Thesis (MPsych(Clin))--University of South Australia, 1999

Thesis (DPsych (Counselling Psychology)) - Swinburne University of Technology, 2007. / Submitted to Swinburne University of Technology, in partial fulfilment of the requirements for the Professional Doctorate of Psychology (Counselling) - 2007. Typescript. Includes bibliographical references (p. 210-218).

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 92-97).

Self-injurious behavior (SIB; e.g., wrist-cutting, burning) is a pervasive coping phenomenon that may be indicative of dysfunctional affect regulation and complex developmental trauma. Previous research findings identify the incidence rate of SIB to be approximately 10% to 15% of the general population with 5% to 10% of those engaging in repetitive or recurring SIB. Other sources identify approximately 2 million individuals active in this behavior within the United States; 70% of those individuals are female. However, limited research has used internet technology as a data gathering tool to access individuals who have engaged in SIB and are apprehensive to participate in face-to-face interviews. The purpose of this qualitative study was to examine the fundamental nature of SIB using an interpretive-phenomenological methodology via internet interviews. Data were gathered from a convenience sample of 18 adult female participants with a reported history of SIB recruited through SIB oriented websites. The data were analyzed through a phenomenological interpretive approach using axial and thematic coding. Results indicated that SIB is a method of coping with stress and emotions as well as a way to regulate and control affect from perceived historical trauma. These findings may advance empirical evaluation of SIB by expanding research designs and informing practitioners about how those who have engaged in SIB view therapeutic treatment. The positive social change implications include generating knowledge useful for program developers, educators, psychologists, and other invested professionals who search for sound, innovative ways to address SIB among women based on the words and experiences of survivors; potential long-term outcomes include improved coping strategies, reduced incidences of bodily harm and improved self-concepts.

Previous research has indicated that the majority of individuals who undergo bariatric surgery have histories of psychological disorders. Only a paucity of research has examined the social and emotional effects of bariatric surgery on patients. Using Kelly's personal construct theory as the conceptual framework, this phenomenological study was designed to gain more insight into how this life-altering bariatric surgery transforms patients socially and emotionally. Fifteen participants who had undergone bariatric surgery in the past 10 years were interviewed for the study. The interviews were transcribed and coded. Similar themes found within the interviews were identified as the primary themes of the study. The majority of the participants saw themselves as "the same" in regards to their personality and sense of self, but felt different physically after undergoing surgery. With weight loss, the participants felt more confident and stable than prior to the surgery. The majority of the participants described how they felt more confident in social situations and felt as though they blended in more. This study enhances social change initiatives through allowing medical professionals, mental health professionals, bariatric patients, and the overall community to have a better understanding of the significant psychosocial changes that bariatric patients undergo after surgery. Thus, the findings of this study may aid clinicians and physicians in providing treatments and information to bariatric patients that can assist patients in adjusting and coping effectively to the social and emotional changes and challenges that they will experience post surgery.

