Tyrimo tikslas – įvertinti kineziterapijos pratimų ir keturgalvio šlaunies raumens elektrinės stimuliacijos poveikį moterų, kurioms endoprotezuotas kelio sąnarys, judėjimo funkcijai. Uždaviniai: 1. Nustatyti kineziterapijos pratimų poveikį moterų, kurioms endoprotezuotas kelio sąnarys, judesių amplitudei, raumenų jėgai, skausmo intensyvumui, kelio tinimui ir funkcinei būklei. 2. Nustatyti kineziterapijos pratimų, derinamų su raumenų elektrine stimuliacija, poveikį moterų, kurioms endoprotezuotas kelio sąnarys, judesių amplitudei, raumenų jėgai, skausmo intensyvumui, kelio tinimui ir funkcinei būklei. 3. Palyginti skirtingų kineziterapijos programų efektyvumą. Išvados: 1. Taikant kineziterapijos pratimus statistiškai reikšmingai padidėjo moterų, kurioms endoprotezuotas kelio sąnarys, operuotos kojos kelio judesių amplitudės, raumenų jėga, sumažėjo skausmo intensyvumas, kelio tinimas bei pagerėjo funkcinė būklė. 2. Taikant kineziterapijos pratimus ir keturgalvio šlaunies raumens elektrinę stimuliaciją statistiškai reikšmingai padidėjo moterų, kurioms endoprotezuotas kelio sąnarys, operuotos kojos kelio judesių amplitudės, raumenų jėga, sumažėjo skausmo intensyvumas, kelio tinimas bei pagerėjo funkcinė būklė. 3. Kineziterapijos pratimai, derinami su keturgalvio šlaunies raumens elektrine stimuliacija, labiau padidino blauzdą tiesiančių raumenų jėgą ir pagerino „Stotis ir eiti“ testo rezultatus nei vien kineziterapijos pratimai. Judesių amplitudei, skausmo intensyvumui, kelio... [toliau žr. visą tekstą] / The aim of the study: to evaluate the effect of physical therapy exercises and electrical stimulation of the quadriceps muscle on motor function in women after total knee replacement. Goals of the study: 1. To assess the effect of physical therapy exercises for range of motion, muscles strength, pain intensity, knee swelling and functional performance in women after total knee replacement. 2. To determine the effect of physical therapy exercises combined with neuromuscular electrical stimulation for range of motion, muscle strength, pain intensity, knee swelling and functional performance in women after total knee replacement. 3. To compare the effectiveness of different physical therapy programs. Coclusions: 1. Physical therapy exercises have significantly increased the knee range of motion, muscle strength, decreased pain intensity, the swelling of the knee and improved functional performance for women after total knee replacement surgery. 2. Physical therapy exercises with quadriceps muscle neuromuscular electrical stimulation have significantly increased the knee range of motion, muscle strength, decreased pain intensity, the swelling of the knee and improved functional performance for women after total knee replacement surgery. 3. Physical therapy exercises combined with quadriceps muscle neuromuscular electrical stimulation whilst compared to physical therapy exercises alone increased the strength of quadriceps muscle and results of “Timed up and go” test more. Both... [to full text]

This longitudinal, descriptive study based on Bandura's self-efficacy theory (1977), examined the effects of educational activities on self-efficacy and of self-efficacy on functional ability in everyday activities in clients undergoing elective, primary, unilateral, total knee arthroplasty (TKA). Educational activities included: attending a joint replacement class and a physical therapy session, performing exercises, and reading educational materials. Other sources of client information were also discussed. Self efficacy was assessed regarding confidence in ability to perform activities required for discharge home. Cronbach's alpha for the self-efficacy scale was .94 (pre-education) and .81 (post-education). Functional ability in everyday activities was operationalized as length of hospital stay, discharge placement, and perceived health status. Perceived health status was assessed using the three-scale Western Ontario McMasters University Osteoarthritis Index (WOMAC). Cronbach's alpha was: pain .85, joint stiffness .76, and physical function .94 (preoperatively); and pain .86, joint stiffness .80, and physical function .94 (postoperatively).Evidence was collected from a convenience sample of 31 participants: (a) when the process of scheduling surgery began; (b) before surgery, after the client had opportunities to participate in educational activities, and (c) approximately six weeks after surgery. The orthopedic surgeon and professional staff reviewed instruments for validity. Five clients reviewed the questionnaires for understandability and readability. Data were analyzed using Pearson r correlation coefficients, independent samples t-tests, analyses of variance and chi-square tests. An alpha level of .05 was designated as significant.Higher self-efficacy scores were associated with more expected benefits, previous TKA, and greater pain relief. Lower self-efficacy scores correlated with greater improvement in self-efficacy. Shorter lengths of hospital stay were associated with greater joint stiffness reduction, younger age and previous TKA. Discharge home was associated with younger age and living with someone else. Participants that were "very sure" of the need for TKA exhibited higher self-efficacy scores than participants that were "unsure". Improved outcomes were not associated with any one type of educational activity.This study highlighted the need for further refinement of context sensitive self-efficacy instruments, more sophisticated means of assessing the impact of an increasing array of information sources and more longitudinal studies with larger sample sizes. / Department of Educational Leadership

No description available.

