Dissertations / Theses on the topic 'Master of Clinical Research'
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Vedin, Elin. "The clinical reasoning among master students specializing in Orthopedic Manual Therapy." Thesis, Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-85765.
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The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) describes Orthopedic Manual Therapy (OMT) as a specialist field in physiotherapy for the treatment of neuromusculoskeletal conditions based on clinical reasoning. The aim of this study was to explore how students in a OMT physiotherapy master programme describe their clinical reasoning. Nine participants were included in the study. Data was collected using a semi-structured interview guide and were analyzed with qualitative content analysis. The analysis resulted in one main category: “A multidimensional picture of clinical reasoning” and three categories: 1) Confidence in the role as physiotherapist; 2) Decision making, a cognitive analytical process 3) Creating alliance and involving the patient in the clinical reasoning. The participants described a multidimensional picture of clinical reasoning which gradually developed and eventually encompassed several aspects in the subcategories. The conclusion of the study is that all the parts above are needed in the clinical reasoning and it takes years to develop effective clinical reasoning. For future studies, it would be of interest to explore how recently graduated physiotherapists with a bachelor degree describe their clinical reasoning.
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Salgueiro, Ana Cláudia Marques. "Curricular training in coordination of clinical trials in a clinical research unit." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/14285.
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Mestrado em Medicina FarmacêuticaThis report describes several activities and projects developed in the context of a curricular training in a clinical research unit, Centro de Investigação Clínica (CIC), led by Professor Joaquim Ferreira. The CIC is one of the research groups of Instituto de Medicina Molecular (IMM) and it is also a group of the Centro Académico de Medicina de Lisboa (CAML) consortium. The principal area of training was the coordination of clinical trials and observational studies. Additionally, other research activities were conducted during the training such as, pharmacovigilance, monitoring, data entry, medical writing and some language coordination activities in a European observational study about Huntington’s Disease founded by European Huntington’s Disease Network (EHDN). It is mention on the State of the Art the Research & Development Process of a new drug and it is characterised some issues about clinical research in Portugal, including advantages in the establishment and organisation of clinical networks. During the training, with the duration of 10 months (that started on 1st September 2013 and finished on 1st July 2014) I deepened my knowledge in clinical research area, understand the importance of the clinical research units, the importance and the role of the study coordinators and expand my areas of interest. The specific training focused in neurological clinical. I had opportunity to understand the practical and logistical difficulties that a research unit faces during the conduction of clinical studies I consider that this training was a valuable experience of introduction of the practice of clinical research. I finished this training with the motivation and interest in working in the area of coordination and monitoring of studies.
Este relatório descreve as actividades e projectos desenvolvidos no âmbito de estágio curricular numa unidade de investigação clínica, o Centro de Investigação Clínica (CIC), liderada pelo Professor Doutor Joaquim Ferreira. O CIC faz parte dos grupos de investigação do Instituto de Medicina Molecular (IMM) inserindo-se na iniciativa do consórcio Centro Académico de Medicina de Lisboa (CAML). A principal área de estágio foi a coordenação de ensaios clínicos e estudos observacionais. Adicionalmente foram abordadas outras actividades durante o estágio, tais como farmacovigilância, monitorização, preenchimento de bases de dados, escrita científica e algumas actividades de coordenação a nível nacional de estudo observacional europeu sobre a doença de Huntington financiado por European Huntington’s Disease Network (EHDN). Refere-se no estado da arte o Processo de Investigação e Desenvolvimento de novos medicamentos e caracteriza-se alguns aspectos da investigação clínica em Portugal incluindo vantagens na organização de redes clínicas de investigação. Ao longo do estágio, com 10 meses de duração (início a 1 Setembro de 2013 e fim a 1 de Julho de 2014) aprofundei o conhecimento na área de investigação clínica, percebi a importância de unidades de investigação clínica, a importância e papel de coordenadores clínicos e expandi as minhas áreas de interesse. O treino específico centrou-se em estudos clínicos na área da neurologia, nomeadamente ensaios de clínicos de fase II e III, e estudos observacionais. Tive ainda oportunidade de compreender a realidade prática e logística da condução de estudos clínicos num centro de investigação. Considero que este estágio foi uma experiência valiosa de introdução á prática de investigação clínica. Desta forma, termino o estágio com motivação e interesse em trabalhar na área de coordenação ou monitorização de estudos.
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Almeida, Nuno Miguel Dias. "Curricular internship in a clinical research unit." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/17113.
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Mestrado em Biomedicina FarmacêuticaO presente relatório descreve em detalhe as tarefas e atividades desenvolvidas no contexto de um estágio curricular durante o segundo ano do Mestrado em Biomedicina Farmacêutica, da Universidade de Aveiro. Este estágio teve lugar na Unidade de Farmacologia Clínica do Professor Joaquim Ferreira, do Instituto de Medicina Molecular, de 14 de setembro de 2015 a 27 de junho de 2016. Esta experiência permitiu-me pôr em prática aquilo que aprendi no mestrado durante dez meses. Tive a oportunidade de trabalhar em três áreas diferentes da biomedicina farmacêutica: farmacovigilância, coordenação de ensaios clínicos e gestão de dados. Durante o estágio, surgiram múltiplas dificuldades e obstáculos. Contudo, consegui ultrapassá-los, melhorando as minhas capacidades profissionais, tais como organização, responsabilidade, comunicação, espírito critico, entre outras qualidades fundamentais para ser um bom profissional. Em conclusão, este estágio curricular permitiu o meu crescimento, não só como profissional, mas também como pessoa. Considero que tenha sido um desafio concretizado com sucesso e estou consciente que me abriu muitas janelas para a minha carreira futura.
This report describes in detail the tasks and activities developed in the context of a curricular internship during the second year of the Master’s degree in Pharmaceutical Medicine of the University of Aveiro. This internship took place in the Professor Joaquim Ferreira’s Clinical Pharmacology Unit (CPU) of the Instituto de Medicina Molecular, from September 14th, 2015 to June 27, 2016. This experience allowed me to put in practice what I learned from my master’s degree during ten months. I had the opportunity to work in three different areas of pharmaceutical medicine: pharmacovigilance, clinical trial coordination and data management. During the internship, several difficulties and obstacles showed up. However, I managed to surpass them, improving my professional skills, such as organization, responsibility, communication, critical thinking, among other fundamental qualities to be a good professional. In conclusion, this curricular internship allowed me to grow up, not only as a professional but also as a person. I think it was a successful challenge and I’m aware that it has opened many windows to future career.
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Mace, Janet-Lee. "An inquiry into the meaning of Guillain-Barré syndrome : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts." Massey University, 2001. http://hdl.handle.net/10179/1180.
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Guillain-Barré Syndrome (GBS) is an autoimmune syndrome characterized by a severe and rapid onset of paralysis that ascends without warning. It has an unknown aetiology and is generally unknown by most people, including medical professionals. When a person who has had GBS is asked to speak about their experience, they are likely to talk about aspects of it that are personally meaningful. Their account can be likened to a story in that it collates seemingly unconnected facts, episodes of activity and emotional attributions into a sequence that provides knowledge and understanding. A story is a powerful form for expressing suffering and experiences and so is particularly suitable for the study of trauma and illness. The actual process of creating the story, plus its presentational and organisational forms, provides sources for uncovering the identities authors choose to create and present of themselves. Six people who have had GBS were interviewed about their experience, and their stories were analysed using a narrative inquiry to discern the meanings attributed to GBS from the participants’ own understandings and perspectives. The intended focus of the research was holistic and content based. The result of the narrative inquiry was a plot common to all six narratives. Namely, GBS is an inexplicable condition, during which horrendous things happen, but people do recover with time and it is likely their life view will be changed in the process. Four fundamental issues, identity, meaning, making sense and meaningfulness were drawn from the stories and configured into a narrative of the researcher’s making. What the participants chose to speak about became the meanings, or themes, major and minor, of their stories. No event has meaning in itself, however traumatic events can precipitate crises of meaning. When these crises are viewed within the context of other events, and are perceived to add value to life, then they have meaningfulness. In the telling of meanings and meaningfulness, the purpose for storying and the audience to whom the story is directed are the criteria for which the storylines are chosen. Both the story and the storying provide opportunities for the authors to create and offer images of themselves, that are then open to interpretation by an audience. As a traumatic experience, GBS enabled six people to tell their stories. In doing so they were able to make sense of important issues for themselves, and re-examine the way they saw themselves and the world.
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Kunda, Richard. "The Outcomes and Impact of a Postgraduate Physiotherapy Master's Programme on Research and Clinical Practice in Africa." Thesis, University of the Western Cape, 2016. http://hdl.handle.net/11394/5526.
