Total knee arthroplasty (TKA) places a large burden on the Canadian Health care system with over 700 million dollars spent on this procedure annually. Exercise has been shown to be effective in improving pain, physical function, mobility and quality of life post-operatively. There is very limited research on adherence to rehabilitation and exercise after TKA. The aim of this thesis was to increase understanding of exercise adherence in this population. The first manuscript in this thesis was a scoping review that evaluated exercise adherence and the quality of reporting of exercise interventions within post-operative TKA rehabilitation trials. A systematic search of scientific databases was conducted for randomized controlled trials (RCT) with an exercise intervention for post-operative TKA. In total, 112 articles were included in this review. This study found that the vast majority of articles (85%) were of poor quality having either high/unclear risk of bias. The majority of RCTs (63%, N=71) on post-operative TKA rehabilitation did not adequately report exercise adherence (e.g., definition, outcome measure used and results), while only 23% (N=15) provided a definition of adherence in the context of their study. Overall reporting of the exercise intervention was poor, with 15 items (of 19) of the Consensus on Exercise Reporting Template (CERT) reported less than 60% of the time. Inadequate reporting of exercise interventions and adherence to exercises leads to decreased reproducibility and translation into clinical practice. Proper reporting of rehabilitation exercises after TKA will ensure standardization for future studies and clinical replication. The second manuscript in this thesis was a qualitative study that aimed to understand the patient- related barriers and facilitators to exercise adherence in patients immediately after undergoing TKA. Using an interpretive description approach, semi-structured qualitative interviews were conducted. Seven participants were interviewed at 8-weeks post-operatively in order to better capture physical, psychological, social and contextual factors linked to exercise adherence. Interview questions explored participants’ experience with physical activity and exercise, motivation to perform physical activity, beliefs that exercise will reduce pain, the factors that limit their ability to engage in exercise, and the importance of using self-regulation to improve exercise adherence. Emergent themes were mapped onto the domains of the WHO adherence framework. This study identified 4 themes that fit within the WHO adherence framework: patient-related factors, condition-related factors, health care system, and social support. In particular, self-regulation, previous knowledge of exercise, post-operative complications, comorbidities, social support, and lack of guidance from health care providers were identified as personal and environmental characteristics that affect exercise adherence. The overall findings of this study suggest exercise adherence is a multifaceted construct with interconnected concepts. / Thesis / Master of Health Sciences (MSc) / Total knee replacement (TKR) surgery costs the Canadian Health care system millions of dollars per year. Exercise is an effective method for improving function and decreasing pain after surgery. However, it is unclear how much patients perform exercise as recommended by health care providers. The purpose of this study was to understand exercise behaviour after knee surgery. The first study was a scoping review that looked at exercise adherence and the characteristics of exercise treatments delivered after knee surgery in previously published clinical trials. The study found that most studies did not report enough information for replication of exercise treatment protocols (e.g. description of provided exercises/progression, who implemented the intervention, etc.). Similarly, exercise adherence was also poorly reported (e.g., definition, how adherence was measured). Poor reporting of exercise treatment methods, and how well participants complete exercises decreases the ability of researchers and therapists to apply the results of these trials. In the second study, patients were interviewed after knee surgery to understand why patients do or do not exercise after surgery. There were several factors, both positive and negative, that patients identified that affected their ability to exercise (e.g. self-regulation (referring to the ability to control thoughts, emotions and behaviour to pursue long-term goals), prior knowledge of exercise, having social support from family and friends, as well as lack of support from health care providers). The overall findings suggest that how well participants exercise after surgery is a complex issue. In order to improve exercise adherence, we need to have a better understanding of the individual factors that may influence adherence.