Objective: The purpose of this study was to examine social cognitive constructs as predictors of preoperative exercise (PE) in a sample of individuals waiting for total joint replacement (TJR) surgery using the framework of Bandura’s Social Cognitive Theory (SCT). Methods: Participants (N = 78) were individuals waiting for TJR at the two major urban centres on Vancouver Island, Canada who completed measures of the SCT (barrier self-efficacy, outcome expectancy, self regulation, task efficacy & sociocultural factors of pain, physical function and neighbourhood walking environment) framed for (PE). Results: Independent t-tests suggested no differences between type of surgery (hip versus knee), gender or age for PE (p<.05). Over half of the sample was considered inactive (55%) using a definition of physical activity as accumulating at least 30 minutes of exercise at a moderate or vigorous intensity at least 3 days per week in bouts of 10 minutes or more. Bivariate correlations relating to PE were significant (p<.05) between self regulation (SR) (.25), task efficacy for exercise (TEE) (.27) and pain (-.28). Hierarchical regression analysis revealed that SR (β=.17) and TEE (β=.20) explained 10% of the variance in PE behaviour, but were not significant predictors of PE independently. The addition of pain to the regression analysis added 4% of the explained variance, and remained the only significant predictor (p<.05) of Pe behaviour. Conclusions: SCT showed modest capability in predicting PE in this sample, suggesting further testing of theoretical models is warranted in this area. These findings highlight the influence of pain on exercise before TJR surgery, and support the importance of considering individual factors such as pain when designing targeted interventions to increase activity in this population.

Tyrimo tikslas: įvertinti slaugos poreikį asmenims po klubo sąnario endoprotezavimo operacijos tolimuoju pooperaciniu laikotarpiu. Metodai. Tyrimas kiekybinis, atlikta anoniminė anketinė pacientų ir slaugytojų apklausa. Anketos pacientams dalintos gydymo įstaigoje, o pildomos namuose. Pacientams išdalintos 152 anketos. Bendruomenės slaugytojams anketos dalintos jų darbo vietoje ir pildomos iš karto. Viso slaugytojams išdalintos 220 anketų. Tyrimo duomenų statistinė analizė atlikta naudojant SPSS 17.0 programinį paketą. Rezultatai: Daugiau nei pusė pacientų savo būklę namuose vertina patenkinamai, daugumai (77 proc.) sunku nuvykti pas šeimos gydytoją, 15 proc. naudojosi slaugytojo teikiamomis slaugos paslaugomis namuose, pacientus namuose dažniausiai slaugo šeimos nariai (91proc.). Pacientams mažiausiai pakito fiziologinių poreikių tenkinimas. Pusė tiriamųjų pripažino (51 proc.), kad jautėsi priklausomi nuo kitų. Tyrimo pacientai dažnai norėtų iš slaugytojo bendravimo (26 proc.), pacientų mokymo (26 proc.), injekcijų į raumenis (21 proc.) ar į veną (26 proc.) paslaugų. Slaugytojų nuomone, pacientams vienodai svarbu patenkinti savimonės, vaidmens funkcijos bei abipusės (tarpusavio) priklausomybės poreikius. Tyrimo slaugytojai nurodo, kad jie dažnai įvertina paciento būklę namuose, aptaria slaugos tikslus (54proc.) ir sudaro slaugos planą (53 proc.). Priežastys trukdančios slaugytojui bendradarbiauti su pacientu namuose - per didelis darbo krūvis (83 proc.). Išvados: 1)... [toliau žr. visą tekstą] / The objective of the research: to evaluate the need of a care for the persons after hip replacement surgery in the remote postoperative period. Methods. The study is quantitative; anonymous questionnaire survey of patients and nurses has been conducted. The questionnaires were served to the patients at the medical institutions and they were filled at home. 152 questionnaires were distributed to the patients. The questionnaires were distributed to community nurses at their workplaces and filled immediately. In total 220 questionnaires were distributed to the nurses. The statistical analysis of research data was performed using SPSS 17.0 program package. Results: More than half of the patients evaluate their condition at home as satisfactory, the majority of them (77 percent) find difficulties to get to a family doctor, 15 percent used the home nursing services provided by the nurses, the patients at home are often being nursed by their family members (91 percent). Satisfaction of physiological needs is the least that changed to the patients. Half of the patients (51 percent) admitted they were feeling dependent on others. The patients of the research would often like to communicate with the nurses (26 percent), services of patients training (26 percent), injections to the muscles (21 percent) or vein (26 percent). The nurses believe that for the patients it is equally important to satisfy the needs of self-awareness, role function and reciprocal (mutual) dependence. The nurses... [to full text]

