Dissertations / Theses on the topic 'Treatment outcome'
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Gorske, Tad T. "Adolescents in residential treatment characteristics and treatment outcome." Morgantown, W. Va. : [West Virginia University Libraries], 1999. http://etd.wvu.edu/templates/showETD.cfm?recnum=828.
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Thesis (Ph. D.)--West Virginia University, 1999.Title from document title page. Document formatted into pages; contains v, 125 p. Vita. Includes abstract. Includes bibliographical references (p. 104-112).
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Elhaj, Ahmed Mohammed. "Breast conservation treatment at Groote Schuur Hospital : treatment outcome." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/2848.
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Kuoppala, R. (Ritva). "Outcome of implant-supported overdenture treatment." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526210889.
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Abstract The retention of a complete denture and the patient’s adaptation varies considerably among different individuals. Resorption of the edentulous alveolar ridge differs greatly and some patients need implant-retained overdentures to enable adequate retention of their prostheses. In some extreme cases it is necessary to increase the volume of the alveolar ridge with bone grafts. The aim of this study was to examine the outcome of implant-supported overdenture treatment conducted in Oulu University Hospital. The aim was also to assess the impact of treatment on oral health-related quality of life and patient satisfaction. The study group was comprised of patients treated with a mandibular or maxillary implant overdenture and a group of patients with extreme mandibular bone resorption treated with extraoral bone grafts and implants. The treatments were performed in 1985–2013 thus also providing long-term results. The results of this study showed predictable and successful treatment outcomes also among elderly patients and in severe situations with bone deficiency. The most frequent complication in the clinical follow-up was loosening of the retention mechanism, commonly noted in other previous studies. Despite some minor mechanical defects in prosthetic structures or mild mucosal inflammation around the implants, they did not hinder everyday use of the prostheses. Neither the number of supporting implants nor the connection type seemed to have a great impact on patient satisfaction. Older patients with a mandibular overdenture seemed to be most satisfied. In conclusion, treatment with implant overdentures seems to be successful also in the long-termTiivistelmä Kokoproteesin pysyvyys ja potilaan sopeutuminen proteesiin vaihtelee huomattavasti eri yksilöiden välillä. Hampaattoman luuharjanteen resorptiossa on eroja, ja osalle potilaista implanttikiinnitteinen peittoproteesi on välttämätön riittävän proteesin pysymisen mahdollistamiseksi. Hyvin pitkälle edenneissä luuharjanteen resorptioissa voi leukaluun lisääminen luusiirteillä olla tarpeellista. Tutkimuksen tarkoituksena oli selvittää Oulun yliopistollisessa sairaalassa tehtyjen implanttikiinnitteisten peittoproteesihoitojen tuloksia. Tavoitteena oli myös arvioida hoidon vaikutusta suunterveyteen liittyvään elämänlaatuun ja potilastyytyväisyyteen. Tutkittava ryhmä koostui potilaista, joille oli valmistettu alaleukaan tai yläleukaan implanttikiinnitteinen peittoproteesi, ja potilasjoukosta, jolle hyvin pitkälle edenneen luuresorption vuoksi implanttihoito oli tehty luusiirteiden avulla. Hoidot tehtiin vuosina 1985–2013, ja tutkimuksissa voitiin arvioida myös peittoproteesihoidon pitkäaikaistuloksia. Tutkimus osoitti, että hoitotulokset olivat ennustettavia ja onnistuneita myös iäkkäillä potilailla sekä potilailla, joilla luupuutos oli kaikkein vaikein. Yleisin todettu komplikaatio kliinisessä tutkimuksessa oli proteesin kiinnitysmekanismin löystyminen. Pienet proteesirakenteiden rikkoutumiset tai lievät limakalvon tulehdusreaktiot implanttien ympärillä eivät kuitenkaan haitanneet proteesin toimintaa ja päivittäistä käyttöä. Peittoproteesia tukevien implanttien määrällä tai kiinnitystyypillä ei todettu olevan suurta vaikutusta potilastyytyväisyyteen. Kaikkein tyytyväisimpiä vaikuttivat olevan iäkkäät potilaat, joille oli tehty alaleuan peittoproteesi. Tutkimus osoittaa, että implanttikiinnitteinen peittoproteesihoito on menestyksellistä myös pitkällä aikavälillä
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McBride, Dawn Lorraine. "Groups for abused women, treatment outcome." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq64874.pdf.
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Abitbol, Sarah. "Outcome of non-surgical endodontic treatment." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ62996.pdf.
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Collado, Carissa M. "DELAY DISCOUNTING AND TREATMENT OUTCOME PROBABILITY." OpenSIUC, 2019. https://opensiuc.lib.siu.edu/theses/2553.
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The purpose of the current study is to apply the delay and probability discounting in the areas of parent training and probability of success of treatment. There was a total of 31 participants that completed one demographic questionnaire and two probability and delay discounting surveys either via computer or with paper and pencil. Participants had two options in the surveys: one was an immediate reward, and one with a probability delay. The first survey gave scenarios of hours of parent training, the second was a monetary probability discounting survey.
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Jansson, Rebecka. "ERIKSBERGSGÅRDEN’S EATING DISORDER TREATMENT UNIT: PATIENT CHARACTERISTICS AND TREATMENT OUTCOME." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-68114.
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Introduction: Eating disorders are serious psychiatric disorders that often require specialized care. Associated psychiatric comorbidity is frequent, with the most common comorbid conditions being anxiety and mood disorders. Eriksbergsgården in Örebro is one of Sweden’s specialized eating disorder treatment units.Aim: Primary aims were to describe clinical characteristics of the adult patient group at Eriksbergsgården and to evaluate treatment outcome and patient satisfaction at the one-year follow-up. An additional aim was to examine if factors such as psychiatric comorbidity affected treatment outcome.Methods: This study used data from Riksät and Stepwise, two large-scale Swedish registers for eating disorder treatment. Data for this study was registered into Stepwise and Riksät at Eriksbergsgården between August 2010 and December 2017 and 489 adult patients of both genders constituted the study group. Patient characteristics and DSM-IV axis I psychiatric comorbidity were assessed at the initial evaluation. At the one-year follow-up, treatment outcome and patient satisfaction were evaluated.Results: The most common diagnoses in this patient material were eating disorder not otherwise specified, 56.6 %, followed by bulimia nervosa, 26.4 %. At the initial evaluation, 62.0 % of the patients suffered from psychiatric comorbidity. Of the patients with initial comorbidity, 43.3 % were recovered at the one-year follow-up, compared to 62.8 % of the patients with no initial comorbidity, p=0.021.Conclusion: Our results confirm the previously known fact that psychiatric comorbidity among eating disorder patients is common. Also, the results identify psychiatric comorbidity as a possible factor to have negative effect on the treatment outcome.
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Stobie, Blake. "Therapist and patient beliefs associated with OCD treatment and treatment outcome." Thesis, King's College London (University of London), 2009. https://kclpure.kcl.ac.uk/portal/en/theses/therapist-and-patient-beliefs-associated-with-ocd-treatment-and-treatment-outcome(e9700445-0e37-49af-bf77-ca85ec1b0f14).html.
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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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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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Rosling, Agneta. "Eating Disorders - Aspects of Treatment and Outcome." Doctoral thesis, Uppsala universitet, Barn- och ungdomspsykiatri, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-204209.
