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Hearing Preservation CI Surgery and Hybrid Hearing : From Anatomical Aspects to Patient SatisfactionErixon, Elsa January 2014 (has links)
A common cause of profound deafness is hair cell dysfunction in the cochlea. Cochlear implants (CI) bypass the hair cells via an electrode and stimulate the cochlear nerve directly. Nowadays, it is possible to preserve residual hair cell function and hearing through flexible electrodes and a-traumatic CI surgery techniques; called hearing preservation CI surgery. This may suit partially deaf patients who can use natural low frequency hearing in combination with electric high frequency hearing; so-called hybrid hearing. The aim of this thesis was to elucidate the effectiveness of hearing preservation CI surgery. The thesis demonstrates human cochlear anatomy in relation to CI and evaluates hearing and patient satisfaction after hearing preservation CI surgery. Analyses of human cochlear moulds belonging to the Uppsala collection showed large variations in dimensions and coiling characteristics of the cochlea. Each cochlea was individually shaped. The size and shape of the cochlea influences the position of the electrode. The diameter of the basal cochlear turn could predict insertion depth of the electrode, which is crucial for hearing preservation. The first 21 patients operated with hearing preservation CI surgery in Uppsala, showed preserved hearing. Nine-teen partially deaf patients receiving implants intended for hybrid hearing, were evaluated concerning pure tone audiometry, monosyllables (MS) and hearing in noise test (HINT). They also responded to a questionnaire, consisting of the IOI-HA, EQ-5D VAS and nine questions about residual hearing. The questionnaire results indicated a high degree of patient satisfaction with improved speech perception in silence and noise. This was also reflected by improved results in MS and HINT. Hearing was preserved in all patients, but there was an on-going deterioration of the residual hearing in the operated ear which surpassed the contralateral ear. There were no correlations between the amount of residual hearing and patient satisfaction or speech perception results. Electric stimulation provides a major contribution to speech comprehension in partially deaf patients. All the patients showed a high degree of satisfaction with their CI, regardless of varying hearing preservation.
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Exploring the value and limits of using outdoor adventure education in developing emotional intelligence during adolescenceOpper, Bjorn January 2013 (has links)
Given today’s social milieu, there is no denying that the nature of the life experiences youth
are facing has drastically changed in recent decades. In this study, outdoor adventure
education (OAE) was explored as a possible intervention strategy for the development of
emotional intelligence during adolescence.
This research project consisted of a case study of an event, namely “The Journey”,
which is a 23-day outdoor adventure education programme for Grade 10 learners at a private
high school for boys in a major South African city. Through this research, which involved
collecting, analysing and interpreting data on the topic, an endeavour was made to explore the
possible impact of OAE on the development of emotional intelligence, as well as the
sustainability of skills acquired, and also on possible design elements that may impact on the
facilitation of the development of emotional intelligence.
This study was based on a socio-constructivist paradigm, which had developed from an
interpretivist world view. This research project represents a multi-method mode of inquiry:
both quantitative and qualitative data-gathering techniques were implemented as a process of
triangulation to provide a comprehensive analysis of the research problem. The research
proper (76 participants) was preceded by a pilot study (28 participants). For the research
proper, participants completed the Bar-On EQ-i: YV (Bar-On, 2007) questionnaire before
embarking on “The Journey” (pre) and again at its completion (post1). This was followed by
another post-test three months later (post2). Furthermore, 10 participants had also been
randomly selected to form part of a pre- and post- “Journey” focus-group interview and to provide reflective essays post- “Journey”. Another focus-group interview with selected staff
members was conducted post-“Journey”.
The identified themes generated from the quantitative and qualitative data collected
were as follows: emotional intelligence; outdoor adventure education; rites of passage;
“Journey” design elements; boarding; the emotional climate of the school; division based on
stereotypes; and sustainability of skills acquired.
In terms of emotional intelligence as a theme, the results indicated that participation in
“The Journey” not only results in an increase in the overall EQ skills of participants, but that
the impact also appears to be sustainable.1 As far as the impact of “The Journey” on the
various subskills of emotional intelligence is concerned, the findings revealed that there was
an increase in all EQ subskills directly after participation (quantitative and qualitative data).
However, the results of the research proper, where pre- and post2-“Journey” scores were
compared (quantitative data), suggest that increases were maintained in only three of the five
subskills mentioned, namely intrapersonal skills, adaptability and general mood. Thus it
appears that the initial increase in interpersonal and stress management skills did not have a
sustainable effect. / Thesis (PhD)--University of Pretoria, 2013. / gm2014 / Educational Psychology / unrestricted
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Modellierung phänotypischer Beschreibungen auf der Grundlage von Bio-OntologienStumpf, Frank 19 February 2018 (has links)
Von besonderem Interesse bei dieser Arbeit ist die Ontologie PATO (für entsprechendes OBO-Dokument siehe [Gko11]). Es handelt sich dabei um eine Ontologie von Qualitäten. Dementsprechend sind dort Konzepte wie concentration of (PATO:0000033) oder color (PATO:0000014) definiert. Diese Qualitäten können in Verbindung mit Konzepten spezies-spezifischer Ontologien (z. B. ChEBI oder MA) zur Beschreibung von Phänotypen genutzt werden. Hierbei treten jedoch einige Probleme auf, die im weiteren Verlauf der Arbeit aufgezeigt und gelöst werden.
