationsmedizin. Der klinische Verlauf von Patienten nach Nierentransplantation wurde untersucht. Die wichtigen Komplikationen standen im Vordergrund: Virusreaktivierungen – insbesondere die BK- und Cytomegalieviren – und akute Abstoßung. Folgende Analysen wurden durchgeführt: (i) Systematische Analyse der Assoziationen zwischen Virusreaktivierungen und deren Einfluss auf das Transplantationsergebnis; (ii) Bewertung der Auswirkungen antiviraler Behandlungsstrategien auf die Transplantationsergebnisse; (iii) Entwicklung eines Tools zur Prätransplantations-Risikoeinschätzung der Abstoßung und (iv) Erstellung eines mathematischen Modells für die personalisierte Charakterisierung der Immunantwort gegen das BK-Virus. Zusammengenommen haben die vier Studien das Potenzial, (i) die Patientenversorgung zu verbessern, (ii) die Überwachung von Virusreaktivierungen zu optimieren, (iii) Präventionsstrategien gegen virale Reaktivierungen zu stratifizieren, (iv) die Behandlung der Patienten an das individuelle Risiko akuter Abstoßung anzupassen, und (v) zur Personalisierung der Immuntherapie beizutragen. Die Studien zeigen, wie das große Datenvolumen einer klinischen Studie zur Weiterentwicklung der personalisierten Medizin unter Einsatz effektiver Strategien für Datenmanagement, Analyse und Interpretation genutzt werden kann. Es ist zu erwarten, dass diese Ergebnisse die klinische Praxis beeinflussen und so das langfristige Überleben und die Lebensqualität der Patienten verbessern.
In spite of the developments in the last decades, long-term graft survival rates in kidney transplantation are still poor: Personalization of treatment can thereby lead to a drastic improvement in long-term outcomes. With this goal, a cohort of 587 patients was characterized for a wide range of markers during the first post-transplantation year to assess their long-term prognosis. Here, I describe along four manuscripts and two chapters my work on personalized medicine for renal transplantation. In detail, we have studied the clinical evolution of patients with emphasis on two most relevant complications: viral reactivations – particularly those of BK virus and cytomegalovirus – and acute rejection. We have analysed in depth these phenomena by (i) exhaustively analysing the associations between different viral reactivations and their influence on transplantation outcome, (ii) evaluating the effects of antiviral treatment strategies on viral reactivation and other transplantation outcomes with emphasis on sex-associated differences, (iii) developing a tool for the pre-transplantation risk assessment of acute cellular rejection, and (iv) creating a mathematical model for the personalized characterization of the immune response against the BK virus under immunosuppression. Taken together, these studies have the potential of improving patient care, optimizing monitoring of viral reactivations, stratifying antiviral prevention strategies, tailoring immunosuppression and monitoring to the individual risk of acute rejection, and contributing to personalization of immunotherapy. They demonstrate how the large volume of data obtained within a clinical study can be employed to further the development of personalized medicine, employing effective data management, analysis and interpretation strategies. We expect these results to eventually inform clinical practice, thereby improving long-term survival and quality of life after kidney transplantation.

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Heynold, Yael Manuela. "Clinical, epidemiological and treatement results of idiopathic epilepsy in 54 labrador retrievers : a long term study /." [S.l.] : [s.n.], 1995. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Nilsson, Tage. "Pulmonary embolism : validation of diagnostic imaging methods in the clinical setting /." Stockholm : Karolinska institutets bibl, 2002. http://diss.kib.ki.se/2002/91-7349-346-5.

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Müller, Joachim, Stefan Brill, Rudolf Hagen, Alexander Moeltner, Steffi-Johanna Brockmeier, Thomas Stark, Silke Helbig, et al. "Clinical Trial Results with the MED-EL Fine Structure Processing Coding Strategy in Experienced Cochlear Implant Users." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134546.

