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Barhamein, Majdah Yaseen Ahmed Flemben /. "Outcome predictors in lupus nephritis." Thesis, Imperial College London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413714.
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Talitman, Eran. "Predictors of outcome in Emotionally Focused Marital Therapy." Thesis, University of Ottawa (Canada), 1995. http://hdl.handle.net/10393/9877.
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The present study assessed the impact of client/relationship variables in predicting outcome in a dynamic/experiential approach to marital therapy. On the basis of an examination of the theoretical assumptions underlying this approach, three predictor variables were assessed: attachment, self-disclosure, and trust. Outcome criteria included (1) marital satisfaction level, (2) marital satisfaction gains, (3) intimacy level, and (4) therapist rating of improvement. It was hypothesized that couples presenting with higher levels of attachment, self-disclosure and trust would be more likely to be maritally satisfied, as indicated by a higher level of marital satisfaction and intimacy at posttreatment and at follow-up. It was also hypothesized that couples presenting with lower levels of attachment, self-disclosure and trust would be most likely to make the largest gains in marital satisfaction at posttreatment and at follow-up, and receive a high rating of improvement from their therapist at termination. Thirty-four couples were provided with 12 sessions of Emotionally Focused Marital Therapy (EFT). Couples were assessed at pretreatment, posttreatment, and at a three-month follow-up. Couples who were most likely to be maritally satisfied at termination indicated a higher level of couple-therapist alliance at the end of the third session. Couples who were most likely to be maritally satisfied at follow-up consisted of: (a) females who indicated a higher level of faith (trust) in their partner at intake, and (b) partners who indicated a higher level of the therapeutic alliance at the end of the third session. Couples who were most likely to make the largest gains in marital sitisfaction at termination indicated a higher level of therapeutic alliance by the end of the third session. Couples who were most likely to make the largest gains in marital satisfaction at follow-up: (a) indicated a lower level of marital satisfaction at intake, (b) consisted of males who indicated a lower level of use of attachment figure at intake, and (c) indicated a higher level of couple-therapist alliance at the end of the third session. There were two additional criteria of outcome: intimacy level and therapist rating of improvement. Results revealed four significant predictors of the level of intimacy. First, the couple's general level of intimacy at intake was the strongest predictor of the couple's general level of intimacy at follow-up. Couples with a higher level of intimacy at intake tended to have a higher level of intimacy at follow-up. Second, couples who established a higher level of alliance with the therapist by the end of the third session tended to show a higher level of intimacy at follow-up. Third, one aspect of trust, the females' level of faith significantly predicted those males who were likely to have the highest level of intimacy at follow-up. Fourth, the females' level of apathy self-disclosure at intake significantly predicted her follow-up level of intimacy. The fourth criteria of outcome was the therapist rating of improvement at posttreatment. There was only one significant predictor of therapist rating of improvement. Couples who had established a higher level of alliance by the end of the third session were most likely to have been rated as improved by therapists. (Abstract shortened by UMI.)
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Ling, Cheuk-ki Cora, and 凌卓錡. "Predictors of swallowing outcome in patients with tracheostomy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206607.
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It is known that the incidence of aspiration is high in patients with tracheostomy. However, it is unclear which patient population with tracheostomy has a higher chance to aspirate. This study aims to determine the predictors of swallowing outcome of patients with tracheostomy. Eighty- three patients with tracheostomies who underwent videofloroscopy for swallowing were recruited in the study. Analysis was done on the presence of aspiration as well as the feeding status with respect to medical conditions and duration of tracheostomy. The prevalence of aspiration and silent aspiration were found to be high in patients with tracheostomy. The incidence of tube feeding was also found to be high in this patient population. Vocal cord paralysis was found to be a significant predictor of aspiration and silent aspiration in patients with tracheostomy. Head and neck cancer and vocal cord paralysis were found to be associated with tube feeding in patients with tracheostomy.published_or_final_version
Surgery
Master
Master of Medical Sciences
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Do, Theresa. "Client Perceptions and Working Alliance: Predictors of Outcome?" VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1989.
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BACKGROUND In recent years, there has been a push to measure and monitor the quality of health care and the delivery of effective services. Substance use disorders are debilitating and in order to better understand this facet of substance abuse, it is important for organizations and providers to assess the quality of services, client satisfaction, and the relationships that exist between clients and treatment providers. PURPOSE The purpose of the study was to (1) assess the extent of the relationship between measures of client perceptions of satisfaction and treatment outcomes and (2) to assess the relationship between measures of therapeutic alliance and treatment outcomes. METHODS Data was obtained from a larger study assessing organizational factors affecting the implementation of evidence-based practices in the treatment of substance use disorders. This study was focused on the client satisfaction survey data obtained during the months of August and December of 2008, consisting of several five-day periods, during which clients were asked to complete the survey. The study population consisted of 371 clients aged 18 to 64 years. Logistic regression was used to evaluate demographic and other substance use-disorder factors for each of the scales pertaining to client satisfaction (general satisfaction, access, and quality/appropriateness) and therapeutic alliance (bond, goal, and task) in order to obtain odds ratios and 95% confidence intervals. Pearson correlation coefficients were used to assess the strength of the relationship of each of the measures of client satisfaction and therapeutic alliance with client perceived outcomes. Due to the nature of the survey questions being adapted from validated measures, Cronbach's coefficient alphas were used to determine internal consistency and reliability within each of the scales. To further assess client measures of satisfaction, multivariate linear regression was used to examine whether a specific client satisfaction measure or therapeutic alliance measure was a significant predictor of better client perceived outcomes. RESULTS Client perceptions of satisfaction - general satisfaction, access, and quality/appropriateness (worse vs. better) were significantly associated with better client perceived outcomes. Therapeutic alliance measures were also significantly associated with better client perceived outcomes. The strongest predictors from logistic regression analysis were quality/appropriateness (OR = 14.45, 95% CI 1.16-19.01) and general satisfaction (OR = 11.96, 95% CI 7.04-20.33) followed by WAI Goal (OR = 5.56, 95% 3.29-9.39), access (OR = 5.81, 95% CI 3.55-9.50), WAI Task (OR = 4.42, 95% CI 3.29-9.39), and WAI Bond (OR =3.61, 95% CI 2.06-5.22). Cronbach's coefficient alphas were all above the .70 threshold indicating strong internal consistency among the measures of client satisfaction, therapeutic alliance and client perceived outcomes. Pearson correlation coefficients indicated moderate relationships between access, general satisfaction, WAI Bond, Goal and Task with client perceived outcomes. The strongest correlation was that of quality/appropriateness of treatment services and client-perceived outcomes (r = 0.61, p<0.0007) CONCLUSIONS Client perceptions of satisfaction and therapeutic alliance were found to be significantly associated with better client perceived outcomes. Age, time in treatment, and number of times a client moved in the past 6 months was implicated in the association of general satisfaction and better client perceived outcomes. Age and race were implicated in the association of access and better client perceived outcomes. Further research is needed to measure the effectiveness of treatment services to ensure that clients are receiving appropriate evidence-based services that result in better outcomes.
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Lame, Ingrid Elisabeth. "Psychological predictors and treatment outcome in chronic pain." Maastricht : Maastricht : Universitaire Pers ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=14652.
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Khachatryan, Naira. "Study of post cataract surgery outcomes and predictors of poor outcome in Yerevan, Armenia." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536931.
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Manning, Clayton T. "Predictors of Outcome of Surgery for Carpal Tunnel Syndrome." DigitalCommons@USU, 2004. https://digitalcommons.usu.edu/etd/6203.