The auroral oval is a region of intense Global Navigation Satellite System (GNSS) radio scintillation. Ionospheric turbulence can cause scintillation below 3 GHz which means it can severely affect Global Positioning System (GPS) and other forms of wireless communication such as radio frequency (RF) and ultrahigh frequency (UHF). These effects are particularly prevalent at high latitudes, where auroral ionization patterns affect signals and low latitudes where plasma instabilities structure the ionosphere to small scales. This thesis addresses the connection between a well-known GPS derived measurement called total electron content (TEC) to ionospheric state parameters through optical imaging and modeling. The first part of this thesis uses the Global Airglow (GLOW) aeronomical model to infer height-dependent ionospheric state parameters. Spectral imagery and GNSS data are combined to constrain the state outputs of GLOW using a Nelder-Mead optimization during periods of auroral-induced scintillation. The second part of the thesis models the ionospheric continuity equation to produce high-rate electron temperature estimates using temperature dependent recombination from a combined optical and GNSS perspective. Both of these methods quantify E-region dynamic state parameters at a rate (<10 second) that is unachievable by any standard means, such as incoherent scatter radar (ISR). The reliability of these methods is contextualized for the E-region response to auroral forcing for coaligned and non-ideal measurement scenarios common in high latitude receiver networks.

Measurement of the total conditions downstream of fans is of primary importance to aeroengine development. Historically, these measurements have been acquired with the use of traditional total condition probes mounted to the guidevanes or engine cowling; however, such a setup can have significant impact on the flow. Difficulties in obtaining direct measurements with traditional total conditions probes have led to the development of an embedded shielded probe. In order to support this development, a model was desired to be developed that accurately modelled the recovery using a low-order analysis that could be implemented quickly. The creation and validation of such a model is the primary focus of the present research. Of secondary interest is to prove the hypothesis that aerodynamics will dominate the recovery of such a sensor. Based around the calculations for recovery used by Moffat, the model uses a linear vortex panel method to calculate the aerodynamics of the sensor. Higher order corrections were also suggested to improve the accuracy of the model. Several of these corrections, which take into account compressibility and variance of individual recovery factors, were included in the final model. Other corrections, such as improved paneling for the panel method and the inclusion of pitch angle have not been incorporated at this time but are part of an ongoing effort to improve and expand the capabilities of the model. Model validation was performed in three steps, starting with comparing the calculations for the recovery without aerodynamics to values present in literature for traditional Shielded probes. The aerodynamics and the panel method used to generate them were validated separately using the widely available program Xfoil. Validation of the combined model could only be accomplished via experimental testing. Several sensors, based on the predictions of the model, were 3D printed for use in experimental testing. Three key geometric parameters were identified and varied within the limits of interest to create the set of sensors tested. The purpose of this was two-fold. One: validate the model or identify key missing aerodynamic effects for inclusion. Two: prove the secondary hypothesis that aerodynamics will dominate the recovery. Testing was performed at a range of Mach numbers, yaw angles, and pitch angles commonly present in aeroengines. The data collected for model validation were simultaneously used to prove the hypothesis that aerodynamic effects dominated the recovery. This hypothesis was concluded to be true for the range of parameters tested. The model was determined to be valid for the range of parameters tested, although with the caveat that not all aerodynamic effects are fully accounted for and physical testing or CFD analysis is advised to verify results once design parameters have been narrowed down sufficiently. Further refinement of the experimental data and investigation of the aerodynamic effects are the subject of further study. / Master of Science

Desiccant-enhanced air conditioning equipment has exhibited both the capability to improve humidity control and the potential to save energy costs by lowering the latent energy requirement of the supply air stream. The resulting increasing popularity of desiccant-enhanced air conditioning systems has sparked new interest in the search for a better, more efficient desiccant material. The ultimate goal of this research was to develop a material that, when applied to an existing air-to-air heat exchanger, would achieve the necessary heat and mass transfer in a single process, thus transforming a sensible heat exchanger into a total enthalpy exchanger. This study focuses on the development and determination of appropriate polymeric desiccant materials for use in different heat and mass transfer applications. Various candidate materials were initially studied. It was decided that polyvinyl alcohol best met the pre-determined selection criteria. After the focus material was chosen, numerical models representing two heat and mass transfer applications were created. One-dimensional numerical models were developed for the performance studies of a rotary wheel total enthalpy exchanger. A two-dimensional numerical model was developed for the performance studies of a fixed plate total enthalpy exchanger as well. Material characterization tests were performed to collect material property information required by the numerical models. Sensible, latent, and total efficiencies gathered from both the rotary wheel total enthalpy exchanger and the fixed plate total enthalpy exchanger models indicate potential uses for some candidate polyvinyl alcohol materials. / Master of Science

