Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs.

Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs.

Coach Behaviors and Athlete Satisfaction in Team and Individual Sports

The coach can have a profound impact on athlete satisfaction, regardless of the level of sport involvement. Previous research has identified differences between coaching behavior preferences in team and individual sport athletes. The present study examined the moderating effect that an athlete's sport type (i.e., individual or team) may have on the relationships among seven coaching behaviors (mental preparation, technical skills, goal setting, physical training, competition strategies, personal rapport, and negative personal rapport) for predicting coaching satisfaction. Moderated multiple regression analyses indicated that each of the seven coaching behaviors were significant main effect predictors of coaching satisfaction. However, sport type (i.e., team or individual sports) was found to moderate six of the seven relationships: mental preparation, technical skills, goal setting, competition strategies, personal rapport, and negative personal rapport in predicting satisfaction with the coach. These findings indicate that high coaching satisfaction for athletes in team sports is influenced to a greater extent by the demonstration of these behaviors than it is for individual sport athletes.

Public Perceptions of the Midwest's Pavements - Executive Summary: Iowa

This report summarizes Iowa results of a five year, Pooled Fund study involving the Wisconsin, Iowa, and Minnesota Departments of Transportation (DOTs) designed to 1) assess the public's perceptions of the DOTs' pavement improvement strategies and 2) develop customer-based thresholds of satisfaction with pavements on rural two lane highways in each state as related to the DOTs' physical indices, such as pavement ride and condition. The primary objective was to seek systematic customer input to improve the DOTs' pavement improvement policies by 1) determining how drivers perceive the DOTs' pavements in terms of comfort and convenience but also in terms of other tradeoffs the DOTs had not previously considered, 2) determining relationships between perceptions and measured pavement condition thresholds (including a general level of tolerance of winter ride conditions in two of the states), and 3) identifying important attributes and issues that may not have been considered in the past. Secondary objectives were 1) to provide a tool for systematic customer input in the future and 2) to provide information which can help structure public information programs. A University of Wisconsin-Extension survey lab conducted the surveys under the direction of a multi-disciplinary team from Marquette University. Approximately 4500 drivers in the 3 states participated in the 3 phases of the project. Researchers conducted 6 focus groups in each state, approximately 400 statewide telephone interviews in each state and 700-800 targeted telephone interviews in each state. Approximately 400 winter ride interviews were conducted in Wisconsin and Minnesota. A summary of the method for each survey is included. In Phase I, focus groups were conducted with drivers to get an initial indication of what the driving public believes in regards to pavements and to frame issues for inclusion in the more representative statewide surveys of drivers conducted in Phase II. Phase II interviews gathered information about improvement policy tradeoff issues and about preliminary thresholds of improvement in terms of physical pavement indices. In Phase III, a two step recruitment and post-drive interview procedure yielded thresholds of ride and condition index summarized for each state. Results show that, in general, the driving public wants longer lasting pavements and are willing to pay for them. They want to minimize construction delay, improve entire sections of highway at one time but they dislike detours, and prefer construction under traffic even if it stretches out construction time. Satisfaction with pavements does not correlate directly to a high degree with physical pavement indices, but was found instead to be a complex, multi-faceted phenomenon. A psychological model was applied to explain satisfaction to a respectable degree for the social sciences. Results also indicate a high degree of trust in the 3 DOTs which is enhanced when the public is asked for input on specific highway segments. Conclusions and recommendations include a 3-step methodology for other state studies.

Redes Sociais Pessoais de Idosos, Satisfação com as Relações Interpessoais e Confiança