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Objectives: To assess the subjective and objective performance of the new fine structure processing strategy (FSP) compared to the previous generation coding strategies CIS+ and HDCIS. Methods: Forty-six adults with a minimum of 6 months of cochlear implant experience were included. CIS+, HDCIS and FSP were compared in speech perception tests in noise, pitch scaling and questionnaires. The randomized tests were performed acutely (interval 1) and again after 3 months of FSP experience (interval 3). The subjective evaluation included questionnaire 1 at intervals 1 and 3, and questionnaire 2 at interval 2, 1 month after interval 1. Results: Comparison between FSP and CIS+ showed that FSP performed at least as well as CIS+ in all speech perception tests, and outperformed CIS+ in vowel and monosyllabic word discrimination. Comparison between FSP and HDCIS showed that both performed equally well in all speech perception tests. Pitch scaling showed that FSP performed at least as well as HDCIS. With FSP, sound quality was at least as good and often better than with HDCIS. Conclusions: Results indicate that FSP performs better than CIS+ in vowel and monosyllabic word understanding. Subjective evaluation demonstrates strong user preferences for FSP when listening to speech and music
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

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Filardo, Giuseppe <1979&gt. "Treatment of knee articular cartilage defects: surgical strategies, results and analysis of factors determining the clinical outcome." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6306/.

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Articular cartilage lesions, with their inherent limited healing potential, are hard to treat and remain a challenging problem for orthopedic surgeons. Despite the development of several treatment strategies, the real potential of each procedure in terms of clinical benefit and effects on the joint degeneration processes is not clear. Aim of this PhD project was to evaluate the results, both in terms of clinical and imaging improvement, of new promising procedures developed to address the challenging cartilage pathology. Several studies have been followed in parallel and completed over the 3-year PhD, and are reported in detail in the following pages. In particular, the studies have been focused on the evaluation of the treatment indications of a scaffold based autologous chondrocyte implantation procedure, documenting its results for the classic indication of focal traumatic lesions, as well as its use for the treatment of more challenging patients, older, with degenerative lesions, or even as salvage procedure for more advanced stages of articular degeneration. The second field of study involved the analysis of the results obtained treating lesions of the articular surface with a new biomimetic osteochondral scaffold, which showed promise for the treatment of defects where the entire osteochondral unit is involved. Finally, a new minimally invasive procedure based on the use of growth factors derived from autologous platelets has been explored, showing results and underlining indicatios for the treatment of cartilage lesions and different stages of joint degeneration. These studies shed some light on the potential of the evaluated procedures, underlining good results as well as limits, they give some indications on the most appropriate candidates for their application, and document the current knowledge on cartilage treatment procedures suggesting the limitations that need to be addressed by future studies to improve the management of cartilage lesions.

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Müller, Joachim, Stefan Brill, Rudolf Hagen, Alexander Moeltner, Steffi-Johanna Brockmeier, Thomas Stark, Silke Helbig, et al. "Clinical Trial Results with the MED-EL Fine Structure Processing Coding Strategy in Experienced Cochlear Implant Users." Karger, 2012. https://tud.qucosa.de/id/qucosa%3A27577.

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Objectives: To assess the subjective and objective performance of the new fine structure processing strategy (FSP) compared to the previous generation coding strategies CIS+ and HDCIS. Methods: Forty-six adults with a minimum of 6 months of cochlear implant experience were included. CIS+, HDCIS and FSP were compared in speech perception tests in noise, pitch scaling and questionnaires. The randomized tests were performed acutely (interval 1) and again after 3 months of FSP experience (interval 3). The subjective evaluation included questionnaire 1 at intervals 1 and 3, and questionnaire 2 at interval 2, 1 month after interval 1. Results: Comparison between FSP and CIS+ showed that FSP performed at least as well as CIS+ in all speech perception tests, and outperformed CIS+ in vowel and monosyllabic word discrimination. Comparison between FSP and HDCIS showed that both performed equally well in all speech perception tests. Pitch scaling showed that FSP performed at least as well as HDCIS. With FSP, sound quality was at least as good and often better than with HDCIS. Conclusions: Results indicate that FSP performs better than CIS+ in vowel and monosyllabic word understanding. Subjective evaluation demonstrates strong user preferences for FSP when listening to speech and music.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

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Cizinauskas, Sigitas. "A long-term treatment study in dogs with steroid-responsive meningitis-arteritis : clinical, laboratory and therapeutic results /." [S.l.] : [s.n.], 1999. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Naef-Freiburghaus, Ursula. "Outcome and complications after laparoscopic Swedish adjustable gastric banding : 5-year results of a prospective clinical trial /." [S.l.] : [s.n.], 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000277040.

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Humphreys, Lauren R. "The couple relationship and adjustment following prenatal genetic testing for advanced maternal age in women with normal test results." Thesis, University of Ottawa (Canada), 2004. http://hdl.handle.net/10393/29116.

