These studies developed methods for quantifying balance control while humans exert manual forces. The global purpose was to assess the situations in which elderly individuals commonly fall. These observations were used to recommend environmental modifications that might decrease the incidence of falling in the elderly. This was a departure from traditional tests of balance in which the subject stands in place with feet fixed; in the present studies, subjects performed various manual operations and walked while making light fingertip contact with a handrail. Balance was assessed on the basis of manual forces, body accelerations, alignment of hand forces with respect to the feet, moments of hand forces about the feet, and ‘body center of pressure.’ The latter measure was analogous to the traditional calculation of center of pressure on the ground, except that the body was subjected to the additional reaction forces at the hands.

The study was an assessment to determine the health rehabilitation interventions employed by Zimbabwe health actors between 2009 and 2011. It also was to ascertain the extent to which the interventions met criteria for effective rehabilitation, and that includes, health rehabilitation should ease the transition between health humanitarian and health development. Data was collected through interviewing health actors and review of policy documents while a vulnerability analysis approach was applied. The study revealed that, while the implemented health recovery interventions resulted in halting the health crisis, their role in facilitating progress towards health development was marginal. There were clear humanitarian residual issues and evidence of weak areas of the health system. A clear pathway needed to be mapped by actors, particularly policy makers to ensure effective rehabilitation. However, this seemed to lack in some areas. There were numerous overlapping and repetitive policies with little detailed guidelines. / Development Studies / M.A. (Development Studies)

The study was an assessment to determine the health rehabilitation interventions employed by Zimbabwe health actors between 2009 and 2011. It also was to ascertain the extent to which the interventions met criteria for effective rehabilitation, and that includes, health rehabilitation should ease the transition between health humanitarian and health development. Data was collected through interviewing health actors and review of policy documents while a vulnerability analysis approach was applied. The study revealed that, while the implemented health recovery interventions resulted in halting the health crisis, their role in facilitating progress towards health development was marginal. There were clear humanitarian residual issues and evidence of weak areas of the health system. A clear pathway needed to be mapped by actors, particularly policy makers to ensure effective rehabilitation. However, this seemed to lack in some areas. There were numerous overlapping and repetitive policies with little detailed guidelines. / Development Studies / M.A. (Development Studies)

O conceito de deficiência caracteriza-se por limitações às atividades e restrições à participação das pessoas na sociedade sob influências contextuais. Compreende assim uma interação dinâmica entre deficiência, funcionalidade e fatores contextuais, com impacto variado sobre a qualidade de vida, o que por sua vez pode acarretar diferentes percepções sobre as necessidades humanas a serem supridas. Entre os instrumentos usados para avaliar o grau de incapacidade da pessoa podemos citar a Medida de Independência Funcional (MIF) e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Por sua vez, a teoria da motivação humana de Maslow é amplamente conhecida por tentar explicar as necessidades humanas através de um modelo hierarquizado. O objetivo desta dissertação é identificar se as necessidades humanas, como explicadas pela teoria de Maslow, das pessoas com deficiência estão sendo adequadamente avaliadas pelos instrumentos comumente utilizados como a MIF e a CIF. Uma revisão da literatura foi realizada e então a metodologia da Teoria Fundamentada nos Dados foi aplicada para comparar a MIF, a CIF e a teoria de Maslow. Como resultado, a grande maioria dos domínios da MIF corresponde à habilidade de executar atividades demandadas pelas necessidades fisiológicas, de segurança e em alguns aspectos sociais, porém nenhuma delas pode ser correlacionada aos campos de estima e autorrealização. Por outro lado, a CIF provê elementos específicos de todos os domínios exceto na autorrealização, cujos elementos são mais subjetivos e variáveis. Portanto, a CIF avalia de uma forma melhor se as necessidades humanas das pessoas com deficiência estão sendo atendidas e, por isso, pode ser usada para monitorar a evolução necessária para atender às necessidades específicas das pessoas com deficiência / The concept of disability is characterized by limitations on activities and restrictions on participation in society of people under contextual influences. Thus it comprises a dynamic interaction between disability itself, functionality and contextual factors, causing impact on quality of life in different levels, which in turn can lead to different perceptions of human needs to be met. Among the instruments used to assess the degree of incapacity of the person we can mention the Functional Independence Measure (FIM) and the International Classification of Functioning, Disability and Health (ICF). In turn, the theory of Maslow\'s human motivation is widely known for trying to explain human needs according to a hierarchical model. The aim of this dissertation is to identify whether human needs, as explained by Maslow\'s theory, of people with disability are been properly evaluated by the commonly used measure instruments like FIM and ICF. A review of literature was performed and the Ground Theory Method was then applied to compare FIM, ICF and Maslow\'s theory of human motivation. As results, the vast majority of FIM domains correspond to the ability to execute activities demanded by physiological, safety and some aspects of belongingness and love needs but none of them can be correlated to the fields of esteem and self-actualization. On the other hand, the ICF provides specific elements for all the domains but self-actualization, where the elements are more subjective and variable. So, we can conclude that the ICF can evaluate in a better way whether the human needs of people with disability are been fulfilled and thus can be used for monitoring the evolution necessary to meet specific needs of people with disability

