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Thesis (Ph. D.)--Universiteit van Amsterdam, 1908. / Includes bibliographical references.

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Following a stroke, the majority of survivors experience challenges returning to participation, also known as “involvement in life situations” in the International Classification of Functioning, Health, and Disability. Contextual factors, such as low income and linguistic minority status, have been shown to have an impact on participation post stroke; however, the process by which this occurs is poorly understood. The aim of this research was to increase our understanding of how low income and official minority language status influence the experience of return to participation following a stroke. A qualitative multiple case study approach was used with eight francophone stroke survivors living in a low-income situation in eastern Ontario (Canada). Data was collected from several sources: semi-structured interviews with the stroke survivors and with their care partners, participant observations, four measures, and chart reviews. Data was categorised, and patterns that furthered understanding of the experience of return to participation were identified during intra and cross-case analyses. The stroke survivors were all able to access healthcare and social services in both official languages, and the findings suggest that official language minority status had limited influence on the experience of return to participation. Low income, however, influenced precursors to participation by limiting the stroke survivors’ ability to afford housing, goods (e.g., medication, equipment), and services (e.g., transportation, private therapy). Certain personal and environmental factors modulated the experience of return to participation – specifically, age, knowledge of the healthcare and social service systems, support of family and friends, the built environment, and health literacy. The healthcare and social policies of the macro environment, which regulates the healthcare and social services, had a critical influence on the experience of return to participation for these stroke survivors, irrespective of their individual situations, unless wealth or financial support was available.

Stroke är en av våra stora folksjukdomar som drabbar cirka 30 000 människor varje år.Strokedrabbade patienter kommer i kontakt med hälso- och sjukvården och sjuksköterskanhar en central roll i omvårdnaden. Därför är det viktigt att sjuksköterskan har kunskap ompatienters upplevelse av att drabbas av stroke. Syftet med denna studie är att beskrivapatienters upplevelse av stroke. Metoden som använts är en litteraturstudie där trettonkvalitativa artiklar analyserats. Tre olika huvudteman framkom ur analysen: upplevelse avförändringar efter stroke, Strategier för att hantera den nya situationen och upplevelse avmötet med sjukvården. Temat upplevelse av förändringar efter stroke har delats in i treolika underteman. Dessa är upplevelse av fysiska och kognitiva förändringar ochupplevelse av sociala förändringar samt upplevelse av emotionella förändringar. Resultatetvisar att patienterna är i behov av stöd och uppmuntran för att hantera de förändringar somuppstår efter stroke. Därför är det viktigt att sjuksköterskan erbjuder patienterna ett adekvatstöd. / Stroke is one of our biggest national diseases which affects about 30 000 people everyyear. People victim of stroke gets in contact with the health and hospital care and at thispoint the nurse has a very central role regarding the nursing care. It is therefore importantthat the nurse has knowledge of patients’ experience of suffering stroke. The aim is todescribe patients’ experience of stroke. The method used is a literature review in whichthirteen qualitative articles analyzed. Three major themes emerged from the analysis: theexperience of changes after stroke, strategies to handle the new situation and theexperience of meeting with the health care. The theme of the experience changes afterstroke has been divided into three different sub-themes. These are experiences of physicalchanges and experience of social changes and the experience of emotional changes. Theresult shows that the patients are in need of encouragement and assistance to be able tomanage the changes that occur after stroke. It is therefore important that the nurse offerspatients an adequate support.

<p>Stroke är en av våra stora folksjukdomar som drabbar cirka 30 000 människor varje år.Strokedrabbade patienter kommer i kontakt med hälso- och sjukvården och sjuksköterskanhar en central roll i omvårdnaden. Därför är det viktigt att sjuksköterskan har kunskap ompatienters upplevelse av att drabbas av stroke. Syftet med denna studie är att beskrivapatienters upplevelse av stroke. Metoden som använts är en litteraturstudie där trettonkvalitativa artiklar analyserats. Tre olika huvudteman framkom ur analysen: upplevelse avförändringar efter stroke, Strategier för att hantera den nya situationen och upplevelse avmötet med sjukvården. Temat upplevelse av förändringar efter stroke har delats in i treolika underteman. Dessa är upplevelse av fysiska och kognitiva förändringar ochupplevelse av sociala förändringar samt upplevelse av emotionella förändringar. Resultatetvisar att patienterna är i behov av stöd och uppmuntran för att hantera de förändringar somuppstår efter stroke. Därför är det viktigt att sjuksköterskan erbjuder patienterna ett adekvatstöd.</p> / <p>Stroke is one of our biggest national diseases which affects about 30 000 people everyyear. People victim of stroke gets in contact with the health and hospital care and at thispoint the nurse has a very central role regarding the nursing care. It is therefore importantthat the nurse has knowledge of patients’ experience of suffering stroke. The aim is todescribe patients’ experience of stroke. The method used is a literature review in whichthirteen qualitative articles analyzed. Three major themes emerged from the analysis: theexperience of changes after stroke, strategies to handle the new situation and theexperience of meeting with the health care. The theme of the experience changes afterstroke has been divided into three different sub-themes. These are experiences of physicalchanges and experience of social changes and the experience of emotional changes. Theresult shows that the patients are in need of encouragement and assistance to be able tomanage the changes that occur after stroke. It is therefore important that the nurse offerspatients an adequate support.</p>

In this thesis, two types of geared linkages are studied in detail. One of the mechanisms is the geared five link mechanism for which the input and output shafts are collinear. The other is a two degree-of-freedom nine-link mechanism which is called the &quot / geared adjustable stroke mechanism&quot / . The geared adjustable stroke mechanism uses the geared five link mechanism in its structure. The geared adjustable stroke mechanism has been used in practice, but neither of these mechanisms have been studied in the literature. Analysis procedures are developed and expressions for the transmission angles of the mechanisms are derived. A synthesis procedure is proposed and charts are prepared for the design of such mechanisms.

