Dissertations / Theses: 'AI in Clinical research'

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Orefors, Emil, and Nouri Issaki. "AI IN CONTEXT BASED STATISTICS IN CLINICAL DECISION SUPPORT." Thesis, Mälardalens högskola, Akademin för innovation, design och teknik, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39923.

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Some treatments may cause unwanted effects and may make it difficult to achieve an optimal personalised decision for a specific patient. Decision support systems in healthcare is a topic that is getting much attention today. The purpose of using such a system is to enhance treatment's quality and to make it easier for clinicians to process and providing information by having access to patient's electronic health record and past experience. In this thesis, the developed a Clinical decision support system (CDSS) that helps clinicians to identify similar patients and extracting relevant experience. The vision here is to enable clinicians to make more informed decisions when choosing a suitable treatment for patient’s condition. So, here we focus on a more generic approach using case-based reasoning (CBR) and clustering in order to enable context-based statistics for a wider usage of CDSS in healthcare. We are testing our framework on a specific register that considers patients with cerebral pares and their ability to walk. In addition, the solution in our framework will measure how much the range of motions during the foot changes (increase or decrease) before and after an operation of the patient. During this work, an interview has been conducted with a clinical expert to collect requirements to develop such systems. The main function of the system is to check if a patient is similar to any previous patients so the clinician can get relevant information in choosing better treatment solution for a patient. The clinician involved in the project was convinced that our approach could become a valuable tool in a clinical decision-making situation.

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Freed, Samuel. "A role for introspection in AI research." Thesis, University of Sussex, 2017. http://sro.sussex.ac.uk/id/eprint/66141/.

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The main thesis is that introspection is recommended for the development of anthropic AI. Human-like AI, distinct from rational AI, would suit robots for care for the elderly and for other tasks that require interaction with naïve humans. “Anthropic AI” is a sub-type of human-like AI, aiming for the pre-cultured, universal intelligence that is available to healthy humans regardless of time and civilisation. This is contrasted with western, modern, well-trained and adult intelligence that is often the focus of AI. Anthropic AI would pick up local cultures and habits, ignoring optimality. Introspection is recommended for the AI developer, as a source of ideas for designing an artificial mind, in the context of technology rather than science. Existing notions of introspection are analysed, and the aspiration for “clean” or “good” introspection is exposed as a mirage. Nonetheless, introspection is shown to be a legitimate source of ideas for AI using considerations of the contexts of discovery vs. justification. Moreover, introspection is shown to be a positively plausible basis for ideas for AI since if a teacher uses introspection to extract mental skills from themselves to transmit them to a student, an AI developer can also use introspection to uncover the human skills that they want to transfer to a computer. Methods and pitfalls of this approach are detailed, including the common error of polluting one's introspection with highly-educated notions such as mathematical methods. Examples are coded and run, showing promising learning behaviour. This is interpreted as a compromise between Classic AI and Dreyfus's tradition. So far AI practitioners have largely ignored the subjective, while the Phenomenologists have not written code – this thesis bridges that gap. One of the examples is shown to have Gadamerian characteristics, as recommended by (Winograd & Flores, 1986). This serves also as a response to Dreyfus's more recent publications critiquing AI (Dreyfus, 2007, 2012).

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BHATTACHARYYA, AMITAVA. "CLINICAL GENOMIC RESEARCH MANAGEMENT." Doctoral thesis, Università degli Studi di Milano, 2013. http://hdl.handle.net/2434/217475.

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Technological advancement in Genomics has propelled research in a new era, where methods of conducting experiments have completely been renovated. Riding the wave of Information Technology, equipped with statistical tools, Genomics provide a revolutionized perspective unthought-of in the past. With the completion of the Human Genome project, we have a common reference for analysis at the level of the complete genome. High throughput technologies for gene expression, genotyping and sequencing are propelling present research. Attempts are now being made for the incorporation of these methods in the health care in a structured format. Clinicians cherish the use of genomics for the assessment disease predisposition and realizing personalized medical care for a better health care. As genome sequencing is becoming swifter and its cost reducing, the public genomic data has increased many folds. Data from other high throughput technologies and annotations further increase the storage requirements. Laboratory management software, LIMS, is now becoming the limiting factor as automation and integration increases. Thus genomics now faces the challenge of management of this enormous data catering to varied needs, not limited only for the research laboratories, but extends also to health care institutions and individual clinicians. Further, there is a growing need for the analysis and visualization of the generated data to be integrated into the same platform for a continuous research experience and systematic supervision. Data security is of prime concern, especially in health care concerning human subjects. The interest of the clinicians adds another management requirement, a delivery system for the concerned subject. Hypertension is a complex disorder with world-wide prevalence. HYPERGENES project was centered on the objective of integrating biological data and processes with Hypertension as the disease model. The HYPERGENES project focuses on the definition of a comprehensive genetic epidemiological model of complex traits like Essential Hypertension (EH) and intermediate phenotypes of hypertension such as Target Organ Damage (TOD). During the HYPERGENES project, the above mentioned challenges were comprehended and evaluated, leading to the present work as an endeavor to provide a generalized integrated solution towards the management of genomic and clinical data for clinical genomic research. This PhD thesis represents the description of AD2BioDB, biological data management platform and SeqPipe, dynamic pipeline management software, in the path of meeting the challenges posed in the area of clinical genomics. AD2BioDB provides the platform where data generated using different technologies can be managed and analyzed with reporting and visualization modules for improved understanding of the results among all research collaborators. AD2BioDB is the management software environment in which the in-silico data can be shared and analyzed. The analysis software is connected within AD2BioDB through the plug-in system. SeqPipe software provides opportunity to dynamically create pipeline workflows for the multi-step analysis of data. The interactive graphical user interface provides the opportunity for coding free pipeline creation and analysis. This tool is especially useful in the dynamic NGS analysis, where multiple tools i with different versions are in use. SeqPipe can be used as independent software or as a plug-in analysis tool within an application like AD2BioDB. The key features of AD2BioDB can be summarized as:  Clinical genomics data management  Project management  Data security  Dynamic creation of graphical representation.  Distributed workflow analysis  Reporting and alert features.  Dynamic integration of high throughput technologies We developed AD2BioDB as a prototype in our laboratory for providing support to the increasing genomic data and complexity of analysis. The software aims at providing a continuous research experience with a versatile platform that supports data management, analysis and public knowledge integration. Through the integration of SeqPipe into AD2BioDB, the management system becomes robust in providing a distributed analysis environment.

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Pieper, Ian J. "Relational autonomy in clinical research: Relational considerations of adult participation in clinical research." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/231386/1/Ian_Pieper_Thesis.pdf.

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The requirement for consent to be both informed and voluntary is a keystone of contemporary bioethics. The need for consent before including people in clinical research demonstrates respect for participants. Demonstrating respect goes beyond mere acknowledgment of the right for people to make their own decisions. To be meaningful, consent must promote and support participant self-governance and enable decisions that align with participant values. A relational perspective of autonomy places people within a web of social and cultural histories and influences that frame the concept of respect. A relational approach to consent can create opportunities to promote respect for autonomy.

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Shah, Manisha. "Clinical ginseng research: a criticalreview." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31969811.

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Hall, Katherine C., and Kendra Todt. "Evaluating Research for Clinical Practice." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8289.

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Pedroso, Ana Isabel de Matos. "Clinical research networks in Europe." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/13595.

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Mestrado em Biomedicina Farmacêutica The theme of the thesis is the European clinical research networks and their impact on clinical research and on the development of new drugs and therapies. This report presents the final product of an exhaustive search about clinical research networks in Europe in order to characterize the profile of these networks in this region. It is also assessed its impact by describing the main relevant activities of these organisations. Finally, a few initiatives that may increase the contribution of these networks for a more effective clinical research are suggested. The search was performed in the Internet between december 2013 and may 2014, as websites are an essential tool for organizations of this nature. Therefore, it was assumed that the number of websites of clinical research networks corresponds to the number of clinical research networks that exists effectively. It was not identified any source that gathered information or that listed clinical research networks in Europe. It was also verified that there are much information in the Internet, but information is dispersed and in the majority of the websites the information is not very well processed, which increases the challenge of this search. This search was focused in Europe, thus the starting point of the search was the website of the European Medicines Agency, EMA. The thesis presents the criteria that were defined to classify the organizations as clinical research networks and the data collected from each identified clinical research network. It is also done a descriptive characterization of the clinical research networks to assess the strengths and weaknesses. Finally, conclusions, suggestions for the future and strategies to optimize/ maximize the performance of the clinical research networks are presented. O tema da tese são as redes de investigação clínica Europeias e o seu impacto na investigação clínica e no desenvolvimento de novos medicamentos e terapias. A tese apresenta o produto final de uma recolha exaustiva de informação sobre redes de investigação clínica existentes na Europa de forma a caracterizar o perfil atual destas redes na Europa. É também avaliado o seu impacto através da descrição das principais atividades dessas redes. Finalmente assinalam-se iniciativas que poderão potenciar a contribuição destas redes para uma investigação clínica mais efetiva na Europa. A pesquisa foi realizada através da Internet entre dezembro de 2013 e maio de 2014, uma vez que um website é uma ferramenta essencial para o funcionamento de organizações desta natureza. Assim, partiu-se da premissa de que o número de websites de redes de investigação clínica existentes na Internet corresponde ao número de redes de investigação clínica efetivamente existente. Não foi identificada nenhuma fonte que reunisse informação ou listagens referentes a redes de investigação clínica na Europa. Verificou-se ainda a existência de bastante informação na Internet, mas que esta se encontra dispersa de um modo aleatório na Internet e na maioria dos websites a informação não está muito trabalhada, o que incrementou o desafio desta recolha. Uma vez que pesquisa se focou na região da Europa, o ponto de partida desta pesquisa foi o website da Agência Europeia do Medicamento, EMA. Nesta tese apresentam-se os critérios definidos para a classificação de redes de investigação clínica, bem como os dados recolhidos sistematicamente de cada uma das redes. É feita ainda uma caracterização descritiva do conjunto das redes europeias de investigação clínica, a partir da qual se parte para uma discussão dos pontos fortes e pontes fracos. Finalmente, são apresentadas conclusões, perspetivas para o futuro e potenciais formas de otimizar/ maximizar a performance das redes europeias de investigação clínica.

