Thesis (Ph. D.)--University of Wisconsin--Madison, 1984. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 144-153).

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 37-40).

Thesis (M.S.)--University of Wisconsin--Madison, 1921. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaf [31]).

No description available.

Le scaphandre autonome donnant de l’air à la demande naît en France dans l’Aveyronau début des années 1860. L’invention est efficace mais moyennement satisfaisante du pointde vue du travail sous-marin. L’apnée et la plongée en scaphandre lourd relié à la surface parun tuyau amenant de l’air, sont utilisées pour s’immerger à des fins utilitaires : la pêche deséponges et des coquillages. Les scientifiques comme Paul Bert et J.S. Haldane posent lesbases de la décompression mais il faut attendre les années 1930 pour voir naître un loisir sousmarin: la pêche à la nage sur les côtes méditerranéennes puis les premiers scaphandresautonomes de Yves Le Prieur qui crée le premier club de plongée loisir en 1935. A la fin de laguerre, les militaires s’approprient et perfectionnent l’invention autour de Jacques-YvesCousteau et Philippe Tailliez. La plongée autonome de loisir poursuit son développementautour de la jeune fédération française nationale d’études et de sports sous-marins (1948) etdu Club Méditerranée. Les premières entreprises de travaux sous-marins utilisent lescaphandre autonome de Cousteau et Gagnan et la plongée entre au cinéma en obtenant unepalme d’or à Cannes en 1956 (Le monde du Silence de Cousteau et Louis Malle). Unenouvelle presse spécialisée se construit et, vers 1960, la plongée s’émancipe du modèlemilitaire pour devenir une pratique de loisir avec ses brevets et contenus spécifiques. Laconstruction de modèle technique de référence, le développement d’une offre commerciale etla professionnalisation de l’encadrement transforment les imaginaires de l’immersion etinstallent l’activité comme une pratique, certes aventureuse mais possible. La plongée enscaphandre autonome devient un bien de consommation avec ses équipements, ses voyagesthématiques et ses centres de plongées. La profession de moniteur est à peine envisageable àplein temps mais les premiers syndicats de défense des professionnels de l’enseignementvoient le jour. Au milieu des années 1980, la plongée de loisir professionnelle existe, elleparticipe à la mise en place d’une pratique d’aventure raisonnée où l’immersion devient unenjeu de concurrence. Les innovations technologiques comme l’ordinateur de plongée ou legilet stabilisateur au début des années 1980 participent à une transformation des pratiques,féminisées (30% de pratiquantes) et plus hédonistes. La plongée en associant technologie etimaginaire de l’aventure devient une pratique légitime sans être tout à fait sportive niexclusivement contemplative. / Scubadiving was born in France (Aveyron) in the early 1860s. Although the invention wasefficient under water worker did not find it useful enough. Free diving and scuba diving weremainly used for sponge and shell fishing. P. Bert and J.S. Haldane – two scientists – were thefirst to settle down the basis of decompression. We have to wait until 1930 to considerscubadiving as a hobby : first submarine in the Mediterranean sea, then Yves Le Prieurcreated the first aqualung and established the first diving club in 1935. At the end of theSecond World War, soldiers made the invention theirs and improved the system withCousteau and Tailliez. Scubadiving grew up thanks to the fédération française nationaled’études et de sports sous-marins and the Club Méditerranée. The first submarine workscompanies used the aqualung of Jacques-Yves Cousteau : scubadiving became famous : TheSilent world won the Palme d’Or in Cannes in 1956. Some specialised international pressappeared around 1960, scubadiving was not only for the army but also a hobby for everybodywith degrees and a specific curriculum. Scubadiving became more and more popular thanks toits specific rules, business development and professional instructors. Scubadiving becameconsumer goods thanks to its equipment, its dedicated trips and scubadiving clubs. At thebeginning, it was unbelievable to think of it as a fulltime job but quickly the first unionsappeared. In the middle of the 80s professional scubadiving did exist. It participated to set upa reasonable practice. There were more and more competitors. Technological innovationssuch as scubadiving computers or stabilizing jacket – at the beginnings of the 80s – opened upto women (30% of them) and made the activity more hedonistic. Technology linked to thedesire of adventure helped scubadiving to be a legitimate practise. Scubadiving is not either asport not a contemplative activity.