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Philosophiae Doctor - PhDThe past decade has seen a growth in Physiotherapy schools offering postgraduate programmes in South Africa. The Republic of South Africa assists other African countries like Kenya, Malawi, Rwanda, Tanzania and Zambia in upgrading the education of diploma-trained physiotherapists (DTPs) to Bacherlor of Science (Honours) (BSc (Hons) and Master's Degrees respectively. The three institutions offering Physiotherapy training in Cape Town make it the largest training locality for Physiotherapy in South Africa. The University of Cape Town (UCT), University of the Western Cape (UWC) and Stellenbosch University are situated within a twenty kilometre radius from each other. These schools have taken a leading role in the postgraduate training of their own PTs, and those from other developing countries. In 2007, for example, about 20% of postgraduate students in Cape Town Physiotherapy schools were from other African countries. The Department of Physiotherapy at UWC in particular has been upgrading DTPs from other African countries to BSc (Hons) and Master's degrees for the last twenty years. However, compared to the wealth of educational literature on other healthcare professions, literature on the evaluation of postgraduate Physiotherapy programmes is scarce. Thus, the aim of this study was to evaluate the outcomes and impact of the UWC postgraduate Physiotherapy BSc (Hons) and Master's programme on clinical practice and research in East and Southern Africa. The dissertation used an explorative and descriptive theory-based evaluation approach using qualitative research methodology. The steps involved in the research process determined the choice and use of the qualitative methodology. The use of qualitative methods was undertaken to provide a comprehensive analysis of the research problem. The study had three main phases. Initially, administrative document reviews and in-depth interviews with UWC postgraduate Master's programme designers (PDs) were conducted to help develop and test the programme theory and measuring instruments (interview guides). Secondly, postgraduates were interviewed to establish and test the implementation process theory, as well as investigate perceived programme outcomes. Then focus group discussions with postgraduate students of UWC, and individual interviews with workplace supervisors of the UWC postgraduates were undertaken to investigate the perceived outcomes and impact of the UWC Master's programme. A variety of methods appropriate for the different steps or stages of the programme were employed, to ensure this evaluation exercise becomes an integrated function in which data are continuously collected and used for decision-making and programme improvement. Multiple types of data were collected to inform each phase. The researcher used purposive sampling technique to constitute the sample. The sampling technique yielded three official documents, three (3) PDs and two (2) implementers, 27 UWC postgraduates, seven (7) workplace supervisors and 30 students of UWC postgraduates. Data was collected via document analyses, in-depth interviews, telephonic in-depth interviews and focus group discussions. Qualitative data analysis occurred concurrently with data collection. Atlas Ti software version 10 was used to assist with data management. The UWC postgraduates reported acquiring knowledge of manual therapy, better management of musculo-skeletal conditions and enhanced clinical reasoning. Participants also reported career growth, pursuit of higher degrees such as PhDs, promotions, job changes from physiotherapy clinicians to educators, involvement in research and the introduction of BSc programmes in their respective countries. The current study demonstrates that the primary objective of the UWC BSc (Hons) and Master's programmes such as increasing access to physiotherapy training in Africa and empowering DTPs with research skills and knowledge of community-based rehabilitation was being realised. However, many postgraduate participants in all countries emphasised the need to include basic sciences, clinical practice and specialisation in the UWC BSc (Hons) and Master's programmes respectively. Furthermore, the participants reported that the programmes did not have much impact on management of conditions other than musculo-skeletal. On the other hand, the employers that participated in the current study identified that the UWC programmes had a positive impact on Physiotherapy education in their respective countries, producing a total of five Physiotherapy degree programmes between the year 2000 and 2014. Kenya, Rwanda, Tanzania and Zambia reported introducing two, one, one and two BSc Physiotherapy programmes respectively. The study also revealed moderate research activity among UWC postgraduates, a challenge most employers attributed to institutional research agendas, high patient work-load and personal strengths of postgraduate students. The students of UWC graduates who participated in the current study reported acquiring new assessment skills for musculo-skeletal conditions, enhanced treatment techniques for musculoskeletal conditions and use of evidence to guide their clinical practice. The participants also reported reduced hospital visits among patients with musculo-skeletal conditions and relatively short treatment durations. However, in all universities but one, students indicated that most lecturers had difficulty applying basic sciences during lectures. The participants also reported a lack of specialist lecturers in areas other than musculo-skeletal. This thesis focused on evaluation of the outcomes and impact of postgraduate BSc (Hons) and Master's programmes in Physiotherapy for DTPs in SADC and East Africa. While the thesis has highlighted many achievements, it has also identified training needs of DTPs that require attention. First, we recommend that the curriculum be reviewed to incorporate clinical practice and more theoretical content in the BSc (Hons) programme and that the UWC special BSc (Hons) programme be considered an RPL project to ensure the visible (documented) and nonvisible (undocumented) knowledge claimed by applicants are subjected to a form of assessment through the UWC RPL process, thus enabling the university to identify the knowledge gap that requires bridging among DTPs seeking admission to the degree programme. Second, we recommend a review of the Master's degree by coursework programme to include more theoretical and clinical practice components that would allow for specialisation.
National Research Foundation (NRF)
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Jarden, Rebecca Jane. "Gastric residual volumes in the adult intensive care patient : a systematic review : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-Thesis, 2009. http://hdl.handle.net/10063/1188.
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Dodsworth, Caroline. "How can midlife nurses be supported to deliver bedside care in the acute clinical services until retirement? : a thesis presented in partial fulfilment of the degree of Master of Philosophy (Nursing), Massey University, Turitea, Palmerston North, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/902.
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As the baby boomer generation move inexorably towards retirement and the requirement for health care services increases, the supply of nurses available to provide care at the patient bedside is forecast to fall significantly short of demand. This thesis has explored the perspectives of midlife nurses, asking what it would take to keep them in bedside practice until retirement. These nurses have provided insights which offer employers of valuable senior nurses, suggestions for maximising their potential. Through the use of questionnaires and focus groups nurses aged 45 years and over were asked what the employer can do to ensure that they are able to continue to work at the patient bedside until they reach the age of retirement. The results of this research demonstrate a workforce of nurses who are passionate and committed to their profession, but feeling disillusioned and disempowered. The nursing environment has changed over the span of their career and they find the increased workload, together with increasing professional demands, too hard to cope with. They feel they have no control over their workload, their shift patterns, or the expectations of their patients and colleagues. They want their experience to be recognized but they do not want to have to prove competency; they want to have a voice but they are unwilling to pursue postgraduate education to learn how to become visible and emancipated.
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Andrae, Daniela. ""Diabetes? I can live with it" : a qualitative evaluation of a diabetes self-management programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1199.
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Self-management programmes provide one form of education for people with diabetes. Evaluations of these programmes allow for a better understanding in regard to their impact and whether outcomes are met. Very little research has used qualitative methods to capture participants’ experiences of these programmes and their perception of psychological outcomes. This is the first qualitative evaluation of the Type 2 Diabetes Self-Management Programme in Whangarei. It has adopted an interpretative-phenomenological approach to explore participants’ experiences of the programme and participants’ perceptions in regard to their self-efficacy and quality of life after attending a course. A sample of 7 participants with diabetes provided data via interviews 4 weeks and 3 months after attending the course. The themes that emerged from the initial interview were separated into three evaluation components. In “6 weeks sounded very long but it was worth the time”, participants discussed enrolment, benefits of the course and suggestions for future participants. In “I know what I need to do and I’m confident to do it”, participants linked the gained knowledge from the course to improvements in their self-efficacy regarding self-management behaviours, education and control of own life. In “Life is good, diabetes is just another thing to handle”, participants reflected on the impact of living with diabetes and changes to their life. An overarching theme of settling into a comfortable routine emerged from the follow-up interview. Participants reflected positively on their course and research participation. The programme was perceived to be beneficial to participants, impacting positively on increasing knowledge, self-efficacy development, behaviour changes and quality of life. The participants maintained these benefits in the short-term. These results are discussed in terms of the need for further research to evaluate if benefits are maintained in the long-term, referral process to the programme, decision-making process in regard to enrolment and impact of a support person attending the programme. Practice implications for the programme are discussed in regard to incorporating a follow-up phone call to participants after they attended a course and offering follow-up sessions with the latest information on diabetes care.
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Rifshana, Fathimath. "Outcome evaluation of the Massey University Concussion Clinic: a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1165.
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The primary aim of the present study was to evaluate the effectiveness of the intervention provided by Massey University Concussion Clinic for individuals following Mild Traumatic Brain Injury (MTBI). Concussion Clinics were set up across New Zealand to provide early intervention and assessment for individuals with MTBI to prevent long term complaints. Treatment outcomes at these clinics have not been empirically examined before. The current study compared the levels of post concussion symptoms, anxiety, depression, and psychosocial functioning between an intervention and a control group using a quasi-experimental design. In addition, reasons for nonattendance to the clinic, and participants’ perceptions of their recovery were also explored. The main outcome measures used were the Rivermead Postconcussion Symptoms Questionnaire, the Hospital Anxiety and Depression Scale, and the Sydney Psychosocial Reintegration Scale-2. Outcomes were initially assessed soon after injury or referral to the clinic and then three months later. Participants were recruited from the Palmerston North Hospital Emergency Department and the Massey University Concussion Clinic. With 20 participants in the intervention group and 15 in the control group, the main results showed that the Concussion Clinic intervention significantly decreased the level of anxiety and depression reported by participants in the intervention group over the control group. Greater improvements in post concussion symptoms and psychosocial functioning were also indicated in the intervention group. Additional findings suggest difficulty with transportation as a reason for nonattendance, which could be a potential barrier to recovery. Furthermore, participants highlighted the benefits of attending the service and its role in their recovery. Important issues relating to the referral processes were also identified. Findings of the current study suggest that the Concussion Clinic intervention is effective in improving recovery for those accessing the service. Nevertheless, these results must be interpreted with caution due to the small sample size. Further research is warranted to examine the effectiveness of the Concussion Clinics with larger samples, and the current study may serve as a valuable pilot for these future investigations.
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Wilkinson, Catherine Joy. "Reflections and analysis to improve clinical practice : a student music therapist's journey with a preschool child with special needs : a dissertation presented in partial fulfilment of the requirements for the degree of Master of Music Therapy at the New Zealand School of Music, Wellington, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/858.
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This qualitative study critically examines the researcher’s music therapy clinical practice with a preschool child with global developmental delay. The researcher/student music therapist critically examined and refined her clinical practice using an action research model. Each cycle consisted of a plan, action, data collection, reflection, and analysis. The researcher was the main participant. The child, his mother and a speech-language therapist were co-participants with different roles. The child and his mother participated in the sessions. The speech-language therapist observed three sessions through a window. Feedback from the child’s mother and the speech-language therapist contributed to the reflective data. Important issues that developed through the cycles related to early intervention techniques (having fun, being playful and spontaneous, and being in close proximity). Other important issues that developed were, the use of the voice and guitar; confidence; professionalism with parents and other health professionals; self-awareness; and the understanding of early childhood development (especially in the area of communication). Related literature on aspects of music therapy practice, music therapy in early intervention, music therapy and communication, and action research are described. These results cannot be generalised. However, they may firstly, illustrate relevant trends in early intervention, and secondly, enable the researcher to adapt skills learnt to use in future practice in early intervention
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Coles, Andrew H. "Long-Term Survival and Prognostic Factors in Patients with Acute Decompensated Heart Failure According to Ejection Fraction Findings: A Population-Based Perspective: A Master Thesis." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/722.