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Almeida, João Pedro da Silva. "Curricular internship in clinical research." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16581.

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Mestrado em Biomedicina Farmacêutica This report presents my internship experience at the Clinical Pharmacology Unit where I could participate in research projects, mainly as a medical writer, data manager, project manager and monitor of observational studies and at the Neurological Clinical Research Unit, where I could work in coordination of clinical trials. The internship is part of the curricular activities of the second year of the Masters in Pharmaceutical Biomedicine, University of Aveiro. The internship took place from 15th September 2015 to June 30th, 2016. This report will address the activities that I performed, namely the coordinating activities of clinical trials and observational studies, or activities related to medical writing. Throughout the internship, I had the opportunity to put into practice the knowledge acquired during the master's degree, and deepen my knowledge of the coordination activities of clinical and observational trials. In scientific writing component, I was able to improve my scientific writing skills, to know how to develop a systematic review and understand some of the concepts of meta-analyses. In conclusion, the internship allowed me to put into practice the knowledge acquired in the University, and served as an extremely valuable learning source and for professional and personal growth. Este relatório apresenta a minha experiência de estágio na Unidade de Farmacologia Clínica onde pude participar em projetos de investigação, essencialmente como “medical writer”, “data manager”, gestor de projeto e monitor de estudos observacionais e na Unidade Neurológica de Investigação Clínica, onde pude desenvolver atividades de coordenação de ensaios clínicos. O estágio realizou-se entre 15 de setembro de 2015 a 30 de Junho de 2016. O estágio insere-se nas atividades curriculares do segundo ano do Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro. Serve o presente relatório para relatar as atividades que tive a oportunidade de desenvolver, nomeadamente de coordenação de ensaios clínicos e estudos observacionais, bem como as atividades de “medical writer”, farmacovigilância, entre outras. No decurso do estágio, tive a possibilidade de pôr em prática os conhecimentos adquiridos ao longo do Mestrado, e aprofundar o meu conhecimento sobre as atividades de coordenação de ensaios clínicos e observacionais. Na componente de escrita científica, tive a possibilidade de melhorar as minhas capacidades de escrita científica, perceber os processos necessários para a publicação de uma revisão sistemática e compreender algumas noções de meta-análises. Em conclusão, o estágio permitiu-me pôr em prática o conhecimento adquirido no Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro e serviu como nova fonte de aprendizagem e crescimento profissional e pessoal.

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Baguley, David M., and Marc A. Fagelson. "Tinnitus: Clinical and Research Perspectives." Digital Commons @ East Tennessee State University, 2015. https://www.amzn.com/1597567213.

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Book Summary: Tinnitus: Clinical and Research Perspectives summarizes contemporary findings from basic and clinical research regarding tinnitus mechanisms, effects, and interventions. The text features a collection of international authors, active researchers, and clinicians who provide an expansive scope of material that ensures relevance for patients and professionals. Reviews and reports of contemporary research findings underscore the text s value for classroom use in audiology and otolaryngology programs. Patients and students of audiology will benefit from the text s coverage of tinnitus mechanisms, emerging practice considerations, and expectations for outcomes--for example, recent successes of cognitive behavioral therapy, neuromodulation, and hearing aid use. These and other topics, such as the effects of noise and drugs on tinnitus, are reported in a way that enhances clinicians ability to weave such strategies into their own work. The influence of tinnitus on all aspects of life is explored, from art to medicine and communication to isolation, thereby providing clinicians and patients a deeper understanding of and greater facility managing a tinnitus experience. Finally, this text includes case studies that provide a practical view of tinnitus effects and management approaches. The editors hope that the consideration of mechanisms, interventions, and outcomes resonates with patients, clinicians, and students of audiology. https://dc.etsu.edu/etsu_books/1179/thumbnail.jpg

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Uga, Brenda. "Towards Trustworthy AI : A proposed set of design guidelines for understandable, trustworthy and actionable AI." Thesis, Uppsala universitet, Institutionen för informatik och media, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-385392.

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Artificial intelligence is used today in both everyday applications and specialised expert systems. In situations where relying on the output of the AI brings about the risk of negative consequences, it becomes important to understand why the AI system has produced its output. Previous research in human-computer trust has identified trust antecedents that contribute to formation of trust in an AI artifact, understanding of the system being one of them. In the context of Pipedrive, a sales management system, this thesis investigates how can AI predictions be designed as understandable and trustworthy, and by extension which explanatory aspects provide guidance towards actions to take, and which presentation formats support for- mation of trust. Using a research-through design approach, multiple designs for displaying AI predictions are explored for Pipedrive, leading to a proposal for a set of design guidelines that support understandability, trustworthiness and actionability of AI. Both the designs and the guidelines have been iteratively developed in collaboration with users and design practitioners. Artificiell intelligens används idag både i vardagliga applikationer och expertsystem. I situationer då förtroendet för utdata från AI innebär en risk för negativa konsekvenser blir det viktigt att förstå varför AI-systemet har producerat dess utdata. Tidigare forskning inom människa-datorförtroende har identifierat förtroendeföregångare som bidrar till att skapa förtroende för en AI-artefakt, varav förståelse för systemet är en av dem. Inom ramen för Pipedrive, ett säljhanteringssystem, utreder denna avhandling hur AI-förut-sägelser kan designas på ett förståeligt och pålitligt sätt, och i förlängningen vilka förklarande aspekter som kan ge vägledning gällande de åtgärder som ska vidtas, samt vilka presentationsformat som stödjer skapande av förtroende. Med hjälp av en metod för forskning genom design undersöks flera utföranden för att visa AI-förutsägelser för Pipedrive, vilket leder till ett förslag till en uppsättning riktlinjer för design som stödjer förståelse, pålitlighet och funktionsduglighet. Både design och riktlinjer har utvecklats iterativt i samarbete med användare och designutövare.

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Farrica, Anabela de Jesus Prates. "Internship in clinical data management at a clinical research organization." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15136.

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Mestrado em Biomedicina Farmacêutica The aim of this report is to describe the training activities carried out at the Data Management Sub-Unit of Eurotrials, Scientific Consultants, as part of the 2nd year of the Master’s Program in Pharmaceutical Medicine. This internship was focused on the development of skills and on gaining experience in Clinical Data Management activities. Over the course of this internship, I had the opportunity to build upon the knowledge obtained in the Bachelor’s Degree in Biomedical Sciences and in the Master’s Program in Pharmaceutical Medicine. Concepts, requirements and practices related to Clinical Data Management were explored and strengthened throghout. Furthermore, an unique perspective on the lifecycle of clinical research projects was obtained – that of a CRO. Besides the acquisition of theoretical knowledge, this training period was paramount for the development of a number of social and personal skills that contributed for my profissional growth within the host institution. This document begins by a description of the theoretical principles that set the ground for the Clinical Data Manager’s work. Then, the generic and specific training elements of the curricular training are detailed. After presenting my training activities, I discuss the various challenges I had to overcome during these 9 months. Finally, some personal remarks and conclusions are presented. Este relatório tem como objetivo descrever as atividades de estágio realizadas na Unidade de Gestão de Dados da Eurotrials, Consultores Científicos, como parte do 2º ano do Mestrado em Biomedicina Farmacêutica. Este estágio focou-se no desenvolvimento de competências e obtenção de experiência em atividades de Gestão de Dados Clínicos. No decurso do estágio tive oportunidade de complementar o conhecimento obtido na Licenciatura em Ciências Biomédicas e no Mestrado em Biomedicina Farmacêutica. Foram aprofundados e explorados os conceitos, requisitos e práticas inerentes à Gestão de Dados Clínicos e obteve-se uma visão única do ciclo de vida de um projeto de investigação clínica – a de uma CRO. Para além da aquisição de conhecimentos teóricos, este período de estágio foi fundamental para o desenvolvimento de um conjunto de aptidões sociais e pessoais que contribuíram para o meu crescimento profissional dentro da instituição de acolhimento. O presente documento começa por expôr os príncipios teóricos que servem de base à atividade do Gestor de Dados Clínicos. Seguidamente, são detalhados os componentes genéricos e específicos de treino adquiridos durante o período de estágio. Depois da apresentação das atividades de estágio, são discutidos os vários desafios enfrentados e é feito um balanço pessoal desta experiência.

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Shah, Manisha. "Clinical ginseng research a critical review /." Click to view the E-thesis via HKUTO, 1999. http://sunzi.lib.hku.hk/hkuto/record/B31969811.

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Martin, Faith. "Doctorate in Clinical Psychology : research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633160.

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Objective: Somatisation as a process suggests that mood changes are responded to physically rather than psychologically. This concept is linked to “medically unexplained symptoms”, including conditions such as chronic fatigue or fibromyalgia. Alexithymia, difficulty in identifying or expressing emotions, is the proposed causal mechanism. This study tested this proposal by measuring association between alexithymia and somatic symptoms and exploring whether experimentally induced mood changes are responded to by those with higher alexithymia scores with more physical than psychological sensations than those with lower alexithymia. Methods: A median split of Toronto Alexithymia Scale scores was used to create two groups (higher and lower alexithymia) from a sample of 21 participants with a diagnosis of chronic fatigue syndrome and / or fibromyalgia. Participants rated mood and physical and psychological state at baseline and following sad and happy mood induction. Ratio scores of psychological over physical state ratings were calculated for each mood state. Measures of depression, anxiety, somatic complaints, acceptance, beliefs about emotions and health anxiety were also administered. Results: No correlation was found between alexithymia and intensity of somatic or psychological symptoms. There was no significant difference in ratio scores by mood or between those with higher or lower alexithymia. The mood manipulation did lead to changes in psychological sensations and physical sensations. Conclusion: The alexithymia hypothesis of medically unexplained symptoms was not supported in this study using a clinical sample. Further research should include a control group of people experiencing depression or anxiety without significant physical symptoms.

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Carrigan, Neil. "Doctorate in Clinical Psychology : research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633168.

