Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 132-156.

Thesis--Copenhagen. / Chapter summaries also in Danish.

Thesis (M.Sc.)--York University, 2004. Graduate Programme in Biology. / Typescript. Includes bibliographical references (leaves 121-137). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ99345

Thesis (M.Sc.)--York University, 2005. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references. Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss &rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR11734

Background This study is a qualitative assessment of a group diabetic education programme using motivational interviewing (MI) in underserved communities in South Africa. The programme was delivered by health promotion officers (HPOs) who are mid-level workers trained to deliver health education messages. The aim of the study was to explore the experience of the HPOs in the training course and in facilitating the group education sessions, and from an understanding of their perspective to contribute towards an in-depth evaluation of the educational programme. Methods The study made use of three focus group interviews with 14 health promoters who delivered the educational programme in 17 health centres in the Cape Town area. Interviews were recorded and transcribed verbatim. The data was analysed using the Framework method. Results Training was perceived as successful and the use of small group education as the main teaching method mirrored the challenges involved in group diabetes education. HPOs felt confident in their ability to deliver the group education after training. HPOs reported a significant shift in communication style and skills, but felt the new approach was feasible and better than usual. Resource materials were found to be relevant, understandable and useful. HPOs felt that the number of sessions and topics should be increased and that family members should also attend. HPOs struggled with poor patient attendance and a lack of suitable space at the facilities. HPOs reported that patients who attended demonstrated improved self-efficacy and self-care. Conclusion This qualitative assessment of HPOs perspective on a group diabetes education programme using MI showed that HPOs can deliver such a programme with the necessary confidence after adequate training. The HPO’s perspective needs to be triangulated with other research projects focused on the patient outcomes and perspectives and evaluation of the HPO’s fidelity and competency. This study however supports wider implementation of the educational programme.

Neuropathy, a common complication of human diabetes, is not prevented by current antidiabetic therapy. Several mechanisms, some reversible, have been proposed. Clinical assessment of drug efficacy in this condition is difficult because of its slow and unpredictable development and its possible irreversibility, once established. A reliable animal model of diabetic neuropathy would be very useful. Changes such as reduced nerve conduction velocity are used as models but their relationship to neuropathy is uncertain. The main purpose of this study was to examine autonomic changes in the experimentally diabetic rat with the aim of identifying more appropriate models. The effects of three treatments which correct specific biochemical abnormalities which may underlie diabetic complications, were also studied.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / The purpose of this research was to assess the quality of the inpatient, health education diabetes program as it relates to primary Spanish speaking patients. Complications from diabetes account for huge personal and financial costs. There is substantial evidence supporting the use of targeted diabetes education to reduce complications but we need to know if our education interventions are valid. In order to accomplish this by auditing the knowledge of a sample of inpatient diabetics before and after receiving the standard MMC Spanish language diabetes education interventions via Spanish language pre and post surveys (standardized by the previously validated SKILLD survey). Demographic and clinical data were analyzed and all significant data (p value <0.05) were considered for their importance. The data demonstrated that in all 10 items on the survey, overall patients were able to demonstrate significant improvement in survey scores. Additionally, comparisons of demographic data demonstrated that being less than 50 years old was associated with improved survey scores. This indicates overall benefit of the training program as well as possible insight into need for more aggressive training for patients greater than 50 years in age.

Diabetic Retinopathy (DR) is a disorder of the retinal vasculature. It develops to some degree in nearly all patients with long-standing diabetes mellitus and can result in blindness. Screening of DR is essential for both early detection and early treatment. This thesis aims to investigate automatic methods for diabetic retinopathy detection and subsequently develop an effective system for the detection and screening of diabetic retinopathy. The presented diabetic retinopathy research involves three development stages. Firstly, the thesis presents the development of a preliminary classification and screening system for diabetic retinopathy using eye fundus images. The research will then focus on the detection of the earliest signs of diabetic retinopathy, which are the microaneurysms. The detection of microaneurysms at an early stage is vital and is the first step in preventing diabetic retinopathy. Finally, the thesis will present decision support systems for the detection of diabetic retinopathy and maculopathy in eye fundus images. The detection of maculopathy, which are yellow lesions near the macula, is essential as it will eventually cause the loss of vision if the affected macula is not treated in time. An accurate retinal screening, therefore, is required to assist the retinal screeners to classify the retinal images effectively. Highly efficient and accurate image processing techniques must thus be used in order to produce an effective screening of diabetic retinopathy. In addition to the proposed diabetic retinopathy detection systems, this thesis will present a new dataset, and will highlight the dataset collection, the expert diagnosis process and the advantages of the new dataset, compared to other public eye fundus images datasets available. The new dataset will be useful to researchers and practitioners working in the retinal imaging area and would widely encourage comparative studies in the field of diabetic retinopathy research. It is envisaged that the proposed decision support system for clinical screening would greatly contribute to and assist the management and the detection of diabetic retinopathy. It is also hoped that the developed automatic detection techniques will assist clinicians to diagnose diabetic retinopathy at an early stage.

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