published_or_final_version / Business Administration / Master / Master of Business Administration

Thesis (M. Phil.)--University of Hong Kong, 1997. / Includes bibliographical references (leaf 254-261).

Submitted by Joel de Lima Pereira Castro Junior (joelpcastro@uol.com.br) on 2017-07-04T19:39:42Z No. of bitstreams: 1 Dissertação - Suzzany Barreto.pdf: 1498459 bytes, checksum: 67f74d77c527ac0697d47a06aaf38074 (MD5) / Approved for entry into archive by Biblioteca de Administração e Ciências Contábeis (bac@ndc.uff.br) on 2017-07-06T19:16:24Z (GMT) No. of bitstreams: 1 Dissertação - Suzzany Barreto.pdf: 1498459 bytes, checksum: 67f74d77c527ac0697d47a06aaf38074 (MD5) / Made available in DSpace on 2017-07-06T19:16:24Z (GMT). No. of bitstreams: 1 Dissertação - Suzzany Barreto.pdf: 1498459 bytes, checksum: 67f74d77c527ac0697d47a06aaf38074 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Pontifícia Universidade Católica do Rio de Janeiro / Este trabalho buscou compreender como ocorre o processo de construção ideológica da burocracia em torno da TQM. O objetivo central foi analisar a forma como este conjunto de práticas foi aplicado à rotina de uma distribuidora de energia elétrica. O pressuposto é que a qualidade total é um apanhado de práticas de teorias administrativas anteriores, amparada no discurso ideológico neoliberal. Ademais, a implementação das práticas da TQM por meio dos chamados programas de qualidade, em geral, não respeitam as particularidades culturais dos trabalhadores e empresas brasileiras originando distorções formalísticas. A estratégia desse trabalho consistiu na contextualização histórica até a concepção e implementação do programa de qualidade na distribuidora. Categorias foram elaboradas após análise de literatura da TQM, bem como de depoimentos colhidos nesta pesquisa. Essas categorias foram elencadas para facilitar a identificação dos pressupostos da TQM. A metodologia de História Oral (doravante HO) foi utilizada na construção de novas fontes históricas, no caso dos relatos de trabalhadores. Além disso, a metodologia foi empregada para compreender as implicações da construção ideológica da TQM e suas práticas na forma de trabalhar. / This work sought to understand how the process of ideological construction of the bureaucracy around TQM occurs. The central objective was to analyze how this set of practices was applied to the routine of an electric energy distributor. The assumption is that total quality is a collection of practices from previous administrative theories, supported by neoliberal ideological discourse. In addition, the implementation of TQM practices through the so-called quality programs, in general, do not respect the cultural particularities of Brazilian workers and companies, causing formalistic distortions. The strategy of this work consisted in the historical contextualization until the conception and implementation of the quality program in the distributor. Categories were elaborated after TQM literature analysis, as well as testimonials collected in this research. These categories were listed to facilitate the identification of the TQM assumptions. The Oral History methodology (hereafter HO) was used in the construction of new historical sources, in the case of workers reports. In addition, the methodology was used to understand the implications of the ideological construction of TQM and its practices in the way of working