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Eating disorders (ED) usually develop during adolescence, and intervention to stop further weight loss is believed to improve outcome and long-term prognosis. Adolescents with ED who do not receive effective treatment risk poor outcome and even untimely death as adults. The first aim of this thesis was to investigate long-term mortality and causes of death in a series of female adults with chronic ED. The second aim was to study the one-year outcome of an unselected series of adolescent girls with anorexia nervosa (AN) and “other restrictive eating disorders” who had been treated within a specialist ED out-patient service focused on nutritional rehabilitation based on family therapy and without planned hospitalization. The third aim was to investigate the possible metabolic and hormonal side effects of olanzapine when used as an adjunct to facilitate nutritional rehabilitation. The fourth aim was to investigate the relationship between polyunsaturated fatty acid (PUFA) status and depression. In adult women with chronic ED, a very low body mass index and psychiatric co-morbidity confer a substantially increased risk of premature death. A treatment programme for adolescent ED with rapid access to assessment and prompt start of treatment with initial emphasis on nutritional rehabilitation proved efficient. The outcome was encouraging, as 43% of all patients with ED and 19% of those with AN did not have an ED at one-year follow-up. Of the remaining patients the vast majority had gained weight and regained menstruation, and were back in school on a full-time basis. Olanzapine was used to reduce anxiety, excessive exercise and rumination over weight and shape. Side effects were similar to those observed in normal-weight individuals, and do not preclude its use in underweight adolescents with ED. Low ω3 PUFA were associated with depression. The ω3 PUFA status improved during nutritional rehabilitation with ordinary foods and without supplementation. The investigations indicate that adolescent ED can be successfully treated in an out-/day-patient setting. An essential feature of the service is rapid handling and weight gain. Further weight loss can be avoided, and chronic disease hopefully prevented.
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Bakri, Issam. "Stress and the outcome of periodontal treatment." Thesis, University of Sheffield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.489127.
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At the beginning of this study there was evidence suggesting that stress was one factor associated with periodontal disease progression. However, there was no information on the relationship of patient stress and the outcome of non-surgical periodontal treatment (NPT). The aim of this study, therefore, was to test the hypothesis that psychological stress leads to a poorer outcome of treatment.
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Griffiths, Peter V. "Treatment factors and neuropsychological outcome in phenylketonuria." Thesis, University of Stirling, 1997. http://hdl.handle.net/1893/22863.
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Phenylketonuria (PKU) is an inherited metabolic disease that affects about one in 10,000 of the population worldwide. In the classical form of the condition, the hepatic enzyme phenylalanine hydroxlase is absent or much reduced. If untreated, severe or profound mental handicap customarily results due to the accumulation of dietary phenylalanine (phe) which is neurotoxic. The mechanism by which phe impairs growth in the immature nervous system is little understood, but myelin metabolism appears to be disturbed. Treatment is by reduction of phe in daily food intake. Treatment should ideally begin in the neonatal period if intellectual loss is to be avoided. However, the safe range of phe concentrations during treatment and the age at which treatment can be discontinued without further damage being inflicted are uncertain. The studies reported in this volume investigated neuropsychological outcomes of treatment control and cessation factors. In addition, the question of whether executive functions are especially vulnerable to elevated phe concentrations during treatment was addressed. Patient samples conformed to the practice adopted in the West of Scotland regional centre for the management of PKU of maintaining dietary treatment until age 10 or beyond. Almost exclusively, negative findings emerged. These suggested that, if control of phe intake conforms to current UK recommendations for the preschool and primary years, neither global nor specific intellectual deficit result. Furthermore, the data supported the view that cessation of treatment at 10 years of age does not have harmful consequences. These findings have direct implications for the formulation of clinical policy on the treatment of PKU, but it must be recognized that the history of the successful treatment of PKU and mass screening for the disease spans a mere three decades. Thus, treatment outcome research to date is based only on children and young adults. In future investigations, a life-span approach will be required before the issues raised in this thesis can be finally settled.
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Engelbrecht, Leon Anton. "School refusal : clinical characteristics, treatment and outcome." Master's thesis, University of Cape Town, 1990. http://hdl.handle.net/11427/25829.
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Clinical characteristics, methods of treatment and outcome in School Refusal have been investigated. School refusal/phobia has been reported in the literature not to be a true clinical entity with a uniform aetiology, psychopathology, course, prognosis and treatment, but rather a collection of symptoms or a syndrome occurring against the background of a variety of psychiatric disorders. Aetiological and precipitating factors also vary with age, psychosocial level of development and personality factors in the individual child, family structure and function, and the school setting. Data were collected retrospectively from 20 cases treated at the Child and Family Unit, Red Cross War Memorial Children's Hospital, Cape Town during a specific time period. Analysis of the data revealed a gender distribution of 11 boys and 9 girls; 1 girl, 5 - 8 years old and 11 boys and 8 girls 9 - 13 years old. One Asian, no Black, 13 Coloured and 6 White children were represented. A large section of the sample population represented the lower socio-economic group as determined by parental qualification and occupation. Most of the families tended to consist of more than 2 children (5 member families). Family dysfunction was recorded in all but one case, with evidence of a recognizable psychiatric disorder also recorded quite frequently in the nuclear family members. Educational difficulties were recorded in a third of the sample together with below average total IQ scores in virtually all the subjects evaluated. The bulk of referrals were from medical practitioners and relatively few from schools. Refusal to attend school was of relatively short duration in three-quarters of the sample. Most of the cases were first time school refusers. Accompanying symptoms or problems were mainly anxiety or depression - related whereas significant associated events were mainly family - oriented. Psychiatric disorders diagnosed most often were anxiety and affective disorders with overlap of the 2 conditions recorded in half the sample. Response to treatment was positive in two thirds of the sample and a combination of treatment methods proved to be the most successful treatment plan. School refusal as investigated in this study, was well represented in a population of children treated at a Child Psychiatric Out-Patient Unit. A high rate of resemblance on various aspects of school refusal was recorded between the study sample and reports in the literature reviewed.
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Binen, Lenore M. "Treatment outcome at a university counseling center /." free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9904835.
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Rose, A. Danielle, and Marc A. Fagelson. "Treatment Outcome in a VA Tinnitus Clinic." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/1619.
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Anastassaki-Köhler, Alkisti. "On temporomandibular disorders : Time trends, associated factors, treatment need and treatment outcome." Doctoral thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Oral hälsa, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-19842.
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During the last few decades, and especially during the 1990s, an increase in musculoskeletal pain conditions and stress-related ill-health has been observed in Sweden. At the same time, an improvement in the oral health of the population has been noted. The overall aim of this thesis was to acquire knowledge relating to possible time trends for the presence of temporomandibular disorders (TMD) in the population. A further objective was to study factors that possibly influence the presence of these disorders and the outcome of their treatment. Studies I–III are based on a series of repeated cross-sectional population-based investigations. Three independent samples of 130 individuals in the age groups of 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years were randomly selected from the inhabitants of the city of Jonkoping, Sweden in 1983, 1993 and 2003. The total participation rate was 21%, 22% and 29% respectively. The participants were examined using a questionnaire, interview and a clinical examination of the stomatognathic system regarding the presence of symptoms and signs indicative of TMD. Study IV is a retrospective survey of a clinical sample of patients referred to and treated at the Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jonkoping, in 1995–2002. The overall frequencies of symptoms and the rates for some clinical signs and consequently of an estimated treatment need in adults increased during the study period. In 2003, the prevalence of frequent headache in 20-year-olds, mainly females, had markedly increased. The reports of bruxism among adults increased from 1983 to 2003. Awareness of bruxism and self-perceived health impairment were associated with TMD symptoms and signs. A favourable treatment outcome was observed for the majority of patients with common TMD sub-diagnoses and no strong predictors of treatment outcome were found. In conclusion, the results suggest some time trends towards an increased prevalence in the overall symptoms and some signs indicative of TMD in the Swedish adult population during the time period 1983–2003. A profound understanding of the social determinants of health is recommended when planning public health resources.