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Wrist surgery is a common method for treating carpal tunnel syndrome (CTS) although few studies have examined patient outcomes or predictive correlates of such procedures. The objectives of this study were to characterize Utah workers who received surgery for CTS in terms of relevant presurgical and outcome variables and to identify presurgical correlates of patient outcomes. Participants were 75 Utah workers' compensation patients who underwent surgery for CTS from 1999-2002 and were at least 6 months postsurgery at time of follow-up. A retrospective cohort design was utilized consisting of a review of presurgical medical records and a postsurgical telephone survey. Presurgical variables included: gender, age, history of depression, and litigation status. Correlational analyses revealed that age and lawyer involvement were consistent significant predictors of poorer outcomes. The importance of conceptualizing CTS surgery patient outcomes from a biopsychosocial perspective is discussed.
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Lahtinen, J. (Jarmo). "Predictors of immediate outcome after coronary artery bypass surgery." Doctoral thesis, University of Oulu, 2007. http://urn.fi/urn:isbn:9789514286339.
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Abstract
The identification of risk factors for major adverse events after coronary artery bypass surgery is of main importance as it allows outcome prediction, facilitates preoperative patient selection and improves the quality of care. In the present clinical studies we have evaluated the impact of preoperative angiographic severity of a coronary artery disease and preoperative C-reactive protein (CRP) on the immediate outcome after coronary artery bypass surgery. We have reviewed the results of off-pump (OPCAB) versus conventional on-pump coronary artery bypass surgery (CCAB) in high risk patients. We have evaluated the impact of postoperative pulmonary artery blood temperature on the immediate outcome as well. In addition, we have investigated the incidence, timing and outcome of an atrial fibrillation (AF) related stroke after surgery.
The multivariate analysis showed that among 2233 patients, the overall coronary angiographic score was predictive of postoperative death (p = 0.03; OR 1.027, 95% CI: 1.003–1.052) and of a low cardiac output syndrome (p = 0.04; OR 1.172, 95% CI: 1.010–1.218). The poor status of the proximal segment of the left circumflex coronary artery, the diagonal branches and the left obtuse marginal artery were most closely associated with adverse postoperative outcome.
Patients (114/764) with a preoperative serum concentration of CRP ≥ 1.0 mg/dL had a higher risk of overall postoperative death (5.3% vs. 1.1%, p = 0.001), cardiac death (4.4% vs. 0.8%, p = 0.002), a low cardiac output syndrome (8.8% vs. 3.7%, p = 0.01).
Among 179 high risk patients with an additive EuroSCORE6, the 30-day postoperative death and stroke rates were 7.5% and 6.0% in the OPCAB group, and 5.4% (p = 0.75) and 8.0% (p = 0.77) in the CCAB group, respectively. No significant differences were observed in other major outcome end-points between these non-randomised groups either.
High pulmonary artery blood temperature on admission to the ICU among 1639 patients was significantly associated with an increased risk of overall postoperative death (p = 0.002), cardiac death (p = 0.03), and a low cardiac output syndrome (p < 0.0001), and was significantly correlated with prolonged length of the ICU stay (r = 0.095; p < 0.0001), and postoperative bleeding (ρ = –0.091; p = 0.001).
Among 2,630 patients who underwent coronary artery bypass grafting (CABG), 52 (2.0%) experienced a postoperative stroke. Twelve out of these 52 patients (23.1%) died postoperatively. The ischemic cerebral event occurred after a mean of 3.7 days (0–33). In 19 patients (36.5%), atrial fibrillation preceded the occurrence of neurological complication.
The angiographic severity of the coronary artery disease and the preoperative serum concentration of CRP predict postoperative outcome after a CABG operation. OPCAB can be performed safely in high-risk patients with results as satisfactory as those achieved with CCAB. CABG patients with a high pulmonary artery blood temperature on admission to the ICU seem to have a higher risk of postoperative adverse events. Atrial fibrillation occurring after coronary artery bypass grafting is a major determinant of a postoperative stroke.
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Kalyan, Raman. "Predictors of outcome in stable thoraco-lumbar spine fractures." Thesis, Queen's University Belfast, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.437740.
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Kalula, Sebastiana Zimba. "Predictors of good outcome in upper gastrointestinal bleeding (UGIB)." Master's thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/26756.
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Background and literature review: Introduction: Acute upper gastrointestinal bleeding is a common cause of emergency hospital admission. It is also not uncommon in patients already in hospital. The bulk of severe morbidity and mortality occurs in patients with recurrent bleeding or significant comorbid illness. The use non-steroidal anti-inflammatory drugs (NSAID), which is more common in the elderly, more than doubles the mortality associated with peptic ulcer complications. Endoscopy and endotherapy have improved outcome in patients with continued or recurrent bleeding. Clinical Predictors of Outcome: Despite improved technology in the management of upper gastrointestinal bleeding (UGIB), mortality has remained high. This has been attributed to the increase in the population of elderly people who tend to have other underlying diseases leading to the high mortality rate. From international literature, mortality varies from 4-10%. Most of the reports reflect mortality around 8%. A local retrospective study by Van Stiegmann et. al. (1983) on patients with bleeding peptic ulcer had an overall mortality of 5.4 %, and mortality of 9.8% in those treated surgically. Ideally to avoid waste of resources and time, emergency endoscopy should primarily be considered in relatively few patients at risk of further haemorrhage. In this class of patients, endoscopy is used not only for diagnosis but also for endoscopic treatment to control massive ulcer bleeding. This approach is worthy of consideration in a "resource poor" environment. Most previous studies have employed endoscopic criteria for identifying patients at high risk of poor outcome. These data are not available at the time of admission. This is therefore not helpful in the triage of patients prior to endoscopy. Groote Schuur Hospital (location for the current study) has experienced a significant staff cutback over the past 5 years. Few of our regional hospitals and none of our primary health care facilities have endoscopy facilities and endoscopic expertise is similarly limited. Given the pressures on the limited endoscopy services, there is a need for guidelines for the referral of patients to centres with these facilities. There is a possibility that the number of potential referrals of patients with upper gastrointestinal bleeding (UGIB) will increase as the primary health care services improve, a rational review of criteria for referral appeared timely. There would be need to triage patients into: i). those who must have endoscopy urgently and ii). those who could be safely referred for elective endoscopy. Most previous studies have looked at predictors of adverse outcome. To our knowledge no study has been done in South Africa to determine clinical predictors of good outcome prior to endoscopy, that would help determine patients who would recover uneventfully without urgent endoscopy. Study Rationale: Given the scarcity of both endoscopy resources and of information for the triage of patients who would recover uneventfully following UGIB without urgent endoscopy in our setting, this study set out to answer the question: Is it possible to identify clinical criteria that will predict patients with UGIB in whom endoscopy could be safely deferred? OBJECTIVES: 1. To identify clinical criteria that predict uneventful recovery. 2. To determine the accuracy of individual symptoms and signs or combinations. of symptoms or signs at the time of presentation in predicting uneventful recovery. Study population and Methods: Study design and study setting: The design was a prospective, descriptive, cross sectional study with an analytical component. The study was conducted at Groote Schuur Hospital (GSH), which is a tertiary referral teaching hospital with 14 70 beds. It is affiliated to the University of Cape Town.
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Wasielewski, Noah Jon. "Predictors of functional outcome following anterior cruciate ligament reconstruction /." view abstract or download file of text, 2002. http://wwwlib.umi.com/cr/uoregon/fullcit?p3061971.
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Thesis (Ph. D.)--University of Oregon, 2002.Typescript. Includes vita and abstract. Includes bibliographical references (leaves 212-238). Also available for download via the World Wide Web; free to University of Oregon users.
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Badve, Monica Sunil. "Frequency, Predictors, Management and Outcome of Post-Stroke Pneumonia." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18794.