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Comparative life cycle assessment of organic building materialsYossef, Delav, Hot, Dino January 2021 (has links)
The ever-increasing awareness of global warming has made the building industry startlooking for alternative building solutions in order to meet the changing demands. Thesechallenges have given rise to organization which aim to go further and construct moresustainable alternatives in the form of Ecovillages. This thesis is conducted in collaborationwith Bysjöstrans Ekoby and aims to investigate what type of organic alternatives exist andhow they perform in building elements.The study was carried out through a comparative LCA where a base case construction forboth roof and wall was established. Followed by comparing different organic materials toeach other and the base case materials in order to determine low-impact materials. The goalwas to replaces as many layers within the structure such as insulation, structure, roofcladding, façade, wind and vapor barrier.This was later followed by combing the materials together in order to identify whichalternative construction options would perform the best in regard to greenhouse gasemissions (CO2 eq kg) and primary energy use (MJ).The results of the study show that the performance or organic materials vary significantly.Whit a lot of materials being better but also worse than traditional materials. It showed thatfor internal wall and roof surface adding clay plater can reduce the GHG emission with 68%, timber frame with 98 %, façade with 43 %, roof cladding with 93 %, vapor barrier with76 % and insulation with 79 %. The best preforming construction option could reduce thebase case emission with 68 %.
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Outcomes of tissue reconstruction in distal lower leg fractures: a retrospective cohort studyAydogan, Emrah, Langer, Stefan, Josten, Christoph, Fakler, Johannes Karl Maria, Henkelmann, Ralf 17 February 2022 (has links)
Background: Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures, or infections. This study evaluated the postoperative outcomes in patients with open or closed lower leg fractures, related soft tissue defects, and subsequent flap coverage.
Methods: We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed the patients treated from January 2012 through December 2017 and recorded demographics, treatment, and outcome data. The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.
Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent soft tissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-one patients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16 patients underwent arterial examinations via angiography and six underwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, and EQ-5D VAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular, quality of life was 32.3 ± 28.8. The rate of returning to work in our patient group was 37.5% after 1 year.
Conclusions: Distal tibial fractures often require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life, and return to work. Furthermore, patients suffering from flap ischemia have worse outcomes than those without flap ischemia.
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Using management information systems to determine the client loyalty drivers in small and medium-sized enterprises within the banking industry / Anis StewartStewart, Anna Isabella January 2013 (has links)
The landscape of banking has changed drastically over the past two decades. Client loyalty is key for banks to stay relevant and deliver sustainable growth. In that context the objective of this research is to identify the main factors that determine client loyalty of small to medium sized businesses to banks and to rank these according to importance.
The purpose of the study is using management information systems to determine the client loyalty drivers in SMEs within the banking industry as well as ranking them according to the level of importance.
The study defines and provides a broad overview of the different concepts. It further provides an overview of the banking industry and casual factors driving the need to focus on client loyalty. A high-level overview of SMEs are also covered The current problem statement has a look at the various areas of concern to the banking industry such as high level debt ratios, weak corporate demand, and more The research methodology; objectives; design; scope; significance and the limitations of the study are outlined.
Obtaining high levels of client loyalty remains a challenge for banks; failing, places banks at risk and hampers their ability to grow. MIS is the main enabler in understanding client loyalty, tracking client behaviour and changing needs. For this purpose a questionnaire was employed to obtain a deeper understanding of what drives client loyalty. A secondary source of information incorporated into the study is recent surveys done by KPMG, Accenture, Ernest & Young, and others.
The model currently used by banks is based on the net promoter system. Client satisfaction, and Relationship and Service Quality are factors that get measured and incorporated in the net promoter system. Other factors that showed relevance and impact on client loyalty are Product Quality, Skills/EQ and Corporate/brand image. The researcher aims to explain the effect and influence the aforementioned have on client loyalty as well as rank these in order of importance in small to medium-sized business banking clients in South Africa. Primary data has been used in this study complemented by secondary data. A quantitative method has been adopted for this study. The techniques employed are: Frequency, Reliability (including the mean, standard deviation & Cronbach’s Alpha coefficient) and the Spearman Rank Order Correlations.
