Yes / Evidence indicates that post − stroke rehabilitation improves function, independence and quality of life. A key aspect of rehabilitation is the provision of appropriate information and feedback to the learner. Advances in information and communications technology (ICT) have allowed for the development of various systems to complement stroke rehabilitation that could be used in the home setting. These systems may increase the provision of rehabilitation a stroke survivor receives and carries out, as well as providing a learning platform that facilitates long-term self-managed rehabilitation and behaviour change. This paper describes the application of an innovative evaluative methodology to explore the utilisation of feedback for post-stroke upper-limb rehabilitation in the home. Methods: Using the principles of realistic evaluation, this study aimed to test and refine intervention theories by exploring the complex interactions of contexts, mechanisms and outcomes that arise from technology deployment in the home. Methods included focus groups followed by multi-method case studies (n = 5) before, during and after the use of computer-based equipment. Data were analysed in relation to the context-mechanism-outcome hypotheses case by case. This was followed by a synthesis of the findings to answer the question, ‘what works for whom and in what circumstances and respects?’ Results: Data analysis reveals that to achieve desired outcomes through the use of ICT, key elements of computer feedback, such as accuracy, measurability, rewarding feedback, adaptability, and knowledge of results feedback, are required to trigger the theory-driven mechanisms underpinning the intervention. In addition, the pre-existing context and the personal and environmental contexts, such as previous experience of service delivery, personal goals, trust in the technology, and social circumstances may also enable or constrain the underpinning theory-driven mechanisms. Conclusions: Findings suggest that the theory-driven mechanisms underpinning the utilisation of feedback from computer-based technology for home-based upper-limb post-stroke rehabilitation are dependent on key elements of computer feedback and the personal and environmental context. The identification of these elements may therefore inform the development of technology; therapy education and the subsequent adoption of technology and a self-management paradigm; long-term self-managed rehabilitation; and importantly, improvements in the physical and psychosocial aspects of recovery. / This paper is part of the SMART programme of research funded by Engineering and Physical Sciences Research Council (EPSRC).

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Thesis (MS)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Sexuality is one quality of being human. Sexual health must be addressed as a significant and integral element of total health care. Nurses caring for patients with oncology and neuromuscular related disabilities are presented with situations concerning sexual dysfunctions that require judgement, knowledge and sensitivity. Yet, studies have shown that nurses demonstrate low sexual knowledge levels and conservative sexual attitudes. They often neglect this aspect of patient care. The sexual attitudes of nurses may be a significant obstacle to their effective functioning in the field of sexual counseling. This proposed study will investigate sexual attitudes of oncology nurses and rehabilitation nurses. / 2999-01-01

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Mental Health / Master / Master of Social Sciences

This thesis discusses the process and value of theatrical and performance-based rehabilitation programming in prisons, specifically focusing on the non-profit organization Shakespeare Behind Bars (SBB). SBB has programs in two prisons in which they read, rehearse and produce a Shakespeare play annually. Using performance theories, theories of rehabilitation and personal interviews, this thesis aims to develop an understanding of the way culture functions in prisons, how the act of performance changes that functioning, and how these programs effect incarcerated people. This thesis includes analyzed interviews with Curt Tofteland, founder of Shakespeare Behind Bars and Sammie Byron, a previously incarcerated alumnus of the program. Ultimately, this project focuses on the possibilities for rehabilitation within incarceration and how performance-based rehabilitation programming offers something unique. SBB creates spaces through performance that allow incarcerated people to reflect on their choices and take responsibility for who they want to become. Central to this thesis and the program it analyzes is the idea of story-telling and allowing incarcerated people to have the access and ability to create their own narratives.

In response to the potential benefits of task specific training in rehabilitation of gait after stroke and the need for affordable, simple ways to implement it, our group designed the elliptically based robotic gait trainer (EBRGT). A design review of the EBRGT, covering the design goals, an overview of the mechanical and electrical design, and a discussion of the novelty of the device and why it may be beneficial for individuals with hemiparesis secondary to stroke is discussed (Chapter 2). To characterize the new device, a study was performed to determine if the EBRGT produced a gait pattern that mimicked level surface walking in healthy adults (chapter 3). Sagittal plane kinematic analysis suggested the EBRGT produced joint movement patterns that are similar to level surface walking at the hip and knee with less similarity between activities at the ankle. Electromyography (EMG) revealed that the EBRGT induced a cyclic muscle firing pattern that had some similarities when compared to level surface walking. We also examined the feasibility of ambulatory individuals after stroke to use the EBRGT and if their movement patterns were similar to healthy adults walking on the same device (Chapter 4). All six participants were able to walk on the device with minimal assistance. These participants had joint kinematics and EMG similar to healthy adults, suggesting that individuals with hemiparesis perform a gait like movement when using the EBRGT. Lastly, a study was performed to determine if the EBRGT could improve gait parameters and function in ambulatory individuals with hemiparesis after stroke (chapter 5). Four participants walked on the EBRGT 3x/week for 4 or 8 weeks. After the intervention, all 4 participants increased their preferred gait speed. One participant had an improvement in gait speed that indicated functional gains. The results of this research suggest that the EBRGT can produce a gait pattern that has some similarities to level surface walking and that it is feasible for ambulatory individuals with hemiparesis to use the device. The device may also improve gait parameters in ambulatory individuals after stroke, but future studies with a control group need to be performed.

