Dissertations / Theses on the topic 'Rehabilitative aim'
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1
ROMANO', SIMONA. "Il ruolo dei giudizi prognostici nel sistema sanzionatorio." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2019. http://hdl.handle.net/10281/258915.
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Il lavoro analizza il ruolo fondamentale delle prognosi nel sistema sanzionatorio penale. Dopo una breve presentazione delle questioni problematiche che emergono nella formulazione delle prognosi, vengono esaminate le singole disposizioni che richiedono al giudice una valutazione del rischio di recidiva e degli effetti special-preventivi della risposta al reato. Sul piano normativo, le tipologie di giudizio prognostico si differenziano a seconda delle informazioni di cui il giudice dispone per prevedere il comportamento futuro dell'autore di reato (o dell'imputato). Dinanzi a questo quadro normativo, l'analisi si sposta sull'importanza del sapere empirico e delle scienze umane per attribuire maggiore affidabilità e controllobilità ai giudizi prognostici. Solo attraverso una formulazione legislativa più accurata delle disposizioni che richiedono una valutazione prognostica e un ampliamento delle basi conoscitive necessarie per effettuarla, sembra possibile dare concreta attuazione alla finalità rieducativa della pena.The work analyzes the fundamental role of prognosis in the penal sanction system. After a brief presentation of problematic issues that emerge in the formulation of the prognosis, the study examines the provisions that require recidivism risk assessment by. On regulatory level, prognostic judgments differ according to the information available to the judge in order to predict the future behavior of the offender (or defendant). Faced with this regulatory framework, the analysis shifts to the great importance of empirical and scientific knowledge to give greater reliability to the prognostic judgments. Only through a more careful legislative formulation of provisions that require prognostic judgments and the widening of knowledge necessary to carry it out, it seems possible to implement the rehabilitative purpose of the penal sanction system.
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Vuorialho, A. (Arja). "Costs and effectiveness of hearing aid rehabilitation in the elderly." Doctoral thesis, University of Oulu, 2006. http://urn.fi/urn:isbn:9514282310.
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Hearing aid (HA) rehabilitation was studied in northern Finland. The costs of HA fitting were examined at two hospitals, Kainuu Central Hospital and Oulu University Hospital. The patients were visited and interviewed at their home and use of HAs was charted. The benefit of HAs was evaluated using generic and disease-specific questionnaires. The effect of follow-up counselling of HA users on HA use and on the benefit of HAs was studied.
The proportion of all HA possessors that are regular users has clearly increased during the past twenty years, and the number of non-users, in particular, has decreased significantly. Only 5.3% of first fitted HAs were not in use in 2001.
The costs of HA fitting in 2000 were approximately € 900. There was not much difference in the costs between Kainuu Central Hospital and Oulu University Hospital. The price of a HA accounted for somewhat less than half of the total hospital costs, and the costs of the audiology personnel made up roughly a third of the overall costs.
Emotional problems of HA users were significant before HA fitting, but six months after HA fitting the number of patients who felt handicapped by their hearing problems had decreased significantly. This could be seen in the results of both the social and the emotional items of the disease-specific health-related quality-of-life (HRQOL) measure, the short version of the Hearing Handicap Inventory for the Elderly (HHIE-S). The benefit could not, however, be shown with the generic HRQOL instrument, the EuroQol questionnaire (EQ-5D), which apparently lacks sensitivity for measuring changes brought about by audiological intervention.
Follow-up counselling of HA users can significantly increase HA use and decrease the number of non-users. It can also significantly increase the users' handling skills. The cost of follow-up counselling is approximately € 83 per fitted HA, which is an 8.7% increment to the calculated cost of fitting a HA.
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Culmer, Peter Robert. "Development of a Cooperative Robot System to Aid Stroke Rehabilitation." Thesis, University of Leeds, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486310.
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This thesis details the development of a dual robotic system for upper limb rehabilitation after stroke. The literature shows that stroke is major cause of upper limb impairment in the UK. Rehabilitation is used to affect long term recovery of upper limb function. However, health services have limited resources and struggle to provide sufficient contact time for effective rehabilitation. Robotic rehabilitation technologies offer an opportunity to augment existing rehabilitation practice and improve the treatment recieved by patients. The motivation for this research stems from the need for a robotic rehabilitation system 'that can fully support and assist the upper limb without restricting movement. A prototype single robot rehabilitation system was considered. Testing through simulation and physical models revealed a number of limitations. A dual robot system was developed from the single robot system to address its deficincies. A novel cooperative admittance control scheme was developed for the dual robot system. When compared to the single robot system the dual robot system showed a number of distinct advantages; the' ability to actively support the upper limb, coordination of natural movement patterns, the capacity to target assistance to individual upper limb joints. Preliminary trials with stroke subjects showed that the dual robot system did not impair normal movement patterns and, using a basic control mode, could improve reach movements.
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Shu, Yuan 1983. "Tabletop robot to aid in arm rehabilitation of stroke patients." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/32926.
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Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2005.Includes bibliographical references.
The aim of this project was to design and build a tabletop robot that could move the arm of a patient with limited motor function around on a table in any given trajectory to aid the patient in regaining function. The design that resulted from bench level experiments was that of an arm brace mounted to a moving base. The base needed to be omni directional to accommodate all possible trajectories of motion, the arm brace needed to be able to move vertically as well as be flexible enough to accommodate yaw, pitch and roll of the forearm. After choosing a three-wheeled design using TransWheelsTM, the base of the robot was built and programmed by Adam Kraft. The arm brace, which I designed and built, had a rack and pinion setup with a variable voltage regulator to control its vertical motion and a foam and linear spring combination to allow for yaw, pitch and roll while still providing for support. Testing of the prototype proved extremely valuable in refining the requirements of the robot as well as the design. Issues that were discovered during testing of the robot included drift of the robot, the inability to orient the robot the same each time, the slipping of the pinion on the rack if too much downward force is applied to the arm brace and the stiffness of the arm brace during yaw, pitch and roll.
(cont.) Several suggestions were made for possible solutions to the issues, all which seem very feasible to implement. As it is the robot can only move the patient's arm, the patient cannot move the robot since the motors are not back-drivable. This is an impediment in allowing the patient to initiate movement, which is a critical part of therapy. Solutions were proposed that are worth further examination to determine their feasibility. In addition, with a few changes, the robot act as a guide to move a patient's passive arm along a preprogrammed trajectory to aid the patient in performing tasks such as reaching. Even if the robot is unable to match its initial goal, it has great potential to become a valuable asset to stroke patients with limited arm motor function.
by Yuan Shu.
S.B.
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Eager, Katrise Mary. "Rehabilitation of unilateral profound sensorineural hearing loss with a bone anchored hearing aid." University of Western Australia. School of Surgery, 2010. http://theses.library.uwa.edu.au/adt-WU2010.0061.
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The long-term outcomes of subjects fitted with a bone anchored hearing aid (BAHA) for a unilateral profound sensorineural hearing loss (UPSHL) are still evolving. Previous studies have focused on the comparison between shortterm outcomes obtained with hard-wired contralateral routing of signal (CROS) hearing aids and those obtained with BAHA devices. Published results on subjects who have worn their BAHA devices for UPSHL for more than twelve months are limited. This study explored the long-term outcomes of adults fitted with a BAHA for UPSHL. The aims were firstly to examine subjects' pre-operative and postoperative speech perception in quiet and noise, as well as administer two standardised questionnaires, the Abbreviated Profile of Hearing Benefit (APHAB) and the Glasgow Hearing Aid Benefit Profile (GHABP). The second aim was to evaluate the responses of implanted subjects following the preoperative test protocols using a supplementary questionnaire, the Single Sided Deafness Questionnaire (SSDQ). The third aim was to monitor the subjects' implant or repair issues. In addition, questionnaire results were compared to subjects who underwent pre-operative assessment but were not implanted. All subjects had a UPSHL resulting from various aetiologies including vestibular schwannoma or other skull base tumour removal, viral infections, cochlear trauma, idiopathic sudden hearing loss, and Meniere's disease. There was a significant difference between the implanted groups' pre- and post-operative outcomes measures, indicating a treatment effect from the fitting of the BAHA device. No significant changes were found with the non-implanted groups' longterm outcome measures in regards to their perceived hearing difficulties. No significant correlations were found between outcome measures and gender, age of fitting, length of deafness, or ear affected for either group.
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Potts, Geoffrey. "Biomechanic analysis of 'heavy-load eccentric calf muscle' exercise used in the rehabilitation of achilles tendinosis a dissertation submitted in partial fulfilment for the degree of Master of Health Science, Auckland University of Technology, January 2005." Full thesis. Abstract, 2005. http://puka2.aut.ac.nz/ait/theses/PottsG.pdf.
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Freeman, C. "The background, development and management of an aid assisted mining rehabilitation programme in central Africa." Thesis, University of Nottingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287178.
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Hearns, Annette. "Humanitarian Aid Workers' Perceptions of Stress Management Services." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3248.