This study uses flow rate and blood oxygen saturation signals to detect apnea and hypopnea events. The detection process consist two phases, by using the peaks of flow rate signals to determine respiratory cycles, the first phase uses seven flow rate feature to distinguish normal and abnormal respiratory events. To reduce the false detection rate, by appending two additional blood oxygen saturation variables into the feature set, the second phase tries to filter out some falsely detected events made in the first phase. Experimental results show that the proposed approach achieves detection accuracy is 81%. The corresponding false detection rate is 67%. One reason for the high false detection rate is that many normal respiratory events has lower amplitude airflow pattern. To resolve such a difficulty, additional physiological signals may be required.

published_or_final_version / Surgery / Master / Master of Medical Sciences

　　　Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder and is associated with a range of adverse physical, social and psychological outcomes that affect quality of life (QoL). Two systematic reviews of the literature (part of this thesis work) found there is conflicting evidence of how different mandibular advancement device (MAD) designs features may affect clinical and subjective OSA outcomes in certain patients. Therefore, a randomized cross-over trial was conducted. Firstly, the correlation between clinical OSA indicators and QOL was explored among patients referred for OSA treatment using MADs. In addition, associations of OSA risk factors, dental status and demographic variables with clinical OSA indicators and QoL indices were determined. Secondly, the efficacy of two different MADs in the treatment of adult OSA patients was assessed and compared. Thirdly, the efficacy of the two MADs in the treatment of adult OSA patients from the subjective perspective of their bed partners was determined. 　　　A consecutive sample of 45 adult OSA patients referred from Queen Mary Hospital Sleep Centre to the Prince Philip Dental Hospital for oral appliance therapy was recruited and treated with a monobloc MAD and a twinblock MADs for a period of 3 months per MAD (cross-over randomised trial). Changes in clinical OSA outcomes were assessed by polysomnography (PSG) and changes in subjective outcomes by the disease-specific Sleep Apnoea Quality of Life Index (SAQLI) questionnaire, the Functional Outcome of Sleep Questionnaire (FOSQ) and Epworth Sleepiness Scale (ESS). Patient compliance, side-effects and MAD preference, as well as MAD treatment impact on the patients’ bed partner was also assessed. At baseline, some clinical OSA indicators, subjective QoL and certain OSA risk factors were significantly correlated (p<0.05). There were significant variations in clinical OSA indicators and subjective QoL indices with respect to certain risk factors (p<0.05), demographic variables (p<0.05) and dental status (p<0.01). 　　　There was a significant difference in favour of the monobloc MAD in terms of improving the apnoea-hypopnoea index (AHI) (p<0.05) and oxygen desaturation index (ODI) (p<0.01). Significantly more patients achieved clinical treatment success with the monobloc compared to the twinblock (p<0.05). Both MADs were efficacious in improving patients’ SAQLI score (p<0.01), FOSQ score (p<0.01) and ESS score (p<0.01). Significantly more patients achieved QoL treatment success with the monobloc (p<0.05) compared to the twinblock. More patients were ‘very satisfied’ with the monobloc treatment (p<0.05) and 63% preferred it to the twinblock. 　　　 No significant difference was found between patients’ and bed partners perceptions of symptom improvement post treatment, however, the monobloc resulted in a significant reduction in bed partners’ daytime sleepiness (p<0.01) and allowed significantly more co-sleeping at night (p<0.05). 　　　 　　　This study concluded that the monobloc is superior in improving subjective QoL and clinical OSA indicators. The monobloc was the preferred MAD and patients were more satisfied with it; bed partners rated this MAD as superior in improving their own daytime sleepiness and co-sleeping. / published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Poor adherence to continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnoea (OSA) limits its therapeutic effectiveness and has a major impact on clinical outcomes. Effective education programme is important to enhance CPAP use. However, existing education programmes are either manpower or resource demanding and may not be feasible in clinical practice. Moreover, the Self-Efficacy