A user (or human) mobility context is defined as a type of user context that describes a type of whole body posture (e.g., standing versus sitting) and/or a type of travel or transportation mode (e.g., walking, cycling, travel by bus, etc). Such a context can be derived from low-level sensor data and spatial contexts, including location coordinates, 3D-orientation, direction (with respect to magnetic north), velocity and acceleration. Different value-added services can be adapted to users’ mobility contexts such as assessing how eco-friendly our travel is, and adapting travel information services such as maps to different transportation modes. Current sensor-based methods for user mobility detection have several key limitations: narrow range of recognition, coarse user mobility recognition capability, and low recognition accuracy. In this thesis, a new Foot-Force and GPS (FF+GPS) sensor method is proposed to overcome these challenges that leverages a set of wearable FF sensors in combination with mobile phone GPS. The novelty of this approach is that it provides a more comprehensive recognition capability in terms of reliably recognising various fine-grained human postures and transportation modes. In addition, by comparing the new FF+GPS method with both an accelerometer (ACC) method (62% accuracy) and an ACC+GPS based method (70% accuracy) as baseline methods, it obtains a higher accuracy (90%) with less computational complexity, when tested on a dataset obtained from ten individuals. In addition, the new FF+GPS method has been further extended and evaluated. More specifically, the trade-off between the computation and resources needed to support lower versus higher number of features and sensors has been investigated. The improved FF+GPS method reduced the number of classification features from 31 to 12, reduced the number of FF sensors from 8 to 4, and reduced the use of GPS in mobility activity recognition.

Soft tissue infection in a diabetic foot with an ulcer is often clinically obvious but the diagnosis of osteomyelitis underlying a diabetic foot ulcer is challenging. It has been calculated that there are over 1 million amputations worldwide for diabetes related complications every year, many preceded by an ulcer complicated by osteomyelitis. <br /> This research encompasses two studies attempting to add to the ways in which osteomyelitis is diagnosed. <br /> The first was examining the role of inflammatory blood markers in recognising and separating ulcers with cutaneous infection from both suspected and proven osteomyelitis. The response of the body to produce these markers when an injury occurs is well known but arguments exist as to the capacity of the individual with diabetes to do so. Despite the recognition and allowance for common confounding factors no trend was found. This study may have been more difficult than originally thought due to the many interactions of the diseased state of diabetes, the drugs used to control it and the many other confounders that would have influenced the inflammatory process and as such the level of the markers. <br /> The second study was comparing a new form of scanning technique (SPECT/CT) to the technique most commonly used as a ‘gold standard’ – MRI. The results of each type of scan were compared to the clinical diagnosis and each other. The SPECT/CT scan appears to show some good results and may be a more suitable scan for individuals who are unable to have a MRI for example due to the need to introduce a renally excreted drug to help make the images clearer but it does mean introducing a small amount of radiation into the individual.

Orientador: Ana Maria Minarelli Gaspar / Coorientador: Sidney Jose Lima Ribeiro / Coorientador: Helena Megumi Sonobe / Banca: Marlus Chorilli / Banca: Rondinelli Donizetti Herculano / Banca: Carlos Alberto Fortulan / Banca: Eliana Cristina da Silva Rigo / Resumo: Feridas crônicas são multifatoriais e resultantes do processo de cicatrização inadequada, no qual não ocorre reparação tecidual ordenada e temporal, ou ainda, há ausência de restauração anatômica e funcional completa, comprometendo a vida cotidiana dos indivíduos. Para a melhoria da assistência à saúde destas pessoas, buscou-se uma alternativa de cobertura com a utilização de membrana de celulose bacteriana (CB), por esta ser biodegradável, biocompatível, não tóxica e não alergênica, na aplicação na pele com área queimada ou lesada e para alívio da dor; foi associada à membrana um medicamento anti-inflamatório, aprovado pela Agência Nacional de Vigilância Sanitária (ANVISA) e já comercializado. Assim, o objetivo deste estudo foi desenvolver cobertura de CB incorporado com antiinflamatório Ibuprofeno (CB/Ibu) e avaliar a utilização em pacientes com feridas crônicas vasculogênicas de membros inferiores. Foram utilizadas membranas de celulose, obtidas com o cultivo de bactérias Gluconacetobacter xylinus com incorporação do anti-inflamatório Ibuprofeno e avaliadas por diferentes técnicas físico-químicas como MEV (Microscopia Eletrônica de Varredura), Difração de Raios X, TG (Análise Termogravimétrica), DSC (Calorimetria Exploratória Diferencial), Infravermelho, UV-vis (Espectroscopia Eletrônica na região do UV-Visível); ensaios de proliferação celular com fibroblastos cultivados testes de liberação do Ibuprofeno e da membrana de CB/Ibu e os testes de permeação e retenção de Ibupr... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