O conceito de deficiência caracteriza-se por limitações às atividades e restrições à participação das pessoas na sociedade sob influências contextuais. Compreende assim uma interação dinâmica entre deficiência, funcionalidade e fatores contextuais, com impacto variado sobre a qualidade de vida, o que por sua vez pode acarretar diferentes percepções sobre as necessidades humanas a serem supridas. Entre os instrumentos usados para avaliar o grau de incapacidade da pessoa podemos citar a Medida de Independência Funcional (MIF) e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Por sua vez, a teoria da motivação humana de Maslow é amplamente conhecida por tentar explicar as necessidades humanas através de um modelo hierarquizado. O objetivo desta dissertação é identificar se as necessidades humanas, como explicadas pela teoria de Maslow, das pessoas com deficiência estão sendo adequadamente avaliadas pelos instrumentos comumente utilizados como a MIF e a CIF. Uma revisão da literatura foi realizada e então a metodologia da Teoria Fundamentada nos Dados foi aplicada para comparar a MIF, a CIF e a teoria de Maslow. Como resultado, a grande maioria dos domínios da MIF corresponde à habilidade de executar atividades demandadas pelas necessidades fisiológicas, de segurança e em alguns aspectos sociais, porém nenhuma delas pode ser correlacionada aos campos de estima e autorrealização. Por outro lado, a CIF provê elementos específicos de todos os domínios exceto na autorrealização, cujos elementos são mais subjetivos e variáveis. Portanto, a CIF avalia de uma forma melhor se as necessidades humanas das pessoas com deficiência estão sendo atendidas e, por isso, pode ser usada para monitorar a evolução necessária para atender às necessidades específicas das pessoas com deficiência / The concept of disability is characterized by limitations on activities and restrictions on participation in society of people under contextual influences. Thus it comprises a dynamic interaction between disability itself, functionality and contextual factors, causing impact on quality of life in different levels, which in turn can lead to different perceptions of human needs to be met. Among the instruments used to assess the degree of incapacity of the person we can mention the Functional Independence Measure (FIM) and the International Classification of Functioning, Disability and Health (ICF). In turn, the theory of Maslow\'s human motivation is widely known for trying to explain human needs according to a hierarchical model. The aim of this dissertation is to identify whether human needs, as explained by Maslow\'s theory, of people with disability are been properly evaluated by the commonly used measure instruments like FIM and ICF. A review of literature was performed and the Ground Theory Method was then applied to compare FIM, ICF and Maslow\'s theory of human motivation. As results, the vast majority of FIM domains correspond to the ability to execute activities demanded by physiological, safety and some aspects of belongingness and love needs but none of them can be correlated to the fields of esteem and self-actualization. On the other hand, the ICF provides specific elements for all the domains but self-actualization, where the elements are more subjective and variable. So, we can conclude that the ICF can evaluate in a better way whether the human needs of people with disability are been fulfilled and thus can be used for monitoring the evolution necessary to meet specific needs of people with disability