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Jones, Nicole Tuomi. "Comorbidity, typologies and treatment outcome in a correctional substance abuse treatment population /." free to MU campus, to others for purchase, 2001. http://wwwlib.umi.com/cr/mo/fullcit?p3036836.
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Liu, Pei, and 刘沛. "Endodontic treatment outcomes: patient based assessments." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B46288971.
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Campbell, Nicole M. "Treatment Compliance and Post-Treatment Behavior in Adolescents Attending Residential Treatment for Substance Use Disorders." Ohio University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1416255601.
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Tooth, Claire L. "Outcome following neurosurgical treatment of aneurysmal subarachnoid haemorrhage." Thesis, University of Sheffield, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.421001.
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Auce, P. "Biomarkers for treatment outcome in newly diagnosed epilepsy." Thesis, University of Liverpool, 2017. http://livrepository.liverpool.ac.uk/3006594/.
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Introduction and aims Epilepsy is a common neurological condition and around 25% of patients are resistant to treatment with currently available drugs (Brodie et al., 2012). Currently there is only a limited ability to predict treatment outcome and no genome based biomarkers for treatment efficacy. The main aim for this thesis was to investigate clinical and genome based biomarkers for treatment response in newly diagnosed epilepsy as well as explore methodological aspects related to the assembly of a large scale international research cohort. Methods An EU-funded project entitled “Epilepsy Pharmacogenomics: delivering biomarkers for clinical use (EpiPGX)” was undertaken by a pan-European research consortium to explore genome-based biomarkers that could be used to individualize treatment of epilepsy. University of Liverpool led work on newly diagnosed epilepsy. Work presented in this thesis is solely based on this project. Cases with newly diagnosed epilepsy were either de-novo phenotyped or data was transferred from existing clinical databases. Analysis of clinical covariates using logistic and Cox regression, and a subsequent GWAS were performed. Methodological and data transfer quality aspects were assessed separately using descriptive statistics and Cohen's kappa and Lin’s coefficients. Results and Conclusion The following clinical factors were significantly associated with twelve month remission after application of first well tolerated antiepileptic drug: age at diagnosis, abnormal neurological examination, GTCs-only, epilepsy type, number of seizures before the treatment, MRI and EEG results. Heterogeneity of outcomes between cohorts, effect of mode of cases ascertainment was also demonstrated. Data quality assessment showed that simple variables can be robustly transferred between data bases whereas more complicated variables have a potential for introduction of bias. A GWAS was carried out on newly diagnosed cases with focal epilepsy and failed to identify any SNPs significantly associated with treatment outcome. Clinical factors associated with treatment outcome potentially can be useful in daily clinical practice when assessing patients with newly diagnosed epilepsy. Large scale multi-centre studies utilizing historical retrospective data are possible but prospective recruitment should be preferred. Sound methodology and quality assurance methods should be applied in future epilepsy pharmacogenetic research particularly involving large multi-centre cohorts.
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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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Nakachi, Shogo Wichai Supanaranond. "Outcome of treatment in leprosy reactions /cShogo Nakachi." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd388/4838789.pdf.
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Thematic Paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2006.LICL has E-Thesis 0012 ; please contact computer services. LIRV has E-Thesis 0012 ; please contact circulation services.
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Stevens, Kimberly Toby. "DISTRESS INTOLERANCE AND OBSESSIVE-COMPULSIVE DISORDER TREATMENT OUTCOME." OpenSIUC, 2018. https://opensiuc.lib.siu.edu/dissertations/1600.
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Obsessive-compulsive disorder (OCD) contributes to significant distress and chronic individual and societal impairment (e.g., DuPont et al., 1995; Ruscio et al., 2010). Despite the effectiveness of existing exposure-based therapies, some clients do not achieve symptom reduction or remission (Öst et al., 2015). Thus, identification of the mechanisms of change in treatment and more focused interventions are warranted to improve intervention effectiveness (e.g., Zvolensky et al., 2006). Distress intolerance may be an important but understudied mechanism of change in treatment for OCD. The current study replicated and extended previous findings that were limited by a small sample size (Macatee & Cougle, 2015), lack of focus on OCD specifically (McHugh et al., 2014; Bornovalova et al., 2012; Williams et al., 2013), and the use of non-clinical participants (Cougle et al., 2011; Macatee & Cougle, 2015) by using a residential and intensive outpatient sample of patients diagnosed with OCD. The current study found that reductions in DI accounted for significant improvement in OCD severity beyond changes in biological sex, anxiety change, depression change. Further, reductions in DI significantly contributed to OCD treatment response. Limitations and future directions were discussed.
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Langlois, Andre. "Working alliance and its effects on treatment outcome." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1862.
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Barbaro, Pasquale. "Telomere dynamics in children undergoing cancer treatment and the relationship between telomere length and treatment outcome." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/21162.
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Telomeres are specialised DNA structures that protect the ends of linear chromosomes, and their length is important for cell viability. Telomere length declines with age, and there is a large variability seen within the general population. Patients with short telomere disorders (STD) suffer increased toxicity from chemotherapy given for haematopoietic stem cell transplant (HSCT), however little is known of the relationship between telomere length, outcome and toxicity in the general population undergoing chemotherapy. This thesis shows that patients with STDs have poor short- and long-term outcomes following HSCT with mortality mostly due to pulmonary disease or infections. To define the relationship between telomere length and outcome in patients receiving therapy for cancer, we undertook retrospective analysis of outcome and telomere dynamics in children who had undergone HSCT, treatment for childhood acute lymphoblastic leukaemia (ALL) and who were long term survivors of childhood cancer. Children undergoing cancer treatment have an acute decline in telomere length at the time of cancer therapy, however there is no evidence that this telomere attrition continues in the long term, with the exception of patients with some cancer types, and who received certain specific chemotherapy agents. Patients undergoing HSCT or treatment for ALL with shorter telomere length have higher rates of specific organ toxicity and certain infections. However there does not appear to be any relationship between telomere length and significant late effects from childhood cancer, aside from avascular necrosis. These findings highlight the complex relationship between telomere length and cancer therapy. They require further confirmation in prospective clinical trials, and in a wider population with differing initial malignancies, and undergoing different chemotherapy regimes in order to better define the complex relationship between telomere length, chemotherapy and outcome.
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Gerdner, Arne. "Compulsory treatment for alcohol use disorders clinical and methodological studies of treatment outcome /." Lund : Dept. of Clinical Alcohol Research, Lund University, 1998. http://catalog.hathitrust.org/api/volumes/oclc/39072757.html.
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Kooperman, Rochelle. "Using psychological measures to predict treatment outcome of nerve blocks for pain treatment." Thesis, Kooperman, Rochelle (1994) Using psychological measures to predict treatment outcome of nerve blocks for pain treatment. Masters by Coursework thesis, Murdoch University, 1994. https://researchrepository.murdoch.edu.au/id/eprint/41193/.