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Limited data exists describing the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to currently recommended ejection fraction (EF) findings. In addition, little is known about the magnitude of, and factors associated with, long-term prognosis for these patients. Based on previously validated and clinically relevant criteria, we defined HF-REF as patients with an EF value ≤40%, HF-PEF was defined as an EF value > 50%, and HF-BREF was defined as patients with an EF value during their index hospitalization between 41 and 49%. The hospital medical records of residents of the Worcester (MA) metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during the 5 study years of 1995, 2000, 2002, 2004, and 2006 were reviewed. Follow-up was completed through 2011 for all patient cohorts. The average age of this population was 75 years, the majority was white, and 44% were men. Patients with HF-PEF experienced higher post discharge survival rates than patients with either HF-REF or HF-BREF at 1, 2, and 5-years after discharge. Advanced age and lower estimated glomerular filtration rate findings at the time of hospital admission were important predictors of 1-year death rates, irrespective of EF findings. Previously diagnosed chronic obstructive pulmonary disease, chronic kidney disease, and atrial fibrillation were associated with a poor prognosis in patients with PEF and REF whereas a history of diabetes was an important prognostic factor for patients with REF and BREF. In conclusion, although improvements in 1-year post-discharge survival were observed for patients in each of the 3 EF groups examined to varying degrees, the post- 7 discharge prognosis of all patients with ADHF remains guarded. In addition, we observed differences in several prognostic factors between patients with ADHF with varying EF findings, which have implications for more refined treatment and surveillance plans for these patients.
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Coles, Andrew H. "Long-Term Survival and Prognostic Factors in Patients with Acute Decompensated Heart Failure According to Ejection Fraction Findings: A Population-Based Perspective: A Master Thesis." eScholarship@UMMS, 2008. http://escholarship.umassmed.edu/gsbs_diss/722.
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Limited data exists describing the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to currently recommended ejection fraction (EF) findings. In addition, little is known about the magnitude of, and factors associated with, long-term prognosis for these patients. Based on previously validated and clinically relevant criteria, we defined HF-REF as patients with an EF value ≤40%, HF-PEF was defined as an EF value > 50%, and HF-BREF was defined as patients with an EF value during their index hospitalization between 41 and 49%. The hospital medical records of residents of the Worcester (MA) metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during the 5 study years of 1995, 2000, 2002, 2004, and 2006 were reviewed. Follow-up was completed through 2011 for all patient cohorts. The average age of this population was 75 years, the majority was white, and 44% were men. Patients with HF-PEF experienced higher post discharge survival rates than patients with either HF-REF or HF-BREF at 1, 2, and 5-years after discharge. Advanced age and lower estimated glomerular filtration rate findings at the time of hospital admission were important predictors of 1-year death rates, irrespective of EF findings. Previously diagnosed chronic obstructive pulmonary disease, chronic kidney disease, and atrial fibrillation were associated with a poor prognosis in patients with PEF and REF whereas a history of diabetes was an important prognostic factor for patients with REF and BREF. In conclusion, although improvements in 1-year post-discharge survival were observed for patients in each of the 3 EF groups examined to varying degrees, the post- 7 discharge prognosis of all patients with ADHF remains guarded. In addition, we observed differences in several prognostic factors between patients with ADHF with varying EF findings, which have implications for more refined treatment and surveillance plans for these patients.
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German, Millberg Lena. "Akademisering av specialistsjuksköterskans utbildning i Sverige : Spänningsförhållanden med anledning av utbildningsreform i enlighet med Bologna." Licentiate thesis, Karlstads universitet, Avdelningen för omvårdnad, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-15627.
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Licentiatavhandlingens övergripande syfte var att studera konsekvenser av ökad akademisering och akademiskt lärande inom Svensk specialist-sjuksköterskeutbildning efter genomförande av ny utbildningsreform enligt Bologna. Bakgrund: Specialistsjuksköterskor förväntas i dagens hälso– och sjukvård att kunna bedriva en patientsäker och evidensbaserad vård, vilket kräver akademisk kompetens. Utbildningen till specialistsjuksköterska fördes i och med Bolognaprocessens införande i Sverige 2007 till avancerad utbildningsnivå. Både yrkesexamen och akademisk examen (magisterexamen) skulle inkluderas och integreras i samma utbildning. Detta medförde en förändring från en ämnesinriktad (samlingskodsinriktad) läroplan till en läroplan som syftar till att integrera ämnen (integrationskodsinriktad). Förutom ämnesintegrering skulle yrkesspecifika mål integreras med akademiska mål. Metod: Artikel I genomfördes i form av ett didaktiskt aktionsforskningsprojekt som pågick under 2½ år. En projektledningsgrupp (n=15-18) från fem lärosäten bildades. Denna grupp har aktivt deltagit i hela aktionsforskningsprocessen och vid projektmöten. Vid varje lärosäte utsågs en projektansvarig som ansvarade för den lokala aktionsforskningsprocessen. Dessa personer samlande in data i form av kursplaner, utbildningsplaner, studiehandledningar, minnesanteckningar från lärarmöten och möten med vårdverksamheter samt minnesanteckningar från forskargruppensmöten. Analys har gjorts med hjälp av konstant komparativ analysmetod. I artikel II användes konstruktivistisk Grounded Theory för att samla in och analysera data. Datainsamlingen påbörjades utifrån specialistsjuksköterskestudenters svar på en enkäts öppna fråga (n=120) i samband med utbildningens avslutning 2009 och 2010. Enkätsvaren reste frågor om specialistsjuksköterskans akademiska lärande. För att inhämta en djupare förståelse genomfördes intervjuer med specialistsjuksköterskor (n=12) som yrkesarbetat mellan 5 och 12 månader efter sin examen. Intervjuerna genomfördes från juni till oktober 2011. Avslutningsvis jämfördes svaren på den öppna enkätfrågan med analysen av intervjuerna. Resultat: Vid utbildningsreformens införande fanns pedagogiska motsättningar och didaktiska svårigheter som gav upphov till spänningsförhållanden mellan vårdutveckling, forskning, yrkesspecifika mål och akademiska mål. Spänningsförhållanden framkom också när specialistsjuksköterskorna inte erfor att deras akademiska kompetens tillvaratogs och värderades i vårdverksamheten. När stöd inte fanns för akademiskt lärande uppkom villrådighet och specialistsjuksköterskorna blev ambivalenta över om akademiskt lärande var meningsfullt. För att främja meningsfullt akademiskt lärande framhåller deltagarna betydelsen av samverkan och gemensamma arenor mellan lärosäten och vårdverksamhet där nyttoaspekten med akademiskt lärande tydliggörs. De spänningsförhållanden som framkommer var av både positiv och negativ karaktär.
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Iitula, Helena. "Master of Education research portfolio." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1008196.
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This Portfolio was submitted in 2005 to Rhodes University as a Research Portfolio presented in partial fulfilment of the requirements for the degree of Master of Education in General Education Theory and Practice. The Portfolio consists of seven (7) key parts. The reader of this Portfolio is courteously informed that the structure of this portfolio is to some extent differ from the thesis structure. Thus, the reader should be attentive not to weigh against the two. Further more, I hereby declare that this portfolio is my own work and that all the sources that I have used or quoted have been indicated and acknowledged by means of references indicated at the end of each part. Part 2 and 6 are the core parts of the portfolio. The focal point of part 2 is the contextual curriculum analysis of Grade 8-10 Oshindonga Curriculum in order to investigate its implementation in four educational circuits: Oshigambo, Onathinge, Onyaanya and Omuthiya in Oshikoto Region. Based on the findings of this analysis, lack of critical inquiry and reflective practice among Oshindonga teachers was identified as one of the major obstacles that preventing the effective implementation of the curriculum. Most of these teachers are Basic Education Teacher Diploma (BETD) postgraduates. Thus, part 3 and 4 were developed as supplements to inform the main research paper (part 6) which is related to teacher's professionalism in the classroom. The focus of part 3 (literature review) was on the teacher as a reflective practitioner. This is in line with the Namibian Education Policy, which identifies reflective practice as the heart of teacher professionalism. In this part, I explored a variety of views related to the notion of professionalism in teaching. I have also focused on views related to teacher's professional development both on macro and micro levels. These views provided a clarification and an underpinning framework on which to base my analysis of reflective practice as professionalism in education. Part 4 (education theories) focused on the digging of understanding of knowledge as an important theoretical domain of behaviourist and constructivist theories. I have tried to establish how the two theories (Behaviourist and Constructivist) view knowledge and its acquisition and to gain an understanding of how the two theories have been informing the practice. Subsequently, part 6 meant to investigate and assess the extent to which Basic Education Teacher Diploma postgraduate teachers are autonomously applying the theory of critical inquiry and reflective practice in the classroom. Both part 2 and 6 have findings. There is much correlation between the issues and problems in the implementation of the curriculum as identified in part 2 and the findings of the main research paper (part 6). Though critical inquiry and reflective practice is the key journey towards a high level of reflectivity and one of the significant characters of teacher professionalism in the classroom, most issues and problems identified were related to the insufficient practice of critical inquiry and reflective practices. Low correlation was found between critical inquiry and reflective practice theory and teachers' practices in the classroom. Despite to the fact that various rationales were mentioned as to why critical inquiry and reflective practice successful implementation is not taking place, the study positioned an emphasis on team working at school, cluster and circuit base that could contributed to a great extend to making teachers more competent and supporting themselves in mastering the applicable critical inquiry and reflective practice skills.
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Passantino, Andrea. "Master narratives, counterstories and identity mothering in a clinical setting /." Diss., Online access via UMI:, 2009.
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Schultz, Karen Kennedy. "What do Master Clinical (Experiential Teachers do When Teaching Clinically?" Diss., Virginia Tech, 2002. http://hdl.handle.net/10919/26957.
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An urgent need exists for balance between students learning the theory of clinical practice and becoming an expert. While theory is taught in the didactic setting, it is the experiential setting where the mastery of the clinical teacher is demonstrated. What does the master clinical teacher do that makes the studentâ s learning experience so significant? One must recognize the moment, capture the learning opportunity, and draw the student in so that learning can occur. Effective clinical teaching is paramount in creating empowered students and practitioners.
This qualitative case study of a doctoral pharmacy program identified two master clinical preceptors and shadowed one in a hospital and the other in a retail pharmacy. Interactions between clinical preceptors and students were captured through direct observation, audio-tape, and complemented with in-depth interviews. Content analysis identified emerging themes yielding an emerging model of master clinical teaching, illuminating teachable moments between student and clinical preceptor, and the manner in which they interacted with each other and the clinical environment.