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Main Project Multiple Sclerosis (MS) is an incurable disease which is commonly associated with psychological complications. Previous research by Hayter and colleagues found that in patients with MS, health anxiety (HA) can account for part the variance in quality of life (QoL) independent of any physical and cognitive impairment caused by the disease and that MS patients with health anxiety perceived their (intact) physical and cognitive performance as impaired relative to MS patients without health anxiety, attributing the impairment to MS. The findings suggest that such misperceptions might be useful targets in the treatment of health anxiety in MS using adapted cognitive behavioural therapy (CBT). The first of two studies presented here sought to replicate the findings from Hayter et al. before a second presents the findings from a brief case series of treatment for HA using CBT. In Study 1, twenty participants with Relapsing and Remitting MS were screened for HA and assigned to either a high or low HA group. Participants then completed assessment of cognitive and physical functioning before rating their performance on these tasks. Measures of QoL, mood and physical disability were then completed. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. Given the high rates of HA in MS patients and its impact on QoL, this case series suggests a brief CBT intervention could significantly improve patients’ wellbeing. The findings pave the way for larger, controlled studies into the effectiveness of CBT for health anxiety in MS. Service Improvement Project Background: Early diagnosis of neurodevelopmental conditions such as Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) in children are enshrined in national UK policy, as is ensuring that parents’/carers’ views shape service delivery. Aim: The present study attempted to measure adherence to service guidelines of a neurodevelopmental disorders assessment clinic within a Child and Adolescent Mental Health Service (CAMHS) to identify service needs. It also assessed parents’/carers’ satisfaction with the service and what information should be included in a patient information leaflet. Method: An audit of cases referred during 2012 -2013 plus a postal survey of parents/carers of children referred during the audit period. Results: The service was mostly compliant with NICE guidelines but quantifying this was difficult under its current record keeping. While satisfied with the clinic’s service, the main concern of parents/carers was the length of time the assessment process took. Conclusions: Adoption of NICE audit tools would help document compliance with guidelines. A patient information leaflet might help manage parents’ expectations about the time the assessment process takes. Literature Review This review considers the closely related concepts of rumination and worry; examining their role in insomnia and chronic pain. Worry has been seen for many years as a major contributor to insomnia but only recently has attention been paid to the role of rumination. Similarly, worry and rumination have both been implicated in the maintenance of distress in chronic pain. However, across these two diagnostic categories (and the wider research literature) definitions of worry and rumination vary and are often used interchangeably. This review considers the research literature on rumination/worry in relation to insomnia, chronic pain and insomnia that occurs alongside chronic pain (pain-related insomnia). The empirical findings to date suggest patterns of repetitive negative thinking characterise both worry and rumination, but the content of the thinking may be distinct, opening the way for the application of transdiagnostic approaches. It suggests cognitive behavioural approaches to treating pain-related insomnia can be improved by incorporating elements which have been successful elsewhere in allowing people to manage repetitive negative thinking. Assessment of these targeted treatments in future research should lead to a reduction in suffering for patients with chronic pain who have trouble sleeping.

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Anderson, Catriona. "Doctorate in Clinical Psychology research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698975.

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Background – Psychosis is one of the most stigmatised mental health problems. Individuals who experience psychosis can internalise this stigma, resulting in self-stigma where an individual’s self-concept is eroded with a negative impact on recovery. Conversely, peer support has been shown to impact positively on recovery and theory suggests that this may be achieved through challenging stigmatising attitudes. Aims – The aim of this study is to further investigate one potential mechanism underpinning peer support, that is the impact of peers on challenging self-stigmatising attitudes. Methodology – 20 people with first episode psychosis were recruited and randomised to watch a psycho-educational video delivered either by an individual with experience of psychosis (a peer) or a health professional. Levels of self-stigma were measured before and after the video. Results – The findings of this study did not support the hypothesis that psycho-education delivered by a peer reduces internalised stigma to a greater degree than someone without this, however, the results are underpowered and require a larger sample before conclusions can be drawn. Conclusions – Further research is needed to better understand the effective components of peer support and to better understand the relationship between peer support and internalised stigma. Service Improvement Project Abstract Pulmonary Arterial Hypertension (PAH) is a chronic disease, which is monitored by a series of complex treatments including cardiac catheterisation (CATH). Evidence suggests that patients can experience CATH as anxiety provoking, however, most undergo this procedure without any formal psychological support. The current study aimed to explore patients’ beliefs about the CATH procedure and to better understand adaptive coping and self-management skills. It was hoped that this knowledge would inform recommendations to improve the psychological experience and coping resources of those undertaking CATH. Ten participants were recruited through purposive sampling and completed a qualitative interview, which explored their beliefs about CATH and factors which enhanced coping resilience. Findings suggest that factors which increase an individual’s understanding of CATH and sense of control were associated with positive coping. The results also suggest that whilst perceptions of the CATH procedure are very individual, the importance of relationships with health professionals and trust in their expertise was highlighted across participants. The findings informed service recommendations, including the introduction of a patient experience leaflet aimed at promoting positive coping in those attending the CATH procedures. Critical Literature Review Abstract Background – Stigma is a global phenomenon affecting many health conditions. Stigmatised attitudes can become internalised (internalised stigma), a process that can negatively impact on an individual’s sense of self, their emotional wellbeing and wider life. Recently interventions have been developed to reduce internalised stigma, including interventions led by people with personal experience of health conditions (peers). Aim – This review aimed to draw together literature on peer-led interventions for stigmatised health conditions, which have included internalised stigma as an outcome. The review aimed to synthesis interventions and their components; relate the findings to social identity theory and summarise what is known and not known about the relationship between peers and internalised stigma. Method – Using specific search terms and inclusion criteria, this review yielded 13 papers in total. The papers were examined in terms of their methodology and findings, and common components of the interventions were collated across the papers. Results – The results revealed methodological limitations amongst the papers and highlighted the need for replication. However, the findings suggest there is evidence that peer led interventions can impact positively on internalised stigma, if designed in the right way for the people who receive it. The key components include sharing experiences, narrative components, information provision and problem-solving. Conclusions – Peer-led interventions present an empowering way of countering the stigma surrounding certain conditions through role-modelling recovery, sharing hopeful experiences and enhancing positive identity. Current evidence shows promise, however, more high quality research is needed to better understand this relationship and to develop effective, accessible interventions.

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Ferrão, Ângela Filipa Machado. "Clinical research in a pharmaceutical industry." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/14880.

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Mestrado em Biomedicina Farmacêutica This training report describes the knowledge and experience gained during the curricular internship at the Medical Affairs unit of the Research Department of Bluepharma Indústria S.A.. The main activities addressed are related with the conduction of phase I clinical trials by a sponsor, namely bioequivalence clinical trials. In this context, is described the main applicable regulations, the management process of a clinical trial and a reflection about the main challenges in the field. Furthermore, are outlined the activities related with the management of Research, Development and Innovation projects, particularly the analysis of ideas of new pharmaceutical products, where I contribute with several researches. This first contact with the pharmaceutical industry allowed me to integrate the knowledge and skills gained in the Pharmaceutical Sciences degree with those gained in the master’s course of pharmaceutical medicine, fulfilling one of the main objectives that I define for myself: the growth and acquisition of skills, coupled with the access to a different professional reality. O presente relatório de estágio propõe-se relatar o conhecimento e a experiência adquirida durante o estágio curricular no setor de Assuntos Médicos do departamento de Investigação da Bluepharma Indústria, S.A.. Nele são abordadas as principais atividades realizadas, inerentes à condução de ensaios clínicos de fase I por parte de um promotor, nomeadamente de ensaios de bioequivalência. Neste contexto é feita uma descrição da legislação aplicável, do processo de gestão de um ensaio clínico e uma reflexão acerca dos principais desafios nesta área. Para além disso, são também descritas atividades relacionadas com a gestão de projetos de Investigação, Desenvolvimento e Inovação, particularmente na análise de ideias de novos produtos farmacêuticos para as quais contribuí com diversas pesquisas. Este meu primeiro contacto com a indústria farmacêutica permitiu-me integrar os conhecimentos e competências da licenciatura em Ciências Farmacêuticas com os adquiridos no mestrado de Biomedicina Farmacêutica, cumprindo um dos principais objetivos que estabeleci para mim: o do crescimento e aquisição de competências aliado ao acesso a uma diferente realidade profissional.

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Ribeiro, Patrícia Graziela Cunha. "Clinical practice of e research nurse." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16507.

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Mestrado em Biomedicina Farmacêutica This paper proposes to present the main activities of a Research Nurse, its role in clinical research, and in the development and introduction of new drugs on the market. The Master in Pharmaceutical Medicine brought together knowledge and development of new technical and personal skills extremely valuable in daily activity as research nurse. During my professional activity as a research nurse, were detected many gaps in academic and professional training of nurses, with regard to this specific area. I intend to present a personal view, describing the main activities developed and how the knowledge acquired in this Master influenced my work performance. The main objective of this work is to provide a reference or guide to other nurses who want to enter into the area of clinical research. O presente trabalho propõe apresentar as principais atividades de um Enfermeiro de investigação, o seu papel em investigação clínica, no desenvolvimento e na introdução de novos medicamentos no mercado. O Mestrado em Biomedicina Farmacêutica permitiu reunir conhecimentos e desenvolver novas competências técnicas e pessoais de extremo valor na atividade diária, como enfermeira de investigação. No decorrer da minha atividade profissional como Enfermeira de investigação, foram detetadas muitas lacunas na formação académica e profissional dos enfermeiros, no que diz respeito a esta área específica. Pretendo apresentar uma visão pessoal, descrevendo as principais atividades desenvolvidas e como os conhecimentos adquiridos neste Mestrado influenciaram o meu desempenho profissional. O principal objetivo deste trabalho é constituir uma referência ou guia para outros enfermeiros que queiram enveredar pela área da investigação clínica.

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Hon, Wai-fan. "Fraud in clinical research : perceptions among clinical investigators and biomedical researchers /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38478584.

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Taylor, Michael Dennis. "Prostate cancer clinical practice guidelines clinical and economic outcomes /." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010098.