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Introduction: Pneumonia is a common complication of acute stroke, occurring in up to one quarter of cases. Those who develop post-stroke pneumonia are at an increased risk of death or poor functional recovery. Despite significant advances in the treatment of stroke in the last few years uncertainty remains regarding the frequency of post-stroke pneumonia. Whether prophylactic antibiotics are effective, and the appropriateness of other management strategies to improve stroke outcomes, remains uncertain. Aims: To systematically review the evidence on post-stroke pneumonia to determine: (i) the frequency, predictors, management and outcome of post-stroke pneumonia, and (ii) whether there are effective and safe interventions to prevent pneumonia and improve the management and outcome of post-stroke pneumonia. Methods: All observational studies published before October 2017 were assessed for studies with adult patients (age ≥18 years) admitted within 30 days of acute ischaemic or haemorrhagic stroke with prospective consecutive recruitment and quantification of the proportion of people who developed pneumonia after acute stroke. Studies were included in the frequency review if they were of adult patients with acute stroke where an assessment of pneumonia was performed within 30 days of ictus (Systematic review registration: PROSPERO CRD20171221). All randomised controlled trials published before December 2016 with adult patients (age ≥18 years) admitted within 30 days of acute ischaemic or haemorrhagic stroke comparing prophylactic antibiotics for the prevention of pneumonia with placebo, no treatment or standard care were included in the management review (Systematic review registration: PROSPERO CRD42016053133). Data were identified from Medline (Medical Literature Analysis and Retrieval System Online) via Ovid, EMBASE (Excerpta Medical Database), CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative index to nursing and allied health literature) and PsycINFO electronic databases. Results: Data were available from 47 observational studies (n=139,432 participants) and 6 trials (n=4,111 participants). The pooled frequency of post-stroke pneumonia was 12.3% (95% confidence interval [CI] 11%-13.6%, I2=98%). In pre-specified subgroup analyses, the pooled frequency of post-stroke pneumonia in 2011-2017 was 13.5% (95% CI 11.8%-15.3%, I2=98%) and this was comparable with earlier periods (P interaction=0.31). The pooled estimate of frequency of post-stroke pneumonia in the studies including only patients treated in stroke units was 7.1% (95% CI 5.8% -8.5%, I2=84%) which was significantly lower than for those treated in other locations (P interaction=0.005). The pooled frequency of post-stroke infection was 21% (95%CI 13%-29.3%; I2=99%) and of post-stroke urinary tract infection was 7.9% (95% CI 6.7%-9.3%; I2=96%). Compared to controls, preventive antibiotics reduced the risk of post-stroke pneumonia (relative risk [RR] 0·75, 95% [CI 0·57-0·99), and all infections (RR 0.58, 95%CI 0.48-0.69). There was no significant difference in the risks of dependency (RR 0.99, 95%CI 0·88-1·11), or mortality (RR 0·96, 95%CI 0·78-1·19) between the preventive antibiotic and control groups. Preventive antibiotics had uncertain effects on the risk of adverse events. Conclusions: Despite advances in the availability of acute stroke interventions, the frequency of post stroke pneumonia remains high at more than 10%. Pooled estimates indicate that the frequency of pneumonia has remained stable over recent decades. The frequency of post-stroke pneumonia is lower in patients who receive stroke unit care as compared to care in other hospital areas. While preventive antibiotics do reduce the risk of post-stroke pneumonia, uncertainty remains over whether this translates into improvements in other clinical outcomes. As such, there is insufficient evidence to recommend routine use of preventive antibiotics in the management of patients with acute stroke.
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Arcelli, Alessandra <1983>. "Outcome analysis of predictors in locally advanced pancreatic cancer." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9565/3/arcelli_alessandra_tesi.pdf.
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Guidelines report a wide range of options in locally advanced pancreatic cancer (LAPC): definitive chemotherapy or chemoradiotherapy or the emerging stereotactic body radiotherapy (SBRT) (+/- chemotherapy). On behalf of the AIRO (Italian Association of Radiation Oncology and Clinical Oncology) Gastrointestinal Study Group, we collected retrospective clinical data on 419 LAPC from 15 Italian centers. The study protocol (PAULA-1: Pooled Analysis in Unresectable Locally Advanced pancreatic cancer) was approved by institutional review board of S. Orsola-Malpighi Hospital (201/2015/O/OssN). From this large database we performed tree different studies. The first was a retrospective study about 56 LAPC treated with SBRT at a median biologically equivalent dose of 48 Gy +/- chemotherapy. We demonstrated a statistically significant impact of biologically equivalent dose based on an α/β ratio of 10Gy ≥ 48Gy for local control (LC) (p: 0.045) and overall survival (p: 0.042) in LAPC. The second was a retrospective matched-cohort case-control study comparing SBRT (40 patients) and chemoradiation (40 patients) in LAPC in terms of different endpoints. Our findings suggested an equivalence in terms of most outcomes among the two treatments and an advantage of SBRT in terms of LC (p: 0.017). The third study was a retrospective comparison of definitive chemotherapy, chemoradiotherapy and SBRT (+/- chemotherapy) in terms of different outcomes in LAPC. A predictive model for LC in LAPC was also developed reaching an AUC of 68% (CI 58,7%-77,4%). SBRT treatment emerged as a positive predictive factor for improved LC.
Findings deriving from our three studies suggest that SBRT is comparable to standard of care (definitive chemotherapy and chemoradiotherapy) in terms of outcomes. SBRT seems to be an emerging therapeutic option in LAPC significantly improving local control. Furthermore, we have shown the potential of a predictive model for LC. Randomized trials are needed to compare these different therapeutic options in LAPC.
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Luiker, Henry George. "Predictors of outcome for severely emotionally disturbed children in treatment." University of Sydney, 2008. http://hdl.handle.net/2123/2571.
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Doctor of Philosophy (Phd)Despite general agreement that severely emotionally disturbed children and adolescents are an "at risk" group, and that ongoing evaluation and research into the effectiveness of services provided for them is important, very little outcome evaluation actually takes place. The absence of well-conducted and appropriately interpreted studies is particularly notable for day or residential treatment programs, which cater for the most severely emotionally disturbed youths. This thesis outlines the main areas of conceptual, pragmatic and methodological confusion and neglect which impede progress in research in this area. It argues for plurality of data analytic strategies and research designs. It then critically reviews the reported findings about the effectiveness of day and residential treatment in specialist facilities, and the predictors of good outcomes for this treatment type. This review confirms that there is very little to guide practice. Having argued for the legitimacy of its methods and the necessity to address basic questions, the thesis reports the results of a naturalistic study based on data accumulated during a decade-long evaluative research program taking place at Arndell Child and Adolescent Unit, Sydney. The study addresses the question of what child, family and treatment variables predict outcome for 159 children and adolescents treated at this facility from 1990 to 1999. Statistically significant results with large effect size were obtained. Among the most disturbed subgroup of forty three children, (a) psychodynamic milieu-based treatment was shown to be more effective than the “empirically-validated” cognitive-behavioural treatment which superseded it in 1996, and (b) children from step-families showed better outcome than those from other family structures. Furthermore, it was found for the study sample as a whole that severe school-based problem behaviours were associated with a limited trajectory of improvement in home-based problem behaviour. These results are discussed with regard to implications for treatment, research methodology, policy and further studies.
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Chau, Laurence. "Predictors of outcome of exercise training in COPD patients (POET)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0003/MQ42594.pdf.
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Bachin, Imelda. "Predictors of fetal maturity and perinatal outcome at different gestations." Thesis, Imperial College London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.509795.
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Duckworth, Andrew David. "Proximal forearm fractures : epidemiology, functional results and predictors of outcome." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/23495.