The model highlights an approach for making the critical time on clinical rotations as effective as possible and offers a practical means to study interactions between students and preceptors, discerning those that lead to teachable moments. Features of the teachable moments are identified. Although expertise cannot be taught, current and future clinical teachers can use this study to improve their teaching and effectiveness in clinical teaching practice. The methodology of this study can be applied to future studies in the same discipline, other rotations, or other disciplines.
This study augmented the literature in qualitative research in pharmacy education for clinical practice by 1) utilizing a methodology that could be used in future studies 2) identifying features of teachable moments in the interactions of clinical preceptors and students 3) exploring how the clinical preceptors dealt with the changing environment of their clinical teaching 4) offering an emerging model to guide clinical preceptors for making the critical clinical teaching time as effective as possible.
Future studies could utilize this emerging model to gain further insight on clinical teaching practices thus increasing the expertise of clinical teaching.Ph. D.
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Pieper, Ian J. "Relational autonomy in clinical research: Relational considerations of adult participation in clinical research." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/231386/1/Ian_Pieper_Thesis.pdf.
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The requirement for consent to be both informed and voluntary is a keystone of contemporary bioethics. The need for consent before including people in clinical research demonstrates respect for participants. Demonstrating respect goes beyond mere acknowledgment of the right for people to make their own decisions. To be meaningful, consent must promote and support participant self-governance and enable decisions that align with participant values. A relational perspective of autonomy places people within a web of social and cultural histories and influences that frame the concept of respect. A relational approach to consent can create opportunities to promote respect for autonomy.
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Shah, Manisha. "Clinical ginseng research: a criticalreview." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31969811.
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Hall, Katherine C., and Kendra Todt. "Evaluating Research for Clinical Practice." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8289.
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Pedroso, Ana Isabel de Matos. "Clinical research networks in Europe." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/13595.
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Mestrado em Biomedicina FarmacêuticaThe theme of the thesis is the European clinical research networks and their impact on clinical research and on the development of new drugs and therapies. This report presents the final product of an exhaustive search about clinical research networks in Europe in order to characterize the profile of these networks in this region. It is also assessed its impact by describing the main relevant activities of these organisations. Finally, a few initiatives that may increase the contribution of these networks for a more effective clinical research are suggested. The search was performed in the Internet between december 2013 and may 2014, as websites are an essential tool for organizations of this nature. Therefore, it was assumed that the number of websites of clinical research networks corresponds to the number of clinical research networks that exists effectively. It was not identified any source that gathered information or that listed clinical research networks in Europe. It was also verified that there are much information in the Internet, but information is dispersed and in the majority of the websites the information is not very well processed, which increases the challenge of this search. This search was focused in Europe, thus the starting point of the search was the website of the European Medicines Agency, EMA. The thesis presents the criteria that were defined to classify the organizations as clinical research networks and the data collected from each identified clinical research network. It is also done a descriptive characterization of the clinical research networks to assess the strengths and weaknesses. Finally, conclusions, suggestions for the future and strategies to optimize/ maximize the performance of the clinical research networks are presented.
O tema da tese são as redes de investigação clínica Europeias e o seu impacto na investigação clínica e no desenvolvimento de novos medicamentos e terapias. A tese apresenta o produto final de uma recolha exaustiva de informação sobre redes de investigação clínica existentes na Europa de forma a caracterizar o perfil atual destas redes na Europa. É também avaliado o seu impacto através da descrição das principais atividades dessas redes. Finalmente assinalam-se iniciativas que poderão potenciar a contribuição destas redes para uma investigação clínica mais efetiva na Europa. A pesquisa foi realizada através da Internet entre dezembro de 2013 e maio de 2014, uma vez que um website é uma ferramenta essencial para o funcionamento de organizações desta natureza. Assim, partiu-se da premissa de que o número de websites de redes de investigação clínica existentes na Internet corresponde ao número de redes de investigação clínica efetivamente existente. Não foi identificada nenhuma fonte que reunisse informação ou listagens referentes a redes de investigação clínica na Europa. Verificou-se ainda a existência de bastante informação na Internet, mas que esta se encontra dispersa de um modo aleatório na Internet e na maioria dos websites a informação não está muito trabalhada, o que incrementou o desafio desta recolha. Uma vez que pesquisa se focou na região da Europa, o ponto de partida desta pesquisa foi o website da Agência Europeia do Medicamento, EMA. Nesta tese apresentam-se os critérios definidos para a classificação de redes de investigação clínica, bem como os dados recolhidos sistematicamente de cada uma das redes. É feita ainda uma caracterização descritiva do conjunto das redes europeias de investigação clínica, a partir da qual se parte para uma discussão dos pontos fortes e pontes fracos. Finalmente, são apresentadas conclusões, perspetivas para o futuro e potenciais formas de otimizar/ maximizar a performance das redes europeias de investigação clínica.
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Almeida, João Pedro da Silva. "Curricular internship in clinical research." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16581.
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Mestrado em Biomedicina FarmacêuticaThis report presents my internship experience at the Clinical Pharmacology Unit where I could participate in research projects, mainly as a medical writer, data manager, project manager and monitor of observational studies and at the Neurological Clinical Research Unit, where I could work in coordination of clinical trials. The internship is part of the curricular activities of the second year of the Masters in Pharmaceutical Biomedicine, University of Aveiro. The internship took place from 15th September 2015 to June 30th, 2016. This report will address the activities that I performed, namely the coordinating activities of clinical trials and observational studies, or activities related to medical writing. Throughout the internship, I had the opportunity to put into practice the knowledge acquired during the master's degree, and deepen my knowledge of the coordination activities of clinical and observational trials. In scientific writing component, I was able to improve my scientific writing skills, to know how to develop a systematic review and understand some of the concepts of meta-analyses. In conclusion, the internship allowed me to put into practice the knowledge acquired in the University, and served as an extremely valuable learning source and for professional and personal growth.
Este relatório apresenta a minha experiência de estágio na Unidade de Farmacologia Clínica onde pude participar em projetos de investigação, essencialmente como “medical writer”, “data manager”, gestor de projeto e monitor de estudos observacionais e na Unidade Neurológica de Investigação Clínica, onde pude desenvolver atividades de coordenação de ensaios clínicos. O estágio realizou-se entre 15 de setembro de 2015 a 30 de Junho de 2016. O estágio insere-se nas atividades curriculares do segundo ano do Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro. Serve o presente relatório para relatar as atividades que tive a oportunidade de desenvolver, nomeadamente de coordenação de ensaios clínicos e estudos observacionais, bem como as atividades de “medical writer”, farmacovigilância, entre outras. No decurso do estágio, tive a possibilidade de pôr em prática os conhecimentos adquiridos ao longo do Mestrado, e aprofundar o meu conhecimento sobre as atividades de coordenação de ensaios clínicos e observacionais. Na componente de escrita científica, tive a possibilidade de melhorar as minhas capacidades de escrita científica, perceber os processos necessários para a publicação de uma revisão sistemática e compreender algumas noções de meta-análises. Em conclusão, o estágio permitiu-me pôr em prática o conhecimento adquirido no Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro e serviu como nova fonte de aprendizagem e crescimento profissional e pessoal.
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Baguley, David M., and Marc A. Fagelson. "Tinnitus: Clinical and Research Perspectives." Digital Commons @ East Tennessee State University, 2015. https://www.amzn.com/1597567213.
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Book Summary: Tinnitus: Clinical and Research Perspectives summarizes contemporary findings from basic and clinical research regarding tinnitus mechanisms, effects, and interventions. The text features a collection of international authors, active researchers, and clinicians who provide an expansive scope of material that ensures relevance for patients and professionals. Reviews and reports of contemporary research findings underscore the text s value for classroom use in audiology and otolaryngology programs. Patients and students of audiology will benefit from the text s coverage of tinnitus mechanisms, emerging practice considerations, and expectations for outcomes--for example, recent successes of cognitive behavioral therapy, neuromodulation, and hearing aid use. These and other topics, such as the effects of noise and drugs on tinnitus, are reported in a way that enhances clinicians ability to weave such strategies into their own work. The influence of tinnitus on all aspects of life is explored, from art to medicine and communication to isolation, thereby providing clinicians and patients a deeper understanding of and greater facility managing a tinnitus experience. Finally, this text includes case studies that provide a practical view of tinnitus effects and management approaches. The editors hope that the consideration of mechanisms, interventions, and outcomes resonates with patients, clinicians, and students of audiology.https://dc.etsu.edu/etsu_books/1179/thumbnail.jpg
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Farrica, Anabela de Jesus Prates. "Internship in clinical data management at a clinical research organization." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15136.
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Mestrado em Biomedicina FarmacêuticaThe aim of this report is to describe the training activities carried out at the Data Management Sub-Unit of Eurotrials, Scientific Consultants, as part of the 2nd year of the Master’s Program in Pharmaceutical Medicine. This internship was focused on the development of skills and on gaining experience in Clinical Data Management activities. Over the course of this internship, I had the opportunity to build upon the knowledge obtained in the Bachelor’s Degree in Biomedical Sciences and in the Master’s Program in Pharmaceutical Medicine. Concepts, requirements and practices related to Clinical Data Management were explored and strengthened throghout. Furthermore, an unique perspective on the lifecycle of clinical research projects was obtained – that of a CRO. Besides the acquisition of theoretical knowledge, this training period was paramount for the development of a number of social and personal skills that contributed for my profissional growth within the host institution. This document begins by a description of the theoretical principles that set the ground for the Clinical Data Manager’s work. Then, the generic and specific training elements of the curricular training are detailed. After presenting my training activities, I discuss the various challenges I had to overcome during these 9 months. Finally, some personal remarks and conclusions are presented.