Measure for Sleep Apnoea (SEMSA) has been widely adopted for assessing adherence-related cognitions on CPAP therapy in OSA patients, but it was not available for Chinese. The aims of this thesis are: (i) to perform linguistic and psychometric evaluation of a Chinese version of SEMSA (SEMSA-C); (ii) to examine the efficacy of brief motivational enhancement education programme in addition to standard care versus standard care only on improving adherence to CPAP treatment in patients with OSA. The SEMSA-C was obtained after the standard forward-backward translation process. A randomised controlled trial was then conducted on newly diagnosed OSA patients. Patients in the control group received standard care (SC) comprising advice on the importance of CPAP therapy and its care while those in the intervention group received SC plus motivational enhancement education programme (ME). ME focused to enhance subjects’ knowledge, motivation and self-efficacy to use CPAP, comprising one 45-minute session on the day after CPAP titration and one 10-minute telephone follow-up shortly after commencing CPAP treatment. Epworth Sleepiness Scale (ESS), SEMSA-C, and quality of life were assessed. CPAP usage data were downloaded at the completion of this 3-month study. The primary outcome was the CPAP adherence. Furthermore, 21 patients were randomly sampled at baseline and completed the SEMSA-C at one week. 100 patients (Men : Women, 84 : 16) with OSA indicated for CPAP treatment were recruited, with an average age of 52±10 years, and apnoea hypopnoea index (AHI) of 36.2±22 events/hour. Factor analysis of SEMSA-C identified three factors: risk perception, outcome expectancies and treatment self-efficacy. Their corresponding internal consistency was high with Cronbach’s alpha >0.88, which were larger than all correlations between subscales (Range: 0.14 to 0.58). The correlations between items and their hypothesized subscale (Range: 0.58 to 0.85) were generally higher than the correlations between items and their competing subscales (Range: -0.10 to 0.58). One-week test-retest intra-class correlation ranged from 0.70 to 0.82. CPAP adherence was associated with outcome expectancies and treatment self-efficacy at 3-month assessment. Furthermore, SEMSA-C demonstrated an improvement in self-efficacy (standardised response mean = 0.33, p = .044) but no significant changes were observed in the other two factors, after CPAP use. The 100 patients were followed for 3 months. The interventional effects maintained during the 3-month study period. There were a better CPAP use [higher daily CPAP usage of 2 hours/day (Cohen d = 1.33, p < .001), four-fold the number of subjects using CPAP for ≥ 70% of days with ≥ 4 hours per day (p < 0.001)], and greater improvements in ESS by 2.2 (p = 0.001) and treatment self-efficacy by 0.2 (p = 0.012) in the intervention group, relative to the control group. The traditional Chinese SEMSA-C possesses satisfactory psychometric properties. It is a reliable and responsive instrument to measure perceived risks, outcome expectancies and treatment self-efficacy in Chinese patients with OSA. Moreover, the newly developed brief motivational enhancement education programme in addition to standard care is effective in improving adherence to CPAP treatment, treatment self-efficacy and daytime sleepiness. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Nursing

Obstructive Sleep Apnea (OSA) is a common respiratory disorder during sleep. Apnea is cessation of airflow to the lungs, which lasts for at least 10 seconds accompanied by more than 4% drop of the blood's Oxygen saturation. Polysomnography during the entire night is the Gold Standard diagnostic method of OSA. It's high cost and inconvenience for patients persuaded researchers to seek alternative OSA detection methods. This thesis proposes a technique for assessment of OSA during wakefulness. We recorded tracheal breath sounds of 17 non-apneic individuals and 35 people with various degrees of OSA severity in supine and upright positions during nose and mouth breathing at medium flow rate. We calculated the power spectrum, Kurtosis, and Katz fractal dimensions of the recorded signals. Then, we reduced the number of characteristic features to two. We classified the participant into severe OSA and non-OSA groups as well as non-OSA or mild vs. moderate and severe OSA groups. The results showed more than 91 and 83% accuracy; for the two types of classification. Once veri ed on a larger population, the proposed method may be used as a simple and non-invasive screening tool for assessment of OSA during wakefulness.