• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 143
  • 108
  • 34
  • 24
  • 20
  • 1
  • Tagged with
  • 380
  • 274
  • 268
  • 233
  • 202
  • 202
  • 202
  • 54
  • 53
  • 51
  • 37
  • 33
  • 31
  • 28
  • 28
  • 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.
31

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.
32

An Economic Evaluation of Teratology Information Services

Hancock, Rebecca L. 13 August 2010 (has links)
BACKGROUND: Teratology Information Services (TIS) educate the public and health professionals via telephone regarding the safety of drugs and other exposures during pregnancy and lactation. Currently TIS consultations are free, but funding is eroding. A cost-benefit analysis may inform resource allocation. It was hypothesized that an individual TIS consultation regarding anti-depressant use during pregnancy provides a positive net benefit compared to a family doctor (FD) consultation. METHODS: A survey of international TIS was conducted to gauge TIS costs. A discrete choice experiment (DCE) was designed to assess preferences and willingness-to-pay (WTP, an estimate of benefit) for teratology counseling. DCE respondents (local community volunteers) chose between potential counseling services following an anti-depressant exposure during pregnancy. Services were described by five service attributes and one cost attribute, which were generated in focus groups. Preferences and WTP were estimated using logit regression. Incremental benefits and costs of counseling by TIS and FD were compared in a probabilistic sensitivity analysis to obtain the incremental net benefit from both a societal (productivity costs included) and health system perspective. The FD consultation was costed through OHIP billing codes. The TIS consultation was micro-costed. RESULTS: Eighteen TIS in North America and 16 international TIS completed the survey. Most TIS are small (median two employees, median budget US$69,000). The DCE had 175 respondents. The most important attribute of counseling was receiving very helpful information; information delivery methods were less important. WTP for the TIS scenario was CDN$124 (SD $12); WTP for the FD scenario was CDN$79 (SD $8). Service costs were similar for TIS and FD (approximately $32/consultation); FD had higher productivity costs. Incremental TIS benefits were likely to outweigh costs under both the societal and health system perspectives (probability 99% and 97% respectively). CONCLUSIONS: An economic evaluation of a program that delivers pregnancy health information via telephone required a novel approach. While there are some methodological challenges to valuing benefits through willingness-to-pay, it may be appropriate for valuing counseling. TIS should emphasize their ability to provide high quality information. The benefits of an individual TIS consultation on anti-depressant use during pregnancy are likely greater than the costs.
33

Stigma Resistance: Exploring the Experiences of Young People at Risk for Psychosis Through Photo Elicitation

Volpe, Tiziana 31 August 2011 (has links)
The discovery that it is possible to identify an individual before the onset of first episode psychosis and that treatment may prevent or delay onset have led to a proliferation of early intervention clinics designed to intervene before symptoms of psychosis have fully appeared. Early intervention has generated considerable debate, given the risks associated with intervening and that the majority of those identified will never develop full-blown psychosis. Despite potential stigmatizing effects, little is known about young people’s views regarding the favourable and/or adverse consequences of early intervention. This research examines the experiences and meaning of illness in young people identified as being at ultra high risk for psychosis and participating in a psychological intervention program. Specifically, the study uses photo elicitation to explore how participants construct and interpret their experiences, and the impact an at risk label has on their sense of self, identity, and social relationships. Five young people were invited to photograph their daily experiences at home, at school, and in the community. The participants and I then analyzed the photographs together in a photo elicitation interview. I further analyzed the visual and textual data from an interactionist perspective, exploring the concept of stigma and its relationship to young people’s experiences. Visual and narrative data revealed that young people reject their at risk status and redefine their experiences to fit with more acceptable and familiar notions of health. Participants are conscious of the stigma associated with psychosis and actively undertake strategies of resistance to avoid stigmatization and uphold a normal self conception and social impression. Photo elicitation provided insight and understanding into the experiences of young people at risk for psychosis that were not available through more traditional methods. The results from this study support the call for a reconsideration of the psychosis risk paradigm. There is a need to increase awareness about the power of diagnostic information and the labeling process. Non-specialized settings such as schools and community health centres may offer more appropriate environments for mental health monitoring and intervention.
34