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If a set of predictors of treatment outcome could be found for a medical pain treatment, then screening of patients according to the predictors should increase treatment success. This may also help to channel patients who are unlikely to respond to such treatment towards other treatment options (Abram, Anderson and Maitra-D'Cruze 1981)...
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Garden, O. James. "Prediction of outcome following acute variceal haemorrhage." Thesis, University of Edinburgh, 1986. http://hdl.handle.net/1842/18218.
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Between August 1979 and September 1982, acute variceal haemorrhage has been managed in the University Department of Surgery, Glasgow Royal Infirmary by a policy of oesophageal tamponade and injection sclerotherapy. Haemorrhage was controlled in 90% of admissions with an admission mortality of 28%. Recurrent haemorrhage occurred in half the patients surviving their first admission to hospital despite entering a programme of elective sclerotherapy. The results of this management policy are reviewed and the means of selecting patients for more aggressive therapy discussed. The deficiencies of a modified Child's classification in selection of patients are highlighted and overcome by the development of a prognostic index obtained by regression analysis on data collected on patients managed over this 3 year period. The admission prognostic index clearly defines 'high' and 'low' risk groups and 'predicts' outcome following admission in 90% of patients. The use of this index is validated in a further group of patients managed by a similar policy. Further regression analysis is used to obtain a prognostic index for alcohol cirrhotic patients alone and to determine the factors associated with one year survival. These indices are used to audit the management policy. Prothrombin, creatinine and encephalopathy are shown to have a clear association with outcome when measured at the time of variceal haemorrhage whereas other factors such as albumin and haemoglobin emerge as having prognostic value when measured one month following the acute episode. The possible applications of these prognostic indices are investigated in a prospective two centre study assessing the efficacy of propranolol in preventing recurrent variceal haemorrhage. It is shown that they can be used to exclude patients from entry into a study assessing the longterm benefit of propranolol when the prospects of short-term survival are limited. Their value in auditing management and their possible use in withdrawing treatment are shown. The prognostic indices are used to compare results of treatment at the two hospitals and are shown to be of value in analysing the results of the trial. These prognostic indices provide an objective means of evaluating patient management and may allow selection of patients for consideration of other treatment options.
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Witherspoon, Dawn O. "Prediction of Outcomes of an Eating Disorders Treatment Program." Cleveland, Ohio : Case Western Reserve University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1253034500.
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Thesis(Ph.D.)--Case Western Reserve University, 2010Title from PDF (viewed on 2010-01-28) Department of Psychology Includes abstract Includes bibliographical references and appendices Available online via the OhioLINK ETD Center
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Money, Tyler Adam. "Adolescent girls' perception of residential treatment centers: A qualitative study of how treatment works." BYU ScholarsArchive, 2007. https://scholarsarchive.byu.edu/etd/1611.
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RTCs play an increasingly significant role in the continuum of treatment of emotionally disturbed adolescents. However, outcome research in this area has lagged behind the growth of treatment centers. More specifically, there has been very little investigation of the relative efficacy of the many different aspects of residential treatment, which are referred to as mechanisms of change in other research. The present study attempts to develop a phenomenological understanding of RTC patients' experience of all of the interventions that make up residential treatment. Results suggest that patients view social support, non-therapist staff members, family involvement and family therapy, as most prominent in their change process. Patient articulations indicate that they are able to understand a great deal about the importance of multi-modal treatment, and the importance of receiving a broad range of treatment interventions. Limited four year follow-up data is also included.
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Ijäs, H. (Hilkka). "Gestational diabetes:metformin treatment, maternal overweight and long-term outcome." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526208596.
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Abstract Gestational diabetes mellitus (GDM) is defined as disturbed glucose metabolism first recognized during pregnancy. Untreated GDM increases the risk of obstetric and neonatal complications, such as fetal overgrowth (macrosomia). The first-line treatment of GDM includes diet therapy and the self-monitoring of blood glucose concentrations and, if needed, pharmacotherapy, which is most commonly accomplished with insulin. Oral anti-diabetic agents such as metformin have recently been under investigation. GDM increases the risk of developing overt diabetes, metabolic syndrome and cardiovascular diseases. The aim of the present study was to investigate the effect of metformin vs. insulin therapy on pregnancy and neonatal outcome as well as on later growth and development of the infant and to investigate the independent and concomitant effects of GDM and maternal overweight/obesity on pregnancy outcome and maternal long-term risks. In a randomized study of 100 women, metformin therapy was not associated with an increased risk of pregnancy or neonatal complications when compared with insulin treatment. However, 32% of the women treated with metformin needed additional insulin in the achievement of normoglycaemia. The need of additional insulin was associated with maternal obesity, an earlier need of pharmacotherapy and fasting hyperglycaemia in OGTT. Infants exposed to metformin were taller and heavier at the age of 18 months compared with infants exposed to insulin. There was no difference in the motor, social or linguistic development between these children when assessed at the age of 18 months. In an epidemiological study of 24,565 pregnancies, normal-weight women with GDM did not have an increased risk of macrosomia or Caesarean delivery when compared with normal-weight women without GDM. GDM was an independent risk factor of neonatal morbidity, especially hypoglycaemia. Maternal overweight and obesity were independent risk factors of macrosomia and obesity was also an independent risk factor of Caesarean delivery and neonatal morbidity. In a follow-up study (n = 116), women with a history of insulin-treated GDM had an increased risk of metabolic syndrome when compared with women without GDM 19 years after index pregnancy. However, maternal pre-pregnancy overweight as such was a stronger risk factor as regards the development of metabolic syndrome than previous GDMTiivistelmä Raskausdiabetes on ensimmäisen kerran raskauden aikana ilmaantuva glukoosiaineenvaihdunnan häiriö. Hoitamattomana raskausdiabetes lisää raskaana olevan ja vastasyntyneen komplikaatioriskiä, erityisesti sikiön liiallista kasvua (makrosomiaa). Raskausdiabetestä hoidetaan ruokavaliolla, veren glukoosipitoisuuksien omaseurannalla sekä tarvittaessa lääkehoidolla, joka on useimmiten insuliinihoitoa. Muita diabeteslääkkeitä, kuten metformiinia, on tutkittu viime vuosina paljon. Raskausdiabetes lisää myöhemmällä iällä riskiä sairastua diabetekseen, metaboliseen oireyhtymään sekä sydän- ja verisuonisairauksiin. Tämän tutkimuksen tarkoituksena oli selvittää metformiinihoidon tehoa ja turvallisuutta verrattuna insuliiniin raskausdiabeteksen hoidossa. Lisäksi selvitettiin raskausdiabeteksen ja ylipainon itsenäistä vaikutusta raskauskomplikaatioiden esiintyvyyteen sekä naisen myöhempään sairastuvuuteen. Satunnaistetussa tutkimuksessa (n = 100) metformiini ei lisännyt vastasyntyneen makrosomian eikä vastasyntyneen tai raskauskomplikaatioiden riskiä verrattuna insuliiniin. Metformiinilla hoidetuista naisista 32% tarvitsi lisäksi insuliinia normaalin glukoositasapainon saavuttamiseksi. Lisäinsuliinin tarvetta ennustivat äidin lihavuus, varhainen lääkehoidon tarve sekä kohollaan olevat glukoosin paastoarvot sokerirasituksessa. Metformiinille altistuneet lapset olivat sekä pidempiä että painavampia 18 kuukauden iässä kuin insuliinille altistuneet lapset, mutta heidän motorisessa, sosiaalisessa tai kielellisessä kehityksessään ei ollut eroja. Epidemiologisessa tutkimuksessa (n = 24,565) normaalipainoisen naisen raskausdiabetes ei lisännyt keisarileikkauksen tai sikiön makrosomian riskiä verrattuna normaalipainoisiin naisiin, joiden sokeriaineenvaihdunta oli normaali. Raskausdiabetes lisäsi itsenäisesti vastasyntyneen sairastavuuden ja hypoglykemian riskiä. Äidin ylipaino ja lihavuus lisäsivät itsenäisesti makrosomian riskiä ja lihavuus myös keisarileikkauksen ja vastasyntyneen sairastuvuuden riskiä. Seurantatutkimuksessa (n = 116) insuliinihoidettujen raskausdiabeetikoiden riski sairastua 19 vuotta raskauden jälkeen myöhempään metaboliseen oireyhtymään oli lisääntynyt verrattuna terveisiin verrokkeihin. Raskautta edeltävä ylipaino oli vahvempi riskitekijä metabolisen oireyhtymän kehittymiselle kuin aiempi raskausdiabetes
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Robinson, Anna-Lena. "Axis Fractures in Elderly : Epidemiology and Treatment related outcome." Doctoral thesis, Uppsala universitet, Ortopedi, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333901.