The sample consisted of SMEs in Johannesburg Central Region and 200 questionnaires were distributed to conveniently selected SMEs out of a total population of 550. Sixty one (61) SMEs responded resulting in a 31% response rate.
The study evidenced that the factors listed are interlinked and have an influence on client loyalty. The study has also demonstrated that the link between customer loyalty and true sustainable organic growth is well established.
Limitations of the study are discussed. The researcher also recommends that a management information system be employed; that the study be extended to include large and corporate business and that the framework be broadened to include trust, product/channel, skills/EQ and brand/image. / MBA, North-West University, Potchefstroom Campus, 2014
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Justi?a como integridade : interlocu??es entre Dworkin e HegelRoesler, Ednilson Jos? 12 September 2008 (has links)
Made available in DSpace on 2015-04-14T13:54:53Z (GMT). No. of bitstreams: 1
405133.pdf: 693103 bytes, checksum: 8178bb95ced3a4332de6078959341123 (MD5)
Previous issue date: 2008-09-12 / Esta disserta??o tem como interesse principal a elucida??o da teoria da justi?a de Dworkin ? luz do pensamento hegeliano. A elabora??o desta teoria configura um marco no que se refere ao tratamento do Direito com bases fundamentais nos princ?pios. O autor empreende uma convicta luta contra os ideais do positivismo e o utilitarismo que, na sua vis?o, engessam de tal modo a aplica??o do Direito que impedem a concreta efetiva??o da justi?a. A refer?ncia ? filosofia de Hegel infere um peso filos?fico ? an?lise da teoria da integridade. A integridade ? aceita como uma virtude dial?tica que atua como mediadora do processo conflituoso verificado no ?mbito da justi?a e da equidade. O fomento desta teoria resulta de um processo interpretativo, denominado de construtivo que culmina na tese da ?nica resposta correta, artif?cio de contesta??o dos dogmatismos do positivismo. A caracteriza??o da teoria da justi?a como integridade passa pela aceita??o da comunidade dos princ?pios morais, da imbrica??o entre justi?a e moral, pelo reconhecimento do movimento interpretativo e da participa??o ativa dos processos hist?ricos na forma??o da teoria da justi?a. Estas caracter?sticas fornecem subs?dios para a vitalidade desta teoria no que tange a sua aceita??o nos meios jur?dicos e filos?ficos. A aproxima??o com o pensamento hegeliano mostra um duplo desafio: situar a teoria da justi?a como integridade no contexto filos?fico e jur?dico e analisar as contribui??es do pensamento hegeliano no fortalecimento das teorias da justi?a contempor?nea. A escolha por Hegel remonta da sua concep??o de totalidade e da possibilidade de apresentar tra?os liberais em sua teoria. A interlocu??o entre os dois autores e suas teorias ? poss?vel atrav?s da din?mica dial?tica presente em ambos. Hegel edifica todo seu sistema filos?fico sob as linhas conceituais da dial?tica. O mesmo procede em rela??o ? Dworkin que estabelece a teoria da integridade como um momento de supera??o e conserva??o dos valores presentes nos ideais superados da justi?a e da equidade. A viabilidade dessa interlocu??o s? ? poss?vel nos termos de uma poss?vel cr?tica em rela??o ?s duas teorias. Obviamente n?o h? como considerar a perfeita adequa??o de uma a outra, mas ? poss?vel uma comunica??o aberta entre elas.
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Impact of complications and comorbidities on treatment costs and health-related quality of life of patients with Parkinson's diseaseBach, Jan-Philipp, Riedel, Oliver, Klotsche, Jens, Spottke, Annika, Dodel, Richard, Wittchen, Hans-Ulrich 15 August 2013 (has links) (PDF)
Background: Data regarding both drug-related and non-drug-related costs in patients with Parkinson's disease (PD) are scarce, mainly due to the difficulties in data acquisition in experimental designs. Likewise, the reported impact of drug costs on total direct costs varies across different studies. In addition, the influence of comorbidities on both treatment costs and health-related quality of life has not been adequately evaluated.
Methods: A sample of office-based neurologists (n = 315) in Germany was asked to examine up to five consecutive patients with PD (n = 1449) on a specified day during the study period. Patients of all ages were eligible and their evaluation was performed using standardized questionnaires.
Results: PD-specific therapy costs increased with the stage of the disease, early onset of the disease and disease duration. The major costs were due to PD-related therapy, whereas other medications only resulted in minor costs. Disease stage mainly influenced direct therapy costs, with an observed increase of total daily costs from €7.3 to €11.3/day. In addition, disease onset at age < 65 years resulted in total daily costs of €11.2 compared to late onset of disease (> 75 years) with daily therapy costs of €5.3. In this patient group neuropsychiatric comorbidities such as dementia and depression were only insufficiently treated. In addition, these comorbidities severely affected health-related quality of life.
