Purpose: Transitioning into retirement may be a suitable period to help adults establish an active lifestyle. One innovative approach to promote PA may be through multimedia-based programs. This experiment aimed to explore the feasibility DVD and videogame-based exercise programs in promoting physical activity (PA) in adults transitioning into retirement. Underlying motivations, functional fitness, quality of life, and elicited beliefs from participating in the exercise programs were also explored. Methods: Twenty-seven adults were randomized into either a nine-week exercise DVD (n = 9), exergame (n = 9), or waitlisted control group (n = 9). Main outcomes include adherence was based on attendance during the in-lab component and participant logs during the in-home component. PA levels were measured through accelerometery and assessed at baseline, four-, nine- and 12-weeks. Secondary outcomes related to motivation were assessed at baseline, three- and nine-weeks. Tertiary outcomes such as physiological/functional fitness and quality of life outcomes were assessed at pre- and post-intervention. Results: During the in-lab portion, t-tests showed that adherence was slightly higher in the exergame group than the DVD group (t16 = -0.06, p = .96; d = .31). Repeated measures of analysis showed that the group x time interaction for moderate-to-vigorous physical activity (MVPA) (F2,24 = 0.87, p = .52; η2 = .05), while overall PA saw negligible changes (F2,24 = 0.16, p = .85; η2 = .01). At the end of the intervention, overall adherence was similar between both exercise groups (t16 = -0.06, p = .96; d = .03). The group by time interaction effect yielded a moderate effect size for MVPA (F2,24 = 1.07, p = .36; η2 = .08) and overall PA (F2,24 = 1.11, p = .35; η2 = .08). Overall PA only increased in the exergame group (d = .74). The exergame group saw major decreases in instrumental attitude (d = .64), injunctive norm (d = .79), perceived behavioural control (d = .40) and intention (d = .90). Both exercise groups enhanced strength, mobility, and aerobic endurance outcomes (d = .33-.98), as well as several quality of life domains (d = .32-.89). At the post-intervention follow-up, both exercise groups were more active than the control group (d = .49-1.03). Two-thirds of the DVD group adopted DVD-based exercise, while a third of exergame group adopted videogame-based exercise. Conclusions: With a high adoption rate, DVD-based exercise programs may be a feasible and acceptable approach to promote PA levels. Participants in both groups were generally satisfied, indicating that the exercise program was enjoyable, comprehensive, and a simple and convenient way to exercise at home. Improvements to important functional and quality of life domains were also identified. Further research will be required to fully test the effectiveness of exercise DVDs and exergames on adherence and PA behaviour in adults transitioning into retirement. / Graduate / 0384 / christopher.yao7@gmail.com

Introduction Occupational therapists are concerned with enabling people to perform the daily life tasks they need, want, or are expected to perform for fullest possible integration into community living and participation in society. Children with mild disabilities have problems performing personal and instrumental activities of daily living (ADL) tasks at home or school, and that can limit their full integration and participation in their homes and school lives. There is a need, therefore, to identify their specific problems with ADL task performance so as to be able to develop effective interventions. Not only, there is a need for evidence related to effectiveness of occupational therapy interventions for children with mild disabilities, but also a need for valid occupational-therapy-specific evaluation tools for use with children. Purpose The purpose of this thesis was to contribute evidence to support the valid use of the Assessment of Motor and Process Skills (AMPS) with children, including children living in Middle Europe. More specifically, I aimed to evaluate validity evidence from different sources related to the use of the AMPS in occupation-based and occupation-focused evaluation and intervention. Method This thesis consisted of four studies, implemented in two phases. Phase one focused on evaluation of a) validity evidence of the AMPS scales in relation to internal structure and stability of item difficulty calibration values for a Middle European sample compared to samples from other world regions (Study I); b) the stability of the mean AMPS measures between typically-developing children from Middle Europe and from other world regions (Study II); and c) the sensitivity of the AMPS measures to discriminate between typically-developing children and children with and at risk for mild disabilities (Study III). Participants for phase one were from both Middle Europe and from other world regions and they were selected from the AMPS database, Ft. Collins, Colorado, USA. Data were analyzed using many-facet Rasch analyses, ANOVAs, regression analyses, related post-hoc tests, and effect size calculations. Phase two of the research project focused on evaluating validity evidence for the use of the AMPS as a standardized, occupation-based, and occupation-focused evaluation tool in the context of a feasibility study with children with mild disabilities implemented in a Swiss setting (Study IV). Data were analyzed based on feasibility objectives and the principles of deductive content analysis. The evaluation of validity evidence of the AMPS in relation to consequences of testing and test fairness was a focus of all studies (Studies I to IV). Results In Study I, data for 1346 participants from Middle Europe and 144,143 participants from other world regions were analyzed. The participants were between the ages of 3 and 103 years, and they were well or had a variety of diagnoses. The results revealed that overall the item difficulty calibration values of the AMPS remained stable and that only one out of 36 ADL items of the AMPS demonstrated DIF, but this DIF did not lead to DTF (i.e., all measures fell within 95% confidence bands). In Study II, data for 11,189 typically-developing children from Middle Europe and other world regions who were between the ages of 2 and 15 were analyzed. The results of ANOVAs revealed significant effects for mean ADL motor and for ADL process ability measures by region and a significant age by region interaction effect for mean ADL process ability. Out of 168 estimated contrasts between Middle Europe and the other world regions for mean ADL motor and ADL process ability, only seven were statistically significant (4.17%), and only two were more than ±1 SE from the international means. In Study III, regression analyses of data for 10,998 children, 4 to 15 years, who were typically-developing or with mild disabilities, revealed significant age by group interaction effects. Post hoc t tests revealed significant group differences in ADL ability at all ages beyond the age of 4. ADL process ability effect sizes were moderate to large at all ages and ADL motor ability effect sizes were mostly moderate to large age 6 and above. In Study IV, the use of the AMPS within the context of a feasibility study based on data of 17 Swiss children with mild disabilities was evaluated. The analyses revealed several strengths and problems that were related to the time, equipment, and materials for administering the AMPS, the adherence to standardized administration procedures, the scope of the AMPS as a test of ADL performance, and the reliable rating by the blinded rater. Conclusion This thesis provided evidence to support the validity of the AMPS measures and scales when used to evaluate quality of ADL task performance of persons from Middle Europe. Additionally, this thesis provided evidence that the international age-normative means of the AMPS are likely applicable to children from Middle Europe. Moreover, the findings supported the sensitivity of the AMPS measures to discriminate between typically-developing children and children with and at risk for mild disabilities. When it comes to implementation of the AMPS in the context of a feasibility study, the findings indicated both strengths and problems in using the AMPS as an outcome measure that need to be considered when planning further studies.