Este relatório tem como objetivo descrever as atividades de estágio realizadas na Unidade de Gestão de Dados da Eurotrials, Consultores Científicos, como parte do 2º ano do Mestrado em Biomedicina Farmacêutica. Este estágio focou-se no desenvolvimento de competências e obtenção de experiência em atividades de Gestão de Dados Clínicos. No decurso do estágio tive oportunidade de complementar o conhecimento obtido na Licenciatura em Ciências Biomédicas e no Mestrado em Biomedicina Farmacêutica. Foram aprofundados e explorados os conceitos, requisitos e práticas inerentes à Gestão de Dados Clínicos e obteve-se uma visão única do ciclo de vida de um projeto de investigação clínica – a de uma CRO. Para além da aquisição de conhecimentos teóricos, este período de estágio foi fundamental para o desenvolvimento de um conjunto de aptidões sociais e pessoais que contribuíram para o meu crescimento profissional dentro da instituição de acolhimento. O presente documento começa por expôr os príncipios teóricos que servem de base à atividade do Gestor de Dados Clínicos. Seguidamente, são detalhados os componentes genéricos e específicos de treino adquiridos durante o período de estágio. Depois da apresentação das atividades de estágio, são discutidos os vários desafios enfrentados e é feito um balanço pessoal desta experiência.
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Fisher, Kimberly A. "Impact of COPD on the Mortality and Treatment of Patients Hospitalized with Acute Decompensated Heart Failure (The Worcester Heart Failure Study): A Masters Thesis." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/717.
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Objective: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure, yet little is known about the impact of this condition in patients with acute decompensated heart failure (ADHF), especially from a more generalizable, community-based perspective. The primary objective of this study was to describe the in-hospital and post discharge mortality and treatment of patients hospitalized with ADHF according to COPD status.
Methods: The study population consisted of patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during 4 study years: 1995, 2000, 2002, and 2004.
Results: Of the 9,748 patients hospitalized with ADHF during the years under study, 35.9% had a history of COPD. The average age of this population was 76.1 years, 43.9% were men, and 93.3% were white. At the time of hospital discharge, patients with COPD were less likely to have received evidence-based heart failure medications, including beta-blockers and ACE inhibitors/angiotensin receptor blockers, than patients without COPD. Multivariable adjusted in-hospital death rates were similar for patients with and without COPD. However, among patients who survived to hospital discharge, patients with COPD had a significantly higher risk of dying at 1 (adjusted RR 1.10; 95% CI 1.06, 1.14) and 5-years (adjusted RR 1.40; 95% CI 1.28, 1.42) after hospital discharge than patients who were not previously diagnosed with COPD.
Conclusions: COPD is a common co-morbidity in patients hospitalized with ADHF and is associated with a worse long-term prognosis. Further research is required to understand the complex interactions of these diseases and to ensure that patients with ADHF and COPD receive optimal treatment modalities.
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Fisher, Kimberly A. "Impact of COPD on the Mortality and Treatment of Patients Hospitalized with Acute Decompensated Heart Failure (The Worcester Heart Failure Study): A Masters Thesis." eScholarship@UMMS, 2007. http://escholarship.umassmed.edu/gsbs_diss/717.
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Objective: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure, yet little is known about the impact of this condition in patients with acute decompensated heart failure (ADHF), especially from a more generalizable, community-based perspective. The primary objective of this study was to describe the in-hospital and post discharge mortality and treatment of patients hospitalized with ADHF according to COPD status.
Methods: The study population consisted of patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during 4 study years: 1995, 2000, 2002, and 2004.
Results: Of the 9,748 patients hospitalized with ADHF during the years under study, 35.9% had a history of COPD. The average age of this population was 76.1 years, 43.9% were men, and 93.3% were white. At the time of hospital discharge, patients with COPD were less likely to have received evidence-based heart failure medications, including beta-blockers and ACE inhibitors/angiotensin receptor blockers, than patients without COPD. Multivariable adjusted in-hospital death rates were similar for patients with and without COPD. However, among patients who survived to hospital discharge, patients with COPD had a significantly higher risk of dying at 1 (adjusted RR 1.10; 95% CI 1.06, 1.14) and 5-years (adjusted RR 1.40; 95% CI 1.28, 1.42) after hospital discharge than patients who were not previously diagnosed with COPD.
Conclusions: COPD is a common co-morbidity in patients hospitalized with ADHF and is associated with a worse long-term prognosis. Further research is required to understand the complex interactions of these diseases and to ensure that patients with ADHF and COPD receive optimal treatment modalities.
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Shah, Manisha. "Clinical ginseng research a critical review /." Click to view the E-thesis via HKUTO, 1999. http://sunzi.lib.hku.hk/hkuto/record/B31969811.
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Martin, Faith. "Doctorate in Clinical Psychology : research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633160.
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Objective: Somatisation as a process suggests that mood changes are responded to physically rather than psychologically. This concept is linked to “medically unexplained symptoms”, including conditions such as chronic fatigue or fibromyalgia. Alexithymia, difficulty in identifying or expressing emotions, is the proposed causal mechanism. This study tested this proposal by measuring association between alexithymia and somatic symptoms and exploring whether experimentally induced mood changes are responded to by those with higher alexithymia scores with more physical than psychological sensations than those with lower alexithymia. Methods: A median split of Toronto Alexithymia Scale scores was used to create two groups (higher and lower alexithymia) from a sample of 21 participants with a diagnosis of chronic fatigue syndrome and / or fibromyalgia. Participants rated mood and physical and psychological state at baseline and following sad and happy mood induction. Ratio scores of psychological over physical state ratings were calculated for each mood state. Measures of depression, anxiety, somatic complaints, acceptance, beliefs about emotions and health anxiety were also administered. Results: No correlation was found between alexithymia and intensity of somatic or psychological symptoms. There was no significant difference in ratio scores by mood or between those with higher or lower alexithymia. The mood manipulation did lead to changes in psychological sensations and physical sensations. Conclusion: The alexithymia hypothesis of medically unexplained symptoms was not supported in this study using a clinical sample. Further research should include a control group of people experiencing depression or anxiety without significant physical symptoms.
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Carrigan, Neil. "Doctorate in Clinical Psychology : research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633168.
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Main Project Multiple Sclerosis (MS) is an incurable disease which is commonly associated with psychological complications. Previous research by Hayter and colleagues found that in patients with MS, health anxiety (HA) can account for part the variance in quality of life (QoL) independent of any physical and cognitive impairment caused by the disease and that MS patients with health anxiety perceived their (intact) physical and cognitive performance as impaired relative to MS patients without health anxiety, attributing the impairment to MS. The findings suggest that such misperceptions might be useful targets in the treatment of health anxiety in MS using adapted cognitive behavioural therapy (CBT). The first of two studies presented here sought to replicate the findings from Hayter et al. before a second presents the findings from a brief case series of treatment for HA using CBT. In Study 1, twenty participants with Relapsing and Remitting MS were screened for HA and assigned to either a high or low HA group. Participants then completed assessment of cognitive and physical functioning before rating their performance on these tasks. Measures of QoL, mood and physical disability were then completed. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. Given the high rates of HA in MS patients and its impact on QoL, this case series suggests a brief CBT intervention could significantly improve patients’ wellbeing. The findings pave the way for larger, controlled studies into the effectiveness of CBT for health anxiety in MS. Service Improvement Project Background: Early diagnosis of neurodevelopmental conditions such as Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) in children are enshrined in national UK policy, as is ensuring that parents’/carers’ views shape service delivery. Aim: The present study attempted to measure adherence to service guidelines of a neurodevelopmental disorders assessment clinic within a Child and Adolescent Mental Health Service (CAMHS) to identify service needs. It also assessed parents’/carers’ satisfaction with the service and what information should be included in a patient information leaflet. Method: An audit of cases referred during 2012 -2013 plus a postal survey of parents/carers of children referred during the audit period. Results: The service was mostly compliant with NICE guidelines but quantifying this was difficult under its current record keeping. While satisfied with the clinic’s service, the main concern of parents/carers was the length of time the assessment process took. Conclusions: Adoption of NICE audit tools would help document compliance with guidelines. A patient information leaflet might help manage parents’ expectations about the time the assessment process takes. Literature Review This review considers the closely related concepts of rumination and worry; examining their role in insomnia and chronic pain. Worry has been seen for many years as a major contributor to insomnia but only recently has attention been paid to the role of rumination. Similarly, worry and rumination have both been implicated in the maintenance of distress in chronic pain. However, across these two diagnostic categories (and the wider research literature) definitions of worry and rumination vary and are often used interchangeably. This review considers the research literature on rumination/worry in relation to insomnia, chronic pain and insomnia that occurs alongside chronic pain (pain-related insomnia). The empirical findings to date suggest patterns of repetitive negative thinking characterise both worry and rumination, but the content of the thinking may be distinct, opening the way for the application of transdiagnostic approaches. It suggests cognitive behavioural approaches to treating pain-related insomnia can be improved by incorporating elements which have been successful elsewhere in allowing people to manage repetitive negative thinking. Assessment of these targeted treatments in future research should lead to a reduction in suffering for patients with chronic pain who have trouble sleeping.
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Anderson, Catriona. "Doctorate in Clinical Psychology research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698975.
