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Appendum consists of last two leaves. / Copies of author's previously published articles inserted. / Bibliography: leaves 241-283. / xviii, 284 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / The studies described were designed to identify and address (through the application of relatively novel and potentially useful adjunctive therapeutic strategies) some of the determinants of sub-optimal therapeutic response in intermediate coronary syndrome and chronic congestive heart failure; especially when targeted towards those patients who fail to gain the maximal benefit from pre-existing modalities of pharmacological treatment. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999

Compliance to strict home exercise programs is understood to be a mainstay of post-surgical flexor tendon rehabilitation. Therapists recognise the potential of poor compliance (overuse or under-use of prescribed exercise) and spontaneous movements during rehabilitation. Some therapists may suggest that compliance to specific exercise regimens and control of spontaneous or general movements are fundamentally important in optimising the rehabilitation outcomes and minimising the potential of adverse events. Yet there is little objective data to document the actual levels of exercise or spontaneous finger movement performed outside the clinical setting. The purpose of this study was to document both diary and instrumented methods of reporting finger movement during a 48hr period. Following surgical repair of the flexor tendon, subjects attending a private hand therapy clinic provided consent and reported subjective diary (n=16) data of sets and repetitions of exercise for up to 6 weeks post-operatively. Nine subjects also had instrumented data logged on 3 occasions during the first 6 weeks of rehabilitation and were not fully aware of the purpose of the instrumentation. All subjects were instructed to perform 10 passive followed by 10 active exercises every waking hour, for the first 6 weeks and were assessed on range of motion, DASH, pain and strength. Results demonstrated that patients reported, via their diaries, that they are on average 80% compliant. Parallel data logger information suggests that this figure is more likely to reflect 50% compliance. A significant (p< .05) increase in spontaneous movements in the last 2 weeks of the 6 week assessment period was detected. No significant correlation between patient's level of compliance or spontaneous movement and their outcome were detected.

Thesis (Ph.D.) -- McMaster University, 2005. / "Health Research Methodology". Includes bibliographical references. Also available via World Wide Web.

Thesis (Ph.D.)--University of Wollongong, 2008. / Typescript. Computer optical disc inserted in pocket on p. 195 entitled: Medication alliance core skills demonstration. Includes bibliographical references: p. 147-179.

Thesis (Ph. D.)--RAND Graduate School, 2005. / Includes bibliographical references.

Thesis (Ph. D.)--Pardee RAND Graduate School, 2005. / Includes bibliographical references (p. 126-135). Also available via the World Wide Web.

Thesis (Ph.D. in Clinical Science) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 86-91). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (MSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Successful antiretroviral therapy (ART) depends on appropriate use of antiretroviral agents; which ultimately prevents replication of Human Immunodeficiency Virus (HIV) thus delaying clinical progression of the disease. This study explored how HIV status disclosure affects adherence to antiretroviral therapy at Mamelodi Hospital, using a convenience sampling method with a sample size of 50 adults above 18 years who were on treatment for a minimum of two years prior to the study. An interview protocol was used to uncover patients’ demographics, sexual orientation, and HIV status disclosure, adherence to antiretroviral drugs, drug side effects, how often they missed their doses and how HIV status disclosure / non-disclosure affected their adherence to treatment. Patients’ medical records were assessed to validate and correlate the information obtained from the interviews. The scientific test results used were the CD4count and Viral loads which are used to monitor the HIV/AIDS disease progression. All partakers involved in the study made their HIV status known and reported taking their medicines regularly. The patients’ CD4 count and VL were verified, the CD4 count has shown an upward trend while the VL load showed a downward trend in keeping with patients who are adhering to ART. The majority of participants (54% or 27 patients) reported they had never skipped taking their medication. The participants also reported they had taken their medicine in front of other people and they constituted 74% (37) of the group. Of this 74%, 78.38% (29 patients) said it was because they had disclosed their status. This observation supports the fact that if you have disclosed your HIV status, you have better chances of adhering to prescribed medication. Findings from the study at Mamelodi Hospital revealed that for as long as one has disclosed their HIV status, the outcome of treatment adherence will be better. The only shortfall noted was lack of partakers who did not divulge their HIV status thus a comparison could not be done. It was acknowledged that some participants in the study might have reported disclosure of their HIV status to be in good favour of the researcher to create an impression that they are adhering to their medication. The study has confirmed the existence of a relationship between HIV status disclosure and adherence to ART. / AFRIKAANSE OPSOMMING: Suksessvolle antiretrovirale terapie (ART) hang af van die toepaslike gebruik van antiretrovirale middels, wat replikase van die MI-virus verhoed, en dus die kliniese vordering van die siekte vertraag. Hierdie studie het ondersoek hoe die bekendmaking van MIV-status die gehoorsaamheid tot ART beïnvloed het by die Mamelodi Hospitaal. ‘n Gerieflikheid-streekproef met ‘n groote van 50 volwassenes bo 18 jaar is gebruik en die deelnememers moes ten minste vir twee jaar voor die studie reeds op behandeling gewees het. Data is deur middel van onderhoude ingesamel, met die doel om pasiënte se demografiese inligting, seksuele orientasie, MIV-status, gehoorsaamheid tot ART en newe-effekte van ART in te samel. Pasiënte se mediese rekords is nagegaan om die inligting wat uit die onderhoude verkry is te bevestig. Die wetenskaplike toetse wat gebruik is, was die CD4-telling en virale lading wat gebruik word om MIV/Vigs te monitor. Al die deelnemers het hul MIV-status bekend gemaak en aangedui dat hul hul medikasie gereeld gebruik. Die pasiënte se CD4-tellings en virale lading is bevestig, die CD4-tellings het ‘n opwaartse neiging getoon terwyl die virale lading ‘n afwaartse neighing getoon het. Die meerderheid van die deelnemers (54%) het aangedui dat hul nog nooit hul medikasie oorgeslaan het nie. 74% van die deelnemers het aagedui dat hul hul medikasie voor ander mense neem - hul noem dat dit as gevolg van die feit is dat hul hul status bekend gemaak het. Dit ondersteun die feit dat mense wie hul status bekend maak beter kanse het om gehoorsaam hul medikasie te gebruik. Die studie by die Mamelodi Hospitaal toon dat solank mense hul MIV-status bekend maak, hul meer gehoorsaam is teenoor die gebruik van hul medikasie. Die studie bevestig dus die verband tussen bekendmaking van MIV-status en gehoorsaamheid tot ART.