The Specificity and Neural Basis of Impaired Inhibitory Control

Lipszyc, Jonathan 15 February 2010 (has links)
Impaired inhibition is a deficit of several psychopathological disorders, particularly attention-deficit hyperactivity disorder (ADHD). In the first study, a meta-analysis was conducted to determine whether impaired inhibition as measured by the Stop Signal Task is specific to ADHD, or whether it could be found in other psychopathological disorders. The meta-analysis found an inhibitory deficit in ADHD, but also in obsessive compulsive disorder (OCD) and schizophrenia (SCZ), suggesting that deficient inhibition is not specific to ADHD. A common neural mechanism may underlie deficient inhibition in ADHD, OCD, and SCZ. Study 2 aimed to determine the neural basis of inhibition using a lesion-deficit approach in children with traumatic brain injury (TBI). Only TBI children with white matter lesions in the superior frontal gyrus (SFG) region showed impaired inhibition compared with orthopedic injury controls. This suggests that deficient inhibition may stem from frontal lobe white matter damage, particularly in the SFG.
35

Stigma Resistance: Exploring the Experiences of Young People at Risk for Psychosis Through Photo Elicitation

Volpe, Tiziana 31 August 2011 (has links)
The discovery that it is possible to identify an individual before the onset of first episode psychosis and that treatment may prevent or delay onset have led to a proliferation of early intervention clinics designed to intervene before symptoms of psychosis have fully appeared. Early intervention has generated considerable debate, given the risks associated with intervening and that the majority of those identified will never develop full-blown psychosis. Despite potential stigmatizing effects, little is known about young people’s views regarding the favourable and/or adverse consequences of early intervention. This research examines the experiences and meaning of illness in young people identified as being at ultra high risk for psychosis and participating in a psychological intervention program. Specifically, the study uses photo elicitation to explore how participants construct and interpret their experiences, and the impact an at risk label has on their sense of self, identity, and social relationships. Five young people were invited to photograph their daily experiences at home, at school, and in the community. The participants and I then analyzed the photographs together in a photo elicitation interview. I further analyzed the visual and textual data from an interactionist perspective, exploring the concept of stigma and its relationship to young people’s experiences. Visual and narrative data revealed that young people reject their at risk status and redefine their experiences to fit with more acceptable and familiar notions of health. Participants are conscious of the stigma associated with psychosis and actively undertake strategies of resistance to avoid stigmatization and uphold a normal self conception and social impression. Photo elicitation provided insight and understanding into the experiences of young people at risk for psychosis that were not available through more traditional methods. The results from this study support the call for a reconsideration of the psychosis risk paradigm. There is a need to increase awareness about the power of diagnostic information and the labeling process. Non-specialized settings such as schools and community health centres may offer more appropriate environments for mental health monitoring and intervention.
36

The Specificity and Neural Basis of Impaired Inhibitory Control

Lipszyc, Jonathan 15 February 2010 (has links)
Impaired inhibition is a deficit of several psychopathological disorders, particularly attention-deficit hyperactivity disorder (ADHD). In the first study, a meta-analysis was conducted to determine whether impaired inhibition as measured by the Stop Signal Task is specific to ADHD, or whether it could be found in other psychopathological disorders. The meta-analysis found an inhibitory deficit in ADHD, but also in obsessive compulsive disorder (OCD) and schizophrenia (SCZ), suggesting that deficient inhibition is not specific to ADHD. A common neural mechanism may underlie deficient inhibition in ADHD, OCD, and SCZ. Study 2 aimed to determine the neural basis of inhibition using a lesion-deficit approach in children with traumatic brain injury (TBI). Only TBI children with white matter lesions in the superior frontal gyrus (SFG) region showed impaired inhibition compared with orthopedic injury controls. This suggests that deficient inhibition may stem from frontal lobe white matter damage, particularly in the SFG.
37

Reshaping an Enduring Sense of Self: The Process of Recovery from a First Episode of Schizophrenia

