Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-25T14:58:26Z No. of bitstreams: 1 Luciane Beatriz Grohs Contani .pdf: 1089734 bytes, checksum: bd72d901079afdcce655c14f8b2549a8 (MD5) / Made available in DSpace on 2016-05-25T14:58:26Z (GMT). No. of bitstreams: 1 Luciane Beatriz Grohs Contani .pdf: 1089734 bytes, checksum: bd72d901079afdcce655c14f8b2549a8 (MD5) Previous issue date: 2014-12-11 / The aim of the present study was to analyze the Oxford Foot Model (OFM) repeatability of healthy adults during two clinical tests: the Anterior Step down Test (ASDT) and the Lateral Step down Test (LSDT). Five healthy participants (one male, four females, 10 limbs in total), with a mean age of 22.2 (±4.7) years, were assessed in four sessions of tests using an interval of one week. Two independent examiners performed two sessions of each of the tests. For each session (intra-day), nine repetitions were carried out for each clinical test (ASDT and LSDT). After an interval of three hours, the data were collected once more. The tests were conducted after an interval of a week, using the same experimental conditions. The intra and inter-session repeatability of the range of motion of the foot was determined by the standard error of measurement (SEM) of each examiner and between the examiners. Differences between the test and the retest, as well as between the examiners, were assessed using the students t-test (p<0.05). The repeatability of the data was high for the two tests conducted. The SEM results were as follows: 0.26º to 1.59º for the intra-examiner assessment (ASDT); 0.28º to 1.31º for the inter-examiner comparison (ASDT); 0.02º to 1.03º for the intra-examiner assessment (LSDT); 0.28º to 1.00º for the inter-examiner comparison (LSDT). The OFM model was shown to be reproducible in terms of assessing the range of motion during functional tests (ASDT and DAS) in healthy adults. / Os modelos convencionais usados na análise tridimensional da marcha representavam o pé como um único segmento rígido. Desta forma, são considerados, na grande maioria dos laboratórios clínicos e de pesquisa, apenas os movimentos de flexão plantar e dorsiflexão devido a sua fragilidade para mensurar outros movimentos. Por ser o pé uma estrutura complexa, é necessário tratá-lo de maneira multissegmentar. Pesquisas recentes sobre a análise de marcha, têm utilizado o Oxford Foot Model (OFM), que trata o pé de forma segmentada. Uma vez que um modelo é proposto, o estudo de sua reprodutibilidade deve ser realizado em movimentos que ainda não foram estudados, no intuito de identificar possíveis variações entre os dados obtidos, pois os mesmos podem comprometer a interpretação dos resultados e a tomada de decisão clínica. Dessa forma, este estudo tem por objetivo avaliar a reprodutibilidade do Oxford Foot Model em adultos saudáveis durante testes funcionais, notadamente Single Leg Step Down Test Anterior (SDA) e Lateral Step Down Test (SDL), que são exercícios realizados em cadeia cinética fechada. Foi analisada a cinemática do pé de cinco adultos saudáveis (com idade de 22,2 +/- 4,7 anos) durante quatro sessões para cada um dos avaliadores (dois fisioterapeutas). Os resultados apontam alta reprodutibilidade do modelo para estes testes funcionais quando se analisa o erro padrão de medida e a amplitude de movimento articular. Foram encontradas diferenças estatisticamente significativas apenas em três comparações para a atividade SDL, o que aponta a reprodutibilidade do método. Para o SDA também foram encontradas três diferenças, concentradas nas comparações de mesmo dia. O presente estudo mostrou que o número mínimo de repetições (trials) é de três a cinco, por conterem menor erro padrão de medida; para fins estatísticos aqui elencados utilizaram-se cinco repetições.