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Background: Axis fractures are a common injury in the elderly population. Treatment is often complicated due to osteoporosis and patient comorbidity. Knowledge of the incidence of these fractures, as well as their treatment, outcome and mortality rate, will improve knowledge and decision-making processes for this fragile group of patients. Objectives: This thesis aims (1) to review the literature on the non-surgical and surgical treatment of odontoid fractures type 2 in the elderly population, (2) to provide an updated overview of axis fracture subtypes, their incidence and their treatment in a cohort in two university cities, (3) to map the incidence of fractures and the treatment of these patients in Sweden, (4) to investigate the effect on mortality of both the surgical and non-surgical treatment of axis fractures and (5) to present the protocol for a randomized controlled trial (RCT) on the treatment of odontoid fractures type 2 in the elderly population. Methods: A systematic review was performed using the MeSH keywords “odontoid AND fracture AND elderly”. The data for the cohort study were extracted from the regional hospital information system. The radiographs were reviewed retrospectively. Data were extracted from the Swedish National Patient Registry (NPR) and the mortality registry for the national registry studies. Finally, the RCT protocol was carried out according to the SPIRIT and CONSORT statements for clinical trial reporting. Results and conclusions: So far, there has been a scarcity of existing evidence on treatment of odontoid fractures type 2 in the elderly population. In this thesis, we found in two university cities an increased incidence, and a trend towards more surgical treatment of type 2 and 3 odontoid fractures 2002-2014. Between 1997 and 2014 in Sweden, there was an increasing incidence of C2 fractures, but the treatment trend went towards more non-surgical treatment. Surgically treated patients had a greater survival rate than non-surgically treated patients. Among those over 88 years of age, surgical treatment lost its effect on survival. In the RCT we will study the function of patients with odontoid fractures type 2 and by comparing non-surgical treatment with posterior C1-C2 fusion, the cost-effectiveness of the treatment options.
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Ladjevardi, Sam. "Imaging and Treatment Outcome of Potentially Curable Prostate Cancer." Doctoral thesis, Uppsala universitet, Urologkirurgi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-171754.
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The over-all aim of the present study was to compare the results of treatment with curative intent, with conservative treatment in men with prostate cancer (PCa) without distant metastases. In a population-based cohort in Sweden, the predictive value of prostate-specific antigen (PSA) was evaluated and the relative survival of men considered plausible candidates for treatment with curative intent was investigated. We also evaluated the association between curative treatment and cause-specific mortality, and over-all as well as relative survival in men diagnosed with PCa with a serum PSA level between 20 and 100 ng/ml. Due to the uncertainly of transrectal ultrasound-guided biopsy in the diagnosis of PCa, we created a model for prostate imaging to increase the safety of guided Core Needle Biopsy (CNB) in men with suspect PCa, thereby improving staging. Material and methods. The cohorts in the first three studies were prospectively included in a population-based register (the National Prostate Cancer Register). Study IV was a clinical study on patients included between 2010 and 2011. Results. Regardless of Gleason Score, a positive relationship between survival and serum PSA level categories in patients with a PSA level> 4 ng/ml was found, but a paradoxical inverse relationship was observed in men with a PSA level < 4 ng/ml. Men with a well-differentiated tumour had a 5-year relative survival exceeding 100% regardless of treatment. The survival rate for moderately and poorly differentiated tumours was poor for men managed conservatively. The 10-year cause-specific mortality for patients with PSA 20-50 ng/ml was 36% for patients treated without and 13% for patients treated with curative intent. For patients with a PSA 50-100 ng/ml the 10-year cause-specific mortality was 55% for conservative and 20% for patients treated with curative intent. PCa detection by CNB, magnetic resonance imaging (MR) with ADC (Apparent diffusion coefficient), magnetic resonance spectroscopic imaging (MRSI) and Positron Emission Tomography (PET/CT) ¹¹C Acetate imaging applied to 10 sections of the prostate demonstrated clear conformity between MRI ADC mapping and postoperative findings, showing high specificity (87%) and sensitivity (95%). Conclusion. The inverse relationship between relative survival and PSA at levels below 4 ng/ml should be considered when choosing a PSA cut-off level. Outcome differs little between conservative management and treatment with curative intent in men with localised well- to moderately differentiated tumours over a 10-yr period. For men with poorly differentiated tumours, on the other hand, choice of treatment is crucial for outcome. Treatment with curative intent is beneficial in the group of men with prostate cancer and PSA levels between 20 and 100 ng/ml without distant metastases. A combination of MRI , diffusion ADC and MRSI may provide an improved model for imaging of the prostate for targeted biopsy.
36
Ng, Y. L. "Factors affecting outcome of non-surgical root canal treatment." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/14526/.
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O'Donoghue, M. F. "The measurement of outcome in the treatment of epilepsy." Thesis, University College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391616.
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Debnath, Ujjwal Kanti. "Factors predicting the outcome following treatment for lumbar spondylolysis." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/12780/.