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Proximal forearm fractures account for over 10% of all upper limb fractures. There is limited epidemiological data available and much of the literature focuses on the more complex fracture patterns, with the role of non-operative management for the isolated proximal forearm fracture still to be defined. Prospective short and long-term patient reported outcome data for simple isolated fractures of the radial head and olecranon would help define the indications for the non-operative management of these injuries. This thesis aims to test the hypothesis that non-operative management provides a comparable outcome to operative intervention for defined fractures of the proximal forearm. A large prospective database of 6872 fractures collected over a one-year period was used to define the epidemiology of proximal forearm fractures. A separate large prospective study carried out over an eighteen-month period using a pre-defined management protocol for all isolated radial head and neck fractures was analysed to determine the short and long-term outcome. Additional retrospective databases were collected and analysed to determine the short and long-term outcome for the non-operative and operative management of olecranon fractures, as well as the operative management of complex radial head fractures. Finally, two prospective randomised controlled trials (PRCTs) of isolated displaced fractures of the olecranon were carried out to compare 1) tension band wire (TBW) versus plate fixation in younger patients (< 75 years) and 2) operative versus non-operative management in elderly patients (≥75 years). The primary outcome measure for these studies was the upper limb specific patient reported Disabilities of the Arm, Shoulder and Hand (DASH) score. Secondary outcome measures included surgeon reported outcome scores, complication rates and cost. The incidence of proximal forearm fractures was 68 per 100,000. Radial head fractures fit a type D distribution curve (unimodal young man, bimodal woman) and radial neck type A (unimodal young man, unimodal older woman). Proximal ulna and olecranon fractures were both a type F (unimodal older man, unimodal older woman), with an increasing incidence after the 6th decade. Over 90% of proximal radial fractures were isolated stable fractures. Prospective analysis of 201 isolated proximal radius fractures found that the patient and surgeon reported outcome following primary non-operative management for Mason type 1 and type 2 (n=185) fractures was excellent in the short and long-term, with < 2% of patients undergoing secondary surgical intervention. At a mean of 10 years post injury (n=100), the mean DASH score was 5.8 and 92% of patients were satisfied. Factors associated with a poorer short and long-term patient reported outcome included increasing fracture displacement (≥5mm) and socio-economic deprivation. Retrospective analysis of 105 acute unstable complex radial head fractures found that the mean short-term functional outcome was good (mean Broberg and Morrey Score 80) following radial head replacement. In the long-term (mean 7 years), 28% of patients required removal or revision of the prosthesis, with younger patients and silastic implants independent risk factors (both p < 0.05). Retrospective analysis of 36 operatively managed isolated displaced olecranon fractures found satisfactory short and long-term outcomes, with the symptomatic metalwork removal rate 47% and the mean DASH 2.5 at a mean of seven years post injury. In the PRCT of plate (n=34) versus TBW (n=33) fixation, comparable functional and patient reported outcomes (DASH 8.5 vs 13.5; p=0.252) were found at one year following injury. Complication rates were significantly higher in the TBW group (63.3% vs 37.5%; p=0.042), predominantly due to a significantly higher rate of symptomatic metalwork removal (50.0% vs 21.9%; p=0.021), resulting in equivocal costs for both techniques (p=0.131). In older lower-demand patients, short and long-term retrospective analysis found very satisfactory outcomes following non-operative management of isolated displaced fractures of the olecranon, with patient satisfaction 91% and no patients requiring surgery for a symptomatic non-union. The preliminary results of the PRCT of non-operative (n=8) versus operative (n=11) management demonstrated comparable functional and patient reported outcomes at all points over the one-year following injury (all p≥0.05), with a higher rate of complications (81.8% vs 14.3%; p=0.013) and cost (p=0.01) following surgical intervention. The association found between fragility and the epidemiology of proximal forearm fractures highlighted the importance of considering non-operative management for these injuries. These findings support non-operative management for isolated stable radial head and neck fractures. For more complex injuries when radial head replacement is indicated, there is a high rate of removal or revision, with younger patients most at risk. In younger active patients with an isolated displaced fracture of the olecranon, TBW and plate fixation provide comparable short-term results, with TBW fixation as cost effective despite an increased rate of metalwork removal. In older lower demand patients, this data provides strong evidence for the non-operative management of isolated displaced olecranon fractures.
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Rutterford, Neil A. "Predictors of long term psychosocial outcome following traumatic brain injury." Thesis, Swansea University, 2005. https://cronfa.swan.ac.uk/Record/cronfa42388.
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Outcome after brain injury has, until recently, been assessed using few dimensions, and little attention has been paid to outcome at very late stages of recovery'. A broad range of variables have been found to be predictive of outcome after brain injury, but the nature of the relationship between predictors and outcome is unclear. This study aimed to include the majority of variables that have been reported as predictors, and used a model by Kendall and Terry (1996), based on a theory of stress and adjustment, as a framework to identify significant variables when predicting and explaining multidimensional long term outcome. 131 brain injured participants that were over 10 years post injury, were interviewed and neuropsychologically assessed. They also completed a set of questionnaires providing information about psychosocial variables. Results suggested that long term outcome can be good in this population, specifically in terms of quality of life and emotional adjustment. However, other outcomes, such as employment and community integration, were more severely compromised. Cognitive abilities showed no evidence of deterioration over time, but were still impaired in comparison to pre-injury estimates. Statistical analyses did not generally support the model depicting that appraisal and coping would act as mediators between predictors and outcome. Further analyses also rejected the notion that appraisal and coping were moderators. Predictors varied between dimensions, however, good self- concept, low neuroticism and high self-efficacy were found to be the most consistent significant variables when predicting all outcomes, and they also contributed the most to predictive models. When identifying predictors that directly influence outcome at late stages after brain injury, the findings indicated that the specific dimension of outcome being considered is all important. Furthermore, Kendall and Terry's model did not provide a useful framework to explain psychosocial adjustment.
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Loyden, Jennifer J. "Predictors of Cognitive and Seizure Outcome Post Anterior Temporal Lobectomy." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1184193355.
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Luiker, Henry George. "Predictors of outcome for severely emotionally disturbed children in treatment." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/2571.
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Despite general agreement that severely emotionally disturbed children and adolescents are an "at risk" group, and that ongoing evaluation and research into the effectiveness of services provided for them is important, very little outcome evaluation actually takes place. The absence of well-conducted and appropriately interpreted studies is particularly notable for day or residential treatment programs, which cater for the most severely emotionally disturbed youths. This thesis outlines the main areas of conceptual, pragmatic and methodological confusion and neglect which impede progress in research in this area. It argues for plurality of data analytic strategies and research designs. It then critically reviews the reported findings about the effectiveness of day and residential treatment in specialist facilities, and the predictors of good outcomes for this treatment type. This review confirms that there is very little to guide practice. Having argued for the legitimacy of its methods and the necessity to address basic questions, the thesis reports the results of a naturalistic study based on data accumulated during a decade-long evaluative research program taking place at Arndell Child and Adolescent Unit, Sydney. The study addresses the question of what child, family and treatment variables predict outcome for 159 children and adolescents treated at this facility from 1990 to 1999. Statistically significant results with large effect size were obtained. Among the most disturbed subgroup of forty three children, (a) psychodynamic milieu-based treatment was shown to be more effective than the “empirically-validated” cognitive-behavioural treatment which superseded it in 1996, and (b) children from step-families showed better outcome than those from other family structures. Furthermore, it was found for the study sample as a whole that severe school-based problem behaviours were associated with a limited trajectory of improvement in home-based problem behaviour. These results are discussed with regard to implications for treatment, research methodology, policy and further studies.
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Pellecchia, Melanie. "Predictors of Outcome for Children with Autism Receiving a Behavioral Intervention." Diss., Temple University Libraries, 2013. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/214762.
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School PsychologyPh.D.