Objetivos: O presente estudo tem como objetivo geral caracterizar as redes sociais pessoais dos idosos com idade igual ou superior a 65 anos, analisando-as segundo o nível de satisfação com as relações interpessoais e a confiança nos outros. Metodologia: Este é um estudo descritivo e correlacional, privilegiando a análise bivariada. Os dados foram recolhidos através do Instrumento de Análise da Rede Social Pessoal, IARSP-Idosos (Guadalupe, 2009; Guadalupe & Vicente, 2012) e de uma escala de avaliação da Satisfação com as Relações Interpessoais, construída para o efeito, e de uma questão relacionada com a Confiança. Participantes: A amostra é constituída por 446 indivíduos, maioritariamente do sexo feminino (n=285; 63,9%), com idades compreendidas entre os 65 e os 98 anos; a maioria tem filhos (n = 389; 87,2%), e cerca de 80,0% (n = 357) vivem na sua casa, sendo a zona de residência essencialmente rural (61,2%; n = 273). A maioria tem escolaridade (65,9%; n = 294), sobretudo ao nível do quarto ano (n= 226; 50,7%). Resultados: Os resultados demonstram que os idosos do sexo feminino, com ≤ 75 anos, casado/a ou em união de fato, com filhos, que vivem acompanhados, com o 4ª ano de escolaridade e que não registam qualquer corte relacional, são os que mais confiam nos outros. Registam-se diferenças nas características funcionais da rede segundo esta variável, o que não acontece nas estruturais, com a exceção da proporção das relações com técnicos (p = 0,042) e nas relacionais-contextuais. A confiança nas pessoas com quem se relaciona correlaciona-se de forma positiva e estatisticamente significativa com a satisfação com os filhos, com os netos, com outros parentes, com os amigos e com os vizinhos (p<0,001). Conclusões: Numerosas variáveis sociodemográficas não aparentam estar relacionadas com a confiança nas pessoas com quem os idosos se relacionam, nas múltiplas dimensões consideradas. Em contrapartida, as variáveis que aparecem relacionadas com a confiança, são aquelas que, de forma mais ou menos direta, estão igualmente associadas ao domínio pessoal. É de salientar que no que respeita a esta variável se verificam diferenças nas características funcionais da rede o que não acontece nas estruturais e nas relacionais-contextuais. As relações familiares de filhos, netos e outros parentes são as que mais se associam à confiança e ao apoio social percebido pelos idosos, o qual é complementado por outras relações interpessoais, designadamente as que são estabelecidas com amigos e vizinhos. / Objetives: This study has the general objective to characterize the personal social networks of the elderly aged over 65 years, analyzing them according to the level of satisfaction with interpersonal relationships and trust in others. Methodology: This is a descriptive and correlational study, focusing on bivariate analysis. Data were collected through the Personal Social Networks Analysis Tool, IARSP-Elderly (Guadalupe, 2009; Vicente & Guadalupe, 2012) and a scale measuring satisfaction with interpersonal relations, purpose built, and a question related to the trust. Participants: The sample includes 446 individuals, mostly female (n = 285; 63,9%), aged between 65 and 98 years old; most have sons/daughters (n = 389; 87,2%), and about 80,0% (n = 357) are living in their home, mostly in rural areas (61,2%, n = 273). The majority have education (65,9%, n = 294), especially at the level of the fourth year (n = 226; 50,7%). Results: The results show that the elderly female, with <= 75, married, with children, living together, with the 4th grade, and did not record any relational cut, are the ones that rely in the others. We found differences in the functional characteristics of the network according to this variable, what does not happen on the structural variables, with the exception of the proportion of relations with workers in social services (p = 0,042), and on the relational-contextual. The confidence in the people he meets, correlates positively and statistically significant satisfaction with the children, with grandchildren, other relatives, friends and neighbors (p <0,001) Conclusions: Numerous sociodemographic variables do not appear to be related to trust in the interpersonal relationship, in the multiple dimensions considered. In contrast, the variables which appear related to trust are those which are associated with the personal domain. It is noteworthy that we have found differences in the functional characteristics of the network but not in the structural and the relational-contextual. Family relationships of children, grandchildren and other relatives are the most associated to the confidence and social support perceived by the elderly, which is complemented by other interpersonal relationships, including those with established friends and neighbors.

The Broader Impact of Disability Research: Aligning Public Policy with the Experiences of People with Disabilities and Healthcare Providers

Thesis (Ph.D.)--University of Washington, 2016-07

Applying Career Concepts to Strengthen the Work-Attitudes of Service Professionals

Given the nature of employment relationships today, service organizations can strengthen the organization commitment levels and reduce the turnover intentions of its professionals through providing job features important to their careers. These features include opportunities to perform challenging work, experience trusting relationships with customers/clients, and obtain extrinsic rewards. Using a sample of alumni from a hospitality business program, hypotheses that these features impact organizational commitment and turnover intentions, partially through strengthening professionals' career commitment, are developed and tested. Findings suggest that challenging work opportunities impact these attitudes both directly and indirectly. So too trusting relationships with customers and clients indirectly impact organization commitment and intent to turnover (ITO). Results also suggest that, as a whole, satisfaction with extrinsic rewards has no effect. However, an analysis of multigroup mediation results revealed that for professionals working in professional service firms, satisfaction with pay reduces both attitudes. Implications for research in organization commitment and ITO, specifically the role and impact of career-based antecedents, are discussed.