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Background – Psychosis is one of the most stigmatised mental health problems. Individuals who experience psychosis can internalise this stigma, resulting in self-stigma where an individual’s self-concept is eroded with a negative impact on recovery. Conversely, peer support has been shown to impact positively on recovery and theory suggests that this may be achieved through challenging stigmatising attitudes. Aims – The aim of this study is to further investigate one potential mechanism underpinning peer support, that is the impact of peers on challenging self-stigmatising attitudes. Methodology – 20 people with first episode psychosis were recruited and randomised to watch a psycho-educational video delivered either by an individual with experience of psychosis (a peer) or a health professional. Levels of self-stigma were measured before and after the video. Results – The findings of this study did not support the hypothesis that psycho-education delivered by a peer reduces internalised stigma to a greater degree than someone without this, however, the results are underpowered and require a larger sample before conclusions can be drawn. Conclusions – Further research is needed to better understand the effective components of peer support and to better understand the relationship between peer support and internalised stigma. Service Improvement Project Abstract Pulmonary Arterial Hypertension (PAH) is a chronic disease, which is monitored by a series of complex treatments including cardiac catheterisation (CATH). Evidence suggests that patients can experience CATH as anxiety provoking, however, most undergo this procedure without any formal psychological support. The current study aimed to explore patients’ beliefs about the CATH procedure and to better understand adaptive coping and self-management skills. It was hoped that this knowledge would inform recommendations to improve the psychological experience and coping resources of those undertaking CATH. Ten participants were recruited through purposive sampling and completed a qualitative interview, which explored their beliefs about CATH and factors which enhanced coping resilience. Findings suggest that factors which increase an individual’s understanding of CATH and sense of control were associated with positive coping. The results also suggest that whilst perceptions of the CATH procedure are very individual, the importance of relationships with health professionals and trust in their expertise was highlighted across participants. The findings informed service recommendations, including the introduction of a patient experience leaflet aimed at promoting positive coping in those attending the CATH procedures. Critical Literature Review Abstract Background – Stigma is a global phenomenon affecting many health conditions. Stigmatised attitudes can become internalised (internalised stigma), a process that can negatively impact on an individual’s sense of self, their emotional wellbeing and wider life. Recently interventions have been developed to reduce internalised stigma, including interventions led by people with personal experience of health conditions (peers). Aim – This review aimed to draw together literature on peer-led interventions for stigmatised health conditions, which have included internalised stigma as an outcome. The review aimed to synthesis interventions and their components; relate the findings to social identity theory and summarise what is known and not known about the relationship between peers and internalised stigma. Method – Using specific search terms and inclusion criteria, this review yielded 13 papers in total. The papers were examined in terms of their methodology and findings, and common components of the interventions were collated across the papers. Results – The results revealed methodological limitations amongst the papers and highlighted the need for replication. However, the findings suggest there is evidence that peer led interventions can impact positively on internalised stigma, if designed in the right way for the people who receive it. The key components include sharing experiences, narrative components, information provision and problem-solving. Conclusions – Peer-led interventions present an empowering way of countering the stigma surrounding certain conditions through role-modelling recovery, sharing hopeful experiences and enhancing positive identity. Current evidence shows promise, however, more high quality research is needed to better understand this relationship and to develop effective, accessible interventions.
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Ferrão, Ângela Filipa Machado. "Clinical research in a pharmaceutical industry." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/14880.
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Mestrado em Biomedicina FarmacêuticaThis training report describes the knowledge and experience gained during the curricular internship at the Medical Affairs unit of the Research Department of Bluepharma Indústria S.A.. The main activities addressed are related with the conduction of phase I clinical trials by a sponsor, namely bioequivalence clinical trials. In this context, is described the main applicable regulations, the management process of a clinical trial and a reflection about the main challenges in the field. Furthermore, are outlined the activities related with the management of Research, Development and Innovation projects, particularly the analysis of ideas of new pharmaceutical products, where I contribute with several researches. This first contact with the pharmaceutical industry allowed me to integrate the knowledge and skills gained in the Pharmaceutical Sciences degree with those gained in the master’s course of pharmaceutical medicine, fulfilling one of the main objectives that I define for myself: the growth and acquisition of skills, coupled with the access to a different professional reality.
O presente relatório de estágio propõe-se relatar o conhecimento e a experiência adquirida durante o estágio curricular no setor de Assuntos Médicos do departamento de Investigação da Bluepharma Indústria, S.A.. Nele são abordadas as principais atividades realizadas, inerentes à condução de ensaios clínicos de fase I por parte de um promotor, nomeadamente de ensaios de bioequivalência. Neste contexto é feita uma descrição da legislação aplicável, do processo de gestão de um ensaio clínico e uma reflexão acerca dos principais desafios nesta área. Para além disso, são também descritas atividades relacionadas com a gestão de projetos de Investigação, Desenvolvimento e Inovação, particularmente na análise de ideias de novos produtos farmacêuticos para as quais contribuí com diversas pesquisas. Este meu primeiro contacto com a indústria farmacêutica permitiu-me integrar os conhecimentos e competências da licenciatura em Ciências Farmacêuticas com os adquiridos no mestrado de Biomedicina Farmacêutica, cumprindo um dos principais objetivos que estabeleci para mim: o do crescimento e aquisição de competências aliado ao acesso a uma diferente realidade profissional.
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Ribeiro, Patrícia Graziela Cunha. "Clinical practice of e research nurse." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16507.
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Mestrado em Biomedicina FarmacêuticaThis paper proposes to present the main activities of a Research Nurse, its role in clinical research, and in the development and introduction of new drugs on the market. The Master in Pharmaceutical Medicine brought together knowledge and development of new technical and personal skills extremely valuable in daily activity as research nurse. During my professional activity as a research nurse, were detected many gaps in academic and professional training of nurses, with regard to this specific area. I intend to present a personal view, describing the main activities developed and how the knowledge acquired in this Master influenced my work performance. The main objective of this work is to provide a reference or guide to other nurses who want to enter into the area of clinical research.
O presente trabalho propõe apresentar as principais atividades de um Enfermeiro de investigação, o seu papel em investigação clínica, no desenvolvimento e na introdução de novos medicamentos no mercado. O Mestrado em Biomedicina Farmacêutica permitiu reunir conhecimentos e desenvolver novas competências técnicas e pessoais de extremo valor na atividade diária, como enfermeira de investigação. No decorrer da minha atividade profissional como Enfermeira de investigação, foram detetadas muitas lacunas na formação académica e profissional dos enfermeiros, no que diz respeito a esta área específica. Pretendo apresentar uma visão pessoal, descrevendo as principais atividades desenvolvidas e como os conhecimentos adquiridos neste Mestrado influenciaram o meu desempenho profissional. O principal objetivo deste trabalho é constituir uma referência ou guia para outros enfermeiros que queiram enveredar pela área da investigação clínica.
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Hon, Wai-fan. "Fraud in clinical research : perceptions among clinical investigators and biomedical researchers /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38478584.
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Taylor, Michael Dennis. "Prostate cancer clinical practice guidelines clinical and economic outcomes /." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010098.
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Thesis (Ph.D.)--University of Florida, 2005.Typescript. Title from title page of source document. Document formatted into pages; contains 99 pages. Includes Vita. Includes bibliographical references.
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Rosser, Daniel Ashley. "Improving the measurement of visual acuity in clinical practice and clinical research." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446798/.
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This thesis considers the relationship between the design of a visual acuity test and various aspects of its performance. Using contemporary test design theory, novel tests are developed and evaluated in an attempt to better meet the requirements of a visual acuity test most pertinent to clinical practice, clinical research, and population based surveys. The acuity test of choice in clinical practice is the Snellen chart, a test whose usefulness is limited by several design flaws. Clinical researchers favour the ETDRS logMAR chart which employs robust design principles, but is time consuming to use. A chart featuring an abbreviated ETDRS design was developed and its performance compared with that of the ETDRS and Snellen charts. The prototype chart allows acuities to be measured in half the time of the ETDRS chart with greater precision than the Snellen chart. A tumbling-E version of this chart has been successfully employed in population based surveys in Thailand, Bangladesh and Mongolia. It was noted during the study that the precision of even ETDRS acuities was relatively poor. A computerised version of the ETDRS test was developed and used to investigate the repeating and averaging of acuities as a means to improve precision. Whilst prolonging test time, the computerised test allowed acuities to be measured with improved precision. Optical defocus was investigated as a potential source of reduced precision in visual acuity testing. It was shown that even small degrees of defocus may significantly reduce test precision. An approach which considers test performance in terms of sensitivity and specificity was developed. A mathematical model was used to show that current methods of using estimates of precision to identify clinically important change, are overly optimistic. Predictions derived using the model were shown to agree well with empirical findings.
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Quintero, Michael C. "Constructing a Clinical Research Data Management System." Thesis, University of South Florida, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10640886.
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Clinical study data is usually collected without knowing what kind of data is going to be collected in advance. In addition, all of the possible data points that can apply to a patient in any given clinical study is almost always a superset of the data points that are actually recorded for a given patient. As a result of this, clinical data resembles a set of sparse data with an evolving data schema. To help researchers at the Moffitt Cancer Center better manage clinical data, a tool was developed called GURU that uses the Entity Attribute Value model to handle sparse data and allow users to manage a database entity’s attributes without any changes to the database table definition. The Entity Attribute Value model’s read performance gets faster as the data gets sparser but it was observed to perform many times worse than a wide table if the attribute count is not sufficiently large. Ultimately, the design trades read performance for flexibility in the data schema.
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Quintero, Michael C. "Constructing a Clinical Research Data Management System." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/7081.
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Clinical study data is usually collected without knowing what kind of data is going to be collected in advance. In addition, all of the possible data points that can apply to a patient in any given clinical study is almost always a superset of the data points that are actually recorded for a given patient. As a result of this, clinical data resembles a set of sparse data with an evolving data schema. To help researchers at the Moffitt Cancer Center better manage clinical data, a tool was developed called GURU that uses the Entity Attribute Value model to handle sparse data and allow users to manage a database entity’s attributes without any changes to the database table definition. The Entity Attribute Value model’s read performance gets faster as the data gets sparser but it was observed to perform many times worse than a wide table if the attribute count is not sufficiently large. Ultimately, the design trades read performance for flexibility in the data schema.
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McLean, Donna L. "Patients' perceptions of participation in clinical research." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0005/MQ29015.pdf.
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Rodella, Stefania. "Exploring reliability in epidemiology and clinical research." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23421.
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Quality of measurement is a fundamental issue in medical research and clinical practice, of relevance for any inference or decision-making process. Reliability, as an estimate of the variability in the domain of repeated measurements, is an important component of the quality of measurements.Reliability indices are frequently used and presented in the medical literature and a considerable amount of methodological research has been conducted on this topic in the last decades. However, the debate is still open on some theoretical and operational aspects. Available knowledge concerning reliability, particularly for categorical data, is not easily accessible since it is often confined to specialized journals and almost disregarded by statistical textbooks. Therefore, a thorough understanding is difficult to achieve for a researcher potentially involved in reliability studies.
My main objective was to pursue a conceptual and global understanding of the role of reliability in the domain of categorical data. In order to achieve this goal I reviewed and synthesized the literature according to some specific objectives: (a) to provide an overview on the founding concepts and methods in the measurement of reliability for categorical variables, also contrasting them with what has been done in the domain of continuous variables; (b) to present and discuss the main limitations of traditional indices, particularly the kappa statistic; (c) to briefly introduce some possible alternative methods and areas for future development; (d) to emphasize the implications of reliability for epidemiological and clinical research.