Autism spectrum disorders (ASD) are associated with many different levels of language and social impairment, differences in levels of cognitive impairment, varying levels of aberrant behavior, and discrepancies in the presence or amount of restrictive and repetitive behavior. The heterogeneity found within the ASD population is coupled with significant heterogeneity in outcome for these individuals. Although interventions based on the principles of applied behavior analysis have been repeatedly cited as evidence-based for individuals with autism, significant discrepancies in outcome are evident within the literature. The heterogeneity in treatment outcome has been hypothesized as related to the heterogeneity of children included within the autism spectrum as well as differences related to treatment variables. The current study evaluated individual child characteristics and differences related to intervention intensity and fidelity as predictors of outcome after one year of exposure to a behaviorally based intervention. The primary goal of this study was to identify individual and treatment level characteristics that were predictive of differences in outcome for children with ASD. Information was gathered from a total of 368 students with autism spectrum disorders in kindergarten through second grade classrooms in the School District of Philadelphia. Correlational analyses and multiple regression analyses indicated that increased levels of expressive language skills at the start of the intervention year were correlated with and predictive of improved outcome. However, no other child level variables were related to differential outcomes. Additionally, higher levels of treatment intensity and treatment fidelity were associated with improved outcome.
Temple University--Theses
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Gouse, Hetta. "Neuropsychological, functional and behavioural outcome and predictors of outcome in a sample of traumatic brain injury litigants." Doctoral thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/10552.
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Includes abstract.Includes bibliographical references (leaves 147-162).
Generally, this study aimed to explore whether financial settlement in litigation influences outcome and recovery from closed head injury in a sample of traumatic brain injured (TBI) litigants who were tested and interviewed both during litigation (at time 1, or T1) and 1 year or more after case settlement (at time 2, or T2). More specifically, my major goals were to assess (a) changes between TI and T2 on outcome variables such as neuropsychological test scores and self- and other-reported cognitive function, behaviour, activities of daily living (ADL), and physical dependency (PD), and (b) the impact of demographic (e.g., years of education, employment status) and clinical (e.g., severity of injury, degree of post-traumatic amnesia, Glasgow Coma Scale score) variables on the aforementioned outcome variables.
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Potvin, Kent Monique C. "Predictors of outcome in a short-term psychiatric day hospital program." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0001/MQ36844.pdf.
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Mitra, Angana. "Predictors of sentinel node biopsy positivity and outcome in cutaneous melanoma." Thesis, University of Leeds, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.545705.
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Archer, Janine Elizabeth. "Predictors of Outcome of Collaborative Care for Depression in Primary Care." Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.503669.
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Moore, Stephanie D. "Predictors of Outcome Following Standardized Rehabilitation for Patients with Shoulder Pain." UKnowledge, 2013. http://uknowledge.uky.edu/rehabsci_etds/15.
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Shoulder dysfunction is frequently treated and persistent symptoms are common. Differential diagnosis of shoulder injuries can be challenging and knowledge of a diagnosis alone does not appear to be enough information to predict outcomes. Determination of a set of factors that predict outcome would assist clinicians in making the most effective treatment decision for patients with shoulder pain. The purposes of this dissertation were to investigate patient-clinician agreement in an orthopedic population of patients with shoulder pain and to determine what combination of factors best predicts positive patient-reported outcome following standardized rehabilitation in patients with shoulder pain.
In the first study, it was determined that patient-clinician agreement was moderate to good. This further supports the use of patient reported outcomes as an appropriate approximation of “true” outcome. In the second study, patient-nominated functional limitations were reduced to 14 categories for inclusion as candidate predictors in the prediction model. In the third study, we observed that the combination of absence of neck pain, shorter duration of symptoms and report of exercise as a functional limitation were associated with greater odds of positive clinical outcome following 6 weeks of standardized rehabilitation. Due to limited sample size, generalizations cannot yet be made to other samples. Future investigation of this model in a larger sample and subsequent external validation in a separate sample are necessary to further develop the model for clinical use.
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Mo, Wing-yan Anita, and 巫詠欣. "Acute stroke patients age 65 years and older: outcome and predictors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010298.
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Menezo, V. "The genetic predictors of severe outcome in patients with anterior uveitis." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1334585/.
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Uveitis is a generic term for a wide variety of different types of intraocular inflammation with different clinical phenotypes and visual outcomes. The explanation for why some patients develop chronic anterior disease whereas others do not is unknown. It seems likely that host factors such as the cytokine milieu of the aqueous humor may be an important factor in determining outcome. In turn, their secretion is genetically determined and cytokine gene polymorphisms have been associated with high or low level production whatever the stimulus. Purpose: The aim of this study was to identify key cytokine and chemokine polymorphisms associated with disease susceptibility, clinical phenotype, and development of visually significant complications in patients with anterior uveitis. Methods: PCR amplification was used to genotype a number of biallelic SNPs in several cytokine genes. This genetic data was then compared between patients and healthy controls, and within the patient group itself for association with clinical disease outcomes. Results: Our results show that a significant difference in the frequency of TNF-857T allele in patients with idiopathic anterior uveitis. We found a significant association between TNF-308 allele G and patients with anterior uveitis who were HLA-B27 positive. Patients with HLA-B27 associated anterior uveitis who developed visually threatening complications were more likely to carry the TNFRSF1A-201T or TNFRSF1A-1135T alleles. In addition, the frequency of IL- 1ra allele T was found to be significantly associated with chronicity of the disease. The frequency of MCP-1 (-2076T) allele was found to be significantly higher in healthy individuals when compared to patients with acute idiopathic anterior uveitis. Conclusions: These results suggest that genetic variations in proinflammatory mediators may influence the susceptibility and severity of the inflammatory response in eyes of patients with anterior uveitis. This knowledge may be useful in identifying prognosis and responsiveness to anti-TNF blockade in patients with anterior uveitis.
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Bryant, Elizabeth A. "Reflective Functioning and Treatment Alliance as Treatment Outcome Predictors of Psychoanalysis." Xavier University Psychology / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=xupsy1596479977189954.
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Ellis, Rachel. "Benefit and predictors of outcome from frequency compression hearing aid use." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/benefit-and-predictors-of-outcome-from-frequency-compression-hearing-aid-use(7216039a-4cbf-46b9-b7c4-e8772ce3981e).html.
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Non-linear frequency compression (NLFC) hearing aids are frequency lowering devices that compress a signal into a reduced bandwidth in order to maximise use of residual hearing. Only a few published studies have investigated benefit from NLFC hearing aids. Outcomes vary considerably between studies although most show large differences across listeners. This highlights the need for identification of reliable predictors of benefit. Furthermore, little is known about the time course and magnitude of perceptual learning associated with the use of NLFC amplification. A better understanding of these issues could potentially lead to significant clinical benefit and was therefore the focus of the present study. Two preliminary experiments were conducted on a total of 27 listeners with normal hearing in order to investigate the effect of NLFC on categorical perception and the role of cognition on NLFC outcome. The findings were used to inform the development (particularly with regards to the selection of NLFC fitting parameters) of a longitudinal study of 12 experienced adult hearing aid users with moderate-to-severe high frequency hearing loss. Participants wore the hearing aids, with and without NLFC enabled, in an A-B-A design, for approximately 6-7 weeks in each condition. Speech recognition, in both quiet (nonsense syllables) and noise (nonsense syllables and sentences), was measured at the end of each trial period. It was also measured at several time points when frequency compression was enabled in order to investigate perceptual learning. The opportunity was taken to gather preliminary self-report data (Glasgow Hearing Aid Benefit Profile and Speech, Spatial and Qualities of Hearing Scale) in order to identify possible trends on which to base future research. The results demonstrate that mean benefit on the speech recognition measures was greater when frequency compression was enabled. 9 out of 12 listeners obtained higher scores on the majority of outcome measures. There was no obvious difference on self report measures. Upon initial exposure to NLFC, there was an increase in confusions of some high frequency phonemes, especially of /f/ and /θ/ with /s/ (in both quiet and in noise); however, these confusions were less frequent after 6 weeks of NLFC hearing aid use. Limited evidence of perceptual learning of speech in noise was observed. In agreement with the findings of previous studies, large individual differences in benefit were evident. The relation between sentence in noise recognition (with and without NLFC enabled) and a variety of audiological (high frequency hearing loss and presence of dead regions) and cognitive factors (performance in the reading span and trail making tests) was examined. Audiological factors were shown to be predictive both of speech in noise recognition and of additional benefit obtained from NLFC. Listeners with the greatest high frequency loss derived the most benefit from NLFC. Once the effect of hearing loss had been partialled out, no other predictor correlated significantly with benefit from NLFC. However, the results support previous findings that cognitive functioning is predictive of benefit without NLFC, but suggest that this is primarily due to the influence of executive function rather than working memory span. The novel findings of the study (particularly those relating to speech in noise perception, acclimatisation to NLFC, and predictors of benefit from amplification) may help influence clinical practice, in relation to the assessment of candidacy for NLFC hearing aids and subsequent counselling offered to device users.