Os efeitos das reclamações online na lealdade dos consumidores: um estudo experimental

In an environment of constant change, technological developments, market competition and more informed consumers, the search for a lasting relationship through the conquest of loyalty has become the objective of companies. However, several authors suggest that this loyalty can be affected by negative comments available on the internet. Therefore, this dissertation has as objective to examine if the complaints are available on the internet impact the loyalty to a brand of mobile phone. The research used as the basis the Expanded NCSB model suggest by Johnson et al. (2001), studying five prominent drives of loyalty: image/brand reputation, affective commitment, calculative commitment, perceived value and trust, beyond the satisfaction construct as moderator variable. The research method adopted was the experimental design which included 285 undergraduate students, with the trial which included 285 undergraduate students, with the field study of the mobile industry, specifically, the brands of cell phones. The research approach was quantitative and methods were descriptive statistics, factor analysis, cluster analysis, linear regression and non-parametric test of Wilcoxon for data analysis. Of the 16 hypothesis stemmed from the research model proposed, 12 were confirmed. The results showed that the complaint available on the internet, here represented by the available on the site Reclame Aqui, may impact consumer perceptions about brand loyalty, as well as its antecedents, being that these complaints can affect all the consumers, regardless of historical satisfaction with the brand. It also noted the positive relationship between the independent variables trust, image/brand reputation, perceived value, affective commitment and calculative commitment and the dependent variable - loyalty, even when considering the data obtained after exposure to the complaint. However, no unanimous conclusion that the relationship between these variables was strongest in the group with satisfactory experience. At the first moment of the research, the trust was the most important variable for the formation of loyalty. However, after exposure to treatment, the image/brand reputation, was more relevant. Contributions of the study, limitations and recommendations for future researches are approached in the present investigation

Ocular manifestations of microcephaly with or without chorioretinopathy, lymphedema or intellectual disability (MCLID) syndrome associated with mutations in KIF11

Purpose Microcephaly with or without chorioretinopathy, lymphedema or intellectual disability (MCLID) is an autosomal dominant condition. Mutations in KIF11 have been found to be causative in approximately 75% of cases. This study describes the ocular phenotype in patients with confirmed KIF11 mutations. Methods Standard ophthalmic examination and investigation including visual acuity, refraction and fundus examination was carried out in all patients. Fundus autofluorescence imaging (FAF) was performed in three patients, and four patients underwent spectral domain optical coherence tomography (OCT). Flash electroretinography (ERG) was performed in seven patients, and five underwent additional pattern electroretinography (PERG). Results The patients ranged in age from 2 to 10 years. Most presented with visual acuity loss. Fundus examination revealed lacunae of chorioretinal atrophy. Pigmentary macular changes and optic disc pallor were present in three of seven patients. Fundus autofluorescence demonstrated hypoautofluorescence at the macula in two of three patients. The lacunae of chorioretinal atrophy were hypoautofluorescent. The OCT showed atrophic maculae in three of four patients. Follow-up in one patient showed no deterioration of the vision over a 9-year period. The lesions appear not to be progressive on the follow-up imaging. Electrophysiology showed generalized rod and cone dysfunction and severe macular dysfunction. Inner retinal dysfunction was evident in three of seven patients. Conclusions Patients with KIF11 mutations show a specific ocular phenotype with variable expressivity and intrafamilial variability. Macular atrophy and dysfunction have not been consistently documented before. The fundus lesions appear non-progressive. The findings assist in providing an accurate diagnosis and thus improving the management and follow-up of patients with this syndrome.