O objetivo deste estudo foi adaptar e validar o Foot Health Status Questionnaire (FHSQ) avaliando suas propriedades de medida. Este instrumento foi traduzido, traduzido de volta para o inglês, avaliado por comitê multidisciplinar e submetido a pré-teste, gerando o FHSQ-Br. O FHSQ-Br foi submetido a teste de campo em um grupo de estudo composto por 65 pacientes com Artrite Reumatóide (AR) para avaliar a confiabilidade teste-reteste, a consistência interna e a validade do construto. A validade do construto foi testada correlacionando os escores do instrumento com dados clínicos e laboratoriais usados para avaliar a AR. Este estudo demonstrou que o FHSQ-Br é um instrumento confiável, consistente e válido, útil na avaliação da saúde dos pés, sendo passível de adaptação para diferentes culturas / The purpose of this study was to conduct a cross-cultural adaptation and validation of the Foot Health Status Questionnaire (FHSQ) evaluating its measurement properties. All ten domains of the FHSQ were translated into Portuguese by two Brazilian translators creating Version 1. This version was back-translated by two native English-speaking teachers who made suggestions for Version 1, creating Version 2. A multidisciplinary committee was formed to test the instrument’s semantic, idiomatic, experiential and conceptual equivalences. After being reformulated and approved by the committee, Version 3 was pre-tested on a group of patients from the Rheumatology Service of the Hospital das Clínicas. They answered this version and made suggestions for the better understanding of the instructions, questions and response option. The FHSQ-Br was then created. The translated and adapted version was submitted to field test on a study group composed of sixty-five Rheumatoid Arthritis (RA) patients to evaluate test-retest reliability, internal consistency and construct validity. The construct validity of the FHSQ-Br was tested correlating the scores to clinical and laboratory parameters commonly used to assess RA (Health Assessment Questionnaire; Numbered Rating Scale for foot pain; foot X-rays; erythrocyte sedimentation rate and C-reactive protein). The cultural adaptation of the FHSQ was successfully accomplished, since patients suggested changes in only three items of the instrument during the pre-test phase. In the field test, the intra-class correlation coefficients showed high reliability for both intra- and inter-observer correlations. Internal consistency coefficients were statistically significant (p<0.05) for all domains. As for the evaluation of the construct validity, each domain revealed correlations with a specific group of parameters, according to what the domains were intended to measure. The FHSQ was cross-culturally adapted generating a reliable, consistent and valid instrument. This study has proven the FHSQ-Br to be a useful tool to evaluate foot health in systemic diseases and is easily adaptable to different cultures

Plantar foot stress causing foot ulceration is a diabetic complication causing major economic burden throughout the world. It has long been thought that shear stresses on the plantar surface of the foot are a major contributing factor to the formation of these ulcers. Although there are many instruments available that measure the vertical foot pressure (vertical forces), there are currently no commercially available instruments to measure the horizontal or shear forces. It is the aim of this project to develop a platform instrument capable of measuring the three dimensional forces (i.e. vertical pressure and shear forces) across the plantar surface of the foot.

O design de calçados para a população com diabetes exige conhecimento e especialização, sensibilidade e técnica em um projeto que compreenda as delicadas necessidades e que procure trazer soluções aos problemas e dificuldades das pessoas usuárias acometidas por doença crônica. Nesse sentido, em um projeto desses calçados deve-se considerar as expectativas e realidade do público diabético para além da patologia em si, visando-se o conforto em sentido amplo e a satisfação do usuário. Nesta investigação, características do chamado pé diabético foram levantadas, assim como as respectivas necessidades para analisar o papel do design diante desse problema, visando-se projetivamente a saúde e conforto de usuários, bem como uma melhor noção de calçados de acordo com a situação de risco relacionado ao pé diabético e, principalmente, em relação à função preventiva contra lesões e respectivas complicações decorrentes do diabetes. Embora existam modelos de calçados que auxiliam na manutenção da saúde dos pés, observou-se que a população com diabetes desconhece sua existência e importância / The design of footwear for the population with diabetes requires knowledge and expertise, sensitivity and technique in a project that both comprehends the delicate needs and that looks for solutions to the issues and difficulties of the users who suffer from this chronic disease. Thereby, in a project of such a specific footwear one must consider the expectations and reality of the diabetic public beyond the pathology itself, aiming at the comfort in a broad sense and the satisfaction of the user perceived as a human being. In this investigation we have raised characteristics of the so-called diabetic foot and their respective needs to analyse the role of design in face of this problem. Besides, this project focus on the health and comfort of users, as well as a better notion of shoes according to the situation of risk related to the diabetic foot and, especially, in relation to the preventive function against injuries and respective complications of diabetes. Although models of footwear exist to help maintaining the feet healthy, it was observed that the diabetic population is unaware of its existence and importance