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Humanitarian aid workers live and work in harsh circumstances far from loved ones and support mechanisms. The problem is that international aid must continue to work effectively despite stress levels. The purpose of this phenomenological study was to understand how aid workers perceive their work-related stressors, examine their subsequent experiences of in-house stress management services, and describe the factors that influence aid workers' decisions to access in-house stress management services. The conservation of resources theory was used to understand aid workers experience of stress. A purposive sampling technique was used to identify 12 aid workers with a minimum of 5 years of field experience. Data were collected through semistructured interviews conducted via Skype. After the data were reviewed, unit meanings were assigned and grouped to develop themes. The themes generated were organizational culture, social support, operational environment, the aid worker, adapting and strategizing, stress management services, and services. The greatest stressors participants reported related to the lack of safety and unpredictable working environments, and their experience of accessing stress management services were varied. Assurances of confidentiality and professionalism were the key factors that influenced aid workers engagement with stress management services. Participants received a summary of the findings which included recommendations for aid organizations on improving stress management services for aid workers. The results of this study contribute to the body of knowledge regarding the well-being of aid workers, supporting social change to improve the quality of care for the affected populations they serve.
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Batista, Joana Carreira. "AID : arquitectura dinâmica : capitólio, um paradigma experimental." Master's thesis, Univeridade Técnica de Lisboa. Faculdade de Arquitetura, 2012. http://hdl.handle.net/10400.5/6940.
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Salmon, Elizabeth. "DEVELOPMENT OF AN EEG BRAIN-MACHINE INTERFACE TO AID IN RECOVERY OF MOTOR FUNCTION AFTER NEUROLOGICAL INJURY." UKnowledge, 2013. http://uknowledge.uky.edu/cbme_etds/8.
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Impaired motor function following neurological injury may be overcome through therapies that induce neuroplastic changes in the brain. Therapeutic methods include repetitive exercises that promote use-dependent plasticity (UDP), the benefit of which may be increased by first administering peripheral nerve stimulation (PNS) to activate afferent fibers, resulting in increased cortical excitability. We speculate that PNS delivered only in response to attempted movement would induce timing-dependent plasticity (TDP), a mechanism essential to normal motor learning. Here we develop a brain-machine interface (BMI) to detect movement intent and effort in healthy volunteers (n=5) from their electroencephalogram (EEG). This could be used in the future to promote TDP by triggering PNS in response to a patient’s level of effort in a motor task. Linear classifiers were used to predict state (rest, sham, right, left) based on EEG variables in a handgrip task and to determine between three levels of force applied. Mean classification accuracy with out-of-sample data was 54% (23-73%) for tasks and 44% (21-65%) for force. There was a slight but significant correlation (p<0.001) between sample entropy and force exerted. The results indicate the feasibility of applying PNS in response to motor intent detected from the brain.
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Sundewall, Thorén Elisabet. "Internet Interventions for Hearing Loss : Examing rehabilitation, self-report measures and internet use for hearing-aid users." Doctoral thesis, Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-103824.
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In the future, audiological rehabilitation of adults with hearing loss will be more available, personalized and thorough due to the possibilities offered by the internet. By using the internet as a platform it is also possible to perform the process of rehabilitation in a cost-effective way. With tailored online rehabilitation programs containing topics such as communication strategies, hearing tactics and how to handle hearing aids it might be possible to foster behavioral changes that will positively affect hearing aid users. Four studies were carried out in this thesis. The first study investigated internet usage among adults with hearing loss. In the second study the administration format, online vs. paper- and pencil, of four standardized questionnaires was evaluated. Finally two randomized controlled trials were performed evaluating the efficacy of online rehabilitation programs including professional guidance by an audiologist. The programs lasted over five weeks and were designed for experienced adult hearing-aid users. The effects of the online programs were compared with the effects of a control group. It can be concluded that the use of computers and the internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden. Furthermore, for three of the four included questionnaires, the participants’ scores remained the same across formats. It is however recommended that the administration format remain consistent across assessment points. Finally, results from the two concluding intervention studies provide preliminary evidence that the internet can be used to deliver education and rehabilitation to experienced hearing aid users who report residual hearing problems and that their problems are reduced by the intervention; however the content and design of the online rehabilitation program requires further investigation.
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Lott, Jennifer. "A Mechanized Horseback Riding Simulator as an Aid to Physical Therapy." Scholar Commons, 2006. http://scholarcommons.usf.edu/etd/3752.
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Equine-assisted therapy is a nontraditional form of physical therapy that involves riding horses as a form of rehabilitation. Limited access to these riding programs justifies a need to develop a horseback riding simulator capable of simulating the gaits, bend, and collection of the horse. Research involving the development of horseback riding simulators is limited, but the available research does show promising results in the ability to aid in physical therapy.
A two-dimensional model and simulation was developed using MATLAB. Using the results from the simulation, a horseback riding simulator was designed, fabricated and tested. The physical simulator was capable of simulating a walk, trot, and canter, bend to the left or right, and collection of the gait. The purpose of the testing of the horseback riding simulator was to evaluate the similarity of the physical simulator to the gaits of the data collected from a real horse. The results from the testing are compared with the kinematic data from the MATLAB simulation. The biomechanical effect on the hip flexion angle is also evaluated when the system simulates bend and collection of the horse’s back. The motion data was collected using a Vicon system. Four cameras were set up to collect the data from the five reflective markers that were placed on the rider. The kinematic results of the horseback riding simulator were compared to the computer simulation using the measurements of the inclination of the ellipse, the major axis of the ellipse, and the frequency. The results from the hip flexion angles shows that the test that simulated bend only results in a significant increase in the hip flexion angle compared to the tests without bend. Simulated collection does not change the hip flexion angles of the rider.
Future work on the horseback riding simulator is needed in order to increase the safety so that a person with a disability would be able to use it as part of their physical therapy. Adaptive programming of the system is also necessary to make the horseback riding simulator more similar to that of a real horse.
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Sutera, Krista. "Utilizing psychiatric service dogs as a supplemental intervention to aid in the rehabilitation of veterans suffering from ptsd." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10131638.
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The suicide rate among post-9/11 veterans has become a national crisis. At a staggering number of 22 suicides per day, our wounded warriors are in dire need of psychological assistance. Currently, the treatment interventions used in the rehabilitation of veterans suffering from mental health disorders are limited. Furthermore, these therapy options available to veterans are not realizing adequate improvements in the management of their symptoms.
This business proposal advocates the utilization of psychiatric service dogs as an alternative intervention to help veterans manage their PTSD symptoms. Rescues for Warriors (RFW), a nonprofit 501(c)(3) organization, aims to pair task trained service dogs with veterans in need of a rehabilitative canine companion. Using evidence-based selection tools, RFW rescues dogs from local animal shelters and uses comprehensive techniques to train them to patient-specific symptoms. This service will be free of charge for all veteran participants, and therefore, marketing and funding will be very important aspects of this business. While this plan does acknowledge the potential challenges in opening charitable organizations, RFW is rigorously committed to increase the quality of life of our nation’s heroes and rescue dogs alike.
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Macrae, Joanna Jean. "Aiding recovery? : the role and functioning of international assistance in the rehabilitation of health services in 'post'-conflict Cambodia, Ethiopia and Uganda." Thesis, University of London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325455.
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Since its inception, international aid has been premised on the existence of stable and sovereign recipient states. Official aid relies upon such states for its legitimacy and implementation, and aims to consolidate statehood. In the 1990s, this organising pillar of the international aid system was shaken. The ability of governments to fulfil the basic functions of a sovereign power is now widely questioned. The principle of sovereignty is no longer absolute; rather, it is increasingly contingent upon states' adherence to international, largely Western-defined, norms of behaviour. Where these norms are violated systematically, as in conflict-affected countries, sanctions including trade, political and military measures are deployed. In these 'quasi-states', where sovereignty is contested or weak empirically and juridically, development aid relations are usually suspended and relief the only form of aid available. However, the ability of relief aid to respond to these chronic political emergencies is increasingly questioned. There are increasing demands to make relief more developmental, and for aid to be used to address the cause of crisis - conflict. This thesis examines how aid has worked in a particular type of 'quasi-state': situations of 'post'-conflict transition, and asks whether the new demands on aid in these environments can be met. Examining the cases of rehabilitation assistance to the health sector in Cambodia, Ethiopia and Uganda, it draws three primary conclusions. First, the political meaning, objectives and instruments of relief and development aid are categorically distinct; linking them is ethically and technically problematic. Ethically it implies compromising principles of impartiality and neutrality. Technically, political conditions prevent the transition to more developmental aid instruments. Second, the empirical weakness and juridical ambiguity of statehood in these environments mean that there is no clearly accepted and competent authority to make public policy - no one and everyone owns it. This leads to highly fragmented aid investments that do not provide a basis for the development of public health systems. Third, the absolute scarcity of public resources means that the developmental goal of sustainability is not compatible with that of maximising coverage of health services, level of coverage summary, it suggests that conceptually and operationally the international aid system remains fundamentally ill-equipped to respond to the challenges of chronic political emergencies and their aftermath. 4
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Ashford, Stephen. "Assessment of functional improvement in the hemiparetic arm following focal rehabilitation intervention." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/assessment-of-functional-improvement-in-the-hemiparetic-arm-following-focal-rehabilitation-intervention(ee0a5cd9-9a30-46db-8449-95674ef835b7).html.