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Two studies were undertaken to explore how aspects of the couple relationship might play a role in women's experience of prenatal diagnosis (PND). Both studies involved women referred to the Children's Hospital of Eastern Ontario (CHEO) for prenatal genetic counseling due to advanced maternal age (AMA). The first study examined the role of the partner during the genetic counseling session by comparing 123 women who attended the session alone with 222 women accompanied by their partners, on the basis of self-report measures completed immediately prior to and following the session. Accompanied women reported somewhat higher levels of state anxiety and PND-related decisional conflict before the session than did those who attended alone (p < .05). The presence of the partner could thus reflect a support-seeking coping strategy employed by women to cope with feelings of indecision and anxiety surrounding the issue of prenatal diagnosis. Alternatively, it is possible that attendance by the partner contributed to anxiety and uncertainty among women. The second study sought to clarify the reasons for partner attendance or non-attendance at the genetic counseling and testing appointments, and to explore how certain relationship variables might relate to women's individual and marital adjustment following PND. Ninety-five women completed self-report measures prior to genetic counseling (Time 1), during the waiting period for PND test results (Time 2), and after normal results were known (Time 3). Many women reported that their partners attended the appointments on the basis of the couple's view of PND as a shared experience, or to provide emotional and decisional support for the women. The most common reason for partner non-attendance was work-related conflicts. At Time 2, distress was predicted by the degree to which women approached the PND decision jointly with their partners, and marital adjustment was predicted by women's satisfaction with the support received from their partners. Marital adjustment at Time 3 was predicted by earlier levels of partner agreement about PND-related issues. The association between pre-counseling partner agreement and Time 3 well-being was mediated by women's use of relationship-focused coping (partner support seeking and empathic responding) and moderated by women's satisfaction with their partners' support. Joint decision-making at Time 1 was linked to Time 3 adjustment indirectly, through women's satisfaction with their partners' support. Finally, women's use of avoidant coping strategies mediated the association between perceived partner support and Time 3 adjustment outcomes. Results suggest that aspects of the couple relationship have the potential to facilitate or hinder women's experience of PND counseling and testing, thus highlighting the potential benefits of focusing at least a portion of the genetic counseling session on couple-related issues.

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O'Donnell, Rose Marie Roisin. "Pilot RCT of Mindfulness-Based Stress Reduction (MBSR) Versus Progressive Muscle Relaxation (PMR) to Reduce Symptoms of Distress Among Elderly Dementia Caregivers| Results at One Year Post-Intervention." Thesis, The University of Arizona, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10277682.

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Providing care for a frail older adult who is suffering from dementia has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. The burden and stress is increased when the caregivers are themselves elderly. The present study investigated an 8-week stress-reduction program, Mindfulness-Based Stress Reduction (MBSR), and compared it to a similarly structured, alternative behavioral intervention, Progressive Muscle Relaxation (PMR), to determine if MBSR was as effective or more effective than PMR at reducing subjective burden, symptoms of depression, perceived loneliness or perceived stress among middle-aged and older family caregivers of persons with dementia and other neurocognitive disorders. Twenty-eight participants were randomly assigned to either MBSR or PMR. Self-report and biological measures were collected on five occasions: At the beginning and end of intervention training, and at 8 weeks, 6 months and 1 year following the end of intervention training. In addition to a packet of self-report questionnaires and home-collected salivary cortisol, a laboratory controlled emotional stress test was designed to elicit an emotionally stressful response relevant to caregivers’ experience of caregiving, and facilitate the measurement of stress-related changes in systolic blood pressure and cortisol reactivity. At 1 year post-intervention, the PMR group showed a significantly greater reduction in perceived stress and disruptive patient behaviors. A reduction in emotional reactivity to patient problem behaviors approached significance (p = .08) at 1 year post-intervention for the PMR group. The MBSR group showed significantly greater reductions in self-reported symptoms of depression and perceived isolation from pre- to post-intervention, and those changes remained significant at 8 weeks post-intervention. However, by 1 year post-intervention, interaction effects were non-significant as both groups showed similar decreases in symptoms of depression and perceived isolation. Both groups showed similar decreases in diurnal cortisol, cortisol awakening response, and daily average cortisol (but not laboratory cortisol) from pre- to post-intervention and further decreases at 8 weeks post-intervention, and showed similar reductions in magnitude of change by 1 year post-intervention. This pattern was similar for both groups with systolic blood pressure, showing decreases from pre- to post-intervention, additional decreases at 8 weeks post-intervention, and returning towards baseline by 1 year post-intervention. Both groups also reported similar increases in levels of dispositional mindfulness and self-compassion and similar improvement in overall sleep quality that was sustained at 1 year post-intervention. No changes were seen for perceived burden or loneliness. Significant correlations with amount of daily practice of the instructed stress-reduction approaches were observed for several of the dependent measures from pre- to post-intervention and 8 weeks post-intervention. From pre-intervention to 1 year post-intervention, an overall pattern emerged, where both groups showed similar improvements from pre- to post-intervention, and additional improvements at 8 weeks post-intervention, but displayed a curvilinear reduction in improvements—with some exceptions—and a return towards baseline at 6 months and 1 year post-intervention. In general, reductions in the magnitude of changes observed by 1 year post-intervention remained below baseline levels. Results suggest that both MBSR and relaxation-based interventions may be differentially effective in reducing psychological and physiological indices of chronic stress among older caregivers of relatives with neurocognitive disorders. However, further research, employing wait-list control participants, will be necessary for unambiguous interpretation of the present results.