Cheng, Yuk Lap. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 64-67). / Abstracts in English and Chinese; appendix and questionnaire also in Chinese. / ACKNOWLEDGEMENT --- p.I / ABSTRACT --- p.II / TABLE OF CONTENT --- p.V / LIST OF FIGURES --- p.VII / LIST OF TABLES --- p.VIII / Chapter I --- INTRODUCTION --- p.1 / Background --- p.1 / Statement of Problem --- p.3 / Hypothesis --- p.3 / Significance of Study --- p.4 / Theoretical Contribution --- p.4 / Practical Contribution --- p.4 / Operational Definition --- p.5 / Chapter II --- REVIEW OF LITERATURE --- p.7 / Problem of poor fitting --- p.7 / Common foot problem --- p.10 / Definition of fit --- p.11 / Recommendation of shoe fit --- p.13 / Sizing --- p.13 / Pressure distribution --- p.14 / Subjective fit --- p.15 / Footwear Comfort --- p.15 / Chapter III --- METHODOLOGY --- p.18 / Design --- p.18 / Subject --- p.18 / Instrumentation --- p.18 / Fit questionnaire --- p.18 / Foot scanner --- p.19 / Pressure sensors --- p.19 / Running shoes --- p.20 / Shoe lasts --- p.20 / Procedure --- p.21 / Foot scanning --- p.22 / Fit questionnaire --- p.24 / Set up --- p.24 / Reliability test --- p.25 / Pressure measurement --- p.25 / Data Reduction --- p.29 / Foot scanning --- p.29 / Fit questionnaire --- p.29 / Video --- p.29 / Pressure distribution --- p.30 / Data Analysis --- p.30 / Chapter IV --- RESULT --- p.32 / Subject Detail --- p.32 / Questionnaire --- p.32 / Fit Rating --- p.37 / Size Difference --- p.39 / Pressure Distribution --- p.43 / Regression --- p.46 / Chapter V --- DISCUSSION --- p.52 / Subjective fit rating --- p.52 / Reliability of the fit questionnaire --- p.52 / Fit rating --- p.53 / Size --- p.54 / Foot shape --- p.54 / Dimensional Difference --- p.54 / Correlation with subjective fit --- p.55 / Pressure --- p.58 / Dimensional Difference and Pressure --- p.59 / Subjective fit and objective measures --- p.60 / Limitation --- p.61 / Future Direction --- p.62 / Chapter VI --- CONCLUSION --- p.63 / Chapter VII --- REFERENCE --- p.64 / APPENDIX / Appendix A -Explanation of study --- p.68 / Appendix B - Informed consent --- p.69 / Appendix C - Footwear fit questionnaire --- p.70 / Appendix D -Explanations of fit questionnaire --- p.72 / Appendix E - Anthropometric information of the subjects --- p.73 / Appendix F - Fit rating --- p.74 / Appendix G - Foot dimensions of the subjects --- p.89 / Appendix H - Foot - last size difference of each subject --- p.90 / Appendix I - Guilford's suggested interpretation for value of r --- p.92

