No description available.

Abstract Dog phobia is a complex psychological phenomenon classified under the anxiety disorders. Twelve female students suffering from dog phobia participated in this qualitative study which included an initial screening, therapeutic intervention and eight-month follow-up. Initial screening was conducted by means of a Fear Survey Schedule and observational assessment of non-verbal behavior during a behavioral approach test (dog stimulus). Therapeutic intervention involved a combination of systematic desensitization and instructional learning. Qualitative data analysis followed a phenomenological approach. The results indicate that the onset age of dog phobia varied from early childhood to late adolescence. Twothirds of the participants reported a direct traumatic event as the onset context of their dog phobia, while 17% reported vicarious learning contexts and 17% an inability to recall the onset context. The most widely used sensory focal mode of perception during contact with dogs was visual cues, followed by auditory cues. Half of the participants reported “eye” aspects as the fear-evoking stimulus. A wide variety of anxieties and fears were found to co-occur with dog phobia, although some participants were still able to accommodate dogs and other companion animals in their lives. The poststudy follow-up indicated that the intervention yielded significant real life improvement in 75% of the cases. The implications of this study for therapeutic situations are discussed.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.

The experience of stress and associated coping responses are often described as playing an important role in the onset of schizophrenia and other psychotic disorders. Despite widespread acceptance of this model, there is little empirical evidence to support such a relationship. This is partly due to a lack of well-designed prospective studies of the onset of psychotic disorders that incorporate different aspects of the stress and coping process. The relatively recent development of validated and reliable criteria for identifying young people at high-risk (UHR) of developing psychosis has enabled the process of onset of psychotic illnesses to be studied more closely than was previously possible. It has also opened the way to the development and evaluation of preventive interventions. This longitudinal study aimed to compare the experiences of stress and coping between a UHR cohort (N = 143) and a group of young people without mental health concerns (HC group, N = 32). In addition, the contribution of stress and coping in the development of acute psychosis in a subgroup of the UHR cohort (UHR-P, n = 18) was also investigated.

Eine depressive Erkrankung kann sich mit unterschiedlicher Geschwindigkeit innerhalb weniger Stunden oder über Monate hinweg ausbilden. Zur Erfassung dieses bisher wenig untersuchten klinischen Merkmals wurde das Onset of Depression Inventory (ODI), ein standardisiertes klinisches Interview, entwickelt. Die vorliegende Studie prüfte die Test-Retest-Reliabilität des Onset of Depression Inventory und betrachtete die Frage nach dem optimalen Zeitpunkt der Durchführung des Interviews im Krankheitsverlauf. Es konnte gezeigt werden, dass die Patientenangaben zur Geschwindigkeit des Depressionsbeginns über den Beobachtungszeitraum zwischen zwei Untersuchungszeitpunkten stabil sind und auf hohem Niveau signifikant korrelieren. Im Weiteren zeigte sich keine Beeinflussung der Angaben zur Geschwindigkeit des Depressionsbeginns durch die Schwere der depressiven Symptomatik. Die hohe Übereinstimmung der Patientenangaben resultiert in einer hohen Test-Retest-Reliabilität und spricht für die Verlässlichkeit der mit dem ODI erhobenen Daten. Damit ist mit dem ODI ein geeignetes Instrument für die reliable Erfassung der Geschwindigkeit des Depressionsbeginns gegeben, was gleichermaßen für die klinische Arbeit als auch für wissenschaftliche Zwecke anwendbar ist und vor allem im klinischen Kontext eine frühe Differenzierung zwischen Unipolarer Depression und Bipolarer Affektiver Störung ermöglicht.

Community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an evolving problem, and there is a great need for a reliable method to assess MRSA risk at hospital admission. A new MRSA prediction score classifies CO-pneumonia patients into low, medium, and high-risk groups based on objective criteria available at baseline. Our objective was to assess the effect of initial MRSA therapy on mortality in these three risk groups. We conducted a retrospective cohort study using data from the Veterans Health Administration. Patients were included if they were hospitalized with pneumonia and received antibiotics within the first 48 hours of admission. They were stratified into MRSA therapy and no MRSA therapy treatment arms based on antibiotics received in the first 48 hours. MRSA risk groups were analyzed separately. The primary outcome was 30-day patient mortality. Multivariable logistic regression was used to adjust for potential confounders. A total of 80,330 patients met inclusion criteria, of which 36% received MRSA therapy and 64% did not receive MRSA therapy. The majority of patients were classified as either low (51%) or medium (47%) risk, with only 2% classified as high-risk. In the high-risk group, unadjusted 30-day mortality was lower among patients who received initial MRSA therapy (40% versus 58%; p<0.0001). Likewise, multivariable logistic regression analysis also demonstrated that initial MRSA therapy was associated with a lower 30-day mortality in the high-risk group (adjusted odds ratio 0.57; 95% confidence interval 0.42-0.77). There was no benefit of initial MRSA therapy in the low or medium-risk groups. This study demonstrated improved survival with initial MRSA therapy in high-risk CO-pneumonia patients. The MRSA risk score should not replace clinical judgment, but it might be a useful tool to spare MRSA therapy for only those patients who are most likely to benefit. / text