Finally, in order to illustrate the application of some of the methods discussed, I used a real set of data, concerning 209 slides of lymphomas tissue samples, reviewed by a panel of four pathologists, according to a standard classification based on 10 categories.
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Stewart, Nick. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761009.
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Critical Review of the LiteratureCan Borderline Personality Disorder be treated effectively in forensic settings? A systematic reviewBorderline Personality Disorder (BPD) is a common diagnosis in forensic settings. Certain features of BPD, such as impulsivity and emotional dysregulation, can create a vulnerability to impulsive acts. The condition is also associated with poor mental and physical health, making the treatment of BPD and its clinical features an important goal in forensic settings. This paper reviews evidence for the effectiveness of treating BPD and its symptoms using psychological approaches in forensic settings. A systematic search found 2913 papers, of which 13 met the inclusion criteria. The papers reported nine separate studies (six controlled) that implemented four distinct interventions, often adapted for particular forensic settings. Improvements in overall BPD symptomatology and specific BPD symptoms were reported for all types of intervention, although few differences in outcome between intervention and control groups were found. There were also reported improvements in BPD-related behaviours, but data on offending behaviour were absent. Heterogeneity in study quality and design makes it challenging to draw any firm conclusions about the effectiveness of any one form of treatment over another, nor about which treatment may best suit a particular setting. Further randomised controlled trials are needed to answer these questions. Service Improvement ProjectEvaluation of a brief educational intervention for clinical staff aimed at promoting trauma-informed approaches to careThere is growing evidence that trauma plays an important role in the aetiology of severe and enduring mental health problems. Yet staff can be reluctant to ask patients about trauma for reasons such as anxiety about harming patients and limited access to training. Where services have adopted trauma-informed approaches (TIAs) to mental health care (i.e., considering the ways in which trauma affects individuals when planning and delivering services), improved clinical outcomes have been observed. With this in mind, a new educational video was developed for mental health staff at an NHS trust. The video was intended to be (a) brief (10 minutes); (b) contemporary and engaging; and (c) accessible using computers, smartphones and tablets. Forty-one multidisciplinary staff viewed the video. Quantitative and qualitative evaluation indicated improvements in self-reported knowledge and confidence with regard to trauma, and a decrease in worries with regard to asking patients about such experiences. Participants found the video to be enjoyable, understandable and informative. Importantly, many indicated that it spurred them to further action, such as further training and asking patients about possible trauma. These findings indicate that a video of this type can offer an important ‘taster’ of trauma-related learning, constituting an important step towards embedding trauma-informed ways of working at a service. Main Research ProjectThe Role of Intrusive Imagery in Hoarding DisorderThe cardinal feature of Hoarding Disorder (HD) is persistent difficulty discarding possessions, with the resulting clutter compromising the intended use of living areas. Within the dominant cognitive-behavioural model of hoarding (Frost & Hartl, 1996), hoarding behaviours are positively and negatively reinforced in the context of certain object-related beliefs. Available treatments for HD have so far yielded modest outcomes, indicating a need for new approaches. Intrusive imagery has so far been neglected in HD research, despite the frequency of trauma in the histories of people with the condition. To address this, 27 individuals who met the DSM-5 criteria for HD and 28 community controls (CCs) were interviewed about their everyday experiences of mental imagery. Participants were also asked about the images they experienced during two recent real-life examples of actual or attempted discard of (1) an object of low subjective value; and (2) an object of high subjective value. Everyday imagery in the HD group commonly reflected themes of illness, death and reminiscence. Imagery in HD participants tended to carry negative emotional valence in comparison with CCs, and was associated with greater interference in everyday life and attempts to avoid the imagery. HD participants reported more negative experiences of intrusive imagery in comparison with CCs during recent episodes of discarding objects of low subjective value. However, HD participants experienced positive imagery when discarding, or trying to discard, high value objects. These findings indicate that although people with HD frequently report traumatic histories, this is not reflected in the everyday imagery that they experience. There is some evidence to suggest that the negative and positive memories experienced in relation to low and high value objects may aid our understanding of discarding and saving behaviour in HD. The theoretical and clinical implications of these findings are further discussed.
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Harris, Madeline. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761014.
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Critical Review of the Literature The consequences of childhood maltreatment are pervasive and implicated in the development of a range of mental health difficulties, including eating disorders. However, the mechanisms which mediate the link between childhood maltreatment and eating disorders are unknown. This has important implications for effective intervention, as eating disorders are notoriously difficult to treat. There are numerous factors which predict poor therapy outcome that overlap with mediators between childhood maltreatment and disordered eating behaviours in non-clinical samples. This may suggest people with a history of maltreatment could be at greater risk of developing an eating disorder which does not respond to currently available interventions. This review aimed to identify the mediating variables between childhood maltreatment and eating disorders. Studies which tested mediators of the relationship between childhood maltreatment and eating disorders were systematically reviewed and a narrative synthesis of the findings reported. The findings suggested mediators of the relationship between childhood maltreatment and eating disorders could be mapped onto cognitive-emotional-behavioural and affective models of eating disorders. Limitations of the reviewed studies and clinical implications are discussed. Service Improvement Project Formulation, in the context of clinical psychology, involves integrating a breadth of knowledge to create a tentative hypothesis to describe the difficulties service users may experience. Team formulations, created by a multi-disciplinary team to construct a shared understanding of a service user’s experiences, can facilitate a more consistent and collaborative approach within a team and lead to a more holistic, psychosocial understanding of a person’s difficulties. This project was carried out in two recovery teams in a locality within an NHS trust in which staff had been trained to use the 5 Ps model of formulation (Weerasekera, 1995). The project aimed to establish whether staff were using 5 Ps formulations in their work, whether these were experienced as useful, what supports staff to use a 5 Ps formulation, and what staff feel the barriers to using a 5 Ps formulation are. A questionnaire and two focus groups were used and analysed using descriptive statistics and thematic analysis. The results suggested staff used the model to inform their clinical thinking, in consultation with therapist colleagues, and in group reflective practise. Overall, the 5 Ps model was well received. The model appeared to support staff both with their clinical work and to be more reflective and holistic in their approach. However, staff did raise some drawbacks with the model and difficulties with integrating it consistently into their clinical practise. Service recommendations include areas for continued practise, areas for development and change, and areas for further service evaluation and potential research opportunities. Main Research Paper The ‘Common Sense Model’ (CSM; Leventhal, Meyer, & Nerenz, 1980) aims to explain how psychological factors influence long-term health condition (LTC) management. Research has shown the CSM applies to children and young people (CYP) as well as adults. However, the model does not incorporate systemic factors, which are especially relevant for CYP, for whom families hold more illness management responsibilities. Caregiver perceptions of an illness have been linked with outcomes for the person with the health condition. Other factors which have been shown to affect illness perceptions include the LTC itself. This pilot study examines differences in illness perceptions between two groups of parents: those whose children had type 1 diabetes, and parents of children with juvenile idiopathic arthritis. This study also examined mood, anxiety and time since the child’s diagnosis as predictors of parental illness perceptions. It was found that having a child with type 1 diabetes was predictive of anticipating longer illness duration and perceiving greater control over the condition. Additionally, having greater levels of anxiety was predictive of more perceived control, which may be associated with condition monitoring behaviours in type 1 diabetes. Finally, scores indicating lower mood predicted perceiving the consequences of the condition as more severe and lower levels of perceived control over the condition. Future research directions and clinical implications are discussed.
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Panting, Holly. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761024.
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Keane, Lisa. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698990.
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Mental Imagery (MI) and implementation intentions (II; creating concrete plans for when, where and how a goal is to be achieved) have shown promise in enhancing performance and goal achievement. As depressed mood is often characterized by loss of interest and reduced engagement in previously rewarding activities, the aim of this study was to investigate whether MI and II strategies could be used to enhance rates of goal achievement in participants presenting to services with low mood/depression. An experimental three-group comparison was used, with random allocation to the levels of the independent variable (MI, II, Control). Each participant (N = 44) devised three idiosyncratic goals, with the researcher guiding the participants in the MI/II groups through the relevant cognitive strategy in relation to their first goal. Those in the MI group reported a significant increase in the perceived likelihood of achieving their goals post-strategy. There were no significant differences in the achievement of goals amongst the three groups, although higher rates of goal achievement were apparent in the MI group. The current study suggests that generating specific goals and using MI may represent a valuable technique for improving individuals’ beliefs that their goals are attainable and within their reach. Further research with larger samples is recommended to explore the impact of techniques on actual goal attainment. Service Improvement Project Background: Clinical guidance recommends that multi-family psychoeducation groups) should be offered as part of the stepped-care model of intervention in early intervention for psychosis services. This results from the recognition of the important role that families play in supporting the recovery of service users experiencing a first episode of psychosis. Aims: This study aimed to evaluate and improve a series of multifamily information sessions within the North Somerset Early Intervention for Psychosis Team. Methods: Following the initial running of a multifamily psychoeducation group (Group 1), telephone interviews were conducted with six family members who attended to evaluate and identify recommendations for the improvement of the group. This feedback was used to inform the format and content of a second running of the group (Group 2). Three further participants provided evaluative qualitative feedback on this revised group. Results: Following collection of feedback from Group 1, four key themes were identified including the positive aspects of group attendance (e.g. receiving relevant information, opportunity to meet the team and other families), challenges of groups (e.g. accommodating the needs of different families), impact of caring (e.g. feeling isolated and unknowledgeable) and recommendations for improvement (e.g. additional content for siblings, simplifying information). This information was used to develop Group 2, which was adapted to make the information more family-friendly (e.g. simplifying information), with the inclusion of some further information. Conclusions: The positive feedback received from those who attended the group supports the continued use of family information sessions within the service. The use of feedback and the development of this aspect of the service were perceived positively by the team. Systematic Review of the Literature Background: Cognitive behavioural therapy for low self-esteem (LSE) has shown promise as a trans-diagnostic model for treating mental health difficulties in adults. To ascertain the potential value of this treatment approach in working with young people with internalising disorders, we need to develop our understanding of LSE within these mental health conditions. The aim of this review is to explore 1) the co-occurrence of clinically significant anxiety/depression and LSE in young people, and 2) the association between LSE in childhood and adolescence and mental health difficulties in later adolescence and emerging adulthood. Method: A systematic search of two electronic databases (PsychInfo/Pubmed) was conducted to identify relevant studies. Results: Ten studies examining the association between LSE and clinically significant anxiety/depression in young people met the inclusion criteria, as did eight studies investigating the association between LSE in under 18 year-olds with internalising difficulties in later adolescence/emerging adulthood. Conclusions: Although relatively few studies investigating ‘clinically significant’ anxiety and depression were identified, the located studies consistently supported the co-occurrence of LSE and internalising disorders in young people. This was found to be particularly true for young people with depression and co-morbid mental health difficulties. There appears to be less evidence for the association between reported LSE in childhood and adolescence and anxiety/depression in adolescence/emerging adulthood, potentially due to the complexity of confounding variables. Further research investigating Fennell’s cognitive model as a trans-diagnostic treatment model for young people with LSE is indicated.