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The complex nature of upper limb function presents a challenge for rehabilitation following neurological injury. Some patients, with relatively mild injury, have potential to recover useful function such as the ability to use the hand to hold and manipulate objects (active function). Others with more severe injury will continue to have a non-functional upper limb, and may require assistance from another person (or their own non-affected arm) to care for the affected limb (passive function). The aim of this thesis was to develop and evaluate a self-report upper limb measure of active and passive function – the Arm Activity measure (ArmA) for use in focal spasticity management. A systematic review demonstrated that no suitable measure was available, but provided possible items for inclusion in the ArmA. Patient-selected items were also included from goal setting for spasticity intervention. A modified Delphi consultation was undertaken to reduce the number of items, followed by item confirmation with a larger group of clinicians and pilot testing with patients and carers. The resulting twenty-item measure has two sub-scales of ‘active’ and ‘passive’ function. Two inter-linked studies were undertaken, firstly to evaluate the psychometric properties of the ArmA, and secondly to undertake a hypothesis-generating cohort investigation of the course of functional changes following spasticity intervention. Internal consistency evaluated by Cronbach’s alpha was >0.85 for both sub-scales. Kappa coefficients for test-retest reliability were >0.90. Mokken analysis demonstrated unidimensionality for both subscales (Item H >0.5 for all items). Expected convergent and divergent relationships were seen with comparison measures (rho 0.5-0.63). The passive function sub-scale was responsive to change following spasticity intervention. In the cohort study, spasticity initially reduced following intervention and then increased again. Passive function improved and was maintained despite the increase in spasticity. Adequate psychometric properties were demonstrated for the passive function sub-scale although further evaluation is indicated, particularly for the active function sub-scale.
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Sposito, Caroline. "Resistência ao uso do sistema FM por adolescentes em um serviço público de saúde auditiva: fato ou mito?" Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-10052018-172611/.
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A concessão do Sistema de Frequência Modulada para estudantes com deficiência auditiva representa um avanço no que diz respeito à participação desses alunos com maior igualdade de condições no âmbito da aprendizagem. É comum encontrar resistência ao uso deste dispositivo por adolescentes, sendo essa uma fase da vida conflituosa, de muitas mudanças fisiológicas, emocionais e necessidade de pertencimento. O objetivo deste estudo foi investigar o uso do Sistema de Frequência Modulada por adolescentes em um Serviço Público de Saúde. Foram analisados os prontuários de 310 adolescentes e coletados os dados demográficos, socioeconômicos e da consistência do uso do Sistema de Frequência Modulada. A estatística descritiva foi realizada por meio do teste Qui-Quadrado (X²), sendo adotado nível de significância de 5% (p=<0,05). Participaram jovens de ambos os gêneros, com deficiência auditiva bilateral (96,45%), provenientes de todo o Brasil, da classe social Baixa Superior (61,83%) e com escolaridade de ensino fundamental II (57,42%)e estudantes da rede pública (80,28%). A investigação da consistência do uso do dispositivo baseou-se nos 185 adolescentes que retornaram para consulta de acompanhamento entre os anos de 2013 e 2016, dos quais 155 revelaram fazer uso (83,78%), principalmente na escola (63,26%), ou ainda para ver televisão (30,52%) ou ouvir música (29,11%). Dentre os 113 (61,08%) que alegaram dificuldades no uso, 40,32% indicaram a vergonha como maior problema, seguido de quebra do Aparelho de Amplificação Sonora Individual ou do FM (20,16%) e falta de apoio dos professores (17,74%). Dentre os 30 adolescentes que revelaram não fazer uso, 20 devolveram (6,45%), justificando principalmente pela sensação de ausência de benefício, contudo mais da metade não o experienciou em sala de aula (68,75%). Conclui-se que a maioria dos adolescentes faz uso consistente do Sistema de Frequência Modulada; houve relação entre o uso consistente e grau de escolaridade dos pais; os estudantes de escola privada são mais adeptos ao uso consistente do que os da escola pública. É indicado o uso de um protocolo de seleção, adaptação e acompanhamento do uso do Sistema de Frequência Modulada, o desenvolvimento de estratégias clínicas e parcerias com a educação que favoreçam a adesão ao uso consistente, ressaltando-se o importante papel do Assistente Social em orientar e garantir o acesso aos direitos sociais desses jovens, visando a acessibilidade ao estudante com deficiência auditiva em condições de igualdade para o seu pleno desenvolvimento intelectual e social.Granting the Frequency Modulation system to students with hearing loss represents an advancement in the participation of these students in a learning environment. Resistance to the use of FM system is common among adolescents, who are going through a confusing time in their lives, dealing with conflicting emotions, physiological changes and the need to belong. This study aimed to investigate the use of Frequency Modulation system by adolescents in a public hearing health service. To collect demographic and socioeconomic data and the consistency of FM system usage, medical records of 310 adolescents were analyzed. The descriptive statistic was analyzed using Chi-square test (X²) at a 5% level of significance (p=<0.05). Adolescents of both sexes from all regions of the country were part of the study, 96.45% of them with bilateral hearing loss; 61.83% of them were from upper-lower class; 57.42% from middle school; and 80.28% from public schools. The analysis of the consistency of FM system usage was based on 185 adolescents who returned for follow-up consultation between 2013 and 2016. From that amount, 155 use FM system (83.78%): mostly to go to school (63.26%), but also to watch TV (30.52%) or to listen to music (29.11%). From the 185 adolescents, 133 (61.08%) claimed that they had difficulties in using the FM system. Embarrassment was indicated as the main cause (40.32%), followed by FM system or hearing aid being broken (20.16%), or lack of support from their teachers (17.74%). Also, 30 of the 185 adolescents did not use FM system: 20 returned the device (6.45%), mostly claiming lack of benefit, even though half of them never used the FM system in the classroom (68.75%). The study showed that most adolescents use the Frequency Modulation system consistently; there was a correlation between consistency usage and parents educational level; and it also showed that private school students use FM system with more consistency than public school students. A protocol for selecting, fitting and monitoring the use of the Frequency Modulation system is recommended. The development of clinical strategies and the incentive to make partnerships with Education to promote the consistent use of FM system is indicated. Also, the important role the social workers play needs to be emphasized. As professionals, they guide and guaranty the access to the social rights of these adolescents and provide accessibility to the hearing-impaired students creating conditions of equality for their full intellectual and social development.
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Schweers, Aimee. "Perceptions of Mental Health First Aid Training Deputies Received in a Jail Setting." Youngstown State University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1546427525796788.
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Geving, Megan McGee. "An Observation System to Aid in the Evaluation and Implementation of Early Intervention Programs for Children with Autism." Thesis, University of North Texas, 2009. https://digital.library.unt.edu/ark:/67531/metadc9928/.
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Early and intensive behavioral intervention outcome research includes descriptions of intervention variables that may increase treatment success. This study was designed to develop an observation system that incorporates and expands on some of these variables. Measures include the number of interventionist teaching units, types of skills addressed during instruction, consequences programmed by interventionists, and engagement with teaching materials. This system allowed for a view of the differences in teaching behaviors among the participants. It is proposed that this observation system is a start toward standardized intervention measures that can be applied to evaluate varied treatment models. Such standardization can help in ensuring that all children have access to evidence-based services.
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Alkhamees, Aseel H. "An investigation of a rehabilitation training programme to facilitate the benefits of hearing aid use for hearing impaired adults in Saudi Arabia." Thesis, University of Surrey, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606695.
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Background: Hearing impairment is one of the most common sensory disabilities, affecting millions of people worldwide. The effects of a hearing impairment can impact on an individual's life in many different ways, for instance affecting their communication skills their social life, their academic progression and their overall quality of life. The current management of hearing impairment as indicated by the literature may be either by the use of hearing aids alone, or via bearing aids combined with an auditory rehabilitation programme The majority of the studies that recommend a programme of auditory rehabilitation wen conducted in the USA and Western Europe; none of this research investigates the hearing impaired population in Arabic-speaking countries. This study is the first in this field to be conducted in an Arabic-speaking country, specifically in Saudi Arabia, and the first to develop an auditory rehabilitation intervention programme in the Arabic language. Aims: The aims of the study were to develop an auditory rehabilitation intervention programme that focuses on adults who are new hearing aid users, to develop home training tasks for new hearing aid users who receive auditory rehabilitation programme, to investigate differences in terms of the perception of benefits from hearing aid use in the performance of new hearing aid users who receive either an auditory rehabilitation intervention programme or a standard package of care, and to investigate whether there is any interrelationship between the demographic and hearing status characteristics of those who receive an auditory rehabilitation intervention programme and their performance on home training tasks. Methods: The study involved a randomised intervention study design and included 35 Saudi Arabian participants with acquired hearing loss that ranged from mild to severe, and who were new. hearing aid users (intervention group n=18, control group n=17). The outcome measures used included a speech test, the Minimal Audible Capabilities (MAC) test battery, a lip reading test and the Glasgow Hearing Aid Benefit Profile (GHABP) questionnaire. Results: The results showed that there were no significant differences in the speech test between the group who received the auditory rehabilitation intervention programme and the group who received a standard package of care. Significant changes were found in the performance of the group who received the auditory rehabilitation programme in the lip reading test and MAC test when compared with the group who received the standard package of care. The GHABP questionnaire showed statistically significant changes in certain listening situations regarding self-reported benefits from the hearing aids among participants who received the auditory rehabilitation programme when compared with the group who received the standard package of care. Conclusion: The findings from this study have added to the evidence that a short auditory rehabilitation intervention programme of two sessions, once per week for one hour, including individually focused home training tasks, can yield a significant improvement in the performance of working-age Saudi Arabian hearing impaired adults with acquired bearing loss living in Riyadh, by enhancing the benefits of hearing aid use.
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Barker, Fiona C. "Development of a theory-based, multi-level, low-intensity, low-cost intervention to improve long-term hearing aid use in adult auditory rehabilitation." Thesis, University of Surrey, 2016. http://epubs.surrey.ac.uk/810877/.