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Thesis (Ph.D.)--University of Florida, 2005. Typescript. Title from title page of source document. Document formatted into pages; contains 99 pages. Includes Vita. Includes bibliographical references.

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Rosser, Daniel Ashley. "Improving the measurement of visual acuity in clinical practice and clinical research." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446798/.

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This thesis considers the relationship between the design of a visual acuity test and various aspects of its performance. Using contemporary test design theory, novel tests are developed and evaluated in an attempt to better meet the requirements of a visual acuity test most pertinent to clinical practice, clinical research, and population based surveys. The acuity test of choice in clinical practice is the Snellen chart, a test whose usefulness is limited by several design flaws. Clinical researchers favour the ETDRS logMAR chart which employs robust design principles, but is time consuming to use. A chart featuring an abbreviated ETDRS design was developed and its performance compared with that of the ETDRS and Snellen charts. The prototype chart allows acuities to be measured in half the time of the ETDRS chart with greater precision than the Snellen chart. A tumbling-E version of this chart has been successfully employed in population based surveys in Thailand, Bangladesh and Mongolia. It was noted during the study that the precision of even ETDRS acuities was relatively poor. A computerised version of the ETDRS test was developed and used to investigate the repeating and averaging of acuities as a means to improve precision. Whilst prolonging test time, the computerised test allowed acuities to be measured with improved precision. Optical defocus was investigated as a potential source of reduced precision in visual acuity testing. It was shown that even small degrees of defocus may significantly reduce test precision. An approach which considers test performance in terms of sensitivity and specificity was developed. A mathematical model was used to show that current methods of using estimates of precision to identify clinically important change, are overly optimistic. Predictions derived using the model were shown to agree well with empirical findings.

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Salgueiro, Ana Cláudia Marques. "Curricular training in coordination of clinical trials in a clinical research unit." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/14285.

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Mestrado em Medicina Farmacêutica This report describes several activities and projects developed in the context of a curricular training in a clinical research unit, Centro de Investigação Clínica (CIC), led by Professor Joaquim Ferreira. The CIC is one of the research groups of Instituto de Medicina Molecular (IMM) and it is also a group of the Centro Académico de Medicina de Lisboa (CAML) consortium. The principal area of training was the coordination of clinical trials and observational studies. Additionally, other research activities were conducted during the training such as, pharmacovigilance, monitoring, data entry, medical writing and some language coordination activities in a European observational study about Huntington’s Disease founded by European Huntington’s Disease Network (EHDN). It is mention on the State of the Art the Research & Development Process of a new drug and it is characterised some issues about clinical research in Portugal, including advantages in the establishment and organisation of clinical networks. During the training, with the duration of 10 months (that started on 1st September 2013 and finished on 1st July 2014) I deepened my knowledge in clinical research area, understand the importance of the clinical research units, the importance and the role of the study coordinators and expand my areas of interest. The specific training focused in neurological clinical. I had opportunity to understand the practical and logistical difficulties that a research unit faces during the conduction of clinical studies I consider that this training was a valuable experience of introduction of the practice of clinical research. I finished this training with the motivation and interest in working in the area of coordination and monitoring of studies. Este relatório descreve as actividades e projectos desenvolvidos no âmbito de estágio curricular numa unidade de investigação clínica, o Centro de Investigação Clínica (CIC), liderada pelo Professor Doutor Joaquim Ferreira. O CIC faz parte dos grupos de investigação do Instituto de Medicina Molecular (IMM) inserindo-se na iniciativa do consórcio Centro Académico de Medicina de Lisboa (CAML). A principal área de estágio foi a coordenação de ensaios clínicos e estudos observacionais. Adicionalmente foram abordadas outras actividades durante o estágio, tais como farmacovigilância, monitorização, preenchimento de bases de dados, escrita científica e algumas actividades de coordenação a nível nacional de estudo observacional europeu sobre a doença de Huntington financiado por European Huntington’s Disease Network (EHDN). Refere-se no estado da arte o Processo de Investigação e Desenvolvimento de novos medicamentos e caracteriza-se alguns aspectos da investigação clínica em Portugal incluindo vantagens na organização de redes clínicas de investigação. Ao longo do estágio, com 10 meses de duração (início a 1 Setembro de 2013 e fim a 1 de Julho de 2014) aprofundei o conhecimento na área de investigação clínica, percebi a importância de unidades de investigação clínica, a importância e papel de coordenadores clínicos e expandi as minhas áreas de interesse. O treino específico centrou-se em estudos clínicos na área da neurologia, nomeadamente ensaios de clínicos de fase II e III, e estudos observacionais. Tive ainda oportunidade de compreender a realidade prática e logística da condução de estudos clínicos num centro de investigação. Considero que este estágio foi uma experiência valiosa de introdução á prática de investigação clínica. Desta forma, termino o estágio com motivação e interesse em trabalhar na área de coordenação ou monitorização de estudos.

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Ayad, Fady. "How is AI research applied in the field of network fault management." Thesis, Högskolan i Skövde, Institutionen för informationsteknologi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-20124.

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The internet growth rapidly increased by the years, and the traffic is increasing daily. The management of the network is becoming more and more complexed for humans to handle on their own, with that being said a new direction of using Artificial Intelligence (AI) technologies is being implemented in the direction of network fault management. In order to keep up with the development network, new solutions need to be implemented. Traditional network fault management are dependent of system administrators and there is too much human error that can happen during operations. That’s why AI is a great tool to be used in future network fault management. There are currently many challenges within network fault management, and this makes an opportunity for AI to be implemented. The studies shows that AI subpart “supervised learning” is the most popular used in network fault management. AI have shown that there is potential to tackle problems such as detection, prediction and also improve the system as whole.

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Quintero, Michael C. "Constructing a Clinical Research Data Management System." Thesis, University of South Florida, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10640886.

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Clinical study data is usually collected without knowing what kind of data is going to be collected in advance. In addition, all of the possible data points that can apply to a patient in any given clinical study is almost always a superset of the data points that are actually recorded for a given patient. As a result of this, clinical data resembles a set of sparse data with an evolving data schema. To help researchers at the Moffitt Cancer Center better manage clinical data, a tool was developed called GURU that uses the Entity Attribute Value model to handle sparse data and allow users to manage a database entity’s attributes without any changes to the database table definition. The Entity Attribute Value model’s read performance gets faster as the data gets sparser but it was observed to perform many times worse than a wide table if the attribute count is not sufficiently large. Ultimately, the design trades read performance for flexibility in the data schema.

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Quintero, Michael C. "Constructing a Clinical Research Data Management System." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/7081.

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Clinical study data is usually collected without knowing what kind of data is going to be collected in advance. In addition, all of the possible data points that can apply to a patient in any given clinical study is almost always a superset of the data points that are actually recorded for a given patient. As a result of this, clinical data resembles a set of sparse data with an evolving data schema. To help researchers at the Moffitt Cancer Center better manage clinical data, a tool was developed called GURU that uses the Entity Attribute Value model to handle sparse data and allow users to manage a database entity’s attributes without any changes to the database table definition. The Entity Attribute Value model’s read performance gets faster as the data gets sparser but it was observed to perform many times worse than a wide table if the attribute count is not sufficiently large. Ultimately, the design trades read performance for flexibility in the data schema.

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McLean, Donna L. "Patients' perceptions of participation in clinical research." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0005/MQ29015.pdf.

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Rodella, Stefania. "Exploring reliability in epidemiology and clinical research." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23421.

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Quality of measurement is a fundamental issue in medical research and clinical practice, of relevance for any inference or decision-making process. Reliability, as an estimate of the variability in the domain of repeated measurements, is an important component of the quality of measurements. Reliability indices are frequently used and presented in the medical literature and a considerable amount of methodological research has been conducted on this topic in the last decades. However, the debate is still open on some theoretical and operational aspects. Available knowledge concerning reliability, particularly for categorical data, is not easily accessible since it is often confined to specialized journals and almost disregarded by statistical textbooks. Therefore, a thorough understanding is difficult to achieve for a researcher potentially involved in reliability studies. My main objective was to pursue a conceptual and global understanding of the role of reliability in the domain of categorical data. In order to achieve this goal I reviewed and synthesized the literature according to some specific objectives: (a) to provide an overview on the founding concepts and methods in the measurement of reliability for categorical variables, also contrasting them with what has been done in the domain of continuous variables; (b) to present and discuss the main limitations of traditional indices, particularly the kappa statistic; (c) to briefly introduce some possible alternative methods and areas for future development; (d) to emphasize the implications of reliability for epidemiological and clinical research. Finally, in order to illustrate the application of some of the methods discussed, I used a real set of data, concerning 209 slides of lymphomas tissue samples, reviewed by a panel of four pathologists, according to a standard classification based on 10 categories.

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Stewart, Nick. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761009.