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Khan, Muhammad Munir Ahmed. "Effects of metal-on-metal hip replacement : clinical results and release, distribution and biological effects of wear debris." Thesis, Keele University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499344.

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This PhD thesis studies the performance of metal-on-metal bearings, which are used in hip arthroplasty. Three aspects in particular were studied, namely the clinical results, the release of cobalt and chromium wear debris from the bearings, and the effects of this debris on a cell's DNA. The clinical results showed that large diameter metal-on-metal bearing hip resurfacing (BHR) restored hip function to an excellent level and had an extremely low failure rate up to eight years after the operation. This makes a metal-on-metal bearing an attractive option for hip replacementin high-demand patients.

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Miller, Fiona, Mita Giacomini, Catherine Ahern, Jason Robert, and Laat Sonya de. "When research seems like clinical care: a qualitative study of the communication of individual cancer genetic research results." BioMed Central, 2008. http://hdl.handle.net/10150/610035.

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BACKGROUND:Research ethicists have recently declared a new ethical imperative: that researchers should communicate the results of research to participants. For some analysts, the obligation is restricted to the communication of the general findings or conclusions of the study. However, other analysts extend the obligation to the disclosure of individual research results, especially where these results are perceived to have clinical relevance. Several scholars have advanced cogent critiques of the putative obligation to disclose individual research results. They question whether ethical goals are served by disclosure or violated by non-disclosure, and whether the communication of research results respects ethically salient differences between research practices and clinical care. Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm.METHODS:This paper explores the implications of the disclosure of individual research results for the relationship between research and clinical care through analysis of research-based cancer genetic testing in Ontario, Canada in the late 1990s. We analyze a set of 30 interviews with key informants involved with research-based cancer genetic testing before the publicly funded clinical service became available in 2000.RESULTS:We advance three insights: First, the communication of individual research results makes research practices seem like clinical services for our respondents. Second, while valuing the way in which research enables a form of clinical access, our respondents experience these quasi-clinical services as inadequate. Finally, our respondents recognize the ways in which their experience with these quasi-clinical services is influenced by research imperatives, but understand and interpret the significance and appropriateness of these influences in different ways.CONCLUSION:Our findings suggest that the hybrid state created through the disclosure of research results about individuals that are perceived to be clinically relevant may produce neither sufficiently adequate clinical care nor sufficiently ethical research practices. These findings raise questions about the extent to which research can, and should, be made to serve clinical purposes, and suggest the need for further deliberation regarding any ethical obligation to communicate individual research results.

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Smurzynski, Jacek. "Preliminary Results of Multiple DPOAE Measurements Performed using the Sentiero System." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/2159.

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Tranæus, Sofia. "Clinical application of QLF and DIAGNOdent : two new methods for quantification of dental caries /." Stockholm : Karolinska Univ. Press, 2002. http://diss.kib.ki.se/2002/91-7349-149-7.

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Leclair, Susan J. "The Correlation Between the Levels of Education of Clinical Laboratory Personnel and the Accuracy of Peripheral Blood Smear Results." ScholarWorks, 2001. https://scholarworks.waldenu.edu/dissertations/1393.