Background: Total hip replacement (THR) with post-operative surveillance is recommended for debilitating osteoarthritis (OA). Using self-reported pain, function or walking performance is one alternative to address increasing surveillance demands. Objective: A cross-sectional cohort study to evaluate the associations of pain, function and performance with two radiographic markers of potential THR failure. Participants: 110 patients, median 6 years after THR surgery for OA. Methods: Questionnaires assessed demographics, co-morbidity, arthritis severity, pain, pain catastrophizing, and functional status. Performance was measured using the six minute walk test. THR outcome was assessed radiographically. Results: Few patients had pain, functional impairment or radiographic markers of potential THR failure. A larger percentage of patients with some intermittent pain (10.7 versus 8.6%) and pain iii after walking performance (40.0 versus 27.6%) had higher wear, but these differences were not significant. Conclusion: Measures of pain are potentially important for larger studies aiming to develop alternative methods of post-operative surveillance.

Background: Total hip replacement (THR) with post-operative surveillance is recommended for debilitating osteoarthritis (OA). Using self-reported pain, function or walking performance is one alternative to address increasing surveillance demands. Objective: A cross-sectional cohort study to evaluate the associations of pain, function and performance with two radiographic markers of potential THR failure. Participants: 110 patients, median 6 years after THR surgery for OA. Methods: Questionnaires assessed demographics, co-morbidity, arthritis severity, pain, pain catastrophizing, and functional status. Performance was measured using the six minute walk test. THR outcome was assessed radiographically. Results: Few patients had pain, functional impairment or radiographic markers of potential THR failure. A larger percentage of patients with some intermittent pain (10.7 versus 8.6%) and pain iii after walking performance (40.0 versus 27.6%) had higher wear, but these differences were not significant. Conclusion: Measures of pain are potentially important for larger studies aiming to develop alternative methods of post-operative surveillance.

For many data access applications, the availability of the most updated information is a fundamental and rigid requirement. In spite of many technological improvements, in wireless networks, wireless channels (or bandwidth) are the most scarce resources and hence are expensive. Data access from remote sites heavily depends on these expensive resources. Due to affordable smart mobile devices and tremendous popularity of various Internet-based services, demand for data from these mobile devices are growing very fast. In many cases, it is becoming impossible for the wireless data service providers to satisfy the demand for data using the current network infrastructures. An efficient caching scheme at the client side can soothe the problem by reducing the amount of data transferred over the wireless channels. However, an update event makes the associated cached data objects obsolete and useless for the applications. Frequencies of data update, as well as data access play essential roles in cache access and replacement policies. Intuitively, frequently accessed and infrequently updated objects should be given higher preference while preserving in the cache. However, modeling this intuition is challenging, particularly in a network environment where updates are injected by both the server and the clients, distributed all over networks. In this thesis, we strive to make three inter-related contributions. Firstly, we propose two enhanced cache access policies. The access policies ensure strong consistency of the cached data objects through proactive or reactive interactions with the data server. At the same time, these policies collect information about access and update frequencies of hosted objects to facilitate efficient deployment of the cache replacement policy. Secondly, we design a replacement policy which plays the decision maker role when there is a new object to accommodate in a fully occupied cache. The statistical information collected by the access policies enables the decision making process. This process is modeled around the idea of preserving frequently accessed but less frequently updated objects in the cache. Thirdly, we analytically show that a cache management scheme with the proposed replacement policy bundled with any of the cache access policies guarantees optimum amount of data transmission by increasing the number of effective hits in the cache system. Results from both analysis and our extensive simulations demonstrate that the proposed policies outperform the popular Least Frequently Used (LFU) policy in terms of both effective hits and bandwidth consumption. Moreover, our flexible system model makes the proposed policies equally applicable to applications for the existing 3G, as well as upcoming LTE, LTE Advanced and WiMAX wireless data access networks.