Romano, Donna M. 10 July 2009 (has links)
Although many advances in the treatment of schizophrenia have been made over the past decade, little is known about the process of recovery from a first episode of schizophrenia (FES). To date, the study of recovery in the field of mental health has focused on long-term mental illness. This in depth qualitative study drew upon Charmaz’s (1990) constructivist grounded theory methodology to address the following questions: How do individuals who have experienced a FES describe their process of recovery? How does an identified individual (e.g. friend, family member, teacher, or clinician) describe their role during the participant’s process of recovery, and their perception of the recovery process? Ten primary participants (who self-identified as recovering from a FES) had two interviews; in addition, there was a one-time interview with a secondary participant, for a total of 30 interviews. Data collection sources included participant semi-structured interviews, participant selected personal objects that symbolized their recovery, and clinical records. The results provide a substantive theory of the process of recovery from a FES. The emergent process of recovery model for these participants is comprised of the following phases: ‘Lives prior to the illness’, ‘Lives interrupted: Encountering the illness’, ‘Engaging in services and supports’, ‘Re-engaging in life’, ‘Envisioning the future’; and the core category, ‘Re-shaping an enduring sense of self,’ that occurred through all phases. A prominent distinctive feature of this model is that participants’ enduring sense of self were reshaped versus reconstructed throughout their recovery. The emergent model of recovery from a FES is unique, and as such, provides implications for clinical care, future research, and policy development specifically for these young people and their families.
38

Learning Deficits after Experimental Subarachnoid Hemorrhage (SAH)

Jeon, Hyo Jin 25 August 2011 (has links)
Survivors of subarachnoid hemorrhage (SAH) often have learning and memory deficits. This study tested the hypothesis that SAH in rats is associated with similar deficits and that they are due to neuronal injury in the hippocampus. SAH was induced in rats. Behaviour was investigated in the Morris water maze and brain injury by microscopy. Rats with SAH had deficits in spatial learning and working memory and had significantly more fluoro-Jade- and TUNEL-positive neurons in the hippocampus, cerebral cortex and cerebellum. Microthromboemboli in microvessels were more frequent in brains of rats with SAH and deficits there was vasospasm of the anterior and middle cerebral arteries. The amount of cell death in the hippocampus did not appear to be sufficient to cause the observed in the Morris water maze. This suggests that other factors such as dysfunction of neurotransmission or other pathology in hippocampal pathways might contribute to the impairment.
39

Reshaping an Enduring Sense of Self: The Process of Recovery from a First Episode of Schizophrenia

Romano, Donna M. 10 July 2009 (has links)
Although many advances in the treatment of schizophrenia have been made over the past decade, little is known about the process of recovery from a first episode of schizophrenia (FES). To date, the study of recovery in the field of mental health has focused on long-term mental illness. This in depth qualitative study drew upon Charmaz’s (1990) constructivist grounded theory methodology to address the following questions: How do individuals who have experienced a FES describe their process of recovery? How does an identified individual (e.g. friend, family member, teacher, or clinician) describe their role during the participant’s process of recovery, and their perception of the recovery process? Ten primary participants (who self-identified as recovering from a FES) had two interviews; in addition, there was a one-time interview with a secondary participant, for a total of 30 interviews. Data collection sources included participant semi-structured interviews, participant selected personal objects that symbolized their recovery, and clinical records. The results provide a substantive theory of the process of recovery from a FES. The emergent process of recovery model for these participants is comprised of the following phases: ‘Lives prior to the illness’, ‘Lives interrupted: Encountering the illness’, ‘Engaging in services and supports’, ‘Re-engaging in life’, ‘Envisioning the future’; and the core category, ‘Re-shaping an enduring sense of self,’ that occurred through all phases. A prominent distinctive feature of this model is that participants’ enduring sense of self were reshaped versus reconstructed throughout their recovery. The emergent model of recovery from a FES is unique, and as such, provides implications for clinical care, future research, and policy development specifically for these young people and their families.
40

Psychological Debriefing of Workplace Trauma: A Case Study of the Toronto Transit Commission (TTC)

Antony, Jesmin 21 July 2010 (has links)
Mental stress resulting from a traumatic event in the workplace has a noteworthy impact on employees. Psychological debriefing is offered to TTC employees as a means of immediate trauma support, however, the usefulness of the intervention is unknown. This thesis explores the debriefing intervention using a mixed methods approach. TTC employees who have experienced a traumatic event were recruited. Post Traumatic Stress Disorder (PTSD) symptom development and time lost from work were compared between debriefed and not debriefed employees. In addition, purposively selected employees were qualitatively interviewed. The quantitative analysis showed no significant differences in PTSD symptomatology or lost time from work between the groups. Despite these results, however, employees who were debriefed had an overall positive perception of the intervention. Further exploration in this area of study would be beneficial to not only the TTC, but to all workplaces at high risk of exposure to traumatic events.

Page generated in 0.041 seconds