Made available in DSpace on 2014-12-17T14:47:07Z (GMT). No. of bitstreams: 1 SamillyMDL_DISSERT.pdf: 2432551 bytes, checksum: 39a06155ddac056ef776f3527c721cf7 (MD5) Previous issue date: 2014-08-01 / The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ / A ades?o terap?utica ainda ? um grande problema entre pessoas com ?lceras venosas (UV), uma vez que a presen?a dessa les?o demanda um tratamento longo, dispendioso, e altera??es no estilo de vida. Nesse contexto, este estudo tem como objetivo geral analisar a ades?o ao tratamento e a qualidade de vida (QV) das pessoas com UV atendidas na aten??o prim?ria ? sa?de. Trata-se de estudo anal?tico, transversal, com abordagem quantitativa de tratamento e an?lise de dados. O estudo teve como cen?rio 13 Unidades de Sa?de da Fam?lia e duas Unidades Mistas da cidade de Natal. A amostra foi composta por 44 pessoas com UV indicadas pelas equipes da Estrat?gia Sa?de da Fam?lia entre fevereiro e abril de 2014. Utilizaram-se tr?s instrumentos: instrumento de caracteriza??o dos aspectos sociodemogr?ficos, de sa?de e assistenciais; a Escala Multidimensional de Ades?o Terap?utica, composta pelas dimens?es: estilo de vida saud?vel, terapia compressiva e vigil?ncia neurovascular; e o Charing Cross Venous Ulcer Questionnaire (CCVUQ), que avalia QV em pessoas com UV atrav?s de quatro dom?nios: Intera??o Social, Atividades Dom?sticas, Est?tica e Estado Emocional, al?m de gerar um Escore Total. A pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE: 07556312.0.0000.5537. Os dados referentes ? caracteriza??o sociodemogr?fica demonstraram que houve predomin?ncia do sexo feminino (65,9%), da faixa et?ria a partir de 60 anos (59,1%) e renda de at? 1 sal?rio m?nimo (81,8%). A caracteriza??o de sa?de evidenciou que a maioria das pessoas relatou doen?as cr?nicas associadas (63,6%), sono maior que 6 horas (81,8%), presen?a de dor (81,8%) e mais de uma recidiva (77,3%). A maior parte negou etilismo (86,4%) e tabagismo (77,3%). Em rela??o ? ades?o terap?utica verificou-se pior ades?o na dimens?o terapia compressiva. N?o foram encontradas associa??es entre os dom?nios da ades?o e as vari?veis sociodemogr?ficas e de sa?de. Observou-se, no entanto, melhor ades?o entre os indiv?duos sem dor e com maior escolaridade. Ao analisar a rela??o das dimens?es da ades?o terap?utica com as caracter?sticas da assist?ncia observou-se associa??o entre: ades?o ? terapia compressiva e orienta??es para uso de terapia compressiva (p-valor = 0,002) e para exerc?cios regulares (p-valor = 0,026). Considerando a m?dia do escore total do CCVUQ (m?dia 51,47 e DP 18,33) observa-se que a QV geral dos pesquisados tem valor aproximado ao da mediana da escala (50). Os participantes apresentaram melhor qualidade de vida nos dom?nios Intera??o Social e Atividades Dom?sticas. Verificaram-se correla??es significativas, por?m fracas, entre ades?o ao estilo de vida saud?vel e o Escore Total (p = 0,012), Intera??o Social (p = 0,048), Est?tica (p = 0,025) e Estado Emocional (p = 0,017) do CCVUQ. A partir da an?lise dos dados conclui-se que a maior dificuldade de ades?o entre as pessoas com UV refere-se ? terapia compressiva. Observou-se correla??o apenas entre a dimens?o estilo de vida saud?vel e os dom?nios do CCVUQ