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Poorly managed hearing loss can lead to cognitive decline, depression and reduced quality of life. Using a hearing aid can help but evidence suggests up to 40% of people who are fitted with a hearing aid do not use it. While there are many reported reasons for non-use, research suggests that audiologist behaviour in the fitting consultation could play a key role in supporting hearing aid use. Following a systematic review of interventions to improve hearing aid use, this research used the steps of the Behaviour Change Wheel to identify four audiologist behaviours that might influence hearing aid use. An observational study and structured interviews with audiologists using the COM-B model as a framework identified potential determinants of the target behaviours. The COM-B model describes how capability (C), opportunity (O) and motivation (M) combine and influence behaviour (B). This analysis was used to select intervention functions and behaviour change techniques likely to affect behaviour change in this context. The intervention functions of education, training, persuasion, coercion, environmental restructuring, modelling and enablement were selected and combined to develop the I-PLAN; a complex intervention combining prompts, information and a behaviour plan for hearing aid use. This is the first study to use the COM-B model and Behaviour Change Wheel to develop a complex intervention in the context of audiology. Use of the COM-B model to analyse patient and professional behaviour has facilitated a consideration of implementation at the development stage of intervention design. The systematic, theory-based development of the I-PLAN intervention will facilitate a thorough evaluation of its feasibility and effectiveness over the next phases of this work.
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Abolfathi, Peter Puya. "Development of an Instrumented and Powered Exoskeleton for the Rehabilitation of the Hand." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3690.
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With improvements in actuation technology and sensory systems, it is becoming increasingly feasible to create powered exoskeletal garments that can assist with the movement of human limbs. This class of robotics referred to as human-machine interfaces will one day be used for the rehabilitation of paralysed, damaged or weak upper and lower extremities. The focus of this project was the development of an exoskeletal interface for the rehabilitation of the hands. A novel sensor was designed for use in such a device. The sensor uses simple optical mechanisms centred on a spring to measure force and position simultaneously. In addition, the sensor introduces an elastic element between the actuator and its corresponding hand joint. This will allow series elastic actuation (SEA) to improve control and safely of the system. The Hand Rehabilitation Device requires multiple actuators. To stay within volume and weight constraints, it is therefore imperative to reduce the size, mass and efficiency of each actuator without losing power. A method was devised that allows small efficient actuating subunits to work together and produce a combined collective output. This work summation method was successfully implemented with Shape Memory Alloy (SMA) based actuators. The actuation, sensory, control system and human-machine interface concepts proposed were evaluated together using a single-joint electromechanical harness. This experimental setup was used with volunteer subjects to assess the potentials of a full-hand device to be used for therapy, assessment and function of the hand. The Rehabilitation Glove aims to bring significant new benefits for improving hand function, an important aspect of human independence. Furthermore, the developments in this project may one day be used for other parts of the body helping bring human-machine interface technology into the fields of rehabilitation and therapy.
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Abolfathi, Peter Puya. "Development of an Instrumented and Powered Exoskeleton for the Rehabilitation of the Hand." University of Sydney, 2008. http://hdl.handle.net/2123/3690.
Full textAbstract:
Doctor of Philosophy (PhD)With improvements in actuation technology and sensory systems, it is becoming increasingly feasible to create powered exoskeletal garments that can assist with the movement of human limbs. This class of robotics referred to as human-machine interfaces will one day be used for the rehabilitation of paralysed, damaged or weak upper and lower extremities. The focus of this project was the development of an exoskeletal interface for the rehabilitation of the hands. A novel sensor was designed for use in such a device. The sensor uses simple optical mechanisms centred on a spring to measure force and position simultaneously. In addition, the sensor introduces an elastic element between the actuator and its corresponding hand joint. This will allow series elastic actuation (SEA) to improve control and safely of the system. The Hand Rehabilitation Device requires multiple actuators. To stay within volume and weight constraints, it is therefore imperative to reduce the size, mass and efficiency of each actuator without losing power. A method was devised that allows small efficient actuating subunits to work together and produce a combined collective output. This work summation method was successfully implemented with Shape Memory Alloy (SMA) based actuators. The actuation, sensory, control system and human-machine interface concepts proposed were evaluated together using a single-joint electromechanical harness. This experimental setup was used with volunteer subjects to assess the potentials of a full-hand device to be used for therapy, assessment and function of the hand. The Rehabilitation Glove aims to bring significant new benefits for improving hand function, an important aspect of human independence. Furthermore, the developments in this project may one day be used for other parts of the body helping bring human-machine interface technology into the fields of rehabilitation and therapy.
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Johansson, Cornelia. "Navigating between pressures andaccountabilities : Local civil society organization's approaches and challenges to link-ing relief, rehabilitation, and development in Malawi." Thesis, Umeå universitet, Statsvetenskapliga institutionen, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-140194.
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Malawi is one of the poorest countries in the world and suffers from recurring disasters but no ongoing conflicts. Civil Society Organizations (CSOs) working there must therefore take relief, rehabilitation, and development into account as shifting between these stages is the reality of the rights-holders. What approaches that should be used while doing this is unique in each context. The aid structure is however clearly divided between those working with relief and those working with development, and even though the conceptual development suggest that the aid structure should join there has been no change towards this. At the same time Result Based Management (RBM) as a principle for aid effectiveness has been heavily criticized for focusing on short term results, among others. This qualitative study has contributed to closing two research gaps; in identifying that Disaster Risk Reduction, Human Rights Based Approach, economic empowerment, and sustainable relief interventions are the approaches that CSOs in Malawi tend to focus on when working close to a community where there is a need to link relief, rehabilitation, and development (LRRD); and in identifying that not only can the pressure from a divided aid structure be blamed for the challenges facing CSOs implementing LRRD approaches, but RBM is also a contributing part. This results in CSOs being torn between accountability issues towards donors and staying legitimate towards rights-holders and that because of these challenges they cannot live up to their potential and provide the most effective aid.Malawi är ett av de fattigaste länderna i världen och lider av återkommande katastrofer men inga pågående konflikter. Perioder av humanitära katastrofer, återuppbyggnad, och utveckling, skiftar och växlar fram och tillbaka i olika stadier och eftersom det är rättighetsbärarnas verklighet så är det också något civilsamhällsorganisationer som arbetar med olika typer av utvecklingssamarbete måste ta hänsyn till att. Vilka metoder som bör användas när organisationer arbetar i detta klimat är unikt för varje kontext. Biståndet är emellertid tydligt uppdelad mellan de som arbetar med humanitärt arbete och de som arbetar med utveckling, och trots att den konceptuella utvecklingen föreslår att biståndet bör kopplas samman så har det inte skett någon strukturell förändring. Samtidigt har resultatbaserat arbete som är en princip för biståndseffektivitet starkt kritiserats, bland annat för att det fokuseras för mycket på kortsiktiga resultat. Denna intervjubaserade studie har bidragit till att minska två forskningsgap; genom att identifiera att katastrofförebyggande arbete, rättighetsbaserat arbete, ekonomisk empowerment, och hållbara humanitära insatser som de tillvägagångssätt som civilsamhällesorganisationer i Malawi tenderar att fokusera på när de arbetar nära ett samhälle där det finns ett behov av att koppla samman humanitärt arbete med rehabilitering och utveckling (LRRD); och genom att identifiera att det inte bara är trycket från en uppdelad biståndsstruktur som förklarar de utmaningar som organisationer står inför när d arbetar med LRRD utan att resultatbaserat arbete också är en bidragande del. Lokala civilsamhällesorganisationer balanserar mellan ansvaret de har mot gentemot givare och legitimiteten de måste ha gentemot rättighetsinnehavare. I slutändan kan de på grund av dessa utmaningar inte leva upp till sin potential och tillhandahålla det mest effektiva stödet.
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Yeung, Kin-wai. "A comparative study of the relative strengths and weaknesses of the self-help and Lap Shun Training Programmes of the Society for the Aid and Rehabilitation of Drug Abusers /." [Hong Kong : University of Hong Kong], 1986. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1232596X.
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Cowan, Kam Hing Rosanna. "Change and transformation : a study of the process of change for female drug-abusers in the Women's Treatment Centre, Society for the Aid and Rehabilitation of Drug Abusers, Hong Kong." Thesis, University of Bristol, 2000. http://hdl.handle.net/1983/1170fd71-66b3-44ff-95ab-9bffa311a034.
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Soo, Kam-hing Rosanna. "A descriptive study of the perceived treatment and post-treatment environment for female ex-drug abusers in S.A.R.D.A." Click to view the E-thesis via HKUTO, 1988. http://sunzi.lib.hku.hk/hkuto/record/B42128328.
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Lombardi, Christiane Mara. "Programas de reabilitação auditiva para idosos: uma proposta alternativa de avaliação de eficácia." Pontifícia Universidade Católica de São Paulo, 2009. https://tede2.pucsp.br/handle/handle/12230.