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Lambe, Sinead. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675714.
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Barden, Rochelle. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698979.
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Objective: To assess if adolescent perfectionism mediates the association between negative parental factors (anxiety, maladaptive perfectionism, critical and authoritarian parenting) and paediatric anxiety. Method: A cross sectional questionnaire design was used. Sixty-six 12-17-year-old adolescents and their primary caregiver were recruited from a local community school and child and adolescent mental health services. Self- and parent-report questionnaires measured anxiety, perfectionism and parenting style. Results: There was a significant association between adolescent perfectionism and anxiety and between parental perfectionism and anxiety. However, there was no evidence that parental perfectionism was associated with child perfectionism or anxiety. Conclusions: The fact that parental factors were not associated with adolescent maladaptive perfectionism implies that the processes associated with the development of maladaptive perfectionism and anxiety in childhood may be different in adolescents. Implications for treatment and future research are discussed. Service Improvement Project Abstract Background: The 5Ps model is a formulation tool which includes the mental health problem as well as predisposing, precipitating, perpetuating and protective factors. The 5Ps model was integrated into the assessment service in the community mental health recovery team by the first author (trainee clinical psychologist) with support from the service manager and clinical psychologist. Objectives: This research aimed to measure whether assessment staff in the community mental health recovery team were using the 5Ps model in assessment meetings and assessment letters to formulate service user’s mental health problems. This research also aimed to assess whether recommendations for mental health care addressed the 5Ps factors which were noted in the assessment letter and assessment meeting notes. Finally, the research aimed to recommend strategies to improve the use of the 5Ps model by assessment staff. Design: Assessment staff (n=6) were interviewed using semi-structured interviews. Assessment letters and meeting notes (n=36) were analysed using case note analysis. Methods: Percentage use of 5Ps in assessment letters and meeting notes and percentage of recommendations linked to 5Ps in assessment letters were calculated. The amount of 5Ps training staff received was also compared to staff members’ use of the 5Ps in assessment letters. Thematic analysis of staff questionnaire data was completed. Results: Assessment staff are using the 5Ps in their assessment work and some recommendations were linked to the 5Ps stated in assessment letters. Recommendations to improve the use of the 5Ps by assessment staff were based on staff feedback and case note analysis and included; updating the letter and assessment formats/processes to ensure that all of the 5Ps are linked to the mental health problem and recommendations made for treatment, completing the formulation section on the electronic notes system and further training for assessment staff in how to identify the 5Ps/how recommendations can address the 5Ps. Conclusion: Results suggest that the 5Ps formulation was operational to assessment staff as it was utilised to formulate service users mental health problem at assessment. However, results suggest that the recommendations need to be implemented to improve assessment staff’s acceptability and use of the 5Ps. The service agreed to adhere to the recommendations suggested to improve the use of the 5Ps and agreed that if recommendations are adhered to these results support the plan to integrate the 5Ps into other adult mental health teams across Bristol. Literature Review Abstract Objective: All studies of solution-focused therapy which included adults with a mental health problem are reviewed and research methodologies are summarised and rated according to the quality of the research methodology used. Method: Sixteen studies were found and data extracted on setting, mental health problem, modality, target and duration of intervention, research methodology, measures, sample size, method of analysis, comparison treatment and quality score. Results: 14 studies utilised quantitative research methodologies. Eight of the studies used a quasi-experimental design including control groups (n=6) and random assignment (n=3). One study used a post-intervention questionnaire follow-up design and one study calculated recovery rates. One study calculated whether or not the patient presented with self-harm within 1 year post intervention and pre-post intervention change on a solution-focused measure. Two studies were randomised controlled trials and another two studies were single case experimental designs. Two studies utilised qualitative research methodologies including transcribing a therapy session/post-intervention interview. Quantitative outcomes were measured using multiple questionnaire measures and multiple analysis methods. Conversation analysis and thematic analysis were used for qualitative studies. The quality scores of the studies varied from 4 (single case experimental design) to 14 (randomised controlled trial) and 15 (controlled quasi-experimental). Conclusion: This review shows that solution-focused therapy is being evaluated using many valid and reliable research methodologies and questionnaires. It is hoped that solution-focused therapists and researchers can use this review to complete and publish further research which measures the effectiveness of solution-focused therapy using research methodologies which produce valid and reliable results.
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Cowdrey, Felicity Ann. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.665408.
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Walters, Sasha. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675709.
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Smith, Emma. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.699004.
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Background and Objectives: It has been suggested that reassurance seeking may play an important role in the development and maintenance of common mental health problems such as OCD and depression. We first considered the extent of reassurance seeking in depression and OCD relative to a healthy comparison group and secondly tested the hypothesis that reassurance seeking is primarily motivated by threat in those suffering from OCD and by interpersonal concerns in those suffering from depression. Methods: The frequency and intensity of reassurance seeking and the motivation for seeking reassurance was measured using the reassurance seeking questionnaire in 28 people with OCD, 18 people with depression and 29 healthy controls. Results: The OCD group sought reassurance more and at a higher intensity than both the depression group and healthy controls. For the OCD group, reassurance seeking was found to be linked to threat concern motivation. The depression group were not motivated by threat or interpersonal concerns. Conclusions: For people suffering from OCD, reassurance is motivated by threat concern. For the depression group the motivation to seek reassurance is less clear but interpersonal concern may not be a distinct motivational factor. Key words: Reassurance seeking, Obsessive-Compulsive Disorder, depression, reassurance seeking questionnaire, threat motivation, interpersonal motivation.
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Fixter, Vera. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675706.
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Eden, Kate Elizabeth. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698989.
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Background: People with intellectual disability (ID) are more likely to be overweight or obese compared to their peers, which fuels the need for effective healthy weight management programmes targeted at this population. In order to inform such programmes, more evidence is needed relating to how people with ID perceive their bodies. Method: This study uses qualitative and quantitative methodology to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale was used to assess how participants perceived themselves, how they would like to look, and how they conceptualised underweight, healthy-weight and overweight. This rating scale was shown to be a valid and reliable measure when used with this population. Results: Results show that young adults with ID tend to hold positive beliefs about their bodies. Females with ID are likely to perceive their bodies to be smaller than they are and neither males nor females report a desire for an altered body size. The results also suggest that individuals with ID understand what is meant by 'overweight', 'healthy-weight' and 'underweight' although these concepts are qualitatively different compared to those held by people without ID. Furthermore, individuals with ID are unable to apply these body size categories to themselves. Conclusion: It is vital to consider these findings when designing healthy weight management programmes for people with ID. These individuals will need to be supported to understand how concepts of body size apply to themselves before they can move on to make positive choices about their weight management.
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Sadhnani, Vaneeta. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633162.
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Critical Literature Review Indiscriminate friendliness (IF) is a concept that is poorly understood within the field of institutionalised and maltreated children. Theories as to its existence vary from IF being a disorder of attachment, to neurobiological theories proposing IF to arise out of the interaction between a severely deprived upbringing and genetically predisposed brain abnormalities. The current literature review aims to look at studies that have investigated the interaction between attachment and indiscriminate friendliness, in order to ascertain whether IF is, in fact, a symptom of disordered attachment. Findings were considered in relation to quality of studies and literature within this field. Using specific search criteria, 11 papers were found and evaluated. Findings concluded that IF was not a symptom of disordered attachment, due to the majority of papers failing to find a link between the two constructs. Studies were evaluated in terms of sampling, measurement, analyses, and design. The review pulls together the literature on indiscriminate friendliness, which has previously been confined to the area of attachment. The review highlights potential areas for exploration such as the background of families, as well as the assessment of quality of care, and how this impacts on the development of IF. The review also raises concerns around the measurement of this construct, and calls for further use of validated measures. Service Improvement Project This study describes the development of a new group using psychological approaches for caregivers of individuals with dementia. This follows consultation with the service and its users, to the implementation and running of this group. Thematic analysis was used to extract key themes on the utility of the group. Barriers to intervention have been identified, and further research recommendations have been made. Main Research Project Background: Metaphors are commonly used within clinical settings to communicate concepts to young people. Whilst theories of how metaphors work have been proposed, alongside ideas to implement metaphors effectively, there has been little research as to whether metaphors impact upon memory and understanding, in comparison to basic language. Aims: The current study aims to assess whether metaphorical explanations leads to improved memory and understanding for psychological concepts. Method: 25 participants took part in the study (10 boys and 15 girls). Individuals who were on the waiting list for Cognitive Behaviour Therapy (CBT) were given the opportunity to watch a video which explained the main concepts of CBT. Half of the participants watched a video with metaphorical explanations (Metaphor group); the other half watched a video using basic language (Psychoeducation group). The participants answered questions immediately after the video and then four weeks later, on psychopathology, memory and understanding measures. Results: T-tests were carried out to determine any differences between the two groups. There were no significant differences on all variables tested (memory, understanding, intention to change) immediately or after four weeks. Correlational data, looking at the link between age and understanding/memory between the two groups found that older individuals were more likely to understand and remember the content of the Psychoeducation video. Whilst this correlation did not differ significantly from the Metaphors group, there were no such trends for individuals exposed to a metaphorical understanding. Conclusions: Metaphors do not appear to enhance memory and understanding of young people, in comparison to basic language. However, it seems they are equally understood by younger and older children, therefore making them an accessible way of communicating complicated concepts. Definitive conclusions cannot be made due to the small sample size, so there is a call for further research in this area.