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This study correlated the performance accuracy of peripheral blood differentials evaluated by clinical laboratory scientists and clinical laboratory technicians. Fifty-one senior-year students from four clinical laboratory science baccalaureate programs and 37 second-year students from five clinical laboratory technician programs were given 10 peripheral blood differentials to perform. Results were compared to the values assigned by the Rajamaki method of proficiency testing. There was a significant discrepancy in the levels of accuracy between the two cohorts, suggesting that the results of peripheral blood differentials performed by clinical laboratory technicians is suspect. Facilities wishing to maintain or improve the quality of laboratory services should consider allowing only baccalaureate level clinical laboratory scientists to perform peripheral blood differentials.

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Zinski, Anne. "Who is in a hurry for HIV test results? an exploration of presentation for OraQuick rapid result HIV andibody testing in urban clinical and outreach settings in Alabama /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2009r/zinski.pdf.

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Heschel, Jessica Rose. "Sexual Satisfaction in Women with Physical Disabilities: Results of an Online Survey." Wright State University Professional Psychology Program / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1309388680.

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Franta, Oliver. "Tibial or hip BMD predict clinical fracture risk equally well : results from a prospective study in 700 elderly Swiss women /." Bern : [s.n.], 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000279089.

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Muller, Reka D. "Evaluation of Clinical Practices and Needs about Variants of Uncertain Significance Results in Inherited Cardiac Arrhythmia and Inherited Cardiomyopathy Genes." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7863.

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The increasing numbers of genetic tests in clinical settings have identified many variants of uncertain significance (VUS) in genes associated with inherited cardiac arrhythmias and inherited cardiomyopathies. Evaluation of clinical practices including counseling strategies and medical management recommendations for patients and their families is important to improve patient outcomes and prevent over- or under-treatment that may result in morbidity or fatality. The purpose of this study is to describe provider practices related to VUS results including how they conduct risk assessments and ascertain what information and medical management recommendations they provide to patients with VUS results and the patients’ family members. Additionally, we aim to describe providers’ concerns and informational needs related to counseling about a VUS. An anonymous online survey was developed for the current study and distributed to genetic counselors through the National Society of Genetic Counselors (NSGC) listerv and to cardiologists via emails obtained from publicly available resources. The survey explored healthcare providers’ confidence in counseling about a VUS, explanation of a VUS to patients, topics covered before and after genetic testing, and recommendations for patients with a VUS and their families using clinical vignettes. Providers (N=102) who completed the survey included 29 cardiovascular genetic counselors, 50 genetic counselors from other specialties, and 23 cardiologists. A hypothetical clinical scenario was used in which a young adult patient had a VUS in a gene causing Arrhythmogenic Right Ventricular Cardiomyopathy, but did not meet clinical diagnostic criteria for the condition. The patient’s only concerning issues included a personal history of fainting during exercising and sudden death of a 45 year old first-degree relative. Nearly 9% of all providers incorrectly described the VUS as likely pathogenic, while 15% would downplay the finding by indicating the VUS is more likely to eventually be reclassified as benign. Genetic counselors feel more confident about counseling about VUS results (p<0.001). Both cardiovascular genetic counselors and cardiologists feel confident in making medical management recommendations; however, cardiologists are more likely to recommend treatment with beta-blockers and exercise limitation for the patient. Compared to cardiac genetic counselors, other genetic counselors (p=0.001) and cardiologists (p=0.014) were more likely to recommend clinical testing for family members even though testing is expected to be uninformative, especially given the absence of any clinical diagnosis in the family. These findings highlight the expertise of different providers in different specialty area and suggest the need for interdisciplinary clinics that include cardiologists, cardiac genetic counselors, nurses, geneticists, psychologists and others to optimize care for challenging cases where VUS results create uncertainty.

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Cullen, Clare M. "A comparision and review of design concepts, kinematics and clinical results of fixed bearing versus mobile bearing cemented total knee arthroplasty." Thesis, University of Strathclyde, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502296.