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Tyack, Zephanie F. "Predictors of functional outcome in children at 6 months post-burn /." St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16237.pdf.
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Park, Veronica. "Treatment of Early Childhood Stuttering: Clinical Presentation and Predictors of Outcome." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/19937.
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Stuttering typically occurs during the pre-school years. Despite this, there is limited understanding about the profile of children who experience early stuttering. Large prospective studies have identified associated risk factors for onset; however, no studies have been designed specifically to comprehensively explore the profile of early stuttering. Moreover, at present there are no known predictors of treatment outcome. There is evidence to suggest that higher stuttering severity at pre-treatment and longer onsetto- treatment interval predict unfavourable treatment outcome. However, those findings have since been contradicted, and only a small percentage of variance has been explained by regression models. The present thesis aimed to contribute to the knowledge base by conducting two studies using a large clinical cohort. Study 1 aimed to develop a profile of early childhood stuttering by conducting descriptive analyses of predictor variables across multiple domains. Study 2 dealt with regression models using those variables as predictors of short-and medium-term treatment outcome. The present thesis did not reveal anything notable about the demography, speech and language, and psychological function of clinically presenting pre-school children with early stuttering. However, preliminary findings on psychological measures revealed the need to comprehensively explore the psychological function of parents of preschoolers who begin to stutter. Regression models revealed that pre-treatment language skills and temperament characteristics predicted short- and medium-term treatment outcome, respectively. However, the models only explained a small percentage of the variance. This thesis concludes that there is nothing notable about the profile of children who present to clinic for stuttering treatment. Additionally, while there are predictors of treatment outcome that are of theoretical interest, further research is needed to understand their clinical relevance.
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Paulson-Karlsson, Gunilla. "Anorexia nervosa : treatment expectations, outcome and satisfaction." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-26142.
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Anorexia nervosa is a serious mental disorder with high mortality. It has the lowest prevalence compared with other eating-disorder diagnoses and the onset is related to adolescence, with a majority of female patients. The focus of this thesis is anorexia nervosa and the aim is to study adolescent and adult patients' comprehension and the course of treatment in order to make a contribution to the clinical work relating to these patients. The areas that were studied are expectations of treatment, outcome, predictors of outcome and satisfaction with treatment. Four research papers are included; three originate from work at a specialist eating-disorder unit at Queen Silvia Children's Hospital, Göteborg, Sweden and one from a multicentre study comprising 15 specialised eating-disorder units in Sweden. Paper I has a qualitative design, where participants, 18-25 years of age, were interviewed about their expectations while on the waiting list at a specialist eating-disorder unit. Three main categories of expectations emerged: "Treatment content," "Treatment professionals" and "Treatment focus." The participants expected to receive the appropriate therapy in a collaborative therapeutic relationship and to recover. Paper II evaluated the outcome of a family-based treatment for adolescent patients, 13-18 years old, and their parents. The results indicate that the treatment that is offered appears to be effective, as 78% of the patients were in full remission with less distance and a less chaotic family climate at the 36-month follow-up. Paper III examined the importance of motivation to change eating behaviour, treatment expectationsand experiences, ED symptomatology, self-image and treatment alliance for predicting weight increase in adult patients, 18-46 years of age. Patients' motivation to change eating habits, social relations, self-image, body image and duration of illness were found to predict weight increase both in both the short term (six months) and the long term (36 months). PaperIV studied adolescent patients' and their parents' satisfaction with a family-based treatment a tan 18-month follow-up. The majority of patients (73%) and parents (83%) stated that their expectations had been fulfilled and individual sessions for patients and parents respectively were of great help. Family-based treatment with a combination of individual and family sessions corresponds well to patients' and parents' treatment expectations. Young adult patients' expectations before treatment are multifaceted and should be taken into account in the therapeutic relationship. From the start of treatment, issues relating to patients' motivation, self-image, body image and social relationships should be continuously addressed in order to establish positive collaboration and a weight increase. Anorexia nervosa treatment for adolescents and their parents should be family-based and include family sessions as well as individual sessions for patients and parents. In addition, prevention programmes with the emphasis on early detection should be a prioritised area.
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Khasawneh, Faisal, Mahmoud Kamel, and Mohammad Abu-Zaid. "Predictors of cardiopulmonary arrest outcome in a comprehensive cancer center intensive care unit." BioMed Central, 2013. http://hdl.handle.net/10150/610246.
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BACKGROUND:Some comprehensive cancer centers in industrialized countries have reported improved outcomes in their cardiopulmonary arrest (CPA) patients. Little is known about the outcomes and predictors of CPA in cancer centers in other parts of the world. The objective of this study was to examine the predictors of CPA outcome in a comprehensive cancer center closed medical-surgical intensive care unit (ICU) located in Amman, Jordan.METHODS:In this retrospective single-center cohort study, we identified 104 patients who had a CPA during their stay in the ICU between 1/1/2008 and 6/30/2009. Demographic data and CPA-related variables and outcome were extracted from medical records. Comparisons between different variables and CPA outcome were conducted using logistic regression.RESULTS:The mean age of the group was 49.7+/-15.3years. The mean APACHE II score was 23.7+/-8.0. Thirty six patients (34.6%) were resuscitated successfully but 8 of them (7.7% of the cohort) left the ICU alive and only 6 out of the 8 (5.8% of the cohort) left the hospital alive. The following variables predict resuscitation failure: acute kidney injury (OR 1.7, CI: 1.1 - 2.6), being on mechanical ventilation (OR 3.8, CI: 1.3 - 11), refractory shock (OR 4.7, CI: 1.8 - 12) and CPR duration (OR 1.1, CI: 1.1 - 1.2).CONCLUSION:Survival among cancer patients who develop CPA in the ICU continues to be poor. Once cancer patients suffered a CPA in the ICU multiple factors predicted resuscitation failure but CPR duration was the only factor that predicted resuscitation failure and ICU as well as hospital mortality.
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Kellett, Susan K. "Causal attributions for problem drinking : gender differences and predictors of therapeutic outcome." Thesis, University of Leicester, 2002. http://hdl.handle.net/2381/31334.
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The aims of the research are to investigate gender differences in causal attributions for problem drinking in clients first presenting to treatment services, and to consider whether attributional style is related to therapeutic outcome. This study employs an independent samples design plus correlational measures, utilising self-administered questionnaires, the sample consisting of 64 new referrals to the alcohol services (33 men, 31 women). Research suggests that women may make more external attributions for problem drinking than men. Causal attributions are considered in terms of items regarding perceptions of alcohol as a problem, plus the attributional dimensions of the revised Causal Dimension Scale. Women were less likely than the men to feel alcohol was the root of their problems, but there were no gender differences in terms of the attributional dimensions. It is suggested that findings may indicate changes in gender-related social stereotypes, leading to a convergence in the attributions of male and female problems drinkers. Evidence is presented from previous research to support this explanation. Research suggests that perceptions of high internal control will be associated with positive therapeutic outcome; high external control and high stability with negative outcome. Using the Alcohol Abstinence Self-Efficacy Scale and the Stages of Change Readiness and Treatment Eagerness Scale to predict the therapeutic outcome it was found that higher internal control was related to more favourable indicators, higher stability with less favourable indicators, with no relationship in terms of external control. It is concluded that different interventions need to be used for men and women as they see the root of their problems differently. In addition, therapy could aim to increase perceptions of internal control and decrease perceptions of stability. Results also demonstrate the necessity of using multi-dimensional measures when assessing casual attributions, and suggestions are made for the use of such measures in clinical work.
