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The Global ETD Search service is a free service for researchers
to find electronic theses and dissertations. This service is
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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.
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Showing 501 to 510 of 518 (0.089 seconds)Spelling suggestions: "subject:"psychiatric anda Mental chealth"" "subject:"psychiatric anda Mental byhealth""
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Intensive Care in Oncology: Admission and Outcomes in Adult Patients with CancerJohn, Surya 01 January 2016 (has links)
Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.
Methods: A total of 768 articles were found in a literature search including all literature from 2005 to 2016 from all countries using the databases CINAHL Plus, MEDLINE, PsycINFO, and Academic Search Premier. These were further narrowed down based on relevancy by topic or reading abstracts. A total of 13 articles utilizing the inclusion and exclusion criteria of the literature search were included in the final literature synthesis.
Results: In addition to general ICU admission criteria several other criteria and scores can be helpful in admitting patients with cancer to the ICU including cancer specific criteria, mortality predictor tools, performance status, and ICU trials. Mortality predictors, in combination with other patient characteristics, demonstrated effectiveness to predict outcomes in patients with cancer. Survival rates in hematological and solid tumor cancers have improved from the past, and lower prognostic scores can predict who will have better outcomes.
Conclusion: Cancer specific criteria, mortality predictor tools, performance status, and ICU trials in addition to general ICU criteria should be used for admission of cancer patients into ICU. Practitioners and nurses should become familiar with the newest outcomes in patients with cancer to make collaborative informed decisions about ICU admission.
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| 502 |
Novel Antipsychotic Drug Carriers: The Development of Nanoparticle and Microgel Drug Carriers for Antipsychotic Delivery in the Treatment of SchizophreniaPiazza, Justin E. 10 1900 (has links)
<p>Lectin-functionalized, Poly [oligo(ethylene glycol) methyl ether methacrylate] (<em>POEGMA</em>) loaded with 3(R)-[(2(S)-pyrrolidinylcarbonyl)amino]-2-oxo-1-pyrrolidineacetamide (PAOPA) and poly(ethylene glycol)–block-poly(D,L-lactic-co-glycolic acid) (PEG-PLGA) nanoparticles loaded with haloperidol were prepared with narrow size distributions and sizes < 135 nm. The microgels and nanoparticles exhibited high <em>Solanum tuberosum </em>lectin (STL) conjugation efficiencies, encapsulation efficiencies, and drug loading capacities. The <em>in vitro</em> release of PAOPA and haloperidol was slow in physiological conditions over 96 hours, demonstrating minimal drug leakage and the potential for efficient drug transport to the targeted brain tissue. POAPA, POEGMA and the STL-functionalized POEGMA microgels were found to be non-toxic in both cell lines, indicating that they would not be toxic when administered intranasally or when they reach the brain. The nasal epithelial cell uptake of rhodamine-labelled microgels was higher in cells when the STL-functionalization was present. All haloperidol-loaded nanoparticle formulations were found to be highly effective at inducing catalepsy, while intranasal administration of STL-functionalized nanoparticles using the intranasal spray device increased the brain tissue haloperidol concentrations by 2-3.5 fold compared to STL-functionalized particles administered intranasally with a pipette. For the first time, brain tissue concentrations of rhodamine-labelled microgels confirmed that microgels are capable of passing the blood-brain barrier and that this uptake is size dependent. These formulations demonstrate promise in the reduction of the drug dose necessary to produce a therapeutic effect with antipsychotic drugs for the treatment of schizophrenia using a non-invasive route of administration.</p> / Master of Science (MSc)
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| 503 |
The Lived Experience of Nurses in Caring for Patients with COVID-19Barre, Jessica 01 May 2024 (has links) (PDF)
Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living hell”; “rationing patient safety”; “mental aftermath of the war zone”; and “post-pandemic pride”. Nurses provided patient care amidst challenging environments of limited to no resources, with extensive, large-scale critically ill patients, and patient deaths. Due to overwhelming patient care demands, nurses were unable to provide safe patient care to everyone in need, resulting in patient deterioration and death. These experiences caused nurses to endure maladaptive mental effects, such as compassion fatigue and moral suffering, which can threaten the safety of patients. Despite these undesirable results, nurses continued to provide patient care and expressed feelings of pride in the profession of nursing for surviving the COVID-19 pandemic. However, this study demonstrates the persistent impacts on nurses’ abilities to provide safe care after the crisis years. Support for nurses is recommended to preserve patient safety.