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Study 1: Study design: A non –randomised continuous retrospective cross sectional and observational study Objective 1) To evaluate the results of nonoperative treatment of symptomatic lumbar pars stress injuries or spondylolysis in sporting as well as non sporting individuals 2) To determine the factors responsible for non-operative method of managing symptomatic lumbar spondylolysis in young population 3) To evaluate the outcome in different types of sports 4) To establish the role of compulsory non-operative treatment for symptomatic lumbar spondylolysis in sporting individuals Summary of Background Data The treatment and management of symptomatic spondylolysis in sporting populations is mainly based on observation rather than experimental study. Conservative treatment in the form of bracing and avoidance of sports for at least three to six months has been recommended. Excellent or good results following bracing and physical therapy have been observed in 80% patients. Criteria for return to sport are dominated by symptom led decisions. Methods The research was carried out as a qualitative, descriptive and analytic study with a non-randomised cohort of patients investigated for spondylolysis in a single centre. A total number of 123 patients treated conservatively following confirmation by imaging studies (SPECT,CT or MRI scans) as having stress fractures of the lumbar pars interarticularis (PI) ranging in age from 8 to 35 years have been selected for the study. All patients attending the Back pain clinic has to follow a protocol of filling up the VAS, ODI and SF-36 questionnaires as a part of their assessment. At the time of the study these questionnaires along with the Back Pain & Sports Questionnaire (BPSQ) were sent to all but only 123 patients responded who were included in the study 1. The background data contains gender, age, date of onset of symptoms with current limitation in sport, pain in flexion or extension, type of sport, level of sport and length of treatment. The data also contains each subject with level, number, laterality and distribution of lumbar spondylolysis, investigations, outcome with VAS, ODI, SF-36 and Back pain and sports questionnaire (BPSQ) and return to sports. We classified the individual sports into seven types depending on the major movements of the body. Descriptive and analytical statistics was performed along with correlation testing between the outcome measures and predictive factors. Results The mean age of onset of back pain was 21.7 years (range 8-35 years). Most patients were between the ages of 15&19 years (43) followed by 20&24 years (32). The Male: Female ratio was 74:49. There were 98/123 (76.9%) sporting individuals. 35/98 (35%) were professional players, 29/98 (29.5%) were semi professional and 34/98 (34.6%) were amateur sportsmen and women. Cricket (22) followed by Football (22) were the most common type of sports played. Trunk twisting movement was the common denominator in most of the patients with pars defect. The cricketers (13) with unilateral pars defect had more commonly left sided pars defect than the right (10 left vs 3 right). Right sided pars defect was more commonly observed in soccer players (7:1). Most incomplete fractures were observed at L4 in the cricketers. The non sporting group had consulted with a delay of more than six months since the onset of pain. 60% pars lesion was observed at L5 followed by L4 (11.3%), L3 (9.7%) and L2 (2.4%). At L5 most were bilateral lesions (81%). Spina bifida was recorded in 16% patients. The mean pre and post treatment VAS score was 4.5 and 0.65 respectively (SD- 0.8,p<0.01). The mean pre and post treatment ODI was 35.5 (SD-7.8) and 6.9 (SD- 7.6) respectively (p<0.01). In the SF-36 scores, the mean score for the physical component of health improved from 34.9 (SD – 5.3) to 49.3 (SD -6.6) (p< 0.001). The mean score for the mental component of health improved from 40.2 (SD -5.2) to 52.0 (SD-6.0) (p<0.001). The mean BPSQ score was 52.5 (range 0-90). The mean pretreatment and post-treatment VAS and ODI scores were slightly better in males as compared to females. In the unilateral group, 28/36 (77%) patients had complete relief of pain by a mean time of 4.2 months (range 3-7 months). In the bilateral group, 47/59 (79%) patients had complete pain relief at a mean time of 6.5 months (3-12 months). In the unilateral pars defect group, 32/36 sporting individuals returned to active sports. In the bilateral pars defect group, 49/59 sporting individuals returned to active sports. There was significant difference between the sporting and the non-sporting group in their age (mean 20.7 vs 25.4 years, p <0.001). There was significant difference between the two groups in all pre and post treatment outcome scores. The pre treatment VAS score had most significant correlation with post treatment ODI ( =0.634, p <0.01) and post treatment VAS scores ( =0.626, p<0.01). Conclusion A treatment protocol of rest for 4-6 weeks followed by the functional restorative program has excellent or good outcome in 85% sporting individuals with symptomatic pars defect. Male sporting individuals have better outcome than females. Unilateral pars lesions have a better outcome than bilateral pars lesions. Bracing may not be required in most patients if the pain subsides on restriction of activity. Full functional recovery to previous level of activity is possible with the help of dynamic spinal stabilization exercises and physical therapy. The individuals involved in trunk twisting sports should be evaluated carefully for muscle imbalance in the lumbar spine and they should have altered techniques of sporting activity without compromising the performance in the rehabilitation phase. Study 2: Study Design: A non –randomised continuous retrospective observational study Objective 1) To identify the most significant determinant of surgical intervention in lumbar pars defect 2) To identify the independent factors that predict a successful outcome following surgery for lumbar pars defect in young sporting individuals 3) Can we establish an outcome predictive model based on these significant factors responsible for a successful outcome? Summary of Background Data Most athletes or young active professional sportsmen or women would like to return to their previous level of sports since they may be earning their livelihood through the sport. Early onset of symptoms and conservative treatment in these patients may lead to a good clinical outcome but it is difficult to predict which group or which individuals will require surgical repair of the defect. Young athletes to have returned to competitive sports after surgery have been reported only in few previous papers. The first cohort from this series was published in 2003. ODI (Oswestry Disability Index) and SF-36 (Short form) scores were used to evaluate the final outcome for the first time in lumbar spondyloysis for outcome analysis. Methods A total number of 55 patients treated operatively following confirmation by imaging studies (SPECT,CT or MRI scans) as having stress fractures of the lumbar pars interarticularis (PI) ranging in age from 8 to 35 years have been selected for the study. All patients attending the Back pain clinic has to follow a protocol of filling up the VAS, ODI and SF-36 questionnaires as a part of their assessment. At the time of the study these questionnaires along with the Back Pain & Sports Questionnaire (BPSQ) were sent to all but only 50/55 patients responded. The background data contains gender, age, date of onset of symptoms with current limitation in sport, pain in flexion or extension, type of sport, level of sport and length of treatment. The data also contains each subject with level, number, laterality and distribution of lumbar spondylolysis, investigations, outcome with VAS, ODI, SF-36 and Back pain & sports questionnaire (BPSQ) and return to sports.
39
Altimimi, Ahmed Shafik. "Quality of life and treatment outcome under inhalation sedation." Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/16230/.
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AIM: To assess the outcome of treatment and changes in quality of life (QoL) following comprehensive dental treatment using nitrous oxide inhalation sedation. METHODS: Patients attending the Sedation Unit at the Leeds Dental Institute were asked to participate in the study. Baseline questionnaires included a quality of life (QoL) assessment (COHIP-SF19) and the p-IOSN tool (indication of sedation need). Participants were followed up to evaluate the outcome of their treatment. Those who completed treatment as planned completed a second QoL assessment at least 2 weeks following their last appointment. RESULTS: In total, 97 patients were recruited (44 males and 53 females), and of these 47 completed treatment as planned with 31 completing a 2nd QoL assessment, 18 are currently undergoing treatment, and 20 were referred to GA. There was a statistically significant improvement in QoL following treatment (p value= 0.000), with the largest effect size noted in the “oral health well-being” domain. When not controlling for other factors, a change from high to low anxiety was significantly associated with high baseline QoL (B= 6.632 p value = 0.023). Changing from high to low sedation need decreased the likely need for referring to GA and not completing treatment as planned (B -1.788 p value 0.05). CONCLUSION: Rendering the child dentally fit improved QoL. Using anxiety, gender, age group or sedation need as measures could not accurately predict the treatment outcome of the child or the baseline QoL scores, when controlling for sedation need and anxiety.
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Hedberg, Rickard. "Characteristics treatment and outcome of warm autoimmune hemolytic anemia." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-58318.
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Shen, Yuanyuan. "Ordinal Outcome Prediction and Treatment Selection in Personalized Medicine." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:17463982.