付記する学位プログラム名: 充実した健康長寿社会を築く総合医療開発リーダー育成プログラム / 京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第22388号 / 人健博第74号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 黒木 裕士, 教授 高桑 徹也, 教授 妻木 範行 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Title: Effect of therapeutic physical program in patients with type 2 diabetes mellitus Objectives: The aim of my work was to examine the effect of 12 weeks therapeutic physical program on distribution of plantar pressure, muscle strength in plantar flexion, ankle range of motion and physical abilitity by patients with type 2 diabetes mellitus and diabetic foot syndrome. Methods: It was a quantitative research, randomized controlled trials. It was chosen 10 patients with type 2 diabetes mellitus and with diabetic foot syndrome. The patients were devided into 2 groups. In each group were four males and one female, aged from 54 to 73 years old. The first group included exercise patients and the second group nonexercise patients. The intervention took place 5 - 7 times a week and contained two types of training units. The first had 11 exercises, the second self mobilization of leg joint and walking. Basic anthropometric figures - height, weight, girth of waist and hipline (tailoring meter,weighing machine), ankle range of motion (goniometer), muscle strenght in plantar flexion (dynamometer), pressure distribution in stand (MobileMat), physical ability (Senior Fitness Test) were measured and compared in two groups after 12 weeks. The results were evaluated statistically in tables. Results: The...

Foot-and-mouth disease (FMD) is a highly contagious disease caused by the FMD virus (FMDV) belonging to the Picornaviridae family. The virus affects cloven-hoofed animals and occurs as seven immunologically distinct serotypes where six of the seven serotypes occur in Africa. This fact, as well as the role of wildlife in virus maintenance, makes eradication and control of FMDV in Africa difficult. Thus, it is imperative to attain more information regarding the genetic diversity of FMD viruses prevalent on the African continent to further our knowledge of the virus as well as to enable better control strategies and the development of improved vaccines. Sufficient genetic information regarding the Leader (L) and complete capsid-coding, P1, region of serotype A and O viruses prevalent on the African continent is lacking, although the SAT isolates have been extensively characterised in the past. In this study the sequence of the L/P1-coding region was successfully determined using a genome-walking approach for a small number of A and O viruses recovered from outbreaks isolated from various species in East and West Africa over the last 33 years. Phylogenetic analysis of the P1 and capsid-coding regions 1A, 1B, 1C and 1D revealed that the African isolates grouped strictly according to serotype and geographic region which indicated the possibility of transboundary spread of the virus within East and West African countries respectively. In contrast, phylogenetic analysis of the non-structural, Lpro-coding region revealed a different tree topology compared to the capsid-coding regions for the A and O isolates with sub-grouping according to serotype and geographic regions was less apparent. The relatedness between the serotype A and O L region might be the result of genetic recombination. The inter and intratypic nucleotide and amino acid variation of the A and O isolates revealed that the most variable capsid-coding region was the externally located VP1 whilst the internally located VP4 capsid protein was the most conserved. The observed variation is in agreement with other studies and reflects the selective pressures on these proteins which either allow or prevent the occurrence of genetic changes for structural constraints or immune escape. Surprisingly, the L protease-encoding region also displayed a high degree of variation. A detailed analysis of the L/P1 amino acid alignment of the A and O isolates revealed that although the extent of variation is high in these regions, the amino acids identified in previous studies as important for FMDV structure (for the capsid-coding regions) and function were found to be conserved, indicating that the virus has adapted itself to elude the host immune response without affecting its vital functional and structural abilities. Additionally, it was observed that the amino acid residues identified as being important for FMDV attaching to the host cell receptors e.g. the RGD amino acid motif of VP1 was highly conserved for all isolates. To further investigate the FMDV-receptor interaction, RT-PCRs were developed to examine the mRNA expression level of the known FMDV receptors. The â integrins that facilitate FMDV cell entry i.e. â1, â3, â6, â8 and heparan sulphate proteoglycans (HSPG) were investigated in susceptible cell lines used for FMDV vaccine production i.e. IB-RS-2 and BHK-21. The RT-PCRs were successfully developed and optimised. The results showed that the mRNA expression levels were variable for all receptor cDNAs tested across 36 passage levels of IB-RS-2 and BHK-21 cells. No distinct differences in virus susceptibility for three FMDV strains with continuous cell passage of IB-RS-2 and BHK-21 cells at passage levels 5, 21 and 36 could be found. The information gained from this study regarding the viral L and P1 region genetic diversity, and phylogenetic analysis has indeed impacted on our understanding of FMDV African viruses. Additionally, the investigation of the FMDV receptor mRNA expression levels and virus susceptibility on two cell lines with continuous cell passage has proved a vital starting point to determine the possible receptors expressed on the surface of cells used by the vaccine production division at the ARC-OVI-TADP and forms the basis for further investigations of the FMDV receptors on the protein level and the development of a real-time RT-PCR for FMDV receptor expression. / Dissertation (Msc)--University of Pretoria, 2008. / Veterinary Tropical Diseases / unrestricted