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Theme: The majority of the elderly people with presbycusis can benefit from group hearing rehabilitation. The literature on this subject evaluated those programs as effective. Therefore, the literature does not point the origin of this effectiveness. Based on the information collected from these literature, a private hospital located in São Paulo created the Hearing Aid User Support Group GAUAA, which consists of four monthly meetings. Purpose: To find out the effectivness of a group hearing rehabilitation program for the elderly through shifting from quantitative data to qualitative data. Method: Thirty subjects, hearing aid users with monoaural adaptation, showing moderate to severe hearing loss with ages between seventy and ninety-two years old have participated in this research. This study provided two situations: on situation I, the International Outcome Inventory for Hearing Aids questionnaire (IOI-HÁ) was applied before and after the program. The objetive was to evaluate the user degree of satisfaction. The collected data were submeted to the Wilcoxon test method analysis and analysed through the Spearman correlation method. The situation II was divided in two phases: on phase I, the subjects statements were collected and analysed after the program. At phase II, the subjects statements were analysed during the GAUAA meetings. These data were analysed by the french line of the speech analysis proposed by Orlandi(1996). Results: The data found at situation I were statistically significant, but they could not indicate what would be the reason for the positive effectiveness responses from the clinical perpective. Thus, the situation II through the qualitative analysis, made possible to observe the subjects singularities, which suggested that the effectiveness of a hearing rehabilitation program is due to the identification among the participants and by transference, sustained by the coordinator´s position. The GAUAA effectiveness derives from the ludical speech dominance, which its effects promote the effectiveness of the hearing aid use
Tema: possíveis benefícios de um grupo de apoio voltado a idosos com presbiacusia e usuários de auxiliar auditivo. Objetivo: por meio da articulação entre dados quantitativos e dados qualitativos, localizar a origem da eficácia de um programa de reabilitação auditiva em grupo de idosos. No geral, embora a literatura sobre o tema aborde esse aspecto, não há ainda estudos que propõem parâmetros de atuação e estratégias que levem ao uso sistemático do auxiliar auditivo por parte dessa população. Método: participaram deste estudo 30 sujeitos com perda auditiva de grau moderado a severo, na faixa etária de 70 a 92 anos, usuários de auxiliar auditivo com adaptação monoaural e participantes do Grupo de Apoio ao Usuário de Auxiliar Auditivo GAUAA, criado em um hospital privado de São Paulo, sendo o trabalho desenvolvido em quatro encontros mensais. Foram analisadas duas situações: a Situação I, em que foi aplicado o questionário QI-AASI (Questionário Internacional-Aparelho De Amplificação Sonora Individual), antes e depois do programa, para avaliar o grau de satisfação do usuário. Os achados foram submetidos ao método de análise dos Testes dos Postos Sinalizados de Wilcoxon. A situação II foi dividida em duas etapas: na 1ª etapa procedeu-se à coleta e análise de depoimentos dos usuários após o programa, e na 2ª etapa, à análise dos dizeres dos participantes durante as reuniões do GAUAA. Esses dados foram analisados à luz da metodologia de Análise de Discurso de linha francesa, articulada à tipologia do discurso proposta por Orlandi(1996). Resultados: Os achados da situação I mostraram-se estatisticamente significantes, mas, clinicamente, não indicaram o que provocava as respostas positivas sobre a participação no GAUAA. Já a situação II, em que foi utilizada a metodologia qualitativa, possibilitou observar a singularidade dos sujeitos, sugerindo que a eficácia de um programa de reabilitação auditiva se dá pela identificação entre os participantes e pela transferência sustentada pela posição do coordenador. Concluiu-se que a eficácia do GAUAA deriva da dominância do discurso lúdico, cujos efeitos promovem a efetividade do uso do auxiliar auditivo
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Custódio, Carla Maria de Faria. "Cuidados integrados de recuperação no âmbito da doença mental." Master's thesis, Universidade de Évora, 2012. http://hdl.handle.net/10174/12214.
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Problemática: Acompanhamento progressivo dos doentes mentais e disponibilização de cuidados especializados nas Unidades de Ambulatório (vs. internamento), numa perspectiva de cuidados integrados no âmbito da doença mental, ao abrigo do Programa CIR.
Objectivo: Desenvolvimento de competências no processo de avaliação diagnóstica e intervenção a uma população portadora de doença mental.
Metodologia: Seguimento de 10 doentes com patologia mental diversa através de Entrevistas de Ajuda e dos Materiais Informativos do Programa CIR nas sessões realizadas, favorecendo o desenvolvimento de competências.
Resultados: A minha aquisição e desenvolvimento de competências conduziram os doentes a aprenderam a conhecer e a gerir os sinais/sintomas da sua doença e respectivo plano terapêutico, tornando-os mais capazes e autónomos.
Conclusões: Corroborando outros estudos na área, conclui-se que a prática de cuidados integrados no âmbito da doença mental, capacita o doente para um melhor conhecimento/gestão da doença e favorece o desenvolvimento de competências pessoais e rentabilização dos recursos disponíveis; ### ABSTRACT:
Problem: Progressive follow-up of mental patients and availability of specialized care in the Ambulatory Units (vs. hospitalization), in a perspective of integrated care within the field of mental illness, under the CIR Program
Goal: Skill development in the diagnostic assessment and intervention process in a population with mental illness.
Methodology: Follow-up of 10 patients with various mental pathologies via Help/Aid Interviews and the Informative Materials of the CIR Program in the sessions held, favoring the development of skills.
Results: My acquisition and skills development led the patients learned to recognize and manage the signs/symptoms of their illness and its treatment plan, making them more capable and independent.
Conclusions: Supporting other studies in the field, it was concluded that the practice of integrated care within the field of mental illness, enables the patient for a better knowledge/understanding/management of his/her illness and favors the development of personal skills and the maximizing of the available resources.
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Costa, Eliane Carvalho da. "Relações entre audibilidade de sons de fala, uso de amplificação sonora e habilidades auditivas em crianças." Pontifícia Universidade Católica de São Paulo, 2015. https://tede2.pucsp.br/handle/handle/12011.
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Objective: This research focuses on the relationship between audibility of speech, recurrent usage of sound amplification devices and the development of auditory abilities in hearing impaired children. Method: The research was submitted to Ethics Committee for Research at the Pontifícia Universidade Católica de São Paulo was approved on report 731.690. 35 infants and children diagnosed by 3 years of age were selected, with chronological age corrected from 2 to 50 months. The study was conducted at the Centro de Audição na Criança (CeAC/Derdic) on PUCSP. The analysis was based on measurements of audibility (Speech Intelligibility Index SII), use of hearing aid (HA) in an average percentage of daily hours of use in comparison with the time in which the child is awake and reports from parents in HA use situations in everyday life, conducted from structured interviews and scripted interviews. There was also an analysis of medical reports of subjects, the LittlEars® application to evaluate the development of auditory abilities and socio-economic aspects as well as family demographics. Interviews with open-ended questions were recorded and transcribed to exemplify the data that was collected. Children were divided in two groups according to age: those who were chronologically up to 12 months (Group A) when they started using HA and those older than 13 months (Group B). In each group (A and B), children were also subdivided according to audibility classification, that is, in three SII intervals: Gr1 SII below 35%; Gr2 36 to 55% and Gr3 equal or above 56%. Results: We observed that 74% of the subjects were diagnosed with hearing loss before their first year of being born and 37% by 6 months. Children from Gr2 (moderate to severe audibility) are more affected by distance from the speaker, becoming more vulnerable to multiple factors. Findings demonstrate that Gr1 (significant losses) had the lowest average of usage time when compared to other groups and in comparison to the hearing abilities measured in LittlEars®, 51% of children were below the minimum expected when compared to their hearing peers. As for daily use, 70% of mothers of infants up to 12 months said that they use HAs in the car, and children above 13 months reach 78%. 73% pf Group A use products whenever they are with an employed caretaker, compared to only 37% from Group B. As to external environments and going out, 82% (A) and 72% (B) say they always wear the product. 53% and 44% of interviewees, respectively from groups A and B, said they never have to keep adjusting their children s HAs due to feedback. 100% of interviewees check their children's devices every day before being worn. Conclusion: Gr1 children (mostly profound losses), were the least consistent in using hearing aids in daily routine in both age groups. There were no differences between groups when socioeconomic level was considered. Mother referred not to use the hearing aids in unsupervised situations such as car rides, or playing outside. They were unsure about the consistency of HA use during nursery end school hours. Several parents have a hard time noticing hearing changes in babies and children in response to amplification and this seems to affect constant usage
Objetivo: Esta pesquisa visa estabelecer relações entre audibilidade de sons de fala, rotina no uso de aparelho de amplificação sonora e desenvolvimento de habilidades auditivas em crianças diagnosticadas com deficiência auditiva. Método: A pesquisa foi submetida ao Comitê de Ética em Pesquisa da Pontifícia Universidade Católica de São Paulo e Plataforma Brasil e aprovada com o parecer número 731.690. Foram selecionados 35 bebês e crianças pequenas diagnosticadas até 3 anos de idade e idade cronológica corrigida de 2 a 50 meses. O estudo foi realizado no Centro de Audição na Criança (CeAC/Derdic) da PUCSP. A análise foi realizada a partir de medidas de audibilidade (Speech Intelligibility Index SII), uso de aparelho de amplificação sonora individual (AASI) e relatos dos pais de situações de uso do AASI no cotidiano, a partir da entrevista estruturada e roteiro de entrevista. Foi realizada análise dos prontuários, aplicação do LittlEars® para avaliar o desenvolvimento das habilidades auditivas e caracterização socioeconômica e demográfica das famílias. As entrevistas com perguntas abertas foram filmadas e transcritas. As crianças foram divididas em dois grupos segundo a faixa etária: as que tinham idade cronológica de até 12 meses (Grupo A) quando iniciaram o uso de AASI e as que tinham idade cronológica de 13 meses ou mais (Grupo B). Em cada grupo, as crianças foram subdivididas quanto a classificação de audibilidade, segundo valores de SII: Gr1 com SII abaixo de 35%; Gr2 - de 36-55% e Gr3 igual ou maior que 56%. Resultados: Observamos que 74% dos sujeitos receberam o diagnóstico da perda auditiva antes do 1º ano de vida e 37% até os 6 meses. Pesquisa reforça que está crescendo o número de crianças diagnosticadas abaixo de 18 meses e tendo início no processo de seleção e adaptação de aparelhos de amplificação sonora (AASI). Verificamos que as crianças do GR2 (de audibilidade moderada/severa) são mais afetadas pela distância entre o falante e o microfone do AASI sendo, portanto mais vulneráveis a interferência de outros fatores. Achados demonstram que o Gr1 (perdas profundas) teve a menor média de tempo de uso em relação aos outros grupos e com relação às habilidades auditivas verificadas no LittlEars®, 51% das crianças estão abaixo do mínimo esperado em comparação aos seus pares ouvintes. Quanto ao uso no cotidiano, 70% das mães até 12 meses disseram que elas usam sempre os AASIs no carro, e as crianças acima de 13 meses, usam 78%. 73% do grupo A usam os aparelho sempre que estão com uma cuidadora e o grupo B, 37% apenas. Quanto a ambientes externos e passeios, 82% (A) e 72% (B) afirmam usarem sempre os aparelhos. 100% das entrevistadas referiram verificar os aparelhos de seus filhos todos os dias. Conclusão: Crianças do Gr1, a maioria com perda profunda utilizaram os AASI no cotidiano com menor frequência que os outros grupos nas duas faixas etárias. Não houve diferença na consistência de uso quando comparado nível socioeconômico das famílias. Em situações em que as mães não podem supervisionar (no carro, ao ar livre), preferem não colocar os AASI. Não tem certeza se os AASI são utilizados consistentemente na creche ou na escola. Muitos pais têm dificuldade de perceber mudanças auditivas dos bebês e crianças em resposta a amplificação e isto parece afetar o uso consistente
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Goldberg, Miriam A. "Design and Testing of a Novel Communication System for Non-Vocal Critical Care Patients With Limited Manual Dexterity." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsbs_diss/1095.