Call number: LD2668 .T4 1986 S24 / Master of Arts / Communication Studies

D. Litt. et Phil. / The aim of this study was to develop a comprehensive framework for the rehabilitative needs of female offenders, through the use of Grounded Theory methodology. The framework took the form of a two-axis structure, with axis one encompassing the management of prisons and staff, and axis two dealing with the management and rehabilitation of prisoners. Axis two was conceptualised as a sequence of stages from the start of imprisonment until post-release. The framework is offered as a holistic structure for the development and integration of rehabilitative programmes. The framework is anticipated to assist in obtaining additional funding and support from the business community in order to make rehabilitative programmes available to a greater number of prisoners. The framework may also enable individuals and companies to determine where the specific resources at their disposal could be put to use with the greatest effect.

O interesse mundial pela Reabilitação ocorreu principalmente por quatro acontecimentos históricos: as duas grades guerras mundiais, o processo acelerado de urbanização e industrialização o que direta ou indiretamente favoreceu a propagação de epidemias e aumento de acidentes de trabalho, com isso, emerge a necessidade de restituir as pessoas que necessitavam de reabilitação quanto às capacidades físicas, emocionais, sociais e familiares. O surgimento de instituições de atendimento a pessoas com deficiências no Brasil, data de períodos históricos diferentes e adotam modelos também diferentes de acordo com as circunstâncias e agentes de sua constituição, bem como com o tipo de deficiência a que se destina reabilitar. No tocante à enfermagem, o papel educativo e reabilitador do enfermeiro, são considerados desde o início da Enfermagem Moderna, quando Florence Nightingale, na Guerra da Criméia em 1859, prova a eficiência das enfermeiras treinadas para a recuperação dos soldados na manutenção e continuidade da vida, do retorno ao lar e à família. Esse estudo tem como objetivo descrever a trajetória histórica dos serviços que proporcionavam aos indivíduos incapacitados assistência no âmbito da reabilitação, identificar os fatores determinantes para criação de serviços de assistência em reabilitação na cidade de São Paulo e relatar os fatos que levaram à criação e desenvolvimento do Instituto Nacional de Reabilitação até os dias de hoje, conhecido como Instituto de Medicina Física e Reabilitação. Trata-se de uma pesquisa documental com análise categorial de dados históricos oficiais da Instituição em questão. O material foi submetido a técnica de análise de conteúdo conforme o pressuposto de Laurence Bardin. As análises dos dados revelaram três categorias importantes, uma referente a necessidades, que revelou quatro subcategorias: assistência; reabilitação profissional; atendimento integral e recursos humanos especializados. A segunda categoria denominada estrutural configurou duas subcategorias: dependências e leitos, e a última categoria denominada política, determinou outras quatros sub-categorias: administração e coordenação; financiamento e recursos; problema social e importância social e organização e planejamento. Os excertos dos documentos revelaram que fatores intrínsecos e extrínsecos, estão diretamente ligados a origem do Instituto de Reabilitação e posteriormente a Divisão de Reabilitação Profissional do Vergueiro. Esses fatores determinaram que em 1950 a ONU, propusesse ao Hospital das Clínicas a criação de um Centro de Reabilitação, aprovada em dezembro de 1951, foi criado em caráter definitivo em 1958, anexa a Cadeira de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo. Em 1967, foi proposta a transferência desse Centro para o HC. Em 1968 o IR é extinto após perder apoio da ONU. Já em 1970 o então Governador determinou a criação do Centro de Reabilitação do HC, a DRPV, que é inaugurada em 1978. Em 1994, passa-se a chamar Divisão de Medicina e Reabilitação e em 2001 são inaugurado mais duas unidades dessa divisão, na Vila Mariana e no Jardim Umarizal. / The worldwide interest in rehabilitation occurred primarily through four historical events: the two world wars grilles, the rapid process of urbanization and industrialization which directly or indirectly encouraged the spread of epidemics and an increase in accidents at work, thus emerges the need to restore people in need of rehabilitation as the physical, emotional, social and family. The emergence of institutions that care for people with disabilities in Brazil, data from different historical periods and adopt models also differ according to the circumstances of its constitution and officers, as well as the type of disability that is intended to rehabilitate. Regarding nursing, rehabilitative and educational role of the nurse, are considered from the beginning of Modern Nursing, when Florence Nightingale, the Crimean War in 1859, proves the effectiveness of trained nurses for the recovery of the soldiers in the maintenance and continuity of life, return to home and family. This study aims to describe the history of the services they provided to individuals with disabilities assistance in rehabilitation, to identify the determining factors for the development of rehabilitation services at the city of São Paulo and report the facts that led to the creation and development of National Institute of Rehabilitation to the present day, known as the Institute of Physical Medicine and Rehabilitation. It is a documental research with categorical analysis of historical data of the official institution in question. The material was submitted to the technique of content analysis according to the assumption of Laurence Bardin. Data analysis revealed three major categories, one related to needs, which revealed four subcategories: assistance, vocational rehabilitation, comprehensive care and skilled human resources. The second category called structural set up two subcategories: dependencies and beds, and the last category called politics, determined four other sub-categories: administration and coordination, funding and resources, social problems and social importance of organization and planning. The excerpts of the documents revealed that intrinsic and extrinsic factors are directly linked to the origin of the Rehabilitation Institute and later the Division of Vocational Rehabilitation Vergueiro. These factors have determined that in 1950 the United Nations, propose to the Hospital to establish a Rehabilitation Centre, approved in December 1951, was established permanently in 1958, annexed to the Chair of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo. In 1967, it was proposed to transfer this center for HC. In 1968 the IR is defunct after losing support of the ONU. Already in 1970 the Governor directed the creation of the Center for Rehabilitation of HC, the DRPV, which opened in 1978. In 1994, is set to call the Division of Medicine and Rehabilitation and in 2001 opened two more units are in this division, Vila Mariana and Garden Umarizal.