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Grossi, Marcio Lima. "Neuropsychological deficits as predictors of treatment outcome in patients with temporomandibular disorders." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0018/NQ53896.pdf.
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Dymond, Maret Melanie. "Predictors of postpartum depression and moderators of outcome following a preventive intervention." Thesis, University of Reading, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493998.
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Previous research suggests that postpartum depression is related to psychosocial factors, such as life events and difficulties (e.g. Brown & Harris, 1978), and to relationship factors, such as insecure maternal attachment status (e.g. Bifulco et al. 2004). The current study aimed to confirm the relationships between life events/difficulties and postpartum depression, and between insecure maternal attachment and postpartum depression. The current study also aimed to investigate the relationships between life events/difficulties, insecure maternal attachment, and postpartum depression outcome following a preventive intervention for postpartum depression.
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Ma, Xue Jie. "Perinatal complications as predictors of neuropsychological outcome in children with learning disabilities." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036813.
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A prospective study was conducted on a group of 160 students from 9 to 14 years of age with learning disabilities to predict neuropsychological outcome using perinatal information as predictors. Perinatal information was obtained from the Maternal Perinatal Scale (MPS) (Dean & Gray, 1985). Subjects' neuropsychological functioning was assessed by the Short Neuropsychological Screening Device (SNSD) (Reitan & Herring, 1985). Information concerning subjects' intelligence was obtained from the Wechsler Intelligence Scale for Children-III (WISC-III) administered within the past two years. Hollingshead's Four Factor Index of Social Status was employed to determine subjects' socioeconomic status. A stepwise multiple regression analysis yielded a regression model that contained a subset of 7 perinatal risk factors, involving: (1) Obstetric History; (2) Gestational Age; (3) Psychosocial Events; (4) Delivery; (5) Intrauterine Stress; (6) Teratogenic Stress; and (7) Fetal Oxygenation. A hierarchical regression analysis was further performed to examine if adding socioeconomic and intellectual information to the regression model could increase the prediction of neuropsychological outcome. Results showed that up to 82% of the variability in the neuropsychological outcome was explained by the linear composite of the 7 risk factors. When socioeconomic and intellectual information were added to the regression model, the prediction of neuropsychological outcome was significantly improved. About 201 of the students with learning disabilities in the present study were found to display symptoms similar to minimal brain damage (MBD) relating to poor visual-motor integration, underdeveloped language skills, and aphasic conditions. The results support the theory of a "continuum of reproductive casualty" proposed by Pasamanick et al. (1956). The importance of detecting early indicators of neuropsychological deficits in at risk children was further suggested by the present study.Department of Educational Psychology
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Kaddourah, Ahmad M. D. "Prevalence, Outcome, and Predictors of Cardiorenal Syndrome in Children with Dilated Cardiomyopathy." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353949909.
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Jorgensen, Anna Mae. "Familial predictors of long-term outcome following inpatient treatment for eating disorders /." Diss., CLICK HERE for online access, 2009. http://contentdm.lib.byu.edu/ETD/image/etd3086.pdf.
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Cavalhieri, Klaus Eickhoff. "Experiences of Discrimination and Outcome Expectations as Predictors of Health Care Utilization." OpenSIUC, 2016. https://opensiuc.lib.siu.edu/theses/2006.
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This study is an investigation of how experiences of discrimination, self-efficacy, and the associated outcome expectations influence health care utilization of young college students. The relationships tested were informed by Andersen’s Behavioral Model of Health Services Use (Andersen, 2008), the most widely used model to understand and predict health care utilization. Andersen proposed that health care utilization is influenced by predisposing (i.e., personal characteristics), enabling (i.e., income, insurance), and need (i.e., perception of illness) factors. However, his model has been criticized for not taking in consideration social factors and oversimplifying the role of ethnicity as a predictor (Bradley et al., 2002). The purpose of this study is to expand the explanatory power of Andersen’s model, by including psychosocial variables (e.g., discrimination, self-efficacy). One hundred and eighty-five students completed a 20 minute online survey, which included measures of experiences of discrimination, outcome expectations, self-efficacy, attitudes, and demographic variables. Results indicated that self-efficacy to communicate with physicians was a significant predictor of health care utilization, although experiences of discrimination were not. The effects of discrimination on health care utilization were further found to be mediated by self-efficacy to communicate with physicians. The present study's finding provided support for the inclusion of psychosocial variables (i.e., self-efficacy) in Andersen's model to increase its explanatory power.
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Bulteel, Naomi Sarah. "Predictors of disease progression and outcome in chronic hepatitis C virus infection." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/9079/.
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Chronic HCV infection (CHC) is a significant cause of both liver related and non-liver related morbidity and mortality worldwide. Disease progression through to cirrhosis and hepatocellular carcinoma is highly variable, and once chronicity of infection has been established, the likelihood of spontaneous clearance without antiviral treatment is extremely low. Safe and highly effective oral antiviral therapy is now available for the treatment of CHC, however price and accessibility may limit the global use of these agents. Furthermore, concerns have been raised regarding the incidence of hepatocellular carcinoma in HCV-infected individuals receiving oral antiviral regimens, and there appears to be a ‘point of no return’ beyond which cirrhotic HCV-infected individuals fail to benefit from antiviral treatment. Thus, there remain a number of unanswered questions on the natural history of HCV infection. Ageing of the immune system, or immunosenescence, appears to contribute to poorer clinical and treatment outcomes, however robust, non-invasive, clinically relevant biomarkers are lacking. MicroRNAs (miRNAs) are short, endogenous non-coding RNAs responsible for post-transcriptional control of host gene expression. Specific patterns of miRNA deregulation have been described in the serum, liver tissue and peripheral immune cells of HCV-infected subjects, and it is hypothesised that they may be suitable as both diagnostic and prognostic biomarkers. We interrogated 3 patient cohorts (providing access to local and national clinical data) to identify patient factors associated with disease progression and both spontaneous and treatment-associated clearance of CHC. We found that chronological age and elevated BMI had the strongest association with hepatic cirrhosis. Co-morbid type 2 diabetes mellitus was associated with poor clinical outcomes during antiviral therapy. Spontaneous clearance of CHC occurred rarely (0.36 per 100 person-years follow up), and was associated with female gender, earlier age at infection, low HCV viral load and co-infection with HBV. Current injecting drug use was negatively associated with spontaneous clearance. We also explored the use of miRNAs as biomarkers in these cohorts. We correlated miRNA expression with cellular markers of immunosenescence to identify novel prognostic biomarkers for disease outcomes in CHC. Our findings demonstrated that CHC was associated with a distinct miRNA signature in the serum and peripheral immune cells. Serum miR-21-5p, miR-122-5p and miR-885-5p levels correlated with the expression of previously described biomarkers of ageing, however these miRNAs performed poorly as biomarkers of cirrhosis in CHC. Elevated serum miR-21-5p expression was an independent predictor of virologic relapse following antiviral therapy, together with HCV genotype. MiR-21-5p also appeared to predict the likelihood of an adverse clinical event during treatment. We identified a further microRNA, miR-345-5p, elevated baseline expression of which correlated with negative clinical outcome during treatment, and was associated with the presence of both hepatic and extra-hepatic malignancy. We explored the regulation of miRNA expression in an in vitro model, and found that interferon-stimulated gene expression is necessary for IFN-induced miR-21-5p expression. Finally, we performed pathway analysis for target genes regulated by miRNAs deregulated during CHC, and found that pathways in cancer were highly enriched. Pathway enrichment was similar between HCV-infected cirrhotic subjects and non-cirrhotic, immunosenescent subjects, suggesting that non-cirrhotic individuals with elevated biomarkers of immunosenescence may be at an increased risk of hepatocellular carcinoma and may benefit from enhanced surveillance and prioritisation for antiviral treatment. Overall, the wealth of clinical and molecular data provided the opportunity to explore possibilities for integrating novel biomarkers into clinical decision-making for monitoring liver-related disease in HCV-infected subjects.