Glomerular derangement is the major feature of a diverse array of kidney disorders that lead to end-stage kidney disease (ESKD). Podocyte dysfunction is central to the underlying pathophysiology of many common glomerular diseases, including diabetic nephropathy (DN), focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD), and genetic forms of nephrotic syndrome, and is associated with heavy proteinuria. Loss of podocyte foot process structure, or effacement, is the key feature of podocyte injury in these proteinuric glomerular disorders, also called "podocytopathies". However, the degree of effacement can vary: For instance, it is very disseminated (diffuse) in minimal change disease, but more variable (segmental) in focal segmental glomerulosclerosis. Recent work has shown that nephrin, ROBO2, and SLIT2 are proteins implicated in these podocyte foot process effacement and podocytopathy. We sought to evaluate changes in the expression of these proteins using immunofluorescence microscopy, and the degree of foot process effacement in podocytopathies using ultrastructural morphometry. In podocytopathies, we saw increased expression of ROBO2 and decreased expression of nephrin indicating that, upregulation of ROBO2 may lead to podocyte injury and podocyte injury may result in loss of nephrin. In addition, SLIT2, which binds ROBO2, was found in tubules and in glomeruli. A higher degree of geometric mean foot process width was vii observed in podocytopathies as compared to normal kidney. These findings can be used in the clinical setting to diagnose and monitor disease treatment. / 2024-02-07T00:00:00Z

<p> A key mechanism to maintain balance during walking is the foot placement strategy,  where the person steps in the direction of an impending fall. On a clear walkway, the foot  placement strategy translates to maintaining a consistent relationship between the center of mass  state and the base of support (a body-centric constraint on foot placement), which is reflected in  a consistent step length. However, to safely navigate in the community, foot placement must  maintain certain spatial relations with environmental features as well (environmental constraints on foot placement). For stepping over obstacles, the environmental constraint takes the form of  targeting. That is, the feet must be placed at precise locations relative to the obstacle to minimize  the likelihood of tripping.  My dissertation focused on proactive adaptations to foot placements while navigating  cluttered environments. I developed the interstep covariation (ISC) index that quantifies the covariation between consecutive foot placements relative to stationary, visible environmental  features (an obstacle and a visual target). The across-step (or group) changes in this index  indicate how the two constraints (body-centric and environmental) on foot placement are  managed during adaptive gait tasks. I quantified how the ISC index changed (1) across steps  while approaching and crossing an obstacle, (2) due to healthy aging and (3) when the proximity  of two environmental features was systematically altered. Specifically, in Study 1, the ISC index  was quantified for the obstacle crossing step for healthy younger and older adults. In Study 2, proactive changes in the ISC index as healthy young adults approached and crossed an obstacle were characterized. In Study 3, the changes in the dynamics of the across-step ISC index due to  an additional visual stepping target in the approach to the obstacle were identified.  I found that there exists a covariance strategy that healthy adults use to navigate the  environment safely and successfully. First, I found that individuals prioritize the environmental  constraint at the expense of the body-centric constraint when the environment poses a larger risk  to balance (the obstacle), or to satisfy a specified constraint (stepping on a visual target). Second,  I found that the shift in prioritization is proactive, i.e., it occurs while approaching an obstacle.  The strategy to shift priorities is influenced by age (Study 1), environmental features (Study 2  and Study 3), and the proximity of two environmental features (Study 3). These studies add to  the current understanding of foot placement control by demonstrating how this well-known and 15 fundamental strategy to maintain balance while walking is systematically influenced by the  environment and task constraints. These findings can be further extended to study proactive and  reactive adaptations during walking in different populations.   </p>

Preventing diabetic foot ulcers among patients diagnosed with diabetes is an important element of care as diabetic foot ulcers present major medical, psychosocial and economic threats. In addition, about 20% of the diabetic foot ulcer cases will ultimately require amputation and cause greater mortality rates. The purpose of this literature review was to evaluate cellphone use to promote diabetic foot care practices among patients with diabetes. Six electronic databases were searched for articles which included text messaging and or phone interventions geared at improving foot care practices. A total of 14 articles dated 2009-2019 met the inclusion criteria and were included in the review. Cellphone use for text messaging and phone calls to advance diabetic foot care practices appears to be promising. Cellphone interventions among clients diagnosed with diabetes were found to have higher adherence with foot examinations, more frequent foot checks, and better overall performance score of diabetic foot ulcer preventive behaviors. This literature review supports cellphone use for text messaging and phone calls to improve diabetic foot care practices. Particularly among populations with health disparities and limited access to healthcare cellphone improves access to care, is uncomplicated and presents a cost-effective approach to improving diabetic foot care practices.