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Critical Review of the LiteratureCan Borderline Personality Disorder be treated effectively in forensic settings? A systematic reviewBorderline Personality Disorder (BPD) is a common diagnosis in forensic settings. Certain features of BPD, such as impulsivity and emotional dysregulation, can create a vulnerability to impulsive acts. The condition is also associated with poor mental and physical health, making the treatment of BPD and its clinical features an important goal in forensic settings. This paper reviews evidence for the effectiveness of treating BPD and its symptoms using psychological approaches in forensic settings. A systematic search found 2913 papers, of which 13 met the inclusion criteria. The papers reported nine separate studies (six controlled) that implemented four distinct interventions, often adapted for particular forensic settings. Improvements in overall BPD symptomatology and specific BPD symptoms were reported for all types of intervention, although few differences in outcome between intervention and control groups were found. There were also reported improvements in BPD-related behaviours, but data on offending behaviour were absent. Heterogeneity in study quality and design makes it challenging to draw any firm conclusions about the effectiveness of any one form of treatment over another, nor about which treatment may best suit a particular setting. Further randomised controlled trials are needed to answer these questions. Service Improvement ProjectEvaluation of a brief educational intervention for clinical staff aimed at promoting trauma-informed approaches to careThere is growing evidence that trauma plays an important role in the aetiology of severe and enduring mental health problems. Yet staff can be reluctant to ask patients about trauma for reasons such as anxiety about harming patients and limited access to training. Where services have adopted trauma-informed approaches (TIAs) to mental health care (i.e., considering the ways in which trauma affects individuals when planning and delivering services), improved clinical outcomes have been observed. With this in mind, a new educational video was developed for mental health staff at an NHS trust. The video was intended to be (a) brief (10 minutes); (b) contemporary and engaging; and (c) accessible using computers, smartphones and tablets. Forty-one multidisciplinary staff viewed the video. Quantitative and qualitative evaluation indicated improvements in self-reported knowledge and confidence with regard to trauma, and a decrease in worries with regard to asking patients about such experiences. Participants found the video to be enjoyable, understandable and informative. Importantly, many indicated that it spurred them to further action, such as further training and asking patients about possible trauma. These findings indicate that a video of this type can offer an important ‘taster’ of trauma-related learning, constituting an important step towards embedding trauma-informed ways of working at a service. Main Research ProjectThe Role of Intrusive Imagery in Hoarding DisorderThe cardinal feature of Hoarding Disorder (HD) is persistent difficulty discarding possessions, with the resulting clutter compromising the intended use of living areas. Within the dominant cognitive-behavioural model of hoarding (Frost & Hartl, 1996), hoarding behaviours are positively and negatively reinforced in the context of certain object-related beliefs. Available treatments for HD have so far yielded modest outcomes, indicating a need for new approaches. Intrusive imagery has so far been neglected in HD research, despite the frequency of trauma in the histories of people with the condition. To address this, 27 individuals who met the DSM-5 criteria for HD and 28 community controls (CCs) were interviewed about their everyday experiences of mental imagery. Participants were also asked about the images they experienced during two recent real-life examples of actual or attempted discard of (1) an object of low subjective value; and (2) an object of high subjective value. Everyday imagery in the HD group commonly reflected themes of illness, death and reminiscence. Imagery in HD participants tended to carry negative emotional valence in comparison with CCs, and was associated with greater interference in everyday life and attempts to avoid the imagery. HD participants reported more negative experiences of intrusive imagery in comparison with CCs during recent episodes of discarding objects of low subjective value. However, HD participants experienced positive imagery when discarding, or trying to discard, high value objects. These findings indicate that although people with HD frequently report traumatic histories, this is not reflected in the everyday imagery that they experience. There is some evidence to suggest that the negative and positive memories experienced in relation to low and high value objects may aid our understanding of discarding and saving behaviour in HD. The theoretical and clinical implications of these findings are further discussed.

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Harris, Madeline. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761014.

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Critical Review of the Literature The consequences of childhood maltreatment are pervasive and implicated in the development of a range of mental health difficulties, including eating disorders. However, the mechanisms which mediate the link between childhood maltreatment and eating disorders are unknown. This has important implications for effective intervention, as eating disorders are notoriously difficult to treat. There are numerous factors which predict poor therapy outcome that overlap with mediators between childhood maltreatment and disordered eating behaviours in non-clinical samples. This may suggest people with a history of maltreatment could be at greater risk of developing an eating disorder which does not respond to currently available interventions. This review aimed to identify the mediating variables between childhood maltreatment and eating disorders. Studies which tested mediators of the relationship between childhood maltreatment and eating disorders were systematically reviewed and a narrative synthesis of the findings reported. The findings suggested mediators of the relationship between childhood maltreatment and eating disorders could be mapped onto cognitive-emotional-behavioural and affective models of eating disorders. Limitations of the reviewed studies and clinical implications are discussed. Service Improvement Project Formulation, in the context of clinical psychology, involves integrating a breadth of knowledge to create a tentative hypothesis to describe the difficulties service users may experience. Team formulations, created by a multi-disciplinary team to construct a shared understanding of a service user’s experiences, can facilitate a more consistent and collaborative approach within a team and lead to a more holistic, psychosocial understanding of a person’s difficulties. This project was carried out in two recovery teams in a locality within an NHS trust in which staff had been trained to use the 5 Ps model of formulation (Weerasekera, 1995). The project aimed to establish whether staff were using 5 Ps formulations in their work, whether these were experienced as useful, what supports staff to use a 5 Ps formulation, and what staff feel the barriers to using a 5 Ps formulation are. A questionnaire and two focus groups were used and analysed using descriptive statistics and thematic analysis. The results suggested staff used the model to inform their clinical thinking, in consultation with therapist colleagues, and in group reflective practise. Overall, the 5 Ps model was well received. The model appeared to support staff both with their clinical work and to be more reflective and holistic in their approach. However, staff did raise some drawbacks with the model and difficulties with integrating it consistently into their clinical practise. Service recommendations include areas for continued practise, areas for development and change, and areas for further service evaluation and potential research opportunities. Main Research Paper The ‘Common Sense Model’ (CSM; Leventhal, Meyer, & Nerenz, 1980) aims to explain how psychological factors influence long-term health condition (LTC) management. Research has shown the CSM applies to children and young people (CYP) as well as adults. However, the model does not incorporate systemic factors, which are especially relevant for CYP, for whom families hold more illness management responsibilities. Caregiver perceptions of an illness have been linked with outcomes for the person with the health condition. Other factors which have been shown to affect illness perceptions include the LTC itself. This pilot study examines differences in illness perceptions between two groups of parents: those whose children had type 1 diabetes, and parents of children with juvenile idiopathic arthritis. This study also examined mood, anxiety and time since the child’s diagnosis as predictors of parental illness perceptions. It was found that having a child with type 1 diabetes was predictive of anticipating longer illness duration and perceiving greater control over the condition. Additionally, having greater levels of anxiety was predictive of more perceived control, which may be associated with condition monitoring behaviours in type 1 diabetes. Finally, scores indicating lower mood predicted perceiving the consequences of the condition as more severe and lower levels of perceived control over the condition. Future research directions and clinical implications are discussed.

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Panting, Holly. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.761024.

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Keane, Lisa. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698990.

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Mental Imagery (MI) and implementation intentions (II; creating concrete plans for when, where and how a goal is to be achieved) have shown promise in enhancing performance and goal achievement. As depressed mood is often characterized by loss of interest and reduced engagement in previously rewarding activities, the aim of this study was to investigate whether MI and II strategies could be used to enhance rates of goal achievement in participants presenting to services with low mood/depression. An experimental three-group comparison was used, with random allocation to the levels of the independent variable (MI, II, Control). Each participant (N = 44) devised three idiosyncratic goals, with the researcher guiding the participants in the MI/II groups through the relevant cognitive strategy in relation to their first goal. Those in the MI group reported a significant increase in the perceived likelihood of achieving their goals post-strategy. There were no significant differences in the achievement of goals amongst the three groups, although higher rates of goal achievement were apparent in the MI group. The current study suggests that generating specific goals and using MI may represent a valuable technique for improving individuals’ beliefs that their goals are attainable and within their reach. Further research with larger samples is recommended to explore the impact of techniques on actual goal attainment. Service Improvement Project Background: Clinical guidance recommends that multi-family psychoeducation groups) should be offered as part of the stepped-care model of intervention in early intervention for psychosis services. This results from the recognition of the important role that families play in supporting the recovery of service users experiencing a first episode of psychosis. Aims: This study aimed to evaluate and improve a series of multifamily information sessions within the North Somerset Early Intervention for Psychosis Team. Methods: Following the initial running of a multifamily psychoeducation group (Group 1), telephone interviews were conducted with six family members who attended to evaluate and identify recommendations for the improvement of the group. This feedback was used to inform the format and content of a second running of the group (Group 2). Three further participants provided evaluative qualitative feedback on this revised group. Results: Following collection of feedback from Group 1, four key themes were identified including the positive aspects of group attendance (e.g. receiving relevant information, opportunity to meet the team and other families), challenges of groups (e.g. accommodating the needs of different families), impact of caring (e.g. feeling isolated and unknowledgeable) and recommendations for improvement (e.g. additional content for siblings, simplifying information). This information was used to develop Group 2, which was adapted to make the information more family-friendly (e.g. simplifying information), with the inclusion of some further information. Conclusions: The positive feedback received from those who attended the group supports the continued use of family information sessions within the service. The use of feedback and the development of this aspect of the service were perceived positively by the team. Systematic Review of the Literature Background: Cognitive behavioural therapy for low self-esteem (LSE) has shown promise as a trans-diagnostic model for treating mental health difficulties in adults. To ascertain the potential value of this treatment approach in working with young people with internalising disorders, we need to develop our understanding of LSE within these mental health conditions. The aim of this review is to explore 1) the co-occurrence of clinically significant anxiety/depression and LSE in young people, and 2) the association between LSE in childhood and adolescence and mental health difficulties in later adolescence and emerging adulthood. Method: A systematic search of two electronic databases (PsychInfo/Pubmed) was conducted to identify relevant studies. Results: Ten studies examining the association between LSE and clinically significant anxiety/depression in young people met the inclusion criteria, as did eight studies investigating the association between LSE in under 18 year-olds with internalising difficulties in later adolescence/emerging adulthood. Conclusions: Although relatively few studies investigating ‘clinically significant’ anxiety and depression were identified, the located studies consistently supported the co-occurrence of LSE and internalising disorders in young people. This was found to be particularly true for young people with depression and co-morbid mental health difficulties. There appears to be less evidence for the association between reported LSE in childhood and adolescence and anxiety/depression in adolescence/emerging adulthood, potentially due to the complexity of confounding variables. Further research investigating Fennell’s cognitive model as a trans-diagnostic treatment model for young people with LSE is indicated.

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Lambe, Sinead. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675714.

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Barden, Rochelle. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698979.