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| 504 |
THE SOCIAL EXPERIENCES OF SPOUSES OF PERSONS WITH YOUNG-ONSET DEMENTIAHawkins, Stacey A. 10 1900 (has links)
<p>Spousal caregivers of persons with young-onset dementia (YOD) are known to experience significant social impacts, including family conflict, social avoidance, and marginalization. However, no qualitative study has examined the social experiences of YOD spousal caregivers within the Canadian context. This thesis examined the described social experiences of these caregivers. A descriptive, qualitative approach was used to study the nature of these social experiences using in-depth, semi-structured interviews. Ten YOD spousal caregivers living in Ontario completed the study. Four themes emerged from the analysis: sources of social support, giving up activities in favour of new activities, adapting and maintaining in social and recreational activities, and social spaces as safe spaces. Concepts of caregiver social adaptation, and choosing to give up social and recreational activities in favour of new ones builds upon existing research on theories of social support, activity restriction, caregiver adaptation, and avoidance previously described in the existing dementia literature. Themes of giving up activities in favour of new activities, and social spaces as safe spaces also represent new themes not previously discussed in the dementia caregiving literature. Previous, socially-relevant research on YOD spousal caregiving has focused primarily on examining social impacts, with little attention paid to caregiver perceptions of their social experiences in the Canadian context. These findings indicate that caregiving for a spouse with YOD entails complex social experiences, which extend beyond value-laden depictions of social outcomes recorded in the existing literature. These rich experiences challenge and expand our theoretical understanding of spousal caregiving for persons with YOD.</p> / Master of Arts (MA)
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Unheard Voices: Black Adolescents' Perceptions of Mental Health In Urban CommunitiesLudden, Brian James 01 January 2017 (has links)
Mental health in the United States is a rising concern. More concerning still is the growing number of children and adolescents with serious depression and other mental health disorders (SAMHSA, 2009; Merikangas et al., 2010). Despite a growing list of proven and best-practice prevention and intervention initiatives that have been made available to children and adolescents, 80 percent of children and adolescents with a diagnosable mental health disorder will not receive services for their associated mental health concerns (U.S. Department of Health and Human Services, 1999; Cummings 2014). Children and adolescents with mental health disorders are faced with an ever-increasing list of barriers that prevent them from accessing much needed mental health services. At a particular disadvantage are Black adolescents, who are even less likely than their non-minority peers to have access to or receive services for mental health concerns (Lindsey, Chambers, Pohle, Beall, & Lucksted, 2013). As result, this Q Methodology study was designed to understand the perspectives Black adolescents hold toward access to mental health care.
The researcher first developed a naturalistic, 36-item Q Sample from participant responses to open-ended prompts designed to elicit distinct thoughts around perceptions of access to mental health care, including supports and barriers. Thirty Black adolescents sorted this 36-item Q sample in a forced distribution resembling a semi-normal curve ranging from “least like my perspective” (-4) to “most like my perspective” (+4) and also wrote explanations for why they sorted they ways they did. Subsequently, these 30 Q sorts were correlated and these correlations were factor analyzed, rotated, and extracted producing five factors. Based on an analysis of these five factors, or shared perspectives, they were named: Building My Own Barriers (Factor 1), I Don’t Talk About My Feelings! (Factor 2), I’m Looking For A Shift In My Perspective (Factor 3), Counseling When I Want It; Not Always From A Counselor (Factor 4), and Money Is The Least Of My Problems (Factor 5). These five factors represented distinct and diverse viewpoints toward the access to mental health counseling. A primary implication from this study was that school leaders and community leaders, educators, parents and caregivers, and policy-makers must find ways to decrease the barriers youth experience as they seek and attempt to participate in mental health counseling services, while working also to leverage the power of those things that support access.
