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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

A Randomized Double Blind Sham-controlled Comparison of Bilateral and Unilateral Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Major Depression

Blumberger, Daniel 04 September 2012 (has links)
Objectives: High frequency left-sided (HFL) and low frequency right-sided (LFR) unilateral repetitive transcranial magnetic stimulation (rTMS) are efficacious in treatment-resistant major depression (TRD). Similar benefit has been suggested for sequential bilateral rTMS (LFR then HFL). Therefore, this study evaluated the efficacy of HFL and sequential bilateral rTMS compared to sham in TRD. Methods: Seventy-four subjects between the ages of 18 and 85 with TRD and a 17-item Hamilton Depression Rating Scale (HDRS) greater than 21 were randomized to receive unilateral, bilateral, or sham rTMS. Remission rates were compared among the three groups. Results: Remission rates differed significantly among the three groups. The remission rate was significantly higher in the bilateral group (34.6%) than the unilateral (4.5%) and sham (5.0%) groups. The remission rate in the unilateral group did not differ from sham group. Conclusion: These findings warrant larger controlled studies that compare the efficacy of sequential bilateral rTMS and HFL rTMS in TRD.
22

A Patient Opinion Survey to Identify Perceived Barriers to the Introduction of a Screening Program for Depression in a Hemodialysis Population

Farrokhi, Farhat 18 March 2013 (has links)
Patient-related barriers may reduce the effectiveness of screening for depression. This study aimed to explore perceived barriers to participation in a Screening Program for Depression by hemodialysis patients. In a cross-sectional study of hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire was used to measure barriers to the Screening Program. Of 160 participants, 73.1% perceived at least one barrier (95% CI, 66.2% to 80.0%). The most common barriers were concerns about the side effects of antidepressant medications (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%), and perceiving no risk of depression (23%). A high depression score was an independent predictor of barriers related to perceiving no benefit of the Screening Program and psychological, social, and practical barriers. We believe that patient-related barriers need to be addressed before implementing any case identification and treatment program for depression.
23

Neuroanatomical Correlates of Depressive Symptoms Following Acute Ischemic Stroke

Francis, Philip 24 August 2011 (has links)
This study investigated the hypothesis that severity of depressive symptoms following acute ischemic stroke is associated with degree of tissue infarction and severity of white matter changes (WMCs). It employed a novel quantitative region-based approach considering both infarction and WMCs. Of 54 ischemic stroke patients recruited, 50 (72.3 ± 12.8 years, 52.0% male) had useable CT scans. The typical patient was recruited within 3 weeks of their stroke (19.7 ± 31.0 days), exhibited minor cognitive impairment (MMSE score 25.8 ± 4.6), and had mild to moderate stroke severity (NIHSS score 6.5 ± 5.4). 28.0% of patients screened positive for clinical depression with a CES-D score ≥16. While neither degree of infarction nor severity of WMCs (ARWMC score) in the 12 brain regions correlated with depressive symptoms (CES-D score), stroke severity was a significant predictor of depressive symptoms. This stressor, related to physical disability, was a predominant predictor over lesion characteristics.
24

Neuroanatomical Correlates of Depressive Symptoms Following Acute Ischemic Stroke

Francis, Philip 24 August 2011 (has links)
This study investigated the hypothesis that severity of depressive symptoms following acute ischemic stroke is associated with degree of tissue infarction and severity of white matter changes (WMCs). It employed a novel quantitative region-based approach considering both infarction and WMCs. Of 54 ischemic stroke patients recruited, 50 (72.3 ± 12.8 years, 52.0% male) had useable CT scans. The typical patient was recruited within 3 weeks of their stroke (19.7 ± 31.0 days), exhibited minor cognitive impairment (MMSE score 25.8 ± 4.6), and had mild to moderate stroke severity (NIHSS score 6.5 ± 5.4). 28.0% of patients screened positive for clinical depression with a CES-D score ≥16. While neither degree of infarction nor severity of WMCs (ARWMC score) in the 12 brain regions correlated with depressive symptoms (CES-D score), stroke severity was a significant predictor of depressive symptoms. This stressor, related to physical disability, was a predominant predictor over lesion characteristics.
25

Help-seeking and use of Workplace Services for Emotional Needs among Community Residential Staff who Support Adults with Intellectual Disabilities and Aggressive Behaviour

Hensel, Jennifer Marie 18 March 2014 (has links)
Community workers supporting adults with intellectual disability get a lot of positive impact from their work. However, staff are also required to deal with challenges such as aggressive behaviours which can be associated with burnout. This thesis used a cross-sectional mixed methods design consisting of survey data analysis and qualitative interviews. The study aims were to examine staff report of emotional difficulties related to working with aggressive behaviours and use of available workplace resources. Staff frequently reported experiencing emotional difficulties; however use of workplace resources was low. Findings fit within existing models of general health service utilization with workplace resource use affected by: preventing and coping, severity threshold, enabling factors and cost versus benefit appraisal. Some unique factors included o-worker relationships, finding relief, lacking or inflexible rules and organizational focus on the service recipients. Multi-faceted interventions are likely to be the most successful in improving staff and related organizational outcomes.
26

Novel Insights in Language Production Mechanisms in Autism Spectrum Disorder: A Magnetoencephalography Study.