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Objective: To assess if adolescent perfectionism mediates the association between negative parental factors (anxiety, maladaptive perfectionism, critical and authoritarian parenting) and paediatric anxiety. Method: A cross sectional questionnaire design was used. Sixty-six 12-17-year-old adolescents and their primary caregiver were recruited from a local community school and child and adolescent mental health services. Self- and parent-report questionnaires measured anxiety, perfectionism and parenting style. Results: There was a significant association between adolescent perfectionism and anxiety and between parental perfectionism and anxiety. However, there was no evidence that parental perfectionism was associated with child perfectionism or anxiety. Conclusions: The fact that parental factors were not associated with adolescent maladaptive perfectionism implies that the processes associated with the development of maladaptive perfectionism and anxiety in childhood may be different in adolescents. Implications for treatment and future research are discussed. Service Improvement Project Abstract Background: The 5Ps model is a formulation tool which includes the mental health problem as well as predisposing, precipitating, perpetuating and protective factors. The 5Ps model was integrated into the assessment service in the community mental health recovery team by the first author (trainee clinical psychologist) with support from the service manager and clinical psychologist. Objectives: This research aimed to measure whether assessment staff in the community mental health recovery team were using the 5Ps model in assessment meetings and assessment letters to formulate service user’s mental health problems. This research also aimed to assess whether recommendations for mental health care addressed the 5Ps factors which were noted in the assessment letter and assessment meeting notes. Finally, the research aimed to recommend strategies to improve the use of the 5Ps model by assessment staff. Design: Assessment staff (n=6) were interviewed using semi-structured interviews. Assessment letters and meeting notes (n=36) were analysed using case note analysis. Methods: Percentage use of 5Ps in assessment letters and meeting notes and percentage of recommendations linked to 5Ps in assessment letters were calculated. The amount of 5Ps training staff received was also compared to staff members’ use of the 5Ps in assessment letters. Thematic analysis of staff questionnaire data was completed. Results: Assessment staff are using the 5Ps in their assessment work and some recommendations were linked to the 5Ps stated in assessment letters. Recommendations to improve the use of the 5Ps by assessment staff were based on staff feedback and case note analysis and included; updating the letter and assessment formats/processes to ensure that all of the 5Ps are linked to the mental health problem and recommendations made for treatment, completing the formulation section on the electronic notes system and further training for assessment staff in how to identify the 5Ps/how recommendations can address the 5Ps. Conclusion: Results suggest that the 5Ps formulation was operational to assessment staff as it was utilised to formulate service users mental health problem at assessment. However, results suggest that the recommendations need to be implemented to improve assessment staff’s acceptability and use of the 5Ps. The service agreed to adhere to the recommendations suggested to improve the use of the 5Ps and agreed that if recommendations are adhered to these results support the plan to integrate the 5Ps into other adult mental health teams across Bristol. Literature Review Abstract Objective: All studies of solution-focused therapy which included adults with a mental health problem are reviewed and research methodologies are summarised and rated according to the quality of the research methodology used. Method: Sixteen studies were found and data extracted on setting, mental health problem, modality, target and duration of intervention, research methodology, measures, sample size, method of analysis, comparison treatment and quality score. Results: 14 studies utilised quantitative research methodologies. Eight of the studies used a quasi-experimental design including control groups (n=6) and random assignment (n=3). One study used a post-intervention questionnaire follow-up design and one study calculated recovery rates. One study calculated whether or not the patient presented with self-harm within 1 year post intervention and pre-post intervention change on a solution-focused measure. Two studies were randomised controlled trials and another two studies were single case experimental designs. Two studies utilised qualitative research methodologies including transcribing a therapy session/post-intervention interview. Quantitative outcomes were measured using multiple questionnaire measures and multiple analysis methods. Conversation analysis and thematic analysis were used for qualitative studies. The quality scores of the studies varied from 4 (single case experimental design) to 14 (randomised controlled trial) and 15 (controlled quasi-experimental). Conclusion: This review shows that solution-focused therapy is being evaluated using many valid and reliable research methodologies and questionnaires. It is hoped that solution-focused therapists and researchers can use this review to complete and publish further research which measures the effectiveness of solution-focused therapy using research methodologies which produce valid and reliable results.

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Cowdrey, Felicity Ann. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.665408.

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Walters, Sasha. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675709.

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Smith, Emma. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.699004.

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Background and Objectives: It has been suggested that reassurance seeking may play an important role in the development and maintenance of common mental health problems such as OCD and depression. We first considered the extent of reassurance seeking in depression and OCD relative to a healthy comparison group and secondly tested the hypothesis that reassurance seeking is primarily motivated by threat in those suffering from OCD and by interpersonal concerns in those suffering from depression. Methods: The frequency and intensity of reassurance seeking and the motivation for seeking reassurance was measured using the reassurance seeking questionnaire in 28 people with OCD, 18 people with depression and 29 healthy controls. Results: The OCD group sought reassurance more and at a higher intensity than both the depression group and healthy controls. For the OCD group, reassurance seeking was found to be linked to threat concern motivation. The depression group were not motivated by threat or interpersonal concerns. Conclusions: For people suffering from OCD, reassurance is motivated by threat concern. For the depression group the motivation to seek reassurance is less clear but interpersonal concern may not be a distinct motivational factor. Key words: Reassurance seeking, Obsessive-Compulsive Disorder, depression, reassurance seeking questionnaire, threat motivation, interpersonal motivation.

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Fixter, Vera. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675706.

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Eden, Kate Elizabeth. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698989.

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Background: People with intellectual disability (ID) are more likely to be overweight or obese compared to their peers, which fuels the need for effective healthy weight management programmes targeted at this population. In order to inform such programmes, more evidence is needed relating to how people with ID perceive their bodies. Method: This study uses qualitative and quantitative methodology to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale was used to assess how participants perceived themselves, how they would like to look, and how they conceptualised underweight, healthy-weight and overweight. This rating scale was shown to be a valid and reliable measure when used with this population. Results: Results show that young adults with ID tend to hold positive beliefs about their bodies. Females with ID are likely to perceive their bodies to be smaller than they are and neither males nor females report a desire for an altered body size. The results also suggest that individuals with ID understand what is meant by 'overweight', 'healthy-weight' and 'underweight' although these concepts are qualitatively different compared to those held by people without ID. Furthermore, individuals with ID are unable to apply these body size categories to themselves. Conclusion: It is vital to consider these findings when designing healthy weight management programmes for people with ID. These individuals will need to be supported to understand how concepts of body size apply to themselves before they can move on to make positive choices about their weight management.

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Sadhnani, Vaneeta. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633162.

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Critical Literature Review Indiscriminate friendliness (IF) is a concept that is poorly understood within the field of institutionalised and maltreated children. Theories as to its existence vary from IF being a disorder of attachment, to neurobiological theories proposing IF to arise out of the interaction between a severely deprived upbringing and genetically predisposed brain abnormalities. The current literature review aims to look at studies that have investigated the interaction between attachment and indiscriminate friendliness, in order to ascertain whether IF is, in fact, a symptom of disordered attachment. Findings were considered in relation to quality of studies and literature within this field. Using specific search criteria, 11 papers were found and evaluated. Findings concluded that IF was not a symptom of disordered attachment, due to the majority of papers failing to find a link between the two constructs. Studies were evaluated in terms of sampling, measurement, analyses, and design. The review pulls together the literature on indiscriminate friendliness, which has previously been confined to the area of attachment. The review highlights potential areas for exploration such as the background of families, as well as the assessment of quality of care, and how this impacts on the development of IF. The review also raises concerns around the measurement of this construct, and calls for further use of validated measures. Service Improvement Project This study describes the development of a new group using psychological approaches for caregivers of individuals with dementia. This follows consultation with the service and its users, to the implementation and running of this group. Thematic analysis was used to extract key themes on the utility of the group. Barriers to intervention have been identified, and further research recommendations have been made. Main Research Project Background: Metaphors are commonly used within clinical settings to communicate concepts to young people. Whilst theories of how metaphors work have been proposed, alongside ideas to implement metaphors effectively, there has been little research as to whether metaphors impact upon memory and understanding, in comparison to basic language. Aims: The current study aims to assess whether metaphorical explanations leads to improved memory and understanding for psychological concepts. Method: 25 participants took part in the study (10 boys and 15 girls). Individuals who were on the waiting list for Cognitive Behaviour Therapy (CBT) were given the opportunity to watch a video which explained the main concepts of CBT. Half of the participants watched a video with metaphorical explanations (Metaphor group); the other half watched a video using basic language (Psychoeducation group). The participants answered questions immediately after the video and then four weeks later, on psychopathology, memory and understanding measures. Results: T-tests were carried out to determine any differences between the two groups. There were no significant differences on all variables tested (memory, understanding, intention to change) immediately or after four weeks. Correlational data, looking at the link between age and understanding/memory between the two groups found that older individuals were more likely to understand and remember the content of the Psychoeducation video. Whilst this correlation did not differ significantly from the Metaphors group, there were no such trends for individuals exposed to a metaphorical understanding. Conclusions: Metaphors do not appear to enhance memory and understanding of young people, in comparison to basic language. However, it seems they are equally understood by younger and older children, therefore making them an accessible way of communicating complicated concepts. Definitive conclusions cannot be made due to the small sample size, so there is a call for further research in this area.

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Laffan, Amanda. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.633174.