No description available.

Yes / To explore the perception of healthcare workers (HCWs) on diabetic foot ulcers (DFU) and foot care in Rotuma, Fiji. Using a qualitative study design, two focus group discussions (FGDs) were conducted among HCWs. A semistructured open-ended questionnaire was used to guide the discussion session. Each FGD was audiorecorded and was transcribed. The transcriptions were then manually analysed using thematic analysis. Rotuma hospital, Fiji. HCWs who were working in Rotuma hospital for at least a year and were involved in clinical foot care of type 2 diabetes mellitus patients were included. There were five main themes, namely, depth of knowledge, quality of care in practice, factors of influence on practice, lack of resources and capacity building. Participants had superficial knowledge that showed lack of in-depth scientific knowledge. A lack of staffing in the clinics affected the delivery of service. Additionally, patients defaulting clinics, late presentations with DFU and traditional medicine also affected the quality of healthcare service in clinics. There was also a need for a multidisciplinary team to prevent and manage DFU. HCWs mostly advised on glycaemic control and ignored offering foot care advice in clinics due mainly to the lack of sound knowledge on foot care. There was also a lack of resources, infrastructure, space and professional development opportunities, which negatively impacted how HCWs deliver foot care services to patients. HCWs lack significant in-depth knowledge on DFU and foot care. In addition, these are the availability of traditional medicine that delays presentations to hospital, further reducing the quality of services. HCWs need to keep their knowledge and skills updated through regular in-service training on foot care. Resources, infrastructure and supply chains need to be maintained by those in power to ensure HCWs deliver quality foot care services.

Diabetes är en sjukdom som i många fall kan leda till olika senkomplikationer, en av dem är fotsår. Att leva med diabetiska fotsår kan inverka på livskvaliteten, därför är det viktigt att få kunskap om vad som påverkar livskvaliteten för att kunna ge bättre omvårdnad och öka välbefinnandet. Syftet var att belysa vad som påverkar livskvaliteten hos personer med diabetiska fotsår. Datainsamlingen resulterade i 12 artiklar som besvarade studiens syfte. Granskning av artiklarna genomfördes och data kategoriserades. Fem kategorier framkom som visade att rädsla, smärta, immobilitet, kunskap och stöd påverkade livskvaliteten hos personer med diabetiska fotsår. Det fanns en rädsla för fördröjd sårläkning, utveckling av nya sår och att i framtiden eventuellt behöva amputera. Smärta från diabetiska fotsår upplevdes som frustrerande och var en av orsakerna till immobilitet vilket i sin tur skapade social isolering. Kunskap var betydelsefullt för att kunna förebygga uppkomsten av nya fotsår och för att de drabbade skulle kunna söka vård tidigare. För att kunna hantera vardagen var det därför viktigt att få stöd från olika personer i omgivningen. Sjuksköterskan kan förbättra omvårdnaden och skapa förutsättningar för bättre livskvalitet genom att se människan bakom fotsåret. / Diabetes is a disease which in many cases leads to various complications, one of them is foot ulcers. Living with diabetic foot ulcers can affect the quality of life, therefore it is important to gain knowledge about what affects the quality of life in order to provide better care and improve well-being. The aim was to highlight aspects that affects the quality of life in people with diabetic foot ulcers. The data collection resulted in 12 articles who responded to the purpose of the study. The examination of the articles was conducted and data was categorized. Five categories emerged which showed that fear, pain, immobility, knowledge and support affected the quality of life among people with diabetic foot ulcers. There was a fear of delayed wound healing, development of new wounds, and for the risk of amputation in the future. Pain from diabetic foot ulcers was perceived as frustrating and was one of the causes of immobility, which in turn created the social isolation. This knowledge was important in order to prevent the occurrence of new foot ulcers so that those affected could seek treatment earlier. In order to manage everyday life, it was therefore important to receive support from different people in the surrounding. The nurse can improve the care and create better quality of life by seeing the person behind the foot ulcer.