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In personalized medicine, two important tasks are predicting disease risk and selecting appropriate treatments for individuals based on their baseline information. The dissertation focuses on providing improved risk prediction for ordinal outcome data and proposing score-based test to identify informative markers for treatment selection. In Chapter 1, we take up the first problem and propose a disease risk prediction model for ordinal outcomes. Traditional ordinal outcome models leave out intermediate models which may lead to suboptimal prediction performance; they also don't allow for non-linear covariate effects. To overcome these, a continuation ratio kernel machine (CRKM) model is proposed both to let the data reveal the underlying model and to capture potential non-linearity effect among predictors, so that the prediction accuracy is maximized. In Chapter 2, we seek to develop a kernel machine (KM) score test that can efficiently identify markers that are predictive of treatment difference. This new approach overcomes the shortcomings of the standard Wald test, which is scale-dependent and only take into account linear effect among predictors. To do this, we propose a model-free score test statistics and implement the KM framework. Simulations and real data applications demonstrated the advantage of our methods over the Wald test. In Chapter 3, based on the procedure proposed in Chapter 2, we further add sparsity assumption on the predictors to take into account the real world problem of sparse signal. We incorporate the generalized higher criticism (GHC) to threshold the signals in a group and maintain a high detecting power. A comprehensive comparison of the procedures in Chapter 2 and Chapter 3 demonstrated the advantages and disadvantages of difference procedures under different scenarios.Biostatistics
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Cioe, Nicholas Joseph. "Factors influencing post-acute brain injury rehabilitation treatment outcome." OpenSIUC, 2012. https://opensiuc.lib.siu.edu/dissertations/454.
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Brain injury has a tremendous effect on the United States. The medical system has a continuum of care available but many of these services are extremely expensive. Despite the effectiveness of residential post-acute brain injury rehabilitation (PABIR) resistance to provide adequate funding remains because of a dearth of randomized controlled trial (RCT) studies demonstrating effectiveness. Some research suggests observational trials are typically more representative of community samples and yield conclusions similar to RCT studies. This study uses a large multi-state naturalistic community-based sample of individuals who received residential PABIR. The purposes of this study were to (1) use logistic regression to identify a model that considered the relationships among the predictor variables to explain treatment outcome for individuals receiving residential PABIR and (2) better understand how self-awareness influences treatment outcome. The final model contained five independent variables (substance use at time of admit, functioning level at time of admit, change in awareness between discharge and admit, admit before or after 6 months post-injury (TPI), and length of stay (LOS) in the program less than or greater than 2 months). The model was statistically significant, ÷2 (5, N=434) = 194.751, p < .001, accounting for 36.2% (Cox & Snell R square) to 61.3% (Nagelkerke R square) of the variance in success rate, and correctly classified 89.4% of cases. Four of the five predictor variables (current substance use, change in awareness, LOS 2 months and TPI 6 months) made statistically significant contributions to the model. The strongest predictor of successful treatment outcome was change in awareness recording an odds ratio of 29.9 indicating that individuals who improved in self-awareness by at least one level were nearly 30 times more likely to be in the successful outcome group, controlling for other factors in the model. Participants were also more likely to be in the successful outcome group if they admitted within 6-months post-injury (5.5x) and stayed longer than 2-months (4.4x). Findings also suggest that active substance use at time of admission did not prevent people from being successful. Importance and implications of these findings are discussed.
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Hatfield, Derek R. "The Influence of Outcome Measures in Assessing Client Change and Treatment Decisions." Ohio University / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1156442730.
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Sjöström, Malin. "Internet-based treatment of stress urinary incontinence : treatment outcome, patient satisfaction, and cost-effectiveness." Doctoral thesis, Umeå universitet, Allmänmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-84405.
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Background Stress urinary incontinence (SUI) is the leakage of urine when coughing, sneezing, or on exertion. It affects 10-35% of women, and can impair quality of life (QOL). First-line treatment is pelvic floor muscle training (PFMT). However, access barriers and embarrassment may prevent women from seeking care. There is a need for new, easily accessible ways to provide treatment. Aim To evaluate the treatment outcome, patient satisfaction, and cost-effectiveness of an Internet- based treatment programme for SUI. Methods We recruited 250 community-dwelling women aged 18-70 years, with SUI ≥1/week via our website. Participants were randomised to 3 months of PFMT with either an Internet-based programme (n=124), or a programme sent by post (n=126). We had no-face-to face contact with the participants, but the Internet group received individually tailored e-mail support from an urotherapist. Treatment outcome was evaluated after 4 months with intention-to-treat analysis. After treatment, we telephoned a strategic selection of participants (Internet n=13, postal n=8) to interview them about their experiences, and analysed the results according to grounded theory principles. We also performed a cost-utility analysis with a 1-year societal perspective, comparing the treatment programmes with each other and with a no-treatment alternative. To scrutinize our measure of QOL, we performed a reliability study of the ICIQ-LUTSqol questionnaire. Results Participants in both intervention groups achieved highly significant improvements (p<0.001) with large effect sizes (>0.8) in the primary outcomes symptom score (ICIQ-UI SF: mean change Internet 3.4 [SD 3.4], postal 2.9 [3.1]), and condition-specific QOL (ICIQ-LUTSqol: mean change Internet 4.8 [SD 6.1], postal 4.6 [SD 6.7]); however, the differences between the groups were not significant. Compared with the postal group, more participants in the Internet group perceived they were much or very much improved after treatment (40.9%, vs. 26.5%, p=0.01), reduced their use of incontinence aids (59.5% vs. 41.4%, p=0.02), and indicated satisfaction with the treatment programme (84.8% vs. 62.9%, p<0.001). Results from the interviews fell into three categories: about life with SUI and barriers to seeking care; about the treatments and the patient-provider relationship; about the sense of empowerment many women experienced. A core category emerged: “Acknowledged but not exposed.” The extra cost per quality-adjusted life year (QALY) gained through use of the Internet-based programme compared with the postal programme was €200. The extra cost per QALY for the Internet-based programme compared with no treatment was €30,935. The condition-specific questionnaire ICIQ-LUTSqol is reliable in women with SUI, with high degrees of agreement between overall scores (Intraclass correlation coefficient 0.95, p<0.001). Conclusion Internet-based treatment for SUI is a new, effective, and patient-appreciated treatment alternative, which can increase access to care in a sustainable way.
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Schaubhut, Geoffrey J. "Markers Of Alcohol Use Disorder Outpatient Treatment Outcome: Prediction Modeling Of Day One Treatment." ScholarWorks @ UVM, 2020. https://scholarworks.uvm.edu/graddis/1120.
