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Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University

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<p>After the acute spell of poliomyelitis, patients commonly suffers from sequelae of weakness. Some of these patients experience new weakness after a time period of stable symptoms.</p><p>The aim of this thesis was to evaluate the possible mechanisms for persistent weakness and development of new weakness in prior polio patients.</p><p>The usefulness of neurophysiologic methods to study prior polio was evaluated. Also two follow up investigations were performed in the attempt to investigate a possible relationship between development of weakness over time and possible failure in neuromuscular function and relation to muscular activity. In another investigation an evaluation of the exceptional finding of a history of paralytic poliomyelitis without neurophysiologic signs of anterior horn cell death was made. The last investigation dealt with reflex pattern in prior polio and it’s relation to weakness and anterior horn cell loss.</p><p>The weakness in prior polio is mainly due to loss of motor neurons with incomplete compensatory mechanisms of reinnervation. The new weakness is mainly due to exaggerated physiological age dependent loss of whole motor neurons, but also fragmentation of the motor unit is likely when these have reached an upper size. Defective neuromuscular transmission and failure in the central drive contribute to a lesser degree to weakness. </p><p>Neurophysiologic method of choice for the assessment of motor unit size and the micro-physiology of the motor unit is Macro EMG.</p><p>Muscular overuse may accelerate motor unit loss over time in prior polio. Extremely large motor units measured with Macro EMG predict new weakness and Macro EMG can be used for prognostication of development of new weakness in prior polio.</p>

After the acute spell of poliomyelitis, patients commonly suffers from sequelae of weakness. Some of these patients experience new weakness after a time period of stable symptoms. The aim of this thesis was to evaluate the possible mechanisms for persistent weakness and development of new weakness in prior polio patients. The usefulness of neurophysiologic methods to study prior polio was evaluated. Also two follow up investigations were performed in the attempt to investigate a possible relationship between development of weakness over time and possible failure in neuromuscular function and relation to muscular activity. In another investigation an evaluation of the exceptional finding of a history of paralytic poliomyelitis without neurophysiologic signs of anterior horn cell death was made. The last investigation dealt with reflex pattern in prior polio and it’s relation to weakness and anterior horn cell loss. The weakness in prior polio is mainly due to loss of motor neurons with incomplete compensatory mechanisms of reinnervation. The new weakness is mainly due to exaggerated physiological age dependent loss of whole motor neurons, but also fragmentation of the motor unit is likely when these have reached an upper size. Defective neuromuscular transmission and failure in the central drive contribute to a lesser degree to weakness. Neurophysiologic method of choice for the assessment of motor unit size and the micro-physiology of the motor unit is Macro EMG. Muscular overuse may accelerate motor unit loss over time in prior polio. Extremely large motor units measured with Macro EMG predict new weakness and Macro EMG can be used for prognostication of development of new weakness in prior polio.

Eradication of polio outbreaks and tetanus neonatorum mortality, as well as lowering Egyptian infant mortality to less than 50 per 1000 live births, were specific goals to be achieved by the year 2000. National television immunization campaigns were launched to persuade mothers to change their attitude and vaccinate their children against the killer diseases. This study investigates the effects of these campaigns on mothers' knowledge, attitude, and behaviour regarding immunization in Egypt. A comparative study was conducted among three groups of mothers who have a child three to twelve months of age. A total of 158 mothers were selected, by systematic random sample technique (1:2), from the part of Kolosna village, in Upper Egypt, which is supplied with electricity, to constitute the viewer group. From the other part of the same village, which is not yet supplied with electricity, all mothers (98) were selected, representing the non viewer group. Another 76 mothers were selected from two prestigious social clubs in Cairo, to represent a second control group of known social class and educational level. Through comparing mothers' knowledge, attitude, and behaviour between the viewer and the non viewer groups, the effect of television immunization messages can be illustrated. Similarly, comparing the village viewer with the Cairo viewer group determines the effects of some intervening factors such as educational level, health professionals, or experience With a structured interview, mothers in the viewer group showed a significant positive and stable attitude and behaviour towards immunization, as well as more correct knowledge when compared with the non viewer group, demonstrating the positive role of television in child health promotion. Television enhances mothers' efficiency to use the available health services and promotes their perceived control over children's health. Health professionals, experience, and social support can potentiate the television's positive role. Educational level, occupation, baby's sex, or mothers' age are insignificant factors in changing mothers' attitude and behaviour.