No description available.

Background: Home visits are part of general practice work in Germany. Within the context of an expanding elderly population and a decreasing number of general practitioner (GPs), open questions regarding the organisation and adequacy of GPs’ care in immobile patients remain. To answer these questions, we will conduct a representative primary data collection concerning contents and organisation of GPs’ home visits in 2014. Because this study will require considerable efforts for documentation and thus substantial involvement by participating GPs, we conducted a pilot study to see whether such a study design was feasible. Methods: We used a mixed methods design with two study arms in a sample of teaching GPs of the University Halle. The quantitative arm evaluates participating GPs and documentation of home visits. The qualitative arm focuses on reasons for non-participation for GPs who declined to take part in the pilot study. Results: Our study confirms previously observed reasons for non-response of GPs in the particular setting of home visits including lack of time and/or interest. In contrast to previous findings, monetary incentives were not crucial for GPs participation. Several factors influenced the documentation rate of home visits and resulted in a discrepancy between the numbers of home visits documented versus those actually conducted. The most frequently reported problem was related to obtaining patient consent, especially when patients were unable to provide informed consent due to cognitive deficits. Conclusions: The results of our feasibility study provide evidence for improvement of the study design and study instruments to effectively conduct a documentation-intensive study of GPs doing home visits. Improvement of instructions and questionnaire regarding time variables and assessment of the need for home visits will be carried out to increase the reliability of future data. One particularly important methodological issue yet to be resolved is how to increase the representativeness of home visit care by including the homebound patient population that is unable to provide informed consent.

The central nervous system is the most likely target of mobile telephony radiofrequency field (RF) exposure in terms of biological effects. Several EEG (electroencephalography) studies have reported variations in the alpha-band power spectrum during and/or after RF exposure, in resting EEG and during sleep. In this context, the observation of the spontaneous electrical activity of neuronal networks under RF exposure can be an efficient tool to detect the occurrence of low-level RF effects on the nervous system. In this thesis research work we developed a dedicated experimental setup in the GHz range for the simultaneous exposure of neuronal networks and monitoring of electrical activity. A transverse electromagnetic (TEM) cell was used to expose the neuronal networks to GSM-1800 signals at a SAR level of 3.2 W/kg. Recording of the neuronal electrical activity and detection of the extracellular spikes and bursts under exposure were performed using Micro Electrode Arrays (MEAs). This work provides the proof of feasibility and preliminary results of the integrated investigation regarding exposure setup, culture of the neuronal network, recording of the electrical activity and analysis of the signals obtained under RF exposure. In the main experiment (16 cultures), there was a 30% reversible decrease in mean firing rate (MFR) and bursting rate (BR) during the 3 min exposures to RF. Additional experiments are needed to further characterize this effect, especially in terms of temperature elevation at the microscopic level.

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Thesis (Master').

Bibliography / Thesis (MPhil (Journalism))--University of Stellenbosch, 2010.