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ABSTRACT
Background: Alcohol use disorders (AUD) affect health and wellbeing, and have broad societal costs (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011; Rehm et al., 2009; Sudhinaraset, Wigglesworth, Takeuchi, & Tsuker, 2016). While treatments have existed for decades, they are limited in success and expensive to administer. As such, understanding which factors best predict who will benefit most from treatment remains a laudable goal. Prior attempts to predict factors associated with positive treatment outcome are limited by methodology including statistical methods that lead to poor predictive power in new samples. This study aims to use a data-driven approach to clarify the predictors of AUD treatment success (Objective 1) accompanied by a theory-driven analysis assessing the mediation of treatment outcomes through psychological distress (Objective 2). Methods: One hundred forty-five patients seeking treatment for alcohol use problems at the Day One Intensive Outpatient Treatment Program (part of UVM Medical Center) between June 2011 and June 2012 were examined. Variables were extracted through chart review and were categorized using the Bronfenbrenner Ecological Model. First, 20% of the sample was set-aside for model testing, and the remaining 80% was used in an Elastic Net Regularized linear regression, with 10-fold cross validation. Models were tested on the set-aside sample to yield estimates of out-of-sample prediction and repeated models were compared to ensure generalizability. Next, a theoretical model was tested examining a model of psychological distress mediating the relationship between individual predictors and treatment outcome. Results: The models developed from the Elastic Net Regularization approach demonstrated consistency in model strength (mean=0.32, standard deviation=0.03) with models ranging from 14 to 31 included variables. Across the models, 15 variables occurred in >75% of the models, and an additional 7 variables were included in 25% - 75% of the models. Some of the strongest predictors included treatment non-compliance (β=-0.92), ASI Alcohol Composite (β=0.63), treatment dosage (β =-0.36), and readiness to change (β=-0.95). The results of the theory-driven mediation analysis demonstrated several strong direct predictors of outcome frequency of alcohol use, including readiness to change (β=-0.59), initial frequency of alcohol use (β=0.27), and access to a primary care physician (β=-2.20). The theoretical model found that none of the mediation pathways (testing psychological variables) were significantly different from the direct models. Conclusions: This study used both data-driven and theory-driven methods to examine factors affecting treatment of AUDs. The application of data-driven methods provided several predictors of outcome that can guide treatment efforts within Day One IOP treatment, as well as generalized to other abstinence-based treatment settings. For example, focusing on treatment attendance and using motivational interviewing to enhance readiness to change are methods supported by this study. Demographic variables that have been shown to predict treatment outcome in small studies, without cross-validation were not identified by the elastic net regression (e.g., age and gender). It is suspected that this is due to model overfitting in prior studies supporting the importance of using generalizable statistical methods to understand predictors of treatment outcome. This notion is supported by the results of the theory-driven model, which did not yield a strong model of treatment success. Taken together, the results support the use of strong analytic techniques which will guide theory in the future.
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Ferreira, Dominique Abergail. "A critique of the index of the complexity, outcome and need." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The development of a uniform method of epidemiological assessment and grading of malocclusion has been of interest for several decades. Recently, Daniels and Richmond (2000) proposed a new orthodontic index namely the Index of Complexity, Outcome and Need (ICON). Their aim was to develop a single index for assessing treatment inputs and outcomes.The aim of this study was to critique the ICON and to assess to the extent to which each component of the ICON fulfils the ideal requirements of the ideal index as identified in a World Health Organization Report (WHO, 1966). The study was performed in three parts: 1) a gold standard was established to test reliability and validity of the ICON
2) to assess ease of use and simplicity of the index
3) and to test the applicability of the index on patients and study casts. The results showed that the ICON identified 25% of the cases as &lsquo
no treatment&rsquo
, as apposed to the 100% of the gold standard. Validity of the index was shown to be &lsquo
poor&rsquo
for complexity (? = 0.2) and degree of improvement (? = 0.34) and &lsquo
excellent&rsquo
for outcome. Reliability was high for all the components except for treatment need (? = 0.63). This study concluded that except for complexity and degree of improvement, the index performed well with respects to reliability, validity (of treatment outcome), ease of use and simplicity and applicability to patient and study casts.
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Moodie, Erica E. M. "Inference for optimal dynamic treatment regimes /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/9605.
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Lundvall, Anna. "Outcome after surgery of congenital cataract /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-197-7/.
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Surace, Francisco I. "Determined Wellness| The Influence of Mental Illness Models Upon Treatment Outcome Expectancies and Treatment Engagement." Thesis, University of Massachusetts Boston, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10262696.
Full textAbstract:
Multiple campaigns geared towards reducing public and self-stigma associated with depression, and increasing help-seeking behaviors have been launched in the past two decades. There has been an increase in promoting psychoeducation on the biological bases of mental illness. Recent international studies have documented that this increase in public knowledge has not reduced stigma. Indeed, growing evidence suggests that biological models, in comparison to other causal models of mental illness, decrease people’s sense of self-efficacy and self-control, and decrease positive expectancies of treatments and prognosis–among those with and without mental illness. Individuals who have come in contact with health services, however, hold more positive and realistic expectancies of treatments than those who have not. Therefore, adequate education about mental illness and its treatment by providers is key at improving treatment expectancies and engagement. Results documented that biological explanations increased biological causes and reduced endorsement of social and psychological causes, led to decreases in endorsement of non-professional help, and increased endorsement of positive outcome expectancies for attending psychotherapy. Second, psychosocial explanations increased endorsement of social causes, increased likelihood in engaging in psychotherapy, and increased endorsement of positive outcome expectancies for attending psychotherapy and taking psychiatric medications. Third, biopsychosocial conditions produced increases in endorsement of taking psychiatric medications and increased endorsement of positive outcome expectancies for attending psychotherapy. Fourth, control condition increased endorsement of taking psychiatric medications and increased endorsement of positive outcome expectancies for attending psychotherapy. There was no interaction effect of self-stigma for attending psychotherapy or taking psychiatric medications; however, main effects of time suggest that self-stigma for attending psychotherapy and taking psychiatric medication reduced across time. Moreover, after treatment education there were no interactions between time and condition. However, main effects of time showed increased likelihood taking psychiatric medications and decreased likelihood seeking non-professional help, increases positive outcome expectancies of treatment, and decrease in self-stigma for seeking treatment. The findings of the current study suggest that biologically based psychoeducation of depression may hinder patients. It is most optimal to include and highlight the effect of psychosocial factors of depression through psychoeducation campaigns.
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Bowen, Megan Michelle. "Effects of Feedback Assisted Treatment on Post-Treatment Outcome for Eating Disordered Inpatients: A Follow-Up Study." BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/5918.
Full textAbstract:
Research on the effects of progress feedback and clinician problem-solving tools on patient outcome has been limited to a few clinical problems and settings (Shimowaka, Lambert & Smart, 2010). Only one randomized clinical trial has examined feedback-assisted treatment in an inpatient eating-disordered population. Results from this study suggested that those who received feedback-assisted (Fb) treatment were more likely to meet Jacobson and Truax's (1991) criteria for recovery than participants in the treatment-as-usual (TAU) condition; however, while these interventions appear to have worked well in the inpatient setting, the long-term effects of this treatment have not been investigated. This is especially pertinent in an eating disorder population, where outcomes tend to be poor and course of illness tends to be chronic. In this study, the effect of feedback interventions on long-term outcome was investigated. Fifty-three of the individuals from the aforementioned original study were contacted by mail, email, or telephone three to four years after leaving the inpatient facility to assess their current level of distress (as measured by the OQ-45) and overall psychological functioning. Comparisons were made between the outcomes of patients assigned to the experimental feedback condition and the TAU condition. Results suggested that both treatment conditions were nearly indistinguishable from one another and did not significantly differ at follow-up; however, the study was significantly underpowered. Our effect size suggested that the Fb group slightly deteriorated over time, while the TAU group slightly improved; however, effect sizes were minimal and did not meet criteria for "small" change according to Cohen's d. Patients’ Body Mass Index (BMI) largely remained the same since leaving the hospital, with a small portion deteriorating. The vast majority of women sought out multiple forms of treatment over the follow-up period, regardless of treatment condition. This is consistent with past research that suggests women with more severe pathology, and who thus require inpatient treatment, tend to experience a more chronic pattern of symptoms even after receiving intensive treatment. Overall, the superiority of feedback-assisted treatment that was found post-treatment appeared to diminish over time and was not detected at follow-up. Suggestions for further research are delineated.