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Ridley, Anna Mae. "Familial Predictors of Long-Term Outcome Following Inpatient Treatment for Eating Disorders." BYU ScholarsArchive, 2009. https://scholarsarchive.byu.edu/etd/1752.
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The present investigation examined characteristic, symptomatic, and familial predictors of long-term symptom severity of eating disorders. The purpose of the study was to determine if, after accounting for a number of known predictors of outcome, familial variables explained a significant amount of additional variance in disordered eating and general well-being scores measured at post-treatment follow-up. The sample included 398 women, ages 13 to 56, who had completed eating disorder treatment at an inpatient facility. Hierarchal multiple regression analysis demonstrated that familial predictors at admission to treatment did significantly predict long-term outcomes, while changes from admission to treatment in symptoms and perceptions of parents did not predict recovery. Patients' relationships with their fathers significantly contributed to the regression model. Recommendations for future investigations are discussed.
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Kimeldorf, Marcia Beth. "Reactions to Infidelity: Individual, Gender, and Situational Predictors of Relationship Outcome and Forgiveness." Scholarly Repository, 2008. http://scholarlyrepository.miami.edu/oa_dissertations/145.
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Infidelity in romantic relationships can be devastating, and can cause many complex emotional reactions. The Jealousy as a Specific Innate Module (JSIM) hypothesis posits that due to differing reproductive pressures over evolutionary history, men and women have evolved different mechanisms to respond to infidelity. JSIM proposes that men, due to fears of cuckoldry, will respond with intense jealousy to a partner's sexual infidelity. It proposes that women, who are certain of their maternity but may suffer severe consequences if their mate falls in love with another and diverts his resources elsewhere, will respond with intense jealousy to emotional infidelity. These gender effects were examined in a study of participants who had recently been cheated on sexually, emotionally, or both, by romantic partners. Distress, forgiveness, and couple identity were measured. Results among actual victims of infidelity failed to support the JSIM hypotheses. Men and women responded with similar levels of distress to both types of infidelity. Both men and women were less forgiving as sexual infidelity severity increased, yet the severity of sexual infidelity was associated positively and significantly with less forgiveness for women, and it was associated less positively and non-significantly with less forgiveness for men. Men reported more couple identity after infidelity than did women. In a larger sample that used hypothetical scenarios, it was found that men responded with more upset to sexual infidelity and women responded with more upset to emotional infidelity when using a forced choice method.
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Sota, Teresa Lillain. "Outcome in schizophrenia, are cognitive variables predictors of rehospitalization and quality of life?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0028/NQ39309.pdf.
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Appelros, Peter. "Stroke severity and outcome : in search of predictors using a population-based strategy /." Stockholm : [Karolinska institutets bibl.], 2002. http://diss.kib.ki.se/2002/91-7349-275-2/.
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Williams, Lynn. "Predictors of outcome in cardiac disease : the role of personality and illness cognitions." Thesis, University of Stirling, 2007. http://hdl.handle.net/1893/359.
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Background: Coronary heart disease can have a long lasting impact on affected individuals in terms of both physical and psychological adjustment and quality of life. It is, therefore, important to investigate determinants of outcome in these patients. The thesis has four main aims; (i) to investigate predictors of outcome (adherence, quality of life, functional impairment, psychological distress and benefit finding) post-myocardial infarction (MI); (ii) to determine the prevalence and stability of Type D personality in the UK; (iii) to determine if personality predicts outcome after controlling for mood, demographic and clinical factors, and (iv) to investigate potential mechanisms which may explain the link between personality and poor prognosis in cardiac patients. Method: Five studies were conducted. In Studies 1-3, participants completed measures of Type D personality, health-related behaviour, social support and neuroticism. In Study 4, participants completed an experimental stressor with cardiovascular monitoring. Study 5 was a prospective study in which 131 MI patients completed measures of personality, illness cognitions and outcome at two time points, 3-5 days post-MI, then again 3 months later. Results: The prevalence of Type D personality in the UK is 39% in the healthy population, and 34% in the cardiac population. In addition, Type D is predictive of adherence, quality of life, and functional impairment in post-MI patients after controlling for mood, demographics, and clinical factors. Five possible mechanisms (health-related behaviour, adherence, social support, cardiovascular reactivity, and illness perceptions) by which Type D may lead to adverse outcome in cardiac patients were identified. Mood predicted quality of life and functional impairment post-MI, illness perceptions predicted quality of life post-MI, and future thinking predicted quality of life, functional impairment and depression post-MI. Discussion: These findings have important therapeutic and theoretical implications for understanding the role of personality and illness cognitions in the short-term recovery of post-MI patients.
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Everman, Melinda K. "Self regulation, outcome expectancy value, and exercise role identity as predictors of exercise." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1074551.
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A limited amount of research has been conducted on college students' physical activity levels. According to the 1996 Surgeon General's Report, only one fourth of young adults regularly exercise vigorously. Therefore, there is a need to develop effective exercise intervention programs for young adult populations. There has been no previous research using the variables of outcome expectancy value, exercise role identity, and self-regulation skills. The purpose of the study was to describe the relationship among self-regulation skills, outcome expectancy value, and exercise role identity as predictors of exercise levels. Subjects (n=1 83) represented a convenient sample of students from Personal Health classes at Ball State University. All subjects completed a four-part questionnaire divided into: self-regulation, outcome expectancy value, exercise role identity, and seven day recall. Results revealed that selfregulation and exercise role identity were predictors of vigorous activity, but not moderate activity. Outcome expectancy value was not significantly correlated with any of the dependent variables, except for male vigorous days. This study further support self-regulation and exercise role identity as predictors of physical activity.Department of Physiology and Health Science
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Nichols, Melanie. "Self-Efficacy, Outcome Expectancy, and Fear of Failure as Predictors of Physical Activity." OpenSIUC, 2012. https://opensiuc.lib.siu.edu/dissertations/638.
Full textAbstract:
Though the benefits of physical activity are well-studied and accepted, researchers have struggled to identify models of health behavior that accurately predict exercise. This dissertation utilized two components of Bandura's Social-Cognitive Model (self-efficacy and outcome expectancies) and added the construct of fear of failure in order to evaluate what factors influence an individual's decision to exercise or avoid physical activity. Self-report data assessing fear or failure, self-efficacy, outcome expectancies, and physical activity were collected from 248 university students and were analyzed using structural equation modeling techniques in order to evaluate the proposed structural model, which hypothesized that fear of failure would negatively relate to the two Social-Cognitive variables, which were expected to positively predict physical activity engagement. Results revealed that although fear of failure did not add significantly to the Social-Cognitive model, a large portion of the variance in physical activity (i.e., 49%) could be accounted for by the model. Additionally, results indicated that outcome expectancies were a much stronger predictor of physical activity than self-efficacy beliefs. This finding is discussed in relation to how individual differences and genetics may influence how rewarding or aversive individuals find exercising. Implications for intervention and directions for future study, including alternate ways of adding affect to the model are discussed.
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Khatami, Ali. "Early prostate cancer : on prognostic markers and predictors of treatment outcome after radical prostatectomy /." Göteborg : Department of Urology, Institute of Clinical Sciences, The Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, 2007. http://hdl.handle.net/2077/7507.
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