Thesis (M.S.)--Boston University / The purpose of this study is to examine the medical social worker's role in a public health setting in dealing with the social problems ot a group of patients with poliomyelitis who are being seen in a clinic of the Massachusetts Department of Public Health through the services ot the Crippled Children's Program. An attempt will also be made to examine her role in dealing with the social problem apparent at the time the child was referred to the Worcester Crippled Children's Clinic, and as they seem to exist today.

Caregivers' compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers' for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers' age, gender, residence (rural or urban), and their level of education as well as records from their children's immunization cards. Data obtained were tested for associations between caregiver's demographic information and their children's receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher's exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers' residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study's results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers' compliance with full polio dose receipts with timelines, maximizing immunity.

Gintaras Žaržojus Polio laikomosios gebos vertinimai Lietuvos gruntuose SANTRAUKA Šiame darbe yra išnagrinėti tokie uždaviniai: 1. šiuolaikinių polio laikomosios gebos vertinimo metodų apžvalga; 2. Lietuvos kvartero nuogulos kaip polinių pamatų pagrindas; 3. vibromonolitinio polio ir pagrindo sąveikos I ribinėje būklėje fizinio modelio sudarymas. Pirmojo uždavinio sprendimui buvo trumpai išnagrinėta Europos šalių polio laikomosios gebos skaičiavimų metodikos, kurias butų galima suskirstyti į tris grupes: &#61656; skaičiavimas pagal polių bandymų metu gautus duomenis; &#61656; skaičiavimas pagal laboratorinių tyrimų metu gautus duomenis; &#61656; skaičiavimas naudojant įvairių in-sitų atliktų zondavimų duomenis. Antrajam uždaviniui išspręsti buvo sudarytas polio pagrindo laikomosios gebos vidurkinių verčių žemėlapis (M 1:1500 000). Šis žemėlapis yra sudarytas pagal pasirinktą polio modelį ir skaičiavimo metodiką (EN 1997-3). Trečiajam uždaviniui išspręsti buvo atlikti penki lauko bandymai ir išanalizuoti kai kurie šiuolaikiniai grunto ir polio santykio modeliai. Pagrindinės šio darbo išvados būtų šios: 1. polio laikomosios gebos skaičiavimo metodai įvairiose šalyse yra skirtingi dėl savitų geologinių sąlygų, dėl tyrėjų (inžinierių) subjektyvumo. Dėl metodų nesutapimo yra gaunami skirtingi to paties polio galutiniai skaičiavimo rezultatai; 2. didžiausią Lietuvos teritorijos dalį sudaro vidutinio stiprumo ir stiprūs gruntai kaip polių pagrindai; 3. pagal sudarytą hipotetinį... [toliau žr. visą tekstą] / Gintaras Žaržojus ESTIMATION FOR PILES BEARING CAPACITY IN LITHUANIAN SOILS SUMMARY In this work such tasks are analyzed: 1. Review of up-to-date pile bearing capacity estimation methods; 2. Lithuanian quaternary sediments as the base for pile foundation; 3. The creation of physical model of the vibromonolithic pile and foundation interaction while in the I marginal state. For the solution of the first task, the calculation methodology of the pile bearing capacity of the European countries’ was briefly analyzed, and it can be divided into three groups: » calculation according to the data received during pile testing; » calculation according to the data received during laboratory analysis; » calculation using the data of the various probing completed in-situ. For the solution of the second task, the map of the pile base bearing capacity average values was designed (M 1:1500 000). This map is designed according to the chosen pile model and calculation methodology (EN 1997-3). For the solution of the third task the five outdoor tests were performed and the some of the up-to-date soil and pile ratio models were analyzed. The main conclusions would be: 1. The pile bearing capacity calculation methods are different in various countries, because of the individual geological conditions and because of the subjectivity of the researchers (engineers). Due to the method discrepancy, final calculation results for the same pile are different; 2. The biggest part of the Lithuanian territory... [to full text]