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Dantas, Solange Cecilia Cavalcante. "Assessment from the outcomes clinical and humanistic by one plane of pharmaceutical care of a asthmatic patients." Universidade Federal do CearÃ, 2007. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1045.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
The high prevalence of poorly controlled asthma and the associated high morbimortality have been shown to be related mainly to under-diagnosis and inadequate treatment of this condition. This present significant cost adding further burden on the healthcare budget The consequences of poorly controlled asthma are repeated clinic visits repeated emergency room admissions and repeated hospital admissions In extreme but numerous occasions asthma attacks resulting from poor management lead to deaths Therefore it had been stated that a key component of many asthma management guidelines is the recommendation for patient education and regular medical review These (patient education and regular medication/medical reviews) are primary areas for the pharmacist to make an impact Objective To describe and to analyze the influence of a Pharmaceutical Care (PC) service in the clinical and humanistic outcomes through the pharmacotherapeutic follow-up (PF) of a group of asthmatic patients attending an ambulatory care facility by hospital referral in the State of the CearÃ Methods Thirty patients participated of this longitudinal prospective and descriptive study in the period from August 2006 to May 2007 Instruments used to collect information from patients were an asthma-specific quality of life questionnaire (The Brazilian version of the Asthma Quality of Life Questionnaire AQLQ) daily records of symptoms of the asthma and a questionnaire to assess satisfaction with Pharmaceutical Care services The PF and the classification of drug related problems (DPR) followed Cipolle et al criteria (2004) and adopted a systematic PWDT (Pharmacistâs Work up of Drug Therapy) approach in identifying and resolving DPR Results The majority of patients were females (80%) 10% completed primary school level only mean age was 46 Â x 11 9 30% were on married social pension and with income of two minimum salaries Patients used an average of two inhaled medications (corticosteroids and bronchodilator) /day and more than 50% of patients did not use their inhaler medication devices correctly Sixty four DPR were identified, of which 31 25% were related to poor compliance with drug therapy After the provision of Pharmaceutical Care and through following a PWDT strategy 66 6% of the patients did not report nocturnal symptoms of asthma and did not have to use short-acting bronchodilator for asthma symptoms By the conclusion of the study a significant improvement (p< 0 05) was observed in the four domains of the AQLQ In the questionnaire assessing satisfaction with the Pharmaceutical Care services a superior index of 95% was observed in all its domains Conclusion The improvement seen in all aspect of the outcomes measured including clinical and humanistic outcomes after the provision of PC has provided evidence for the role of the pharmacist in asthma management using a structured approach to educate the patient about the pharmacotherapy regimen address compliance issues and making drug therapy interventions that lead to rationalizing therapy and minimizing DPR

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Mohamed, Safia. "A comparative clinical case study of a traditional and positive psychological psychometric feedback." Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/25537.

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The purpose of this clinical case study was to compare clients’ and an Educational Psychologist’s experiences of a psychometric feedback from a traditional perspective with feedback from the perspective of positive psychology. The study consulted relevant literature and integrated readings to design frameworks to guide the two modes of feedback. A mixed-method research approach was applied, with a dominant focus on the qualitative aspects of this study (Qualquan), guided by an interpretivist epistemology. Four adolescent girls and an Educational Psychologist were conveniently selected to participate, with two girls participating in the pilot phase and two in the data collection phase. After the pilot the interview frameworks were adapted. Psychometric profiles were used to generate quantitative data, while audio-visual recordings of the feedback interviews, interview transcripts, field notes , the researcher’s and Educational Psychologist’s reflections, and participants’ pre- and post-feedback narratives contributed to the qualitative data for the study. Following thematic analysis it emerged that the clients’ experienced four similarities between the two modes of feedback interviews. Both feedback interviews were experienced as satisfactory and positive experiences; both modes provided self- and career knowledge to the participants; both were experienced as comprehensive feedbacks and the Educational Psychologist highlighted both strengths and weaknesses of the client in each mode. However, the participant who experienced the positive psychological feedback interview received an additional strength-building opportunity. The lack of significant differentiation between the two modes of feedback interviews may be indicative of the value of the therapeutic alliance between therapists and client. This study’s main contribution to Educational Psychology theory and practice is a framework for a positive psychological feedback interview, which may create opportunities for strength-building discussions.
Dissertation (MEd)--University of Pretoria, 2011.
Educational Psychology
unrestricted

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Saager, Cristoph Peter. "Isthmic spondylolisthesis : an analysis of the clinical and radiological presentation in relation to intraoperative findings and surgical results in 72 consecutive cases /." Bern, 1992. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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