For a graph G = (V, E), a set S ⊆ V is a total dominating set if every vertex in V is adjacent to some vertex in S. The smallest cardinality of any total dominating set is the total domination number γt(G). For an arbitrary edge e εE(Ḡ), γt(G) - 2 ≤ γt(G + e) ≤ γt(G); if the latter inequality is strict for each e ε E(Ḡ) ≠ φ, then G is said to be γt-critical. The criticality index of an edge e ε E(Ḡ) is γt(e) = γt(G) - γt(G + e). Let E(Ḡ) = [e1...,em} and S = ∑j=1m̄ci(ej). The criticality index of G is ci(G) = S/m̄. For any rational number k, 0 ≤ k ≤ 2, we construct a graph G with ci(G) = k. For 1 ≤ k ≤ 2, we construct graphs with this property that are γt-critical as well as graphs that are not γt-critical.

A set S of vertices of a graph G is a total dominating set if every vertex of V(G) is adjacent to some vertex in S. The total domination number γt(G) is the minimum cardinality of a total dominating set of G. Let G be a connected spanning subgraph of Ks,s, and let H be the complement of G relative to Ks,s; that is, Ks,s, = G ⊕ H is a factorization of Ks,s. The graph G is k-supercritical relative to Ks,s, if γt(G) = k and γ1(G + e) = k - 2 for all e ∈ E(H). Properties of k-supercritical graphs are presented, and k-supercritical graphs are characterized for small k.

BACKGROUND: There has been an enormous rise in total joint arthroplasties (TJA) in the United States over the past several years. Researchers have documented the increase in healthcare costs associated with unplanned hospital readmissions among patients post-TJA, specifically total hip and total knee arthroplasties. Additionally, researchers have reported the burden that these costs place on the healthcare system, private payers and on patients and their caregivers. Social routines, quality of life and occupational functioning are often interrupted because of a patient’s unplanned hospital readmission after receiving a total hip or total knee arthroplasty. Investigators have identified the major causes of costly unexpected hospital readmissions among patients with a TJA; they include surgical site infections, blood clots, joint dislocations and periprosthetic fractures. The Occupational Therapy Practice Framework: Domain and Process describes the practice of occupational therapy as promoting health, well-being, and engagement in meaningful occupation. Nonetheless, there is limited literature in the occupational therapy field directed towards reducing hospital readmissions among patients with a total hip or knee arthroplasty, thus suggesting an area that is well-positioned for intervention development and testing. PURPOSE: This Occupational Therapy Doctoral Project entitled Teaching Intervention to Reduce Readmissions-Post Surgery (TIRR-PS) is a proposed program for an acute care hospital setting which: (a) described the problem of hospital readmissions among patients with a total hip or total knee arthroplasty, (b) investigated evidence and best practices for imparting knowledge and/or teaching skills to hospital administrators, healthcare professionals, occupational therapy staff, patients, and caregivers, (c) proposed an intervention based on empirically supported strategies and theoretical frameworks, (d) recommended activities to include as part of the program evaluation, the funding plan and the dissemination plan to promote this multi-level, multi-component pilot program. TIRR-PS will aim to reduce unplanned 30-day hospital readmissions and their associated healthcare costs. Unplanned readmissions are in part caused by inadequate education of hospital administrators, occupational therapy staff, patients, and caregivers. The TIRR-PS program will raise awareness about how to address common medical complication risks and promote the support of hospital administration for the education and skill building activities directed towards healthcare professionals with an emphasis on occupational therapy. CONCLUSION: TIRR-PS was designed for an acute care setting to reduce hospital readmission rates, to reduce healthcare costs, to improve patient quality of life, and to reduce the societal burden of unplanned hospital care. TIRR-PS is an innovative program designed to be comprehensive and to impart knowledge and skills to all relevant professionals in an acute care setting with a particular emphasis on the contribution of the OT profession. TIRR-PS, once evaluated, will provide a standardized, systematic approach to reducing unexpected hospitalizations post-TJA and shows promise for contributing to routine orthopaedic rehabilitative practice in acute care hospitals. This in turn will not only reduce healthcare costs, but will improve the post-surgery quality of life for patients with a recent total hip or total knee arthroplasty.