Purpose: Contact lens (CL) materials, modalities of wear and replacement, and care systems have changed considerably since the early studies of CL compliance were first conducted. Silicone hydrogel (SiHy) and daily disposable (DD) lenses are now the most popular lenses worn worldwide and the care systems that are currently available for them have been designed to be straightforward to use. The purpose of this research was to investigate patient knowledge of and compliance with the use of these contemporary CLs and care products, to determine whether non-compliant CL wearers experience ocular complications relating to lens wear more frequently and are more likely to discontinue lens wear, and to try to determine the factors that may constrain or enable patients to follow recommendations for appropriate lens wear and care. Methods: There are many ways in which compliance can be assessed in health care. Several different methodologies were employed during this research: A questionnaire was administered to just over 100 current lens wearers to determine whether photographic aids would help them to recognize which products they were using. More than 500 contact lens (CL) wearers were recruited by their eye care practitioners (ECPs) and mailed a questionnaire designed to evaluate their compliance with contact lens wear and care and to determine whether they had experienced any contact lens related complications which may have occurred as a result of non-compliance. Close to 5000 Current and lapsed CL wearers in Canada were recruited using Facebook to take part in an on line survey investigating CL wearing experiences during 2008 – 2010 and to establish the percentage of participants who temporarily and permanently discontinued CL wear during the period surveyed, the reasons for discontinuation and whether compliance with lens wear and care may have played a role. ECPs and patients independently completed more than 2000 linked questionnaires evaluating their contact lens wear and care. In addition the frequency with which patients attended their ECP’s office for eye examinations was assessed to determine whether there was a relationship between this and their patients’ compliance. More than 800 daily disposable contact lens (DDCL) wearers in four countries completed an online questionnaire designed to investigate how frequently they reused their lenses, the reasons for reuse and how the lenses were stored between uses. Quantitative (online questionnaire) and qualitative (focus groups) research methods were used to explore in detail the lens wear and care habits of adapted contact lens wearers in an attempt to seek a better understanding of what enables and constrains patient compliance with appropriate lens wear and lens care. Results: The rates of non-compliance with the wear of contemporary CLs were found to be similar to those previously reported. Non-compliance with recommendations for CL replacement was shown to be associated with a higher rate of CL related problems. CL wearers continue to “drop-out” for reasons of discomfort and dryness with their lenses but the drop out rates were not found to be different between compliant and non-compliant CL wearers. Patients who were non-compliant with lens replacement were found to attend their ECP’s offices less frequently. Wearers of DDCLs were the most compliant with lens replacement; however, some did report reusing these lenses and sleeping overnight in them. Focus group participants were able to provide a greater insight into why non-compliant behaviour occurs in CL wearers with the most frequently occurring themes identified as the “consequences” that may occur if patients are non-compliant with one or more aspects of their contact lens wear and the importance of receiving “instructions” regarding the most appropriate way to wear and care for their lenses. Most of the themes that emerged from this qualitative research study were both constraints to, and enablers of, compliance. Conclusions: Compliance with contemporary CLs and care products remains poor. Non-compliant behaviour can result in serious complications and patients may not always be aware of this. Careful counseling and education on the risks associated with CL wear is required to provide patients with a better lens wearing experience and continued successful contact lens wear. ECPs and the contact lens industry can hopefully apply this greater understanding of why patients fail to wear and care for their lenses as they should and to help them develop strategies and tools to aid compliance and success in contact lens wear.

A common theme of discussion raised by contemporary scholars is the making of cities competitive internationally to become a city of world class, which is argued to be the main priority facing urban planning and policy makers in the twenty-first century. These redevelopment projects are justified through various ways, however, mainly that they will spearhead economic development and increase national income. This study explores the Kigamboni redevelopment project in Dar es Salaam, Tanzania. It uncovers the vision and justification performed by the Government and it explores the tensions that emerged as a result of the lack of participation and transparency. When envisioning the future, the actors of the government pictures Kigamboni as very different from what it is today. It is argued that the urban visions of becoming modern are shaped without taking the different memories, stories and desires of the local residents of Kigamboni into consideration. In addition, the study illuminates the contestations by the residents, arisen in the context of the redevelopment project, with a main focus on a local organisation - the Kigamboni Committee. The community formed the Committee in order to reach an understanding of the project affecting them. The local association argues to represent the people of Kigamboni and aims to follow up on the project and undertake initiatives to highlight rights. However, the empirical findings reveals that it is questionable whether the Committee is actually representing the people of Kigamboni as they claim. The thesis further sheds lights on the importance to discuss the politics of social mobilisation.