Dissertations / Theses: 'Medicare FFS'

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Fayyad, Abdalla Mustafa. "The role of soluble FMS-like tyrosine kinase (sFLT1) and FAS associated proteins in pregnancies complicated by preeclampsia and intrauterine growth restriction (IUGR)." Thesis, Queen Mary, University of London, 2005. http://qmro.qmul.ac.uk/xmlui/handle/123456789/1750.

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Current thinking suggests that preeclampsia is associated with activation of the maternal vascular endothelium in response to factors released from the placenta due to placental hypoxia. Failure of physiological modification of spiral arteries due to impaired trophoblast invasion results in a several-fold increase in the risk of developing pre-eclampsia and/or (IUGR). The defect behind impaired trophoblast invasion is not fully explained and the aetiological factor(s) linked with the development of pre-eclampsia, compared to normotensive IUGR, is not known. In this thesis, I examined placental and serum levels of fms-like tyrosine kinase I (sFltl) and placental growth factor (PIGF), as mediators of angiogenesis, and Fas and FasL, as mediators of apoptosis, in three groups; preeclampsia, normotensive IUGR and controls who had abnormal mid-trimester uterine artery Doppler. Uterine artery Doppler flows were examined in 553 women at 24 weeks. 97 of them had abnormal uterine artery Doppler flow and were enrolled in this study. 86 women were followed up; among them eight women developed preeclampsia and seven developed normotensive IUGR. Umbilical artery Doppler examination 24 hours before delivery in both groups, showed significantly lowered resistance indices in the preeclampsia compared to the normotensive IUGR group. I examined placental and serum levels of fms-like tyrosine kinase I (FIt I) and Placental Growth Factor (PIGF) in three groups. Soluble FItI acts as an antagonist for both Vascular Endothelial Growth