The object of research: costs of physiotherapy’s services of stroke patients. The head stroke is the one main cause of disability, independency and social habits. Constantly the increasing number of stroke patients and the increasing cost of stroke treatment and rehabilitation are the main causes of great economical costs. Physiotherapy is one of the main rehabilitation methods, helps to reestablish the disordered functions and reach independency. Health’s functionary of Lithuania attitude towards physiotherapy is incomplete: not established new workplaces, unwarranted the individual physiotherapy, suffer the quality of patients’ treatment and daily life. We think that physiotherapy valuations are incomplete in our health care system and not reflect its real worth. So the aim of this research is to evaluate the costs of physiotherapy of stroke patients. The tasks to reach the aim of this study were: 1) to analyze the structure of physiotherapy valuations; 2) to estimate the valuations of physiotherapy in inpatient, outpatient hospital care and in rehabilitation centre; 3) to compare the real valuations of physiotherapy with norms of the Ministry of Health. The research was performed in neurological, rehabilitation departments of Kaunas Second clinical hospital and in Kaunas Šilainiai polyclinic. In the research took part stroke patients, who were treating in neurological, rehabilitation and outpatient care departments in the year 2005. There were analyzed the documentation... [to full text]

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-07-26T12:53:09Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE ISAAC NEWTON GUIMARAES ANDRADE DIGITAL.pdf: 5924981 bytes, checksum: 481aa6cbdb8b4916d3675f5338bd96d0 (MD5) / Made available in DSpace on 2016-07-26T12:53:09Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE ISAAC NEWTON GUIMARAES ANDRADE DIGITAL.pdf: 5924981 bytes, checksum: 481aa6cbdb8b4916d3675f5338bd96d0 (MD5) Previous issue date: 2016-02-19 / Objetivo: Avaliar a aplicabilidade do European System for Cardiac Operative Risk Evaluation (EuroSCORE) na predição de risco de desenvolvimento das principais complicações pós-operatórias em cirurgia cardíaca: infecção do trato respiratório (ITR), acidente vascular Cerebral (AVC) e insuficiência renal dialítica (IRD).Métodos: Foram analisados, retrospectivamente, os prontuários de 900 pacientes operados no Real Hospital Português do Recife e admitidos na unidade de terapia intensiva pós-operatória. Foram incluídos todos os pacientes com prontuários completos, sendo excluídos aqueles que foram a óbito no transoperatório, submetidos a transplante ou a correção de cardiopatia congênita. Foi avaliado o desenvolvimento de ITR, AVC e IRD, sendo o EuroSCORE comparado em relação às três complicações, usando-se o teste de Mann-Whitney. A calibração do modelo para predição das morbidades estudadas foi avaliada com o teste de ajuste de bondade de Homer-Lemeshow. A acurácia do modelo foi avaliada utilizando-se a área sob a curva ROC (ASROC). Resultados: O modelo apresentou boa calibração na predição de infecção respiratória, insuficiência renal dialítica (P=0,285; P=0,789; P=0,45, respectivamente) e mostrou-se não calibrado para predição de AVC. Obteve-se boa acurácia para infecção respiratória (ASROC =0,710 e P<0,001) e insuficiência renal dialítica (ASROC=0,834 e P<0,001) e sem acurácia para acidente vascular cerebral (ASROC=0,519). Os pacientes de alto risco apresentaram maior chance de desenvolver infecção respiratória (OR=9,05; P<0,001) e insuficiência renal dialítica (OR=39,6; P<0,001). A probabilidade de desenvolver infecção respiratória e insuficiência renal dialítica foi de menos de 10% com EuroSCORE até 7 e de mais de 70% com EuroSCORE maior que 15. Conclusão: O EuroSCORE mostrou-se aplicável na predição das principais morbidades pós-operatórias em cirurgia cardíaca: infecção respiratória e insuficiência renal dialítica, apresentando adequada calibração e bom poder de discriminação. / Objective: Evaluate the applicability of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) in the of risk prediction of major postoperative complications in cardiac surgery: respiratory tract infection (RTI), cerebrovascular accident (CVA) and renal failure dialytic (IRD). Methods: We retrospectively analyzed the charts of 900 patients operated on and admitted to the intensive care unit postoperatively at the Real Hospital Português of Recife. We included all patients with complete medical records, excluding those who died during surgery, underwent transplantation or correction of congenital heart disease. We evaluated the development of respiratory infection, cerebrovascular accident, and dialysis-dependent renal failure, and the EuroSCORE was compared in terms of the three complications using the Mann-Whitney test. The calibration model for predicting the morbidities being studied was evaluated using the test set of Homer-Lemeshow goodness. The accuracy of the model was assessed using the area under the ROC curve (AUROC). Results: The model showed good calibration in predicting respiratory infection, renal dialysis (P = 0.285; P = 0.789; P = 0.45, respectively) and proved not calibrated for stroke prediction. It obtained good accuracy for respiratory infection (AUROC = 0.710 and P <0.001) and renal dialysis (AUROC = 0.834 and P <0.001) and no accuracy for stroke (AUROC = 0.519). The high-risk patients were more likely to develop respiratory infection (OR=9.05, P<0.001) and dialysis-dependent renal failure (OR=39.6, P<0.001). The probability of developing respirato-ry infection and dialysis-dependent renal failure was less than 10% with EuroSCORE up to 7 and more than 70% with EuroSCORE greater than 15. Conclusion: The EuroSCORE proved to be applicable in the prediction of major postoperative morbidities in cardiac surgery: respiratory tract infection and renal failure dialitic, with proper calibration and good discrimination.

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