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Nonvocal alert patients in the intensive care unit setting often struggle to communicate due to inaccessible or unavailable tools for augmentative and alternative communication. A novel communication tool, the Manually-Operated Communication System (MOCS), was developed for use in intensive care settings for patients unable to speak due to mechanical ventilation. It is a speech-generating device designed for patients whose limited manual dexterity precludes legible writing.
In a single-arm device feasibility trial, 14 participants (11 with tracheostomies, 2 with endotracheal tubes, and 1 recently extubated) used MOCS. Participants, family members, and observing nurses were interviewed whenever possible. Interviews included a modified version of the System Usability Scale (SUS) as well as open-ended questions; a qualitative immersion/crystallization approach was used to evaluate these responses.
Participants with a tracheostomy and their family members/care providers rated MOCS on the SUS questions as consistently “excellent” (average rating across all groups was 84 +/- 17; all subgroups also rated the device highly). Through a qualitative interview process, these stakeholders expressed support for the use of MOCS in the ICU. Based on these data, MOCS has the potential to improve communication for nonvocal patients with limited manual dexterity.
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Awan, Ziyad, and Ziaur Rahman. "Supply chain designs for Humanitarian Relief." Thesis, Jönköping University, JIBS, Centre of Logistics and Supply Chain Management, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-12719.
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Due to the unpredictable nature of sudden onset disasters the humans are often caught with surprise so are the humanitarian relief organizations. In order to quickly react to the emergencies, supply chain networks are built instantly by the actors of the relief management. Parallel to this process, need assessment is started with the help of local experts which also confirm that the response cannot be lingered on due a delay in need assessment. After wards the supply chain structure needs to be changed once the right information is gathered by the passage of time. This is not all, actually the situation of the disaster prone area and people also changes by that time which always brings a challenging scenario for humanitarian relief actors to develop the supply chain design with flexibility.Primary focus of this paper is to define right supply chain designs for disaster response and post disaster phases in humanitarian relief.
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Strauss, Susan. "Early hearing intervention and support services provided to the paediatric population by South African audiologists." Diss., University of Pretoria, 2006. http://hdl.handle.net/2263/27877.
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With the introduction of universal newborn hearing screening (UNHS) the need for quality early hearing intervention (EHI) services became critical. Screening is but the avenue to EHI services. Without appropriate intervention infants with hearing loss are at risk for language delay which might subsequently adversely influence academic success and vocational choices later on in life. The numerous socio-economic, cultural and healthcare barriers associated with developing countries such as South Africa, do not negate or diminish the need for optimal outcomes for infants with hearing loss through quality EHI services. The principle of quality EHI services, aligned with international standards, is endorsed by the HPCSA (2003: 2). In order to assure quality in EHI, service evaluation is critical. The necessary first step when evaluating service provision is to measure current service delivery. The main aim of this study was to determine whether South African audiologists provide EHI and support services aligned with international professional best practice to infants following the diagnosis of hearing loss. The first part of this study reviews the evidence available in EHI. The guidelines derived from the international evidence were stated as benchmarks against which South African EHI services were measured. These benchmarks were categorised using the so-called six M variation categories. These categories are: Man, machine (equipment), method (systemaric procedures), measurements, material (amplification devices) and Mother Nature. During the empirical research a descriptive design was followed comprising of questionnaire surveys to audiologists in different working sectors rendering EHI services to infants with hearing loss. The questionnaire survey explored the nature and scope of the EHI services offered to infants with hearing loss with regard to all the components (categorised in the six M categories) of the EHI programme of 40 South African audiologists. The results of this study indicate that respondents often do not use evidence-based measurements or methods during EHI services. Results suggest that undergraduate training in areas regarding the selection and fitting of amplification to infants with hearing loss is often inadequate (>20 respondents indicated that they are not trained). Evidence-based measurements are not typically performed when fitting amplification to infants (29 respondents do not perform probe-microphone or elctroacoustic measurements). Many respondents indicated that they do not have the necessary equipment to do these measurements. EHI services often (50% of respondents) do not provide A/R directly, but refer to other team members. From the results there seems to be significant delays in the rendering of EHI services to infants with hearing loss. Financial constraints of the family of the infants, accessibility problems, as well as a lack of infant support from their families often influence the EHI programmes of respondents. The implications of this study were discussed. Recommendations include the development of South African guidelines, aligned with international guidelines but taking into account the challenges posed by the unique South African context. Other recommendations include: Centres of excellence, relevant continuing education programmes and the evaluation of undergraduate training programmes.Dissertation (M (Communication Pathology))--University of Pretoria, 2006.
Speech-Language Pathology and Audiology
M (Communication Pathology)
unrestricted
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HUANG, CHI-CHENG, and 黃基城. "The design and development for guided rehabilitation walking aid." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/48729482288946907077.
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碩士崑山科技大學
電子工程研究所
104
Population aging has been a global trend in recent years, and population aging is getting serious in Taiwan. Domestic aging index hitting record high as well as the change of eating habits and the increase in life stress resulted from enhancing national standard of living have further enhanced the morbidity of cerebrovascular diseases. Cerebrovascular accidents present high mortality and high recurrence rate and often leave serious sequela. Limb kinetic dysfunction is the most common sequel. The recovery of patients’ limb kinetic function therefore appears great relationship with the rehabilitation treatment. Patients with uncoordinated movement have to rely on walking aid for the walking rehabilitation in the beginning of rehabilitation treatment. Accordingly, walking aid is primary for patients with disabled movement and bad balance. Walking aid could offer larger stability to support patients so that stroke patients could walk with walking aid. Stroke patients are planned the rehabilitation target by sticking footprints on the floor for the rehabilitation in hospitals. Such a rehabilitation method could not have many patients at the same time. Footprints in the rehabilitation could merely restrict patients in the same space. Besides, a patient needs a physiatrist for company during the rehabilitation, but a physiatrist cannot take care of several patients. In this case, physiatrists cannot accompany patients all the time. Moreover, each patient presents different way and habit on using walking aid. It also needs discussion and further improvement. In consideration of space limitations, inadequate physiatrists, and patients’ using habits of walking aid, an effective solution is proposed in this study. A system to improve physiatrists’ work efficiency, have patient rehabilitation not being restricted by space, and judge patients’ using habits is proposed in this study to solve above problems.
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Makan, Aarti. "The value of using the operational model of behaviour change in hearing aid rehabilitation." Diss., 2015. http://hdl.handle.net/2263/50668.
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The prevalence of hearing loss in adults is well documented. Hearing loss leads to poor
communication, which is essential for daily living. Cogitating that we have an ageing population
who are living longer with more co-morbidities, the consequences of a hearing loss can have a
devastating impact on psychosocial aspects of an individual’s life. This in turn can negatively
affect the quality of life of individuals with hearing loss. Although hearing aids are said to improve
quality of life, studies have proven that many patients who are issued with hearing aids do not
comply with aural rehabilitation services (either do not use the hearing aids at all or do not use
them consistently). Research documents how this is costly (both financially and psychosocially) to
patients, their caregivers as well as audiologists providing the service. Motivation and self-reported
hearing disability and handicap have been highlighted in the literature as reasons why patients do
not comply with aural rehabilitation. With current NHS reforms imposing cost-effective care with
more patient choice and patient collaboration, aural rehabilitation services should evolve to include
aspects of patient motivation and self-reported hearing disability and handicap by renouncing old
medical models of rehabilitation and utilising models such as the Operational Model of behaviour
change (OM). This model is said to be cost effective and patient-centred. The main aim of this
study was to determine the value of using the OM of behaviour change on adult aural
rehabilitation outcomes. The sub-aims outlined were designed to compare aural rehabilitation
outcomes between two groups of subjects: one group that did not receive the OM of behaviour
change and one that received the OM of behaviour change. This study was a quantitative,
experimental study that utilised a pre-test post-test design. A total of 141 adult subjects with
sensorineural hearing loss, who have never worn hearing aids, were recruited to this study and 68
of these were deemed suitable to participate as per the inclusion and exclusion criteria. Only 43
subjects completed the study and attended their final follow up appointment. Data from 24 subjects
in the control group and 19 subjects in the experimental group were analysed and reported. The
HHIE-S, HHIA-S, GHABP, IOI-HA and hearing aid data logging statistics were utilised as
outcome measures for this study. Pre-test results displayed no significant difference between
groups prior to implementation of the OM. Post-test results showed no significant difference for
hearing aid use, reported benefit, hearing aid satisfaction and self-reported hearing difficulties.