<p><strong>Introduction: </strong>Hypertension is an important worldwide public health concern and is a concomitant risk factor for brain, kidney and cardiovascular disease, such as myocardial infarction (MI). Highly Active Antiretroviral Therapy (HAART) has greatly increased life expectancy of HIV-positive persons, but has been associated with adverse effects.</p> <p><strong>Objectives: </strong>To assess the association between antiretroviral therapy and incident hypertension; to estimate the incidence of hypertension; and to explore known and potential risk factors for hypertension among HIV-positive individuals in Tanzania and Canada.</p> <p><strong>Methods: </strong>Subjects, 18 years and older, were enrolled into two retrospective cohort studies in Tanzania and Canada. Population and descriptive characteristics were summarized. Hypertension was defined as having a SBP>140 mmHg, DBP>90 mmHg, a diagnosis of high blood pressure, or receiving antihypertensive therapy. Statistical analyses, including independent t-tests, Chi-square tests, multiple linear regression, multivariable logistic and Cox regression were performed to assess for statistical significance (p<0.05) in SPSS14.0.</p> <p><strong>Results: </strong>In Tanzania, 52 HIV-positive, normotensive subjects initiating antiretroviral therapy were enrolled. Subjects had a mean age (SD) of 39.5 (7.9) years, were predominantly Black and 53.8% were male. After one year, 4 (7.7%, 95% CI: 2.1-18.7%) developed hypertension. Blood pressure, weight and body mass index (BMI) significantly increased (p<0.05) by 12 months.</p> <p>In Canada, 486 HIV-positive and normotensive subjects were enrolled; 303 (62.3%) initiated antiretroviral therapy and 183 (37.7%) remained ARV-naive during the study. Subjects were predominantly White (>70%) and male (>75%) with a mean age (SD) of 45.1 (10.0) years. Nine-year incidence of hypertension for ARV-treated and ARV-naïve cohorts was 12.5% (95% CI: 8.8-16.2%) and 8.2% (95% CI: 4.2-12.2%) respectively. Hypertensive individuals were significantly older, heavier, and more likely to have abnormal lipids.</p> <p>In the final multivariable Cox regression model for incident hypertension, antiretroviral therapy was associated with a 125% increased risk (p=0.018), adjusted for age, sex and race. Individuals >50 compared to <40 years had an increased risk of approximately>280% (p=0.003). Current weight (10 kg increments) was associated with a 37% increased risk (p<0.001). An inverse association between CD4-T-lymphocyte count change and hypertension was observed: a positive change of >500 cell/ml compared to a decrease in CD4-T-lymphocyte count was associated with an 80% lower risk (p=0.032).</p> <p><strong> </strong></p> <p><strong>Conclusion: </strong>Hypertension is common among HIV-positive individuals in Tanzania and Canada and expected to increase over time. Hypertension is associated with antiretroviral therapy; however, further research is needed to understand this relationship.<strong> </strong></p> / Master of Science (MSc)

<p>The measurement of compliance is essential in clinical trials to assess the efficacy and side effects of treatment. Multiple methods of measuring compliance and several predictors of it are recognized. However, noncompliance has been defined using arbitrary "cutting" points on scales measuring compliance. Such cutting points should be validated against an external measurement.</p> <p>In the Study of Recent Recurrent Presumed Cerebral Emboli, multiple measurements affected by the drugs (which are meant to prevent such events) are available on multiple occasions in the same subjects. This thesis explores ways in which one can assess the extent to which these measurements agree as indices of the intake of those drugs. Furthermore, it explores how such measurements can be validated against an external measurement, the outcome desired (i.e. the control of cerebral emboli) in order to choose a valid "cutting point" to define compliance and non-compliance. Finally, it suggests methodologies to predict whether a subject will be compliant or non-compliant and to study whether compliance is a constant characteristic of certain subjects or (varies through time, being affected by time or various events in the course of therapy. Thus, this thesis proposes a methodology to obtain a valid index of compliance which will predict outcomes and a methodology to study the factors which predict such compliance.</p> / Master of Engineering (ME)

Thesis (M.Phil.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 223-232) Also available in electronic format. Also available in print.

Master of Health Sciences (MSc)

<p> Research on temperament and the development of behavioral problems across cultures often focuses on comparisons of vastly different countries, such as North American and Asian countries. The present study compares toddler samples from two Western countries, which are considered primarily individualistic in value orientation: the U.S. and Germany (N=100). Results suggest differences in mother&rsquo;s descriptions of child temperament in the two samples. In addition, results obtained via caregiver interviews and observations of parent child interactions indicated a stronger emphasis on childrearing values reflecting <i> independence</i> for U.S. mothers, with German mothers favoring comparably more <i>interdependence</i> in their offspring. Finally, associations of temperament and behavioral problems were found to be distinct across countries and culture was identified as a moderator in respect to Positive Anticipation, predicting externalizing behavior in the U.S. sample at higher levels. Results were interpreted in light of the concept of the developmental niche and cross-cultural value models, relevant to the two cultures compared in this study. This study offers a significant contribution to our understanding of culturally different avenues in the development of early behavioral problems, and likely subsequent mental health problems over the life span. This is a particularly timely issue given increasing globalization and intercultural exchange.</p>