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Main Research Project: Investigating perceptions of disgust in older adult residential home residents As able-bodied people often become increasingly physically-dependent as they make the transition into older age, they may lose the ability to contain bodily fluids as they once had. Contact with bodily fluids is linked with feelings of disgust and, given the necessity of receiving assistance with intimate care activities, it has been suggested that self-focused disgust, and concerns over the disgust of others, may be important preoccupations in older people. This mixed-methods study therefore investigated feelings of disgust in fifty four physically-dependent older adults living in residential homes. Participants completed measures of disgust sensitivity, mood, and two new scales pertaining to feelings of self-disgust and perceived other-disgust when being assisted with intimate care activities. Results indicated that disgust was uncommon, although where present, self-disgust was related to perceptions of others’ feelings of disgust and disgust sensitivity. These results were benchmarked against twenty one community-dwelling older adults, who reported believing they would feel significantly more disgusting if they were to start receiving assistance than those receiving assistance already did. Six of the residents who reported high levels of self-disgust also participated in semi-structured interviews. The thematic analysis was consistent with the quantitative results, with participants reporting that underlying protective factors, the use of strategies and carer characteristics reduced any feelings of disgust. The overall results are discussed with reference to the disgust literature, with recommendations being made for ways in which self-disgust can be minimised in residential homes. Service Improvement Project: Profiling the psychological training and support needs of oncology staff, and evaluating the effectiveness of clinical psychology provision, in a general hospital department The importance of training non-psychology healthcare professionals to offer psychological support to people with cancer is becoming increasingly recognised. Semi-structured interviews with five members of multidisciplinary oncology staff identified that training needs were primarily around communication skills, recognising and dealing with emotions, offering support and empathy, and self-care. Pre and post-training questionnaires developed with these themes in mind revealed that the Level 2 Training Programme workshops run in this network of hospitals are effective in increasing participants’ levels of perceived knowledge and confidence across each of these domains. Recommendations are made for further enhancing this effectiveness. Critical Literature Review: An evaluative review of the relationship between empathy and posttraumatic stress disorder There is a small but growing body of evidence suggesting that PTSD may affect, and be affected by, an individual’s level of empathy. This review identified and examined 20 papers investigating these relationships, exploring them with reference to the cognitive model of PTSD outlined by Ehlers and Clark (2000). The first finding suggested that level of empathy may either increase or decrease following traumatic experiences, depending upon the way in which an individual responds to their trauma. The second finding suggested that higher levels of empathy may either predispose or protect an individual from developing PTSD, depending upon their ability to use protective coping mechanisms. Finally, a third finding suggested that higher levels of empathy facilitate recovery from PTSD. It is recommended that empathy-enhancing work be included in PTSD treatment protocols, and that effective coping skills are taught to those likely to experience traumatic events.

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Wood, Helen. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675686.

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Main Project: This study aimed to 1) investigate if adolescents and young adults with autism spectrum disorder (ASD) who are high in social anxiety underestimate their social performance when compared with those low in social anxiety, and 2) investigate the association between social motivation and social anxiety. Participants (n=20) aged 14-21 years completed measures of social anxiety, loneliness and social satisfaction before taking part in a video-recorded group discussion. Self and observer ratings of social performance were analysed. Results revealed that participants high in social anxiety rated themselves significantly poorer than did observers. The interaction between social anxiety group and rater was non-significant. Loneliness significantly correlated with social anxiety. This study highlights how cognitive factors may be involved in social anxiety for young people with ASD and discusses implications for psychological intervention. Service Improvement Project Objective: Chronic illness, such as Cystic Fibrosis, can make adolescence and young adulthood challenging. During this time, young people must move on from using paediatric to adult healthcare services. This transition is a current research focus, acknowledged to require careful preparation and planning and be considered within a developmental context. This study aimed to explore the experiences of some young people with Cystic Fibrosis and their parents during this transition in order to inform a transition pathway. Method: Five young people and three parents who were either approaching or had experienced transition were interviewed about their experiences. Transcribed interviews were analysed using thematic analysis. Results: Four key themes emerged: moving on from the familiarity and security of children’s services; changes in the nature of relationships with healthcare professionals; transition as a condensed process in the context of adolescence; and changing roles in healthcare. Conclusions: Results highlighted the strong attachment to paediatric team and the anxiety about change for both patients and parents. Themes are discussed along with service recommendations which aim to reduce this anxiety for patients by supporting the establishment of new relationships and increase familiarity and confidence with the new setting and processes. Literature Review: Family members often become significantly involved in obsessive compulsive disorder, changing their lives to accommodate the symptoms. Relatives can experience distress, and feel a great deal of burden relating to the OCD. Families are recognised as a key factor in treatment effectiveness and therefore understanding their burden and how they cope is essential. The aim of this review was to synthesize studies concerned with family burden and coping in OCD to build on the understanding of family experiences and help inform treatment. A search was conducted of Pub Med, Web of Science and APA Psych NET using terms OCD, burden, coping, family, relatives etc. Thirteen articles were included in the review. Burden was found to be a far-reaching and complex construct associated with increased severity of OCD, dysfunction, family accommodation and depressive symptoms. Families have been reported to struggle to know how to cope. Avoidant coping has been associated with decreased hope, negative affect and accommodation whereas active reframing and social support appear to have the opposite associations. Results are discussed along with implications for treatment and further areas of research.

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Chapman, Rosanna. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675698.

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Background: There is some evidence to suggest that computerised Cognitive Behavioural Therapy (cCBT) is effective for reducing adolescent anxiety and depression. However, most studies have used samples of young people in the general population or those who are 'at risk' of anxiety or depression, and so less is known about the usefulness of cCBT for adolescents with clinically significant levels of distress and impairment. Aims: This study aimed to investigate the feasibility of using a novel computerised cCBT intervention, 'Pesky gNATs,' with adolescents aged between 13 and 18 years old who had clinically significant symptoms of anxiety and/or depression. Method: Eleven participants were recruited from a Tier 3 Child and Adolescent Mental Health service (CAMHS). Six participants were allocated to the intervention group and received the intervention immediately, and five were allocated to the control group and received the intervention after a delay. Outcome measures were completed pre- and post- intervention. Qualitative data were also obtained during the final session. Results: A high participation and retention rate was found for the intervention and the majority of participants described the programme as helpful and identified several benefits of completing the programme. No differences in overall self-reported symptoms of anxiety and depression, self-concept and functioning were found when comparing the intervention and control group on pre- and post- intervention scores. However, decreases in parent-reported symptoms of anxiety and depression and the impact of symptoms on functioning were found across both groups. Conclusion: This study demonstrates the acceptability of using a cCBT programme in a Tier 3 CAMHS setting, but shows limited evidence that this intervention is effective at reducing self-reported symptoms of anxiety and depression. Therefore, 'Pesky gNATs' may not be appropriate as a standalone treatment for young people with more severe clinical presentations.

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Garner, Emily. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675708.

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Dixon, Clare. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698991.

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Children may use social support to manage symptoms of post-traumatic stress disorder (PTSD). Good perceived social support is associated with fewer PTSD symptoms. Limited research exists about actual support children receive post-trauma and whether this is associated with PTSD. This study explored actual and perceived support, factors that influence actual and perceived support and the relationship between social support and PTSD 4-weeks and 3-months post-trauma. Eighty-nine children and their parents completed measures of PTSD and social support 4-weeks after attending the emergency department following a single-incident trauma. Seventy children completed PTSD measures 3-months post-trauma. Children had good levels of perceived social support which was associated with lower perceived barriers to support, after controlling for gender. Perceived social support at 4-weeks predicted PTSD cross-sectionally, after controlling for age, but did not predict change in PTSD at 3-months. Eighty-percent of children felt they needed support post-trauma, seeking it from parents or friends. Actual support did not predict PTSD cross-sectionally or longitudinally. These findings support previous research that perceived social support is protective post-trauma. More information is needed about what support children want post-trauma and whether they receive this. These findings will help inform interventions to promote perceived social support post-trauma. Service Improvement Project Children in care are at increased risk of developing mental health problems potentially due to the increased experience and impact of social and environmental risk factors in their early life. However, there are difficulties accessing mental health services that understand their specific needs. Mental health consultations have been recommended to increase access to mental health services for those working with children in care. A child and adolescent mental health service has been providing a consultation service to social workers for over 4 years. Clare Dixon reports the results of an audit of 83 consultations and a survey completed by 34 social workers, to gather their views about the consultations. The results showed that consultations were utilised by several social work teams, were requested for a variety of reasons and resulted in a range of outcomes. The social workers were positive about their experiences of the consultations and reported that it gave them a better understanding of the difficulties they were experiencing and how to manage them. The results highlighted difficulties with the internal administration processes, practicalities 6 and social workers’ understanding of what the consultations provide. Recommendations were provided highlighting areas of good practice and ways to improve the consultations that are provided to the social workers for children in care. Critical Review of the Literature The prevalence of post-traumatic stress disorder (PTSD) in people with psychosis is high. Intervention guidelines for psychosis recommended that if PTSD is diagnosed then intervention guidelines for PTSD should be followed. However, studies evaluating PTSD interventions often exclude people with psychosis. Eighteen studies were included in this review which aimed to evaluate the evidence for the effectiveness of PTSD interventions for people with psychosis and see if there was any additional impact on symptoms of psychosis. Interventions included trauma-focused cognitive therapies, EMDR, prolonged exposure, video testimony and written emotional disclosure to treat single and multiple traumas. The findings suggest PTSD interventions have some positive effects for people with psychosis but there are considerable methodological limitations which bias the results and limit the conclusions that can be drawn. The findings also provide some tentative evidence that the interventions have a positive impact on comorbid symptoms of psychosis but there are several limitations to consider. More work is needed adopting stronger methodologies with better controls and looking at symptoms of psychosis as a specific outcome of the intervention. This review concludes that evidence in this area is still in its infancy thus limited conclusions can be drawn about the effectiveness of PTSD interventions for people with psychosis.

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Rusbridge, Sarah. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675712.

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Knight, Rose A. "Doctorate in Clinical Psychology : main research portfolio." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698974.