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Big Five Personality Traits, Pathological Personality Traits, and Psychological Dysregulation: Predicting Aggression and Antisocial Behaviors in Detained AdolescentsLau, Katherine S. L. 20 December 2013 (has links)
This study tested the utility of three different models of personality, namely the social and personality model, the pathological personality traits model, and the psychological dysregulation model, in predicting overt aggression, relational aggression, and delinquency in a sample of detained boys (ages 12 to 18; M age = 15.31; SD = 1.16). Results indicated that the three personality approaches demonstrated different unique associations with aggression and delinquency. The psychological dysregulation approach, composed of behavioral dysregulation, emotional dysregulation, and cognitive dysregulation, emerged as the overall best predictor of overt aggression, relational aggression, and delinquency. After controlling for the Big Five personality traits, psychological dysregulation accounted for significant variance in overt aggression and delinquency, but not relational aggression. After controlling for callous-unemotional traits and narcissistic traits, psychological dysregulation also accounted for significant variance in overt aggression, relational aggression, and delinquency. Psychological dysregulation did not account for significant variance in aggression or delinquency after controlling for borderline traits. The pathological personality traits approach, comprised of callous-unemotional traits, narcissistic traits, and borderline traits performed second best. In particular, within this approach borderline traits accounted for the most unique variance, followed by narcissistic traits, then callous-unemotional traits. Borderline traits accounted for significant variance in overt aggression, relational aggression, and delinquency when controlling for the Big Five traits, but not after controlling for psychological dysregulation. Narcissistic traits only accounted for significant variance in overt aggression and relational aggression after controlling for the Big Five personality traits, but not after controlling for psychological dysregulation. CU traits only accounted for significant variance in overt aggression after controlling for the Big Five personality traits, but not after controlling for psychological dysregulation. The social and personality model, represented by the Big Five personality traits accounted for the least amount of variance in the prediction of aggression and delinquency, on its own, and when pitted against the other two personality approaches. The exception was that the Big Five personality traits accounted for significant variance in relational aggression beyond narcissistic traits, as well as psychological dysregulation. These findings have implications for assessment and intervention with aggressive and antisocial youth.
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| 507 |
An Analysis and Critique of Mental Health Treatment in American State Prisons and Proposal for Improved CareHayne, Shelby 01 January 2019 (has links)
Mental health treatment in state prisons is revealed to be highly variable, under-funded, and systematically inadequate. Existing literature exposes this injustice but fails to provide a comprehensive proposal for reform. This paper attempts to fill that gap, outlining a cost-effective, evidence-based treatment proposal, directly addressing the deficits in care revealed through analysis of our current system. In addition, this paper provides historical overviews of the prison system and mental health treatment, utilizing theoretical perspectives to contextualize this proposal in the present state of affairs. Lastly, the evidence is provided to emphasize the potential economic and social benefits of improving mental health treatment in state prisons. Significant findings suggest a clear financial, legal, and moral incentive for states to address this issue, while the proposal provides a viable method of doing so.
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| 508 |
PRESERVING, INTERPRETING, AND DISPLAYING MENTAL HEALTH HISTORY: ESTABLISHING THE PATTON STATE HOSPITAL MUSEUM AND ARCHIVELong, Shannon Rene 01 June 2015 (has links)
There are few museums in the western half of the United States that provide an opportunity to educate the public about the history of mental health care. Recently, a mental health museum and archive of artifacts, photographs, and documents was established on the grounds of Patton State Hospital in Highland, California. The purpose of this paper is to reflect on the establishment of this museum and archive and to provide an account of the 125 year history of Patton State Hospital. Understanding the history of Patton provides an opportunity to understand the history of mental health care in the United States from the late 19th century to the present. The establishment of this museum and archive became a joint initiative between Patton and California State University, San Bernardino’s History Department in January 2014. The museum and archive are meant to provide an educational venue that will increase awareness of the plight of the mentally ill, decrease stigmatization of those afflicted with mental illness, and further efforts to improve the care of patients through preservation and display of the artifacts, photographs, and documents related to Patton’s history. The goal of this paper is to assist future public historians with the design and establishment of a museum and/or archive, be it related to mental health history or to projects with other themes, and to provide information to other mental health facilities that wish to establish their own museums.
