<p> The public use version of the National Comorbidity Survey &ndash; Replication (NCS-R) dataset was used (N = 995) to investigate risk factors for recurrent major depressive disorder (MDD) that are evident before recovery from the first major depressive episode (MDE) by comparing persons diagnosed with MDD who experienced a single MDE to persons with recurrent MDD. </p><p> Multiple logistic regression analyses assessed the independent risk of recurrent MDD for each of the following risk factors: an early age of onset (&lt;30 years old), absence of a life stress trigger, chronic first episode, childhood parental loss, parental maltreatment, parental depression, comorbid anxiety disorder, and comorbid substance disorder. The relative excess risk due to interaction (RERI) assessed the risk of recurrent MDD associated with the interaction of an early onset with three childhood-based vulnerabilities: a) parental depression, b) parental loss, and c) parental maltreatment. </p><p> There was a statistically significant risk of recurrent MDD found for the following risk factors: early onset, stress trigger absent, childhood parental loss, parental maltreatment, parental depression, and anxiety disorder; marginally significant results suggested an increased risk of recurrent MDD for substance disorder. There was a significant increased risk found for the interaction of an early onset with parental depression and similar non-significant trends were found for the interactions of early onset with parental loss and early onset with parental maltreatment. </p><p> An early onset, the absence of a life stress trigger, and the presence of parental loss, parental maltreatment, parental depression, a comorbid anxiety disorder, and a comorbid substance disorder each confer greater risk of recurrent MDD among persons that have not yet recovered from their first lifetime MDE. The presence of an early onset combined with a childhood-based vulnerability such as parental depression, parental loss, or parental maltreatment, indicate an especially high risk of recurrent MDD. These findings may inform the development of a screening tool to assess risk for recurrent MDD and early intervention to prevent recurrent MDD. Future research should employ a longitudinal research design to replicate and expand upon these findings.</p>

<p> The purpose of this study was to determine if a relationship exists between the variable duration of case management and outcomes represented by the variables quality of life and functional ability. The samples were selected from archival data collected from the Maryland Medicaid pediatric rare disease population receiving REM case management services during fiscal year 2002. The Barthel Index measured the functional ability from the clinician perspective and PedsQL measured quality of life from the parent and child perspectives. Results indicated the perspectives of clinicians, parents, and children were significantly different for the same patient. Clinicians reported no significant correlations between duration of case management and functional ability as measured by the Barthel Index. Duration of case management was negatively correlated with physical and social functioning from the parent perspective for child-parent dyads. Duration of case management was also negatively correlated with children&rsquo;s perceptions of physical functioning for the child-parent dyads. Duration of case management in a randomly selected patient sample demonstrated similar trends toward significance for physical and social functioning. Children and parents from the same family demonstrated significant differences in perceived quality of life for the patient.</p>

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 1995. / Source: Dissertation Abstracts International, Volume: 56-10, Section: B, page: 5781.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (Ed.D.)--Teachers College, Columbia University, 1994. / Includes tables and appendices. Typescript; issued also on microfilm. Sponsor: John P. Allegrante. Dissertation Committee: Robert Crain. Includes bibliographical references (leaves 82-92).

Thesis (M.S.)--University of Michigan, 1983. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M. N.)--Memorial University of Newfoundland, School of Nursing, 1997. / Bibliography: leaves 103-116.

Thesis (M.S.)--University of Michigan, 1983.

Thesis (Ph. D. (Education))--Rhodes University, 2006.

The value to consider user needs throughout the development of medical devices has been acknowledged in the field of health technology assessment. Yet, user needs are narrowly conceptualised and are mainly examined from an ergonomic perspective. By focusing on the user-device interaction per se with a view to detect use errors and to create design solutions that promote intended use, the dominant approach to user needs research fails to adequately elaborate upon symbolic and practice-related dimensions in the user-technology relationship. Moreover, whilst the examination of user needs from a User standpoint is clearly required, it is also crucial to investigate how the medical device industry understands and addresses this issue, since it is these understandings that will eventually be projected onto the technology. The present research sought to provide a cross-actor account on the issue of user needs by examining the perspectives of two key stakeholders: the users and the medical device manufacturer. Using the example of home blood pressure (BP) monitoring, a qualitative programme of research explored, on the one hand, the process of integrating home blood pressure monitors (HBPMs) into daily life as well as the elements that are conducive to building trust in this technology, and on the other, the practices the medical device manufacturer adopts to capture its users and their needs. The results suggest that people engage with home BP monitoring in an effort to develop an experiential understanding of their health condition reproducing the dominant discourse around the benefits of self-care. Nevertheless, communicating this practice outside the home was not always without tension since concerns around the ascription of undesired identities were expressed. Home measurements were occasionally performed to check the dependability of technology – arguably an unintended device use – indicating the importance of establishing trust in the artefact. Building trust in HBPMs appeared to be a multifaceted phenomenon that was not limited to the perceived trustworthiness of the technology but implicated a network of other trustworthy relationships with humans, institutions and technologies. Medium-to-large medical device manufacturers appear to appreciate the value of a user needs-informed approach to medical device development employing a series of routes, more or less direct and formalised, to reach their user. The challenge for the industry is to synthesise the evidential base deriving from individual user studies to create a higher order knowledge base. The term ‘symbolic’ – also employed in the title of this thesis – signifies people’s representations, reasoning and meanings constructed around the use or production of home medical technology whilst the term ‘practical’ (or practice-related) refers to actions, activities, and routines pertaining to these two aspects.