The purpose of this study is to examine the acoustic implications of using aspirated, well-coordinated, coup de la glotte, and hard glottal onset methods, in order to compare and contrast the radiated acoustic spectra. Twenty-five singers trained in bel canto singing style were asked to sing 5-second samples on three pre-determined pitches comprising the low, middle, and high range in male and female voices. Each participant was instructed and trained to sing the three pitches with the four methods. EGG was used with audio perception to verify onset type, and VoceVista Video Pro was used to analyze power spectra. A repeated measures multivariate analysis of variance (rMANOVA) was performed with the SPSS General Linear Model function, with onset type as the within-subjects variable to determine main effects and interaction effects on harmonic amplitude (up to 5000Hz) from the independent variables. A significant main effect was found for onset type and more specifically, a significant acoustic difference was found between the well-coordinated and coup de la glotte onsets. Substantial inconsistencies were found in the execution of the well-coordinated onset, as well as in participants' reported preferred onset compared to their baseline measurement of executed onset type. Intentional study of the phonatory onset beginning with adducted folds and low subglottal pressure may have important acoustic and efficiency consequences for bel canto singers. There is a need for specificity regarding the prephonatory glottal configuration in vocal pedagogy and voice science research, and a numerical classification system may provide a clearer picture in future onset investigations.

No description available.

Young onset dementia (YOD) affects not only the person diagnosed, but the family unit as a whole. It is estimated that as many as 500,000 people in the United States have YOD and around 250,000 children are involved in caring for these people. A child of a parent with YOD can begin to experience negative effects when the child begins to take part in caregiving for the person with young onset dementia (PWYOD). Feelings of stress, anger, fear of the future, depression, social isolation, and increasing responsibility of caring for the PWYOD can be felt by children as caregivers. Research shows that children of people with YOD have reported an extreme lack of support and decreased communication within the family. The purpose of this thesis was to examine current interventions designed to improve coping for children of parents with YOD. A review of literature using CINAHL, Medline, and PsychINFO was conducted to gather peer-reviewed articles and journals relating to interventions to help children of parents with YOD cope. However, no studies have discussed interventions specifically for the child. Therefore, information was pulled from 5 studies regarding what children of people with YOD feel has helped them, in their respective experiences, to deal with the stresses of a parent with YOD. Research suggests that individualized care should be provided for these children based on: age, developmental stage, and experience. Children have reported that they cope by spending time away from the home, participating in extracurricular activities, and spending time with friends. Clear communication by all members of the family is also reported to be vital in easing the stresses of caring for a parent with YOD. While children have developed these coping mechanisms, interventions need to be formally designed and their effect on improving coping examined. Analyzing the experiences of the children with parents with YOD is necessary for clinicians to gain insight into what interventions worked for this population, and what interventions need to be created for further and more individualized support.

In an attempt to understand girls' involvement conduct problems, this dissertation first reviews two existing theoretical approaches that provide an explanation for the development of conduct problems. Specifically, the available literature on the development and correlates of conduct problems in boys suggests the subtypes of conduct disorder represent two developmental trajectories. The adolescent-onset pathway is associated with deviant peers and few characterological problems, where as the childhood-onset pathway is associated with emotion regulation deficits, negative parenting, callous and unemotional traits, and neurological deficits. Research also suggests a gender-specific model, the delayed-onset model, for the development of conduct problems in girls. Following this theoretical review, differential predictions made by the competing theoretical models are tested in a community sample of school-aged girls and boys. Participants were 202 children (87 males and 115 females) in grades 5-9. The students ranged in age from 10 to 17 years old (M = 13.16). Similar to the total student body, the ethnic breakdown of the sample was as follows: African-American (60%), Caucasian (24%), Hispanic (6%), and Other (5%). Data was also collected from the students' parents and teachers. Results indicated that girls conduct problems did not follow either model in a consistent manner. Specifically, adolescent-onset conduct problem girls, childhood-onset conduct problem boys, and adolescentonset conduct problem boys differed from non-conduct problem children but did not differ significantly amongst themselves on study variables (e.g., deviant peer association, hyperactivity/impulsivity, emotional dysregulation, callous/unemotional traits). However, results suggest that gender-specific risk factors should be taken into account when developing theoretical models for girls' conduct problems. For example, early pubertal maturation is a particularly salient risk factor for conduct problems in girls, and pubertal development interacts with emotion regulation problems to place girls at high risk for deviant behavior. Finally, implications for prevention and intervention as well as future research are discussed.