Le chien de service (CS) émerge comme modalité d’assistance à la gestion des symptômes reliés au trouble de stress post-traumatique (TSPT) auprès des vétérans. Les tâches qu’il accomplit et les changements qu’il induit sur l’activité physique et le sommeil, deux des habitudes de vie perturbées par le TSPT, demeurent peu étudiés à ce jour. Les objectifs spécifiques de cette thèse étaient de : 1) spécifier les rôles et les tâches accomplis par le CSTSPT, les avantages et les obstacles reliés à son utilisation ainsi que les recommandations souhaitables pour améliorer l’efficacité du CSTSPT, 2) décrire la sédentarité, l’activité physique, et le sommeil avant et après l’acquisition d’un CSTSPT à l’aide de l’actigraphie et de questionnaires standardisés et examiner si les changements post-acquisition s’accompagnaient d’un élargissement des aires de déplacement et d’une diminution de l’intensité des symptômes reliés au TSPT et ceux dépressifs, et 3) explorer s’il y a des associations entre la sédentarité, l’activité physique, et l’intensité des symptômes reliés au TSPT et ceux dépressifs avant l’acquisition d’un CSTSPT, ainsi qu’entre les changements de la sédentarité, l’activité physique, et le sommeil, avant et après l’acquisition d’un CSTSPT auprès de vétérans vivant avec un TSPT chronique. Ces objectifs ont été poursuivis à l’aide : d’une étude de cas exploratoire transversale réalisée auprès de 10 vétérans experts utilisant leur CSTSPT depuis deux à quatre ans (objectif/étude 1), une étude exploratoire prépost intervention sans groupe contrôle complétée par 18 vétérans vivant avec un TSPT chronique (objectif/étude 2), et d’une étude corrélationnelle réalisée auprès 27 vétérans vivant un TSPT chronique (objectif/étude 3). Les résultats de l’étude 1 soutiennent que le CSTSPT accomplit plusieurs rôles (p. ex., détecter les symptômes intrusifs) et tâches (p. ex., réveiller le vétéran lors d’un cauchemar), et qu’il procure plusieurs avantages (p. ex. faciliter la gestion des symptômes), malgré la présence d’obstacles (p. ex. coûts reliés à son utilisation). Les constats rapportés supportent l’émission de recommandations (p. ex. création d’un programme national de CSTSPT) afin d’améliorer son utilisation. Les résultats de l’étude 2 indiquent que l’acquisition d’un CSTSPT améliore le pourcentage de temps quotidien d’éveil dédié à réaliser de l’activité physique d’intensité modérée, le nombre de pas réalisés par jour, l’étendue des aires de déplacement (c.-à-d., voisinage et extérieur de la ville), et l’intensité des symptômes reliés au TSPT et ceux dépressifs. Aucune amélioration significative n’a été observée pour le sommeil mesuré par actigraphie, alors que les résultats Pittsburgh Sleep Quality Index indiquent une amélioration de la qualité du sommeil et de l’efficacité du sommeil, ainsi qu’une diminution des perturbations du sommeil. Les résultats de l’étude 3 révèlent des associations faibles et modérées qui suggèrent la présence d’effets synergiques entre l’activité physique, le sommeil et les symptômes associés au TSPT et ceux dépressifs. En conclusion, les résultats confirment que le CSTSPT représente une modalité d’assistance prometteuse pour la gestion des symptômes reliés au trouble de stress post-traumatique (TSPT). / The psychiatric service dog (SDPTSD) is emerging as an assistive modality for the management of symptoms associated with post-traumatic stress disorder (PTSD) among veterans. The scientific evidence pertaining to the tasks the SDPTSD accomplishes and the changes brought about its acquiring on physical activity and sleep, two of the life habits perturbed by PTSD, remain limited. The specific objectives of this thesis were thus to: 1) specify the roles and tasks accomplished by the SDPTSD, the advantages and obstacles associated to its use, and recommendations to increase its efficacy, 2) describe sedentariness, physical activity, and sleep before and after the acquiring of a SDPTSD using actigraphy and standardized questionnaires and examining if the changes reported following its acquiring were accompanied by an expansion of mobility areas and a diminution of the intensity of PTSD-related and depressive symptoms, and 3) explore the associations between 1) sedentariness, physical activity, and the intensity of PTSD-related and depressive symptoms, and 2) sedentariness, physical activity, and sleep three months before and nine months after the acquiring of a SDPTSD among veterans living with chronic PTSD. These specific objectives were carried out with an exploratory cross-sectional case study realized among 10 expert veterans who had been using their SDPTSD for two to four years (objective/study 1), a prepost intervention exploratory study without a control group realized among 18 veterans living with chronic PTSD (objective/study 2), and a correlational study realized among 27 veterans living with chronic PTSD (objective/study 3). In brief, the results of study 1 showed that the SDPTSD accomplishes several roles (e.g., detecting intrusive symptoms), and tasks (e.g., awakening the veteran during a nightmare), and that it brings several advantages (e.g., facilitating symptom management), despite obstacles (e.g., cost related to its use). Observations gathered in this study support issuance of recommendations (e.g., creating a national SDPTSD program) to improve its use. The results of study 2 suggest that the acquiring of a SDPTSD improves the percentage of daily awake time dedicated to practising physical activity of moderate intensity, the number of steps per day, mobility areas (neighborhood and outside of town), and the intensity of PTSD-related and depressive symptoms. No significative improvements emerged when considering actigraphic sleep results, although results at the Pittsburgh Sleep Quality Index revealed an improved sleep quality and efficiency and a diminution of sleep perturbations. The results of study 3 uncovered weak and moderate correlations suggesting the presence of synergic effects between physical activity, sleep and the intensity of PTSD-related and depressive symptoms. In conclusion, these encouraging results confirm that the SDPTSD is a promising assistive aid in the management of PTSD-related symptoms.