Development of variable displacement oil pump for internal combustion engines

In the last years the need to develop more environmentally friendly and efficient cars as led to the development of several technologies to improve the performance of internal combustion engines, a large part of the innovations are focused in the auxiliary systems of the engine, including, the oil pump, this is an element of great importance in the dynamics of the engine as well a considerable energy consumer. Most solutions for oil pumps to this day are fixed displacement, for medium and high speeds, the pump flow rate is higher than the needs of the engine, this excess flow leads to the need for recirculation of the fluid which represents a waste of energy. Recently, technological advances in this area have led to the creation of variable displacement oil pumps, these have become a 'must have' due to the numerous advantages they bring, although the working principle of vane or piston pumps is relatively well known, the application of this technology for the automotive industry is new and brings new challenges. The focus of this dissertation is to develop a new concept of variable displacement system for automotive oil pumps. The main objective is to obtain a concept that is totally adaptable to existing solutions on the market (engines), both dimensionally as in performance specifications, having at the same time an innovative mechanical system for obtaining variable displacement. The developed design is a vane pump with variable displacement going in line with existing commercial solutions, however, the variation of the eccentricity commonly used to provide an variable displacement delivery is not used, the variable displacement is achieved without varying the eccentricity of the system but with a variation of the length of the pumping chamber. The principle of operation of the pump is different to existing solutions while maintaining the ability to integrate standard parts such as control valves and mechanical safety valves, the pump is compatible with commercial solutions in terms of interfaces for connection between engine systems and pump. A concept prototype of the product was obtained in order to better evaluate the validity of the concept. The developed concept represents an innovation in oil pumps design, being unique in its mechanical system for variable displacement delivery.

Patients' satisfaction and quality of life in coronary artery disease

OBJECTIVES: To assess satisfaction of survivors of coronary artery diseases (CAD) with healthcare services and to determine whether specific components of standard health-related quality of life (HRQL) assessment tools might identify areas of satisfaction and dissatisfaction. METHOD: A specific tool developed to provide a comprehensive assessment of healthcare needs was administered concomitantly with generic and specific HRQL instruments, on 242 patients with CAD, admitted to an acute coronary unit during a single year. RESULTS: 92.5% of patients confirmed their trust in and satisfaction with the care given by their General Practitioner; even so, one third experienced difficulty getting an appointment and a quarter wanted more time for each consultation or prompt referral to a specialist when needed. Around a third expressed dissatisfaction with advice from the practice nurse or hospital consultant. Overall 54% were highly satisfied with services, 33% moderately satisfied and 13% dissatisfied.Cronbach's alpha was 0.87; the corrected total-item correlation ranged between 0.55-0.75, with trivial 'floor' score and low 'ceiling' effect. Several domains in all three HRQL tools correlated with items relating to satisfaction. The Seattle Angina Questionnaire Treatment Score correlated significantly with all satisfaction items and with the global satisfaction score. CONCLUSION: Cardiac patients' demanded better services and advice from, and more time with, health professionals and easier surgery access. The satisfaction tool showed acceptable psychometric properties. In this patient group, disease-specific HRQL tools seem more appropriate than generic tools for surveys of patient satisfaction

Cultural and Social Cognitive Predictors of Academic Satisfaction in Southeast Asian American College Students

This study examined the predictive utility of Lent’s (2004) social cognitive model of well-being in the context of academic satisfaction with a sample of Southeast Asian American college students using a cross-sectional design. Path analysis was used to examine the role of perceived parental trauma, perceived parental acculturative stress, intergenerational family conflict, and social cognitive predictors to academic satisfaction. Participants were 111 Southeast Asian American and 111 East Asian American college students who completed online measures. Contrary to expectations, none of the contextual cultural variables were significant predictors of academic satisfaction. Also contrary to expectations, academic support and self-efficacy were not directly linked to academic satisfaction and outcome expectation was not linked to goal progress. Other social cognitive predictors were related directly and indirectly to academic satisfaction, consistent with prior research. Limitations and implications for future research and practice are addressed.

Exploring Health in Military Families: Does Continuity of Care Influence Patient Satisfaction?

To ensure mission-readiness for military members, support for their families is essential. Military family health and health care satisfaction has been a neglected area of study in this population. Satisfaction can be defined in terms of patient-, provider-, and practice-level factors and is influenced by continuity of care, which is often poor in transient military populations. Using a modified patient satisfaction survey, this study found that both the number of moves and assigned providers were significantly associated with continuity of care in military spouses. Further, continuity of care was a significant predictor of satisfaction with military health care.