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AN EXAMINATION OF THE IMPACT TRAUMATIC EVENTS HAS ON PSYCHOSOCIAL IMPAIRMENT IN EATING DISORDER PATIENTSHackett, Jennifer Parker 01 June 2018 (has links)
Research suggests that trauma has an impact on eating disorders. While prior research has demonstrated that the trauma from abuse has a significant impact on eating disorders, research has failed to explore other types of trauma. In addition, previous studies have stopped short of examining the impact trauma has on functioning among individuals with an eating disorder. This study aimed to address that gap in the literature. The purpose of this study is to examine whether traumatic life events impact psychosocial functioning among individuals living with an eating disorder. Furthermore, this study aimed to identify which traumas are shown to have the strongest impact on psychosocial functioning.
A quantitative design was used for this investigation, using measurement scales that have been shown to be valid and reliable in measuring the constructs of trauma and psychosocial functioning among individuals with an eating disorder. Participants completed a single survey of the combined measurement scales. A non-random purposive sample was collected from online social media cites Tumblr, Facebook, eating disorder message boards, and an outpatient eating disorder treatment center. Using a study sample of N= 2,319 descriptive and inferential statistics were conducted using SPSS. Based on the results of correlation and multiple regression analyses, a statistically significant relationship was found between traumatic life events and psychosocial impairment among those with eating disorders. The findings of this study have the potential to impact the way social work policies address the relationship between trauma and eating disorders, and influence the way social work clinicians implement strategies to treat both trauma and eating psychopathology.
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| 510 |
Antenatal Stressful Life Events and Postpartum Depression in the United States: the Role of Women’s Socioeconomic Status at the State LevelMukherjee, Soumyadeep 01 June 2016 (has links)
The purpose of this dissertation was to examine patterns of antenatal stressful life events (SLEs) experienced by women in the United States (U.S.) and their association with postpartum depression (PPD). It further explored the role of women's state-level socio-economic status (SES) on PPD; the racial/ethnic dispartites in SLE-PPD relationship; and the role of provider communication on perinatal depression.
Data from 2009–11 Pregnancy Risk Assessment Monitoring System (PRAMS) and SES indicators published by the Institute of Women’s Policy Research (IWPR) were used. Latent class analysis (LCA) was performed to identify unobserved class membership based on antenatal SLEs. Multilevel generalized linear mixed models examined whether state-level SES moderated the antenatal SLE-PPD relationship. Of 116,595 respondents to the PRAMS 2009-11, the sample size for our analyses ranged from 78% to 99%.
The majority (64%) of participants were in low-stress class. The illness/death related-stress class (13%) had a high prevalence of severe illness (77%) and death (63%) of a family member or someone very close to them, while those in the multiple-stress (22%) class endorsed most other SLEs. Eleven percent had PPD; women who experienced all types of stressors, had the highest odds (adjusted odds ratio [aOR]: 5.43; 95% confidence interval [CI]: 5.36, 5.51) of PPD. The odds of PPD decreased with increasing state-level social/economic autonomy index (aOR: 0.75; 95% CI: 0.64, 0.88), with significant cross-level interaction between stressors and state-level SES. Among non-Hispanic blacks and non-Hispanic whites, husband/partner not wanting the pregnancy (aOR: 1.47; 95% CI: 1.14, 1.90) and drug/drinking problems of someone close (aOR: 1.37; 95% CI: 1.21, 1.55) were respectively associated with PPD. Provider communication was protective.
That 1 out of every 5 and 1 out of every 8 women were in the high- and emotional-stress classes suggests that SLEs are common among pregnant women. Our results suggest that screening for antenatal SLEs might help identify women at risk for PPD. The finding that the odds of PPD decrease with increasing social/economic autonomy, could have policy implications and motivate efforts to improve these indices. This study also indicates the benefits of antenatal health care provider communication on perinatal depression.
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