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Background: Research into the psychological effects of stroke has developed into understanding the fluidity of psychological adjustment rather than distinct diagnostic categories of mental health conditions. Research indicates the role of identity change after stroke, however this is yet to be explored in-depth. A handful of empirical studies also highlight the role social groups and identity in adjustment and quality of life after stroke. Purpose To synthesise qualitative studies on identity after stroke, from stroke survivors’ and caregivers’ perspectives. To develop the understanding of the role of social identity in post-stroke psychological adjustment. Methods A systematic search of qualitative studies in peer reviewed journals from January 2000 to March 2016 was undertaken. The CASP (Critical Appraisal Skills Programme) was used to appraise the quality of selected studies. A synthesis was conducted using a meta-ethnographic approach (Noblit & Hare, 1988). Themes relating to identity and self were analysed in the synthesis. Results 25 studies were included in the meta-ethnography. The results of these papers fell into two themes; Relationships with Self, and Social Relationships. The relationship between the themes was considered using Social Identity Theory, developing a new post-stroke self as an adjustment process. Conclusions This synthesis indicates the relationship between the self, social relationships and social identity post-stroke and highlights the role of these factors in adjustment to life and the ‘new self’ after stroke. This presents a new direction for research into identity after stroke, and needs further exploration to apply this knowledge to interventions after stroke. Main Research Project Abstract Background Recent research indicates the role of intrusive images in Bipolar Disorder (BP). It is hypothesised that imagery is an important internal state in BP (Holmes et al, 2008). This has not yet been compared to a non-clinical population. However, it is also thought that the type of internal state (whether imagery, verbal thoughts, heart rate) does not matter, but the extreme, conflicting appraisals attached to the internal state (Mansell et al, 2006) which results in difficulties in mood regulation in BP through using maladaptive emotional regulation strategies (e.g., rumination, suppression). Aims To investigate whether people with BP have more images in a positive mood state than non-clinical controls, and whether people with BP make extreme and conflicting appraisals of these images. To explore whether people with BP use more emotional regulation strategies in response to images. Methods A semi-structured interview was administered to 19 euthymic BP participants and compared to 17 non-clinical controls, requiring them to report intrusive images from a previous positive mood state, followed by questionnaires. Results BP participants experience significantly more intrusive images in a positive mood state than non-clinical controls, which was not explained by being a more ‘imagery based’ sample as there were no differences in trait use of imagery. BP participants make more extreme positive and negative appraisals of images than non-clinical controls. There were few differences in emotional regulation strategies between the groups, suggesting people with BP did not apply unhelpful emotional regulation strategies to these images. Conclusions These results further support both Holmes’ (2008) hypothesis that imagery is a key internal state in BP, and Mansell et al’s (2006) hypothesis that people with BP appraise the same internal state in conflicting ways. Future research should compare imagery to other internal states in BP to understand their relative importance. Service Improvement Project Abstract The aim of this study was to investigate current practice in managing suicidal ideation and prevention suicide attempts in older people’s services, and to consider ways of improving practice. This is in the light of an ageing population and differential presentations of risk between older and younger adults, although there are no known guidelines in the UK to specifically manage risk in older adults. Psychologists and Community Psychiatric Nurses with at least five years experience of working with older adults in mental health services contributed to focus groups. A thematic analysis was conducted, revealing a number of factors which influence risk management in older adults; sharing the burden, using a formulation driven approach, and clinician characteristics. A number of barriers were also highlighted. The findings informed recommendations, including ways to improve team management of high risk older adults, at a time of working in ageless services.

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Hayden, Douglas. "Causality, uncertainty and falsification in clinical research." Thesis, Boston University, 2012. https://hdl.handle.net/2144/31566.

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Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. We address two foundational issues of inductive reasoning and related applications. We first consider the problem of inferring the causal effect of active versus control treatment in randomized clinical trials. We regard the pairwise differences in outcome between active and control subjects as fixed quantities which may or may not be observed depending on treatment allocation. Causal inference consists of observing a sample of pairwise differences in order to estimate the mean of all possible pairwise differences, which constitutes the complete causal effect. However, because this complete effect is unobservable, there is an unavoidable observational uncertainty, which is a fundamental feature of the physical world. We follow with a focus on the problem of falsification of scientific claims based on experimental data. A scientific claim resulting from an experiment is a function of the observed data, which induces a stochastic model on the space of possible claims, and a probability of falsification by a follow-up experiment. The map from the data into the claim space, the structure of the claim space, and the claim falsification probability, provide a mathematical structure for exploring the statistical approach to inductive reasoning. We then turn from foundational issues and causal inference to the weaker question of association in the high-dimensional setting of microarray studies. We propose a permutation test based on the matrix of pairwise distances between individual genomic profiles to test for an association between a binary classifier and gene expression. If the two groups defined by the binary classifier differ in gene expression then the mean between group distance between profiles should exceed the mean within group distance. Finally, we extend the study of association in genomic studies to consider the accuracy of genomic-based prediction of uncomplicated recovery from severe trauma, for which we seek upper bounds. In this case the dimension of the model space precludes an exhaustive model search, so that we bracket this space in the two dimensions of smoothness and complexity. A sequence of models can be thought of as a visualization of the structure of a cross-section of the gene-outcome space. 2031-01-01

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Washington, Georgita T. "Mentoring the Clinical Nurse in Nursing Research." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7606.

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The purpose of this article is to describe the research mentoring process used with a small team of nurses by a PhD prepared nurse certified as a Nursing Professional Development Specialist and as a Critical Care Clinical Nurse Specialist. It will describe how bedside nurses were actively engaged in the research process by having them learn about research while operationalizing that knowledge as simultaneously were mentored in conducting a relevant research study. The process described and discussed in this article should be useful to nurse leaders to facilitate removing the traditional barriers to nursing research that still remain in healthcare organizations today. These include lack of time and knowledge, about the process, lack of institutional support, and lack of mentoring through the process. It should also be helpful to nurse educators in the clinical area to encourage more nurses to participate in nursing research.

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Almeida, Nuno Miguel Dias. "Curricular internship in a clinical research unit." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/17113.

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Mestrado em Biomedicina Farmacêutica O presente relatório descreve em detalhe as tarefas e atividades desenvolvidas no contexto de um estágio curricular durante o segundo ano do Mestrado em Biomedicina Farmacêutica, da Universidade de Aveiro. Este estágio teve lugar na Unidade de Farmacologia Clínica do Professor Joaquim Ferreira, do Instituto de Medicina Molecular, de 14 de setembro de 2015 a 27 de junho de 2016. Esta experiência permitiu-me pôr em prática aquilo que aprendi no mestrado durante dez meses. Tive a oportunidade de trabalhar em três áreas diferentes da biomedicina farmacêutica: farmacovigilância, coordenação de ensaios clínicos e gestão de dados. Durante o estágio, surgiram múltiplas dificuldades e obstáculos. Contudo, consegui ultrapassá-los, melhorando as minhas capacidades profissionais, tais como organização, responsabilidade, comunicação, espírito critico, entre outras qualidades fundamentais para ser um bom profissional. Em conclusão, este estágio curricular permitiu o meu crescimento, não só como profissional, mas também como pessoa. Considero que tenha sido um desafio concretizado com sucesso e estou consciente que me abriu muitas janelas para a minha carreira futura. This report describes in detail the tasks and activities developed in the context of a curricular internship during the second year of the Master’s degree in Pharmaceutical Medicine of the University of Aveiro. This internship took place in the Professor Joaquim Ferreira’s Clinical Pharmacology Unit (CPU) of the Instituto de Medicina Molecular, from September 14th, 2015 to June 27, 2016. This experience allowed me to put in practice what I learned from my master’s degree during ten months. I had the opportunity to work in three different areas of pharmaceutical medicine: pharmacovigilance, clinical trial coordination and data management. During the internship, several difficulties and obstacles showed up. However, I managed to surpass them, improving my professional skills, such as organization, responsibility, communication, critical thinking, among other fundamental qualities to be a good professional. In conclusion, this curricular internship allowed me to grow up, not only as a professional but also as a person. I think it was a successful challenge and I’m aware that it has opened many windows to future career.

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Cabral, Maria Inês Meneses Miranda. "Clinical research associate: a 9-month experience." Master's thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/7681.

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Mestrado em Biomedicina Farmacêutica O principal objectivo do estágio na Eurotrials foi complementar os conhecimentos adquiridos durante a Licenciatura em Ciências Biomédicas e no Mestrado em Biomedicina Farmacêutica. O estágio na Eurotrials pretendeu preparar o estagiário para trabalhar como Monitor de Ensaios Clínicos. Incluiu também uma visão geral sobre a forma de trabalhar e actividades desenvolvidas nos diferentes departamentos da empresa. Todo o conhecimento previamente adquirido na Universidade foi complementado durante o estágio. Este estágio de 9 meses como Monitora em treino foi uma excelente preparação para trabalhar na área dos Ensaios Clínicos e para isso contribuiu também a experiência transdisciplinar. Continuar como colaboradora da Eurotrials irá proporcionar a oportunidade de realizar outras actividades que até ao momento não foram possíveis, consolidando os conhecimentos já adquiridos, permitindo o desenvolvimento de mais competências e maior autonomia. The primary objective of the training in Eurotrials was to complement the knowledge acquired during the Degree in Biomedical Sciences and during the Master in Pharmaceutical Biomedicine. Eurotrials training program aimed to prepare the trainee to work as a CRA. It also included an overview of Company departments namely the working activities performed. All knowledge previously acquired in the University was complemented during the training. This 9-month experience as a CRA trainee was an excellent preparation to work in Clinical Trials and the transdisciplinar experience greatly contributed to this preparation. Continuing as a collaborator at Eurotrials will give the CRA trainee the opportunity to perform other activities not yet experienced, to consolidate knowhow and to get more experience as well as to become more autonomous.

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Clunie, Gordon J. A. "Collected publications in laboratory and clinical research." Thesis, University of Edinburgh, 1993. http://hdl.handle.net/1842/21150.

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This volume contains 136 copies of articles, chapters and reviews published between 1958 and 1992, set out under a series of headings which cover the major areas of laboratory and clinical research undertaken by me and my associates in that period. Whenever I am listed as first author, all or the greater part of the design and conduct of the work was undertaken by me. Whenever one of my associates or research students is listed as first author, I was intimately involved in the concept, design and conduct of the studies reported in any publication which bears my name. Where original reports are not available, the permission of publishers has been sought for inclusion of photocopies within the thesis and any necessary royalties have been paid. Where such permission was not obtained the articles or chapters have been omitted from the thesis but are listed by title in Appendix 1. Articles in press at the time of submission are listed in Appendix 2. Within each broad area of activity, the publications are grouped in chronological sequence under subheadings which concentrate on particular directions in research or on particular techniques or models. The major components are in the broad field of transplantation immunology, in the related fields of pregnancy and tumour immunology, followed by studies in tissue preservation, the clinical aspects of organ transplantation and dialysis, the surgery of hypertension, some aspects of general surgery and a modest contribution to surgical education. Short summaries of the findings in groups of articles, or in some instances single articles, are presented to highlight particular features of the work and its relevance.

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Dissertations / Theses on the topic 'AI in Clinical research'

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