Conclusion: Therapy costs were influenced by disease stage, disease onset as well as present comorbidities. Furthermore, comorbidities such as depression and dementia were diagnosed but were not adequately treated.
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Using management information systems to determine the client loyalty drivers in small and medium-sized enterprises within the banking industry / Anis StewartStewart, Anna Isabella January 2013 (has links)
The landscape of banking has changed drastically over the past two decades. Client loyalty is key for banks to stay relevant and deliver sustainable growth. In that context the objective of this research is to identify the main factors that determine client loyalty of small to medium sized businesses to banks and to rank these according to importance.
The purpose of the study is using management information systems to determine the client loyalty drivers in SMEs within the banking industry as well as ranking them according to the level of importance.
The study defines and provides a broad overview of the different concepts. It further provides an overview of the banking industry and casual factors driving the need to focus on client loyalty. A high-level overview of SMEs are also covered The current problem statement has a look at the various areas of concern to the banking industry such as high level debt ratios, weak corporate demand, and more The research methodology; objectives; design; scope; significance and the limitations of the study are outlined.
Obtaining high levels of client loyalty remains a challenge for banks; failing, places banks at risk and hampers their ability to grow. MIS is the main enabler in understanding client loyalty, tracking client behaviour and changing needs. For this purpose a questionnaire was employed to obtain a deeper understanding of what drives client loyalty. A secondary source of information incorporated into the study is recent surveys done by KPMG, Accenture, Ernest & Young, and others.
The model currently used by banks is based on the net promoter system. Client satisfaction, and Relationship and Service Quality are factors that get measured and incorporated in the net promoter system. Other factors that showed relevance and impact on client loyalty are Product Quality, Skills/EQ and Corporate/brand image. The researcher aims to explain the effect and influence the aforementioned have on client loyalty as well as rank these in order of importance in small to medium-sized business banking clients in South Africa. Primary data has been used in this study complemented by secondary data. A quantitative method has been adopted for this study. The techniques employed are: Frequency, Reliability (including the mean, standard deviation & Cronbach’s Alpha coefficient) and the Spearman Rank Order Correlations.
The sample consisted of SMEs in Johannesburg Central Region and 200 questionnaires were distributed to conveniently selected SMEs out of a total population of 550. Sixty one (61) SMEs responded resulting in a 31% response rate.
The study evidenced that the factors listed are interlinked and have an influence on client loyalty. The study has also demonstrated that the link between customer loyalty and true sustainable organic growth is well established.
Limitations of the study are discussed. The researcher also recommends that a management information system be employed; that the study be extended to include large and corporate business and that the framework be broadened to include trust, product/channel, skills/EQ and brand/image. / MBA, North-West University, Potchefstroom Campus, 2014
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Legg-Calvé-Perthes Disease – Is it just the hip? : Epidemiological, Clinical and Psychosocial Studies with special focus on EtiologyHailer, Yasmin D. January 2014 (has links)
The overall aim of the thesis was to add some pieces to the etiological puzzle of LCPD with special focus on vascular origin and hyperactivity. Furthermore we wanted to evaluate some consequences of LCPD in adulthood. Swedish registry data were used to identify a cohort of patients with the diagnosis of LCPD. This cohort was compared with a general population– based cohort without LCPD to assess the relative risk of cardiovascular diseases, blood or coagulation defects, injury, ADHD, depression and mortality. In a clinical study we assessed health-related quality of life (EQ-5D-3L), physical activity level (IPAQ) and screened for ADHD (ASRSv1.1) in 116 patients with a history of LCPD who were diagnosed or treated in Uppsala University Hospital between 1978 and 1995. The results confirmed our hypothesis: Patients with a history of LCPD had a 1.7-fold higher risk of cardiovascular diseases, and a 1.4-fold higher risk for blood or coagulation defects compared with gender- and age-matched individuals without LCPD. We found a 1.2-fold higher risk for injuries requiring hospital admission than in gender- and age-matched individuals without LCPD. The risk was more pronounced among females. Furthermore, we found a 1.5-fold higher risk for ADHD. Stratified analysis revealed a 2.1-fold higher risk for ADHD among females with LCPD than among females without LCPD. The risk for depression was 1.3-fold higher, and more pronounced among females with LCPD. Patients with LCPD had a slightly higher mortality risk with higher risk for death from suicide and cardiovascular causes. Patients with a history of LCPD reported a lower health-related quality of life and were more physically active than the Swedish population norm. 28% of 116 patients were likely to have ADHD or had already been diagnosed with ADHD. Both vascular and blood diseases could be present even in childhood and could, in combination with hyperactive behavior pattern and a high physical activity level, contribute to the etiology of LCPD. The lower health-related quality of life and higher risk for depression might reflect the mental burden of LCPD. Patients with LCPD have a higher mortality risk with higher risk for death from suicide and cardiovascular causes.
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