O design de calçados para a população com diabetes exige conhecimento e especialização, sensibilidade e técnica em um projeto que compreenda as delicadas necessidades e que procure trazer soluções aos problemas e dificuldades das pessoas usuárias acometidas por doença crônica. Nesse sentido, em um projeto desses calçados deve-se considerar as expectativas e realidade do público diabético para além da patologia em si, visando-se o conforto em sentido amplo e a satisfação do usuário. Nesta investigação, características do chamado pé diabético foram levantadas, assim como as respectivas necessidades para analisar o papel do design diante desse problema, visando-se projetivamente a saúde e conforto de usuários, bem como uma melhor noção de calçados de acordo com a situação de risco relacionado ao pé diabético e, principalmente, em relação à função preventiva contra lesões e respectivas complicações decorrentes do diabetes. Embora existam modelos de calçados que auxiliam na manutenção da saúde dos pés, observou-se que a população com diabetes desconhece sua existência e importância / The design of footwear for the population with diabetes requires knowledge and expertise, sensitivity and technique in a project that both comprehends the delicate needs and that looks for solutions to the issues and difficulties of the users who suffer from this chronic disease. Thereby, in a project of such a specific footwear one must consider the expectations and reality of the diabetic public beyond the pathology itself, aiming at the comfort in a broad sense and the satisfaction of the user perceived as a human being. In this investigation we have raised characteristics of the so-called diabetic foot and their respective needs to analyse the role of design in face of this problem. Besides, this project focus on the health and comfort of users, as well as a better notion of shoes according to the situation of risk related to the diabetic foot and, especially, in relation to the preventive function against injuries and respective complications of diabetes. Although models of footwear exist to help maintaining the feet healthy, it was observed that the diabetic population is unaware of its existence and importance

Depuis les années 70, la notion d’engagement a été définie comme le lien qu’un individu réalise avec ses actions. Ce lien pourrait être renforcé par la situation dans laquelle l’individu agit. Les conséquences se mesureraient autant d’un point de vue cognitif que comportemental. Le milieu social dans lequel grandit l’individu est susceptible d’entrer en jeu dans l’acquisition des compétences nécessaires à l’engagement. Dans une vision bioécologique du développement, les milieux familial et scolaire amèneraient l’enfant à émettre ces compétences. Pour tester cette hypothèse, sept études ont été réalisées. Elles ont permis de tester le rôle des pratiques éducatives parentales perçues par l’enfant ainsi que l’adaptation psychosociale de l’enfant décrite par l’enseignant en tant que modérateur de l’engagement. Trois méthodes, transversale, longitudinale et méta-analytique ont été utilisées pour rendre au mieux compte de l’effet du développement de l’enfant au cours du temps. Elles nous ont permis de confirmer un effet du style éducatif parental perçu par l’enfant et du profil d’adaptation psychosociale décrite par l’enseignant sur l’efficacité d’une situation de pied dans la porte. Ces résultats sont discutés en termes de l’acquisition de l’indépendance dans la prise de décision de l’enfant en lien avec son environnement social. / Since the 70s, commitment is defined as the link that person makes with his actions. This link could be enhanced by the situation in which the person acts. The consequences seem possible to be measured as much from a cognitive as from a behavioral level. The social environment in which the individual grows up seems to have an impact on the acquisitions of competences required for such a commitment. In a bioecological vision of the development, the child acquires these competences thanks to family and school. To check this, a total of seven studies were made. They allowed a test of the moderating role of the parental educational practices from a child’s point of view and the psychosocial adaptation of the child described by the teacher like moderator on a commitment. Three methods, one transversal, one longitudinal and one meta-analytic method were used to account for the effect of children’s development in life span. This permitted us to confirm an effect of parenting style from the child’s point of view and the psychosocial adaptation profile described by the teacher on the efficiency of the foot in the door paradigm. Results are discussed in terms of relation of child’s acquisition of independency in decision making in to his social environment.

With over 7% (20 million) people in the United States affected by diabetes mellitus (DM), DM has emerged as a significant health problem. The hallmark of DM is multi-system involvement and the lower limbs are frequently involved in the form of foot ulcers. Inability to heal foot ulcers and maintain healing contributes to the high rate of amputation seen in individuals with DM. The development of foot ulcers has been strongly linked with mechanical stress. Changes in muscle characteristics and segmental foot mobility have been postulated to limit forward progression of the leg on the fixed foot during walking. This in turn may result in prolonged and excessive loading on the ball of the foot. However the extent and site of the impairments and their functional consequences are not well understood. The purpose of this work is to examine determinants of dynamic foot function and plantar loading in individuals with DM. Our results revealed that in spite of differences in passive ankle dorsiflexion and stiffness, subjects with DM demonstrated ankle motion, stiffness and plantar pressures, similar to control subjects, while walking at the identical speed, 0.89 m/s (2 mph). In terms of segmental mobility, reductions were particularly dramatic in the calcaneus (20%) compared to the forefoot and first metatarsal. Decreases in frontal plane calcaneal motion were accompanied by reduced midfoot mobility. Sagittal motion of the first metatarsal and forefoot, and frontal motion of the calcaneus, in subjects with DM, was negatively associated with the magnitude of plantar loading under the respective segment. This information is important because it may help elucidate underlying mechanisms and add to our understanding of the disease process and its effects. In addition, these results may help develop more focused intervention strategies.