Thesis (D.E.) - Dept. of Electrical Engineering, University of Adelaide.

Thesis (M.S.)--Wisconsin. / Includes bibliographical references (leaves 29-87).

Thesis (Ph. D.)--Columbia University, 1968. / Includes bibliographical references (leaves 151-159).

Magister Scientiae (Physiotherapy) - MSc(Physio) / Clubfoot is one of the congenital and structural conditions that lead to physical impairment in children globally. Service providers have different perceptions on the various methods of management of clubfoot. This has led to adoption of various approaches of management of clubfoot. Although there is a wide range of experiences of parents/caregivers of children with clubfoot regarding medical management of this condition, there is no documented data on these experiences. The study therefore aimed at exploring the perceptions regarding the medical management of clubfoot in Kenya. The objectives of this study were to explore the service providers and parents/caregivers perceptions on the use of the different methods of medical management of clubfoot; explore the process followed before and after the commencement of management from the service providers and parents/caregivers when using surgical and conservative methods of management as well as exploring the barriers and enabling factors that the service providers experience during the management of clubfoot. Methodology: This study was conducted at talipes clinic of Mbagathi District Hospital, Kenyatta National Hospital and Kijabe Mission Hospital in Kenya. The study utilized a qualitative design and purposive convenient sampling was utilized to recruit participants. Twenty participants were recruited; the sample consisted of ten parents/caregivers of children with clubfoot and ten service providers. Semi-structured interview and probes were used for data collection, interviews were audiotaped and a research assistant took notes, data was collected until saturation. Data was transcribed verbatim and analyzed by thematic-content analysis. The results indicated that most of the service providers perceived Ponseti method as the most effective method of clubfoot management with early intervention. Surgery was found to be the second most utilized method which was indicated for complex and neglected clubfoot. The factors that affected service providers in clubfoot management included: Shortage of trained staff in Ponseti management, missed diagnosis at birth; poor referral system and poor compliance with treatment appointments. The factors that affected parents/caregivers compliance with the treatment regime included: (i) unaffordable transport expenses; (ii) long distance; (iii) little or no social/family support; culture/tradition and stigmatization while compliance was facilitated by (i) good communication between the parents/caregivers and the clinician; (ii) availability of free services (iii) social/ family support. Conclusion: The current study concluded that medical management of clubfoot was a success while majority of parents/caregivers agreed that they were faced with several challenges as fore mentioned which affected the outcome. Recommendation: the study therefore recommends the need to empower the community and service provider with knowledge on clubfoot and its management. There is also need for decentralisation of services and increase the number of health care givers in health facilities who are trained in clubfoot management. Finally physiotherapy academic institutions need to put emphasis on teaching clubfoot management in order to produce effective service providers.

This thesis develops a study for the frequency warping introduced by time-domain methods. The work in this study focuses first on the time-domain methods used in the classical SPICE engine, that is the Backward Euler, the Trapezoidal Rule and the Gear's methods. Next, the thesis considers the newly developed high-order method based on the Obreshkov formula. This latter method was proved to have the A-stability and L-stability properties, and is therefore robust in circuit simulation. However, to the best of the author's knowledge, a mathematical study for the frequency warping introduced by this method has not been developed yet. The thesis therefore develops the mathematical derivation for the frequency warping of the Obreshkov-based method. The derivations produced reveal that those methods introduce much smaller warping errors than the traditional methods used by SPICE. In order to take advantage of the small warping error, the thesis develops a shooting method framework based on the Obreshkov-based method to compute the steady-state response of nonlinear circuits excited by periodical sources. The new method demonstrates that the steady-state response can be constructed with much smaller number of time points than what is typically required by the classical methods.

Class of 2008 Abstract / Objectives: A novel method of predicting vancomycin trough levels at steady state was studied to determine whether it could effectively predict vancomycin trough levels compared to an established predictor method (Matzke). Methods: Adult patients who received at least two consecutive doses of vancomycin and had at least one reported vancomycin trough at steady state were considered. Data extracted and analyzed included patient gender, age, weight, height, and serum creatinine as well as vancomycin dose and interval, number of consecutive doses prior to the trough, time between trough and preceding dose, and measured vancomycin trough level. This data was applied to each of the prediction methods to determine how accurately they predicted actual measured vancomycin trough levels at steady state. Results: Data from 103 patients was analyzed. Vancomycin trough predictions using the Bergstrom method averaged 12.2 mg/dl, with a standard deviation of 3.4. The average actual trough concentration was 10.7 mg/dl with a standard deviation of 3.9, while the Matzke method predicted an average trough concentration of 19.2 mg/dl with a standard deviation of 8.6. Predictions made using the Bergstrom Method were not significantly different than the actual trough concentrations (p = 0.91). The Bergstrom method predicted concentrations within 25% of actual concentrations 42% of the time and within 50% of actual concentrations 78% of the time. Conclusions: The Bergstrom method was a more reliable predictor of vancomycin trough concentrations than the Matzke method in this patient population. Although more research is needed, the Bergstrom method may prove to be a useful tool for pharmacists to predict vancomycin trough concentrations quickly and with relative accuracy for individual patients.

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published_or_final_version / Civil and Structural Engineering / Doctoral / Doctor of Philosophy