[pt] A tomada de decisão de investimento em projetos de serviços pós-venda deve incluir, como etapa anterior, o levantamento dos custos logísticos de sua operação, que podem ser de transporte, provenientes, por exemplo, da roteirização de visitas, e logísticos e tributários se a operação envolver importação de equipamentos/peças. O objetivo deste trabalho envolve a identificação dos processos e custos e a avaliação de uma oportunidade de investimento neste contexto, mensurando o valor que projetos dessa natureza podem apresentar. Sua viabilidade econômica é analisada sob a ótica dos modelos tradicionais de análise de investimento e também sob a abordagem da Teoria das Opções Reais, método de avaliação que considera as flexibilidades gerenciais e modela as variáveis de incertezas do projeto por meio de processos estocásticos. O resultado das análises permite a comparação da viabilidade do projeto de implementação de uma van itinerante de reparos caso a decisão possa ser postergada ou nem mesmo tomada, considerada como uma opção perpétua. São modeladas duas variáveis estocásticas, demanda e taxa de câmbio Real/Dolar, ambas como um Movimento Geométrico Browniano por meio de Simulação de Monte Carlo. Os resultados obtidos indicam a viabilidade do projeto e sugerem o exercício imediato da opção de investir. Deste modo, disponibilizar um serviço pós-venda pode ser atraente para a empresa do ponto de vista econômico-financeiro, além de trazer benefícios aos clientes. Foi, adicionalmente, avaliada a influência dos parâmetros de volatilidade do projeto e de crescimento das variáveis estocásticas a fim de fazer uma análise de sensibilidade para os resultados encontrados. / [en] Prior to taking investment decision in after-sales services projects, the logistics costs of its operations must be known and considered, they may include transportation costs, originated from routing, and logistics and import tax related costs if the project considers the import of equipment/parts. The aim of this dissertation involves the identification of those processes and costs and the valuation of an investment opportunity in this sense, measuring the value that similar projects may present. The economic viability of the project is analyzed from the perspective of the traditional models of investment analysis and also with the approach of the real options theory, a valuation method that considers the managerial flexibilities and that models the uncertainties of the project as stochastic processes. The result of the analyses allows the comparison of the viability of implementing a project for a mobile repair and service van in case the investment decision can be postponed or even not taken, considering it as a perpetual option. Two stochastic variables are modeled in this project, the demand and the RealBRL/DollarUSD exchange rate, both as a Geometric Brownian Motion through Monte Carlo simulation. The results indicate the viability of the project and suggest the immediate exercise of the option to invest. This way, offering after-sale services can be attractive to the company, from an economic and financial perspective, besides offering benefits to customers. Additionally, the influence of the project volatility and the stochastic variables growth parameters were tested through sensitivity analysis for the obtained results.

p. 1-125 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-23T17:34:46Z No. of bitstreams: 1 2222.pdf: 2507518 bytes, checksum: 8106c62d2cb88f8f99606dfdd7859301 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:28:22Z (GMT) No. of bitstreams: 1 2222.pdf: 2507518 bytes, checksum: 8106c62d2cb88f8f99606dfdd7859301 (MD5) / Made available in DSpace on 2013-05-04T17:28:22Z (GMT). No. of bitstreams: 1 2222.pdf: 2507518 bytes, checksum: 8106c62d2cb88f8f99606dfdd7859301 (MD5) Previous issue date: 2010 / A regulação dos leitos hospitalares do SUS no Brasil vem sendo realizada por Centrais Estaduais e ou Municipais de Regulação. O Estado da Bahia, desde 2003, vem tentando regular os leitos hospitalares do SUS no município de Salvador. No entanto, os usuários que acessavam o sistema pelas portas de entrada das emergências tinham dificuldade em conseguir vagas em outras unidades, muitas vezes iam a óbito sem acesso a um leito hospitalar. O projeto de implantação das comissões permanentes de regulação, controle e avaliação de leitos em alguns hospitais visa melhorar a resolutividade da Central Estadual de Regulação. Esse estudo foi uma pré-avaliação do tipo avaliabilidade desse projeto. Para isso, foi realizada a análise documental, entrevistas com informantes-chave, a observação das práticas destas comissões e a elaboração de um modelo lógico. O estudo foi realizado em Salvador, na comissão do Hospital Geral do Estado (HGE). Observou-se que a intervenção aumentou a saída dos pacientes dos corredores do HGE e qualificou as transferências desses pacientes. Contudo, não há governabilidade da CER sobre os leitos da rede hospitalar conveniada, o que reduz o êxito desse projeto. Sugere-se a instalação de comissões dessa natureza nos hospitais fora da rede própria. O estudo aponta ainda outros focos para avaliação futura, como a relação entre o número de leitos existentes hoje no município de Salvador e a necessidade real de internação para população própria e referenciada, o grau de utilização dos leitos existentes de acordo com a necessidade do sistema, a relação entre o público e o privado na oferta de leitos para o sistema, e o mesmo, considerou que é necessário a implantação de comissões permanentes de regulação, controle e avaliação em todos os grandes hospitais de leito retaguarda em Salvador. / Salvador