Conversely, the subjects in the experimental group scored significantly less residual disability for
the GHABP than those in the control group. It could be inferred that subjects in the experimental
group who received the OM, were more engaged and more supported during their rehabilitation
process and as such had less difficulty with hearing aids. With regard to hearing aid benefit, results
did have some positive effect, but this was not statistically significant. Secondary analysis of the
results revealed corroborations with other studies with regard to the value of hearing aids and
improvement in quality of life and reduction of self-reported hearing disability and handicap. On
the basis of this study’s results, further research is required to determine the value of the OM in
similar audiology settings. Adaptation of service delivery models such as the OM corresponds with
the drive for improving the quality of services by giving patients more control of their healthcare.Dissertation (MComm Path)--University of Pretoria, 2015.
tm2015
Speech-Language Pathology and Audiology
MComm Path
Unrestricted
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Pan, Kuan-Yu, and 潘冠宇. "Design and Control of Mobile Rehabilitation System for Lower Limbs with Walking Aid Function." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/sad5dy.
Full textAbstract:
碩士龍華科技大學
機械工程系碩士班
106
This thesis is based on the conception of intelligent universal design according to the theory of Physical Medicine and Rehabilitation and Human Factors and Ergonomics. This design involves new components to Lower Limb Rehabilitation Training and techniques for Mobility Aids, with the purpose to develop the small, lighter and cheap module with Mobile Rehabilitation System for Lower Limbs with Walking Aid Function and provide effective weight support. To improve the defects of the system, we design Mobile Rehabilitation System for Lower Limbs with Walking Aid Function which contains three system modules: (1) Lower Limbs Exoskeleton, (2) Mobility Aids, (3) Hanging weight support system. Lower Limbs Exoskeleton will be tested, verified and had dynamics simulation with Solidworks. To analyze the system of Dynamics and Kinematics, we try to deduce the forward and inverse kinematics solution for the structure of Lower Limbs Exoskeleton with The D-H coordinate transformation. We also deduce the Dynamics formula with The Lagrange method. Then we test and verify the Kinematics formula of Lower Limbs Exoskeleton and do the workspace simulation with MATLAB. The controller is designed with Type II Fuzzy Sliding PWM control and Type II fuzzy slide-mode control to control constant common hanging weight support and the treading track of single-leg Exoskeleton. For controlling the system, we use the core and the control system as the main axis with the core and the controller of NI myRIO by adopting LabVIEW to complete the design of system controller of Lower Limbs Exoskeleton, hanging weight support system and Mobility Aids. In the section of hardware production as well as the test and the setting of the system, the thesis is based on the design to research, produce and test the model of system function and import control system. According to the outcome of the experiment, the controlling system of Mobile Rehabilitation System for Lower Limbs with Walking Aid Function meets the demand of three system modules as mentioned. The controller designed for the thesis can be applied to the static or dynamic common weight support of hanging weight support system and the treading track of Lower Limbs Exoskeleton in order to enhance the safety of Mobility Aids.
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Wentzel, Tracy. "The relationship between practical hearing aid skills and patient satisfaction in the public health care setting." Thesis, 2016. http://hdl.handle.net/10539/22812.
Full textAbstract:
Submitted in partial fulfilment of the requirements for the degree
Master in Audiology
In the Department of Speech Pathology and Audiology
Faculty of Humanities
University of the WitwatersrandThe ability to handle a hearing aid may impact on satisfaction with and acceptance of hearing aids by individuals with hearing loss. Previous research has noted the correlation between hearing aid handling skills and effective hearing aid use. Although many studies have focused on the individuals’ satisfaction with their hearing aids there is a lack of information regarding the relationship between satisfaction with hearing aids and hearing aid handling skills. This is especially true for the South African context, where no studies have been conducted to explore this relationship. The main aim of the study was thus to determine the relationship between the ability to manipulate hearing aids and self-perceived satisfaction with hearing aids in individuals fitted with hearing aids in a public health care hospital. A non-experimental, cross-sectional, correlational research design was employed for the purpose of this study. The sample included 85 adults fitted with hearing aids in a public health care hospital. There was an equal distribution of gender and the mean age of participants was 66.27 years. Participants completed the Practical Hearing Aid Skills Test – Revised (PHAST-R) version and the Satisfaction with Amplification in Daily Life (SADL) questionnaire. The findings of the study indicate that the majority of participants were able to successfully manipulate their hearing aids (Mean score: 75.43%; Range: 10.71 - 100; SD: 21.58). The mean global score for satisfaction with amplification was 5.2 (Range: 3.1 - 6.8; SD: 0.84) indicating high levels of satisfaction with their hearing aids. Overall there was a significant correlation between hearing aid handling skills and satisfaction with amplification (rs= 0.22871; n = 85). Indicating participants who were better able to handle their hearing aids were more satisfied with them. The findings suggest that the majority of participants were satisfied with the hearing aids provided in a public health care hospital and that they were able to successfully handle their hearing aids. The use of the PHAST-R as part of the hearing aid orientation session is encouraged especially in light of the poor return rate for follow-up hearing aid orientation sessions at this public health care settings. The development of standard operating procedures for hearing aid fitting and orientation in the public health care sector is recommended to ensure that the best possible outcomes are ensured for all patients.
GR2017
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Lu, Chiu-Li, and 盧秋利. "A study of ages of suspicion, identification, hearing aid fitting and intervention of habilitation/rehabilitation in hearing impaired children." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/98184514398118497700.
Full textAbstract:
碩士國立台北護理學院
聽語障礙科學研究所
95
The purpose of this study is to survey the ages of suspicion of hearing loss, identification of hearing loss, hearing aid fitting, and intervention of habilitation/rehabilitation in hearing impaired children in Taiwan. We also investigate the influence of severity of hearing loss, high risk factors of hearing loss, education levels of mother (main care-giver) and newborn hearing screening on various ages related with hearing loss and their intervals. The subjects are those who once undertook the hearing tests and habilitation/rehabilitation in Ya-Wen Children’s Hearing Foundation, either in Taipei or Kaohsiung. The subjects were born from 1981 to 2003 and the total numbers of studied subjects are 359. The analysis data were obtained from records of history of hearing loss and demographics, and reports of hearing tests of all subjects from Ya-Wen Children’s Hearing Foundation. Summary of Results: 1. Despite of severity of hearing loss, the average age of suspicion is 20.75 months, the average age of identification is 26.22 months, the average age of hearing aid fitting is 30.89 months and the age of intervention of habilitation/rehabilitation is 37.00 months. 2. Association between the severity of hearing loss and various ages related with hearing loss: The earliest average age of suspicion is 14.40 months in children with profound hearing loss and the latest one is 34.33 months in those with mild hearing loss. The earliest average age of identification is 18.81 months in children with profound hearing loss and the latest one is 36.76 months in those with moderate-severe hearing loss. The earliest average age of hearing aid fitting is 24.43 months in children with profound hearing loss and the latest one is 41.29 months in those with moderate hearing loss. The earliest age of intervention of rehabilitation/ rehabilitation is 33.56 months in children with profound hearing loss and the latest one is 44.18 months in those with moderate hearing loss. Furthermore, there is significant difference in the average age of identification between profound hearing loss group and groups of moderate, moderate-severe and severe hearing loss (p< .05), and between severe hearing loss group and moderate-severe hearing loss group (p< .05). Significant difference in the average age of hearing aid fitting is also shown between profound hearing loss group and groups of moderate and moderate-severe hearing loss (p< .05), and between severe hearing loss group and moderate-severe hearing loss group (p< .05). 3. There is no significant difference in various ages related with hearing loss and their intervals between groups with and without high risk hearing loss (p> .05). 4. Association of education levels of mother and ages related with hearing loss of hearing impaired children: In higher education level group (above high school), the average ages of identification, hearing aids fitting and intervention of habilitation/rehabilitation are earlier, distribution tendency is more concentrated and highly related than in the lower one (below high school). However, there is no significant difference in these average ages between two groups (p> .05). In addition, the age interval between identification and intervention of habilitation/rehabilitation, as well as that between hearing aids fitting and intervention of habilitation/rehabilitation, is significantly shorter in higher education level group. Intervals between identification, hearing aids fitting and intervention of habilitation/ rehabilitation are longer and more inconsistent in lower education level group. In other words, mothers of lower education level very likely need more time to process intervention of habilitation/rehabilitation after identification of hearing loss. 5. In Taiwan, the newborn hearing screening started in 1998. For children born before 1998, the ages of identification and hearing aids fitting are highly related (Pearson Correlation Coefficient .867) and the rest combinations are moderately related (Pearson Correlation Coefficient .552 and .438). For children born after 1998, all ages related with hearing loss are highly related. Significant differences in all ages related with hearing loss, as well as their intervals, are shown between those born before and after 1998 (p< .05). For children born after 1998, significant differences in all ages related with hearing loss are shown between those with and without hearing screening (p< .05), but not in their intervals (p> .05). Conclusions: The severer the hearing loss is, the earlier the ages of suspicion and identification of hearing loss are. For children without newborn hearing screening, the average interval between ages of identification and intervention of habilitation/rehabilitation is about 10 months, no matter who are with or without the high-risk hearing loss, and no matter how the hearing loss severity is in those without the high-risk. It is still a big gap from JCIH(2000) target, identification of hearing loss at 3 months old and intervention of habilitation/ rehabilitation before 6 months old. Therefore early suspicion of hearing loss is a way to match the target of early identification and early intervention, and newborn hearing screening would be a good tool for it. The ages related with hearing loss are all significantly earlier in children with hearing screening born after 1998 than those without hearing screening, indicating that newborn hearing screening can benefit early identification of hearing loss. However, no significant differences in the intervals of various ages related with hearing loss are shown between children with and without hearing screening. The intervals are even longer in children with hearing screening than those without hearing screening, indicating the effect of early intervention is not good enough at present. It needs more professional effort and cooperation including speech and hearing specialty, public health and public media to achieve the aim of early intervention. Furthermore, this research result also shows that interval between identification and intervention of habilitation/rehabilitation is longer for mothers (main care-givers) of lower education level. Therefore, more effort on public education for parents of lower education level is recommended to be the important part of early diagnostic and early intervention plan to shorten the interval between identification and intervention of habilitation/rehabilitation.