Valica, Tatiana 19 March 2014 (has links)
Absence or impairment of functional communication is a fundamental deficit in Autism Spectrum Disorder (ASD). The specific factors that contribute to a great variety of speech and language impairments are still unknown but have a neurobiological substratum. We investigated the brain control of speech production mechanism in children with ASD using Magnetoencephalography (MEG). MEG is a neuroimaging modality with high temporal resolution that records neural activation in real time. A group of children with ASD and age- and sex- matched controls performed simple oromotor (open and close mouth) and speech tasks (one-syllable and multi-syllable phoneme production). Atypical and significantly different brain neural activation in motor (BA 6 and BA 4) areas and speech control (BA 47, BA 22) areas were noted in children with ASD compared to typically developing controls. The present thesis provides new evidence contributing to the understanding of speech and language production in individuals with autism.
27

Exploring the Influence of Optimism and Self-efficacy on New and Professional Immigrants' Retraining Experiences in Canada

Kennedy, Tara 19 July 2012 (has links)
The purpose of this study was to examine the retraining and career development experiences of new and professional immigrants in Canada. The study intended to provide an in- depth perspective into the influence of immigrants’ optimism and self-efficacy on their retraining and career development experiences. Using a qualitative methodology, in-depth interviews were conducted and a grounded theory approach was employed to analyze the data. Central themes within participant narratives emerged and key results were introduced. Participants’ experiences included a myriad of barriers and challenges, yet many viewed this experience as a positive opportunity for growth and development. The results explored differences between optimists’ and pessimists’ retraining and career development experiences, as well as the role of self-efficacy within immigrants’ career development. Results have implications for career and vocational psychology literature, practice, and career counselling, and include suggestions for future researchers.
28

Exploring the Influence of Optimism and Self-efficacy on New and Professional Immigrants' Retraining Experiences in Canada

Kennedy, Tara 19 July 2012 (has links)
The purpose of this study was to examine the retraining and career development experiences of new and professional immigrants in Canada. The study intended to provide an in- depth perspective into the influence of immigrants’ optimism and self-efficacy on their retraining and career development experiences. Using a qualitative methodology, in-depth interviews were conducted and a grounded theory approach was employed to analyze the data. Central themes within participant narratives emerged and key results were introduced. Participants’ experiences included a myriad of barriers and challenges, yet many viewed this experience as a positive opportunity for growth and development. The results explored differences between optimists’ and pessimists’ retraining and career development experiences, as well as the role of self-efficacy within immigrants’ career development. Results have implications for career and vocational psychology literature, practice, and career counselling, and include suggestions for future researchers.
29

A Patient Opinion Survey to Identify Perceived Barriers to the Introduction of a Screening Program for Depression in a Hemodialysis Population

Farrokhi, Farhat 18 March 2013 (has links)
Patient-related barriers may reduce the effectiveness of screening for depression. This study aimed to explore perceived barriers to participation in a Screening Program for Depression by hemodialysis patients. In a cross-sectional study of hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire was used to measure barriers to the Screening Program. Of 160 participants, 73.1% perceived at least one barrier (95% CI, 66.2% to 80.0%). The most common barriers were concerns about the side effects of antidepressant medications (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%), and perceiving no risk of depression (23%). A high depression score was an independent predictor of barriers related to perceiving no benefit of the Screening Program and psychological, social, and practical barriers. We believe that patient-related barriers need to be addressed before implementing any case identification and treatment program for depression.
30

A Cost of Illness Study of Generalized Anxiety DisorderI in Canada

Bereza, Basil G. 14 December 2010 (has links)
Background: Economic evaluations of generalized anxiety disorder (GAD) have been limited to ≤18 months. A decision model was developed; quantifying the lifetime cost-of-illness (COI) of GAD. Methods: An incidence-based Markov-model was developed using TreeAge® software, reflecting 9 health-states (HS): physician-assessed patients (3HS), maintenance therapies(4HS), discontinuation(1HS) and death(1HS). Onset probability (ages 18-80) determined model entry. Canadian Psychiatric Association (CPA) guidelines determined pharmaco-therapy, with revisions/validation by an expert panel. Response, remission based on pooled-analysis of CPA-cited evidence. Remaining clinical rates, absenteeism and hospitalization retrieved from literature. Direct (clinician, pharmacotherapy, hospitalization) and indirect costs (wage rate) retrieved from government publications. Results discounted at 5%. Results: The mean COI was 2008 Canadian $31,213(SD=$9,100)/patient; 96% attributed to absenteeism. Mean age=31years, discontinued treatment=85% by 2nd year, treatment discontinuation duration, 14(SD=9) years. CONCLUSION: GAD is a costly disease with a lifetime COI<$32k/patient; absenteeism exerts a significant impact. Limited prospective data contributes to uncertainty of estimate.

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