Investimento na vida pessoal da pessoa idosa institucionalizada

Enquadramento: Nas últimas décadas, tem-se assistido a um envelhecimento populacional crescente e a um progressivo aumento da institucionalização dos idosos. A institucionalização representa frequentemente para o idoso uma rutura com o seu passado, levando à perda da sua individualidade e consequentemente a um processo de isolamento que poderá contribuir para níveis elevados de insatisfação com a vida. O Investimento na vida pessoal remete-nos para a valorização e atribuição de objetivos de vida ao ser humano, naquela que é a última etapa da sua vida, em todos os seus atributos e caraterísticas, inclusive na sua complexa estrutura física, intelectual e espiritual. Objetivos: Avaliar o nível de Investimento na vida pessoal percecionado pelos idosos institucionalizados e analisar a sua relação com as variáveis socio demográficas, clínicas, e psicossociais. Métodos: Trata-se de um estudo não experimental, transversal, descritivo-correlacional e de caráter quantitativo, que foi realizado numa amostra não probabilística por conveniência, constituída por 90 pessoas idosas a residir nas ERPI do concelho de Vila Nova de Paiva. Para a mensuração das variáveis utilizou-se um instrumento de colheita de dados que integra uma secção de caraterização sócio demográfica, e uma secção de caraterização clínico-funcional (índice de Barthel), caraterização familiar (Escala de Apgar Familiar) e situacional, lazer (Índice de Atividades de Lazer), espiritualidade (Escala da Espiritualidade), perceção da vida atual (Escala de Satisfação com a Vida) e futura, e por fim a Escala de Avaliação de Investimento na Vida Pessoal. Resultados: Os dados mostram que a perceção dos idosos sobre o investimento na sua vida pessoal se distribui de uma forma relativamente equitativa por três níveis. Contudo, o maior grupo percentual (37,8%) perceciona o seu investimento como elevado, enquanto 32,2% o entende como baixo e o grupo mais reduzido (30,0%) o considera moderado. A análise por género mostra que os homens tendem a avaliar o investimento de uma forma mais positiva que as mulheres; também os idosos com habilitações académicas superiores (p= 0,041) e com maior nível de independência funcional (p= 0,037) são os que percecionam um maior investimento na vida pessoal. Constatamos ainda que a família tem um efeito significativo (p= 0,020) no nível do investimento na vida do idoso, à semelhança da existência de mais esperança (p= 0,002), maior satisfação com a vida (p= 0,013) e do desenvolvimento de planos para o futuro (p= 0,032). Conclusão: As evidências encontradas neste estudo mostram que há níveis diferenciados de Investimento na vida pessoal entre os idosos. Este Investimento correlaciona-se de forma significativa com diversas variáveis independentes que depois de devidamente identificadas devem ser promovidas para assegurar aos idosos um envelhecimento ativo e com qualidade. As competências atribuídas ao enfermeiro especialista em reabilitação são de uma mais-valia inegualável no desenvolvimento do referido envelhecimento com qualidade, quando inserido numa equipa multidisciplinar, nas Estruturas Residenciais Para Idosos. Palavras-chave: idosos, institucionalização, satisfação com a vida, investimento na vida pessoal.

Os efeitos das reclamações online na lealdade dos consumidores: um estudo experimental

In an environment of constant change, technological developments, market competition and more informed consumers, the search for a lasting relationship through the conquest of loyalty has become the objective of companies. However, several authors suggest that this loyalty can be affected by negative comments available on the internet. Therefore, this dissertation has as objective to examine if the complaints are available on the internet impact the loyalty to a brand of mobile phone. The research used as the basis the Expanded NCSB model suggest by Johnson et al. (2001), studying five prominent drives of loyalty: image/brand reputation, affective commitment, calculative commitment, perceived value and trust, beyond the satisfaction construct as moderator variable. The research method adopted was the experimental design which included 285 undergraduate students, with the trial which included 285 undergraduate students, with the field study of the mobile industry, specifically, the brands of cell phones. The research approach was quantitative and methods were descriptive statistics, factor analysis, cluster analysis, linear regression and non-parametric test of Wilcoxon for data analysis. Of the 16 hypothesis stemmed from the research model proposed, 12 were confirmed. The results showed that the complaint available on the internet, here represented by the available on the site Reclame Aqui, may impact consumer perceptions about brand loyalty, as well as its antecedents, being that these complaints can affect all the consumers, regardless of historical satisfaction with the brand. It also noted the positive relationship between the independent variables trust, image/brand reputation, perceived value, affective commitment and calculative commitment and the dependent variable - loyalty, even when considering the data obtained after exposure to the complaint. However, no unanimous conclusion that the relationship between these variables was strongest in the group with satisfactory experience. At the first moment of the research, the trust was the most important variable for the formation of loyalty. However, after exposure to treatment, the image/brand reputation, was more relevant. Contributions of the study, limitations and recommendations for future researches are approached in the present investigation