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Moss, Andrew. "Transforming contemporary criminal sentencing: introducing a composite-aims restorative justice model." Thesis, 2010. http://hdl.handle.net/1828/3186.
Full textAbstract:
One of the most important questions facing legal philosophers concerns the legitimacy of state institutions of legal punishment which visit citizens who have broken the law with condemnation and hard treatment. The purpose of this thesis is to attempt to answer the question of how we ought to respond to criminal offenders whose guilt has been established. The Canadian approach to criminal sentencing is evaluated, as are prominent restorative justice sentencing models. A novel composite-aims restorative justice model of responding to convicted offenders is introduced and the model’s aims and limits are specified. The thesis attempts to establish that a composite-aims model which encompasses certain restorative justice values and processes can provide a desirable framework for responding to convicted offenders. The implication for Canadian criminal justice policy is that the practice of applying punitive sanctions that are proportional to the moral gravity of the criminal offence should be abandoned in favour of a model based on securing censure, amends, crime control and reformation.
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Lorenzini, Marie-Céline. "Understanding the Use of Head-Mounted Displays by Individuals with Low Vision : The case of eSight." Thesis, 2020. http://hdl.handle.net/1866/24251.
Full textAbstract:
Les dispositifs permettant d'agrandir les images représentent les formes les plus courantes d'aides en réadaptation visuelle. Grâce à un essor technologique considérable, les lunettes électroniques, qui fonctionnent comme des aides grossissantes électroniques (fournissant un agrandissement variable, amélioration du contraste, utilisables les mains libres), sont devenues d'avantage disponibles, efficaces et utilisées par les personnes malvoyantes. Cependant, il existe un manque de données probantes et de connaissances au regard des taux d'abandon des lunettes électroniques, des facteurs prédictifs de leur utilisation, ainsi que sur les interventions efficaces qui pourraient optimiser leur utilisation.Afin de mieux comprendre l'utilisation des lunettes électroniques au sein de la population malvoyante, une étude en trois phases a été menée à travers l’exemple des lunettes eSight dans le but de : 1) examiner et synthétiser les facteurs qui influencent l'utilisation d'aides visuelles grossissantes à l'aide d'un examen de la portée afin de guider les études ultérieures; 2) déterminer à travers une étude transversale quelles sont les variables qui prédisent un changement d’utilisation des lunettes électroniques chez leur usager; et 3) élaborer des recommandations fondées sur des données probantes concernant la faisabilité d'une intervention de téléréadaptation auprès des utilisateurs de lunettes électroniques et étudier l'impact de cette modalité sur l’utilisation de leur dispositif et leur qualité de vie.Les travaux de cette thèse contribuent à soutenir l’idée que le choix d’utiliser des aides visuelles grossissantes dépend de causes multifactorielles. Les facteurs personnels et surtout la motivation représentent des prédicteurs importants. Les difficultés de transport et le manque d’entrainement ont été identifiés comme des obstacles importants à l’utilisation des aides visuelles. D’autre part, l’amélioration de la qualité de vie favorise le maintien de l’utilisation des lunettes électroniques. Compte tenu de ces résultats, un programme de formation personnalisée par téléréadaptation a été mis au point pour répondre aux besoins spécifiques des utilisateurs, offrant une attention individualisée pour optimiser l'utilisation des lunettes électroniques. Cette thèse fournit des preuves sur la faisabilité d'administrer plusieurs sessions d’entrainement en réadaptation de basse vision via la téléréadaptation chez des utilisateurs de lunettes électroniques. Les lunettes électronique eSight améliorent la qualité de vie et la vision fonctionnelle des utilisateurs, qu’elle soit associée à la téléréadaptation ou au programme d’autoformation du fabricant. Cela indique que les instructions fournies par la téléréadaptation ou par l'autoformation proposée dans un contexte commercial sont tout aussi efficaces pour améliorer la qualité de vie et les capacités visuelles et que la téléréadaptation pourrait être offerte comme une modalité de formation allternative. Afin d’orienter les recommandations de pratiques fondées sur des données probantes en matière de téléréadaptation, et de répondre au mieux aux besoins des personnes avec une basse vision, d'autres études examinant les effets de la pratique et de l’entrainement sont nécessaires.Magnification devices are among the most common forms of aids in low vision rehabilitation. They are intended to increase the level of independence and function during activities of daily living. Novel head-mounted display magnification devices for low vision that operate as electronic vision enhancements (providing variable magnification, contrast enhancement, hands-free use) have become more and more available, efficient and are increasingly being utilized, thanks to considerable technological development. Nevertheless, there is still a lack of knowledge regarding abandonment rates, factors predicting abandonment of such devices, and efficient intervention characteristics that optimize their use.To better understand the use of head-mounted displays throughout the low vision population, a three-phase study has been conducted using eSight Eyewear as an example device in order to: 1) investigate and synthesize barriers and facilitators influencing the use of magnifying visual aids, using a scoping review to guide the subsequent cross-sectional and prospective studies; 2) identify which variables best predict a change in device use among current head-mounted display users, using a cross-sectional design; and 3) develop evidence-based recommendations regarding the feasibility of a telerehabilitation intervention on head-mounted display users and study the impact of this modality on their device use and quality of life.This thesis provides supporting evidence for the multifactorial decision-making process around the use of magnifying visual aids. Device users’ low motivation, transportation to rehabilitation services and insufficient training have been identified as important barriers to magnifying low vision aid use. Improving users’ quality of life helps to maintain the use of head-mounted displays. Considering these findings, a personalized training regime via telerehabilitation was developed to meet specific users’ needs, providing individualizing attention to optimize the use of head-mounted displays. This thesis provides evidence about feasibility of administering several low vision rehabilitation training sessions via telerehabilitation with head-mounted display users. eSight Eyewear, either with telerehabilitation or with the manufacturer self-training standard, improves quality of life and functional vision outcomes.This indicates that instructions provided by telerehabilitation or though the eSight self-training standard are equally successful in improving quality of life and visual abilities outcomes and that telerehabilitation could be provided as an alternative training modality. To help guide evidence-based practice recommendations for low vision telerehabilitation implementation that meet the unique needs of individuals with low vision, further studies examining benefits of practice and training are needed.
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Horne, Maria, G. McCracken, A. Walls, P. J. Tyrrell, and C. J. Smith. "Organisation, practice and experiences of mouth hygiene in stroke unit care: a mixed methods study." 2015. http://hdl.handle.net/10454/7373.
Full textAbstract:
noAims and objectives To (1) investigate the organisation, provision and practice of oral care in typical UK stroke units; (2) explore stroke survivors', carers' and healthcare professionals' experiences and perceptions about the barriers and facilitators to receiving and undertaking oral care in stroke units. Background Cerebrovascular disease and oral health are major global health concerns. Little is known about the provision, challenges and practice of oral care in the stroke unit setting, and there are currently no evidence-based practice guidelines. Design Cross-sectional survey of 11 stroke units across Greater Manchester and descriptive qualitative study using focus groups and semi-structured interviews. Methods A self-report questionnaire was used to survey 11 stroke units in Greater Manchester. Data were then collected through two focus groups (n = 10) with healthcare professionals and five semi-structured interviews with stroke survivors and carers. Focus group and interview data were recorded, transcribed verbatim and analysed using framework approach. Results Eleven stroke units in Greater Manchester responded to the survey. Stroke survivors and carers identified a lack of oral care practice and enablement by healthcare professionals. Healthcare professionals identified a lack of formal training to conduct oral care for stroke patients, inconsistency in the delivery of oral care and no set protocols or use of formal oral assessment tools. Conclusion Oral care post-stroke could be improved by increasing healthcare professionals' awareness, understanding and knowledge of the potential health benefits of oral care post-stroke. Further research is required to develop and evaluate the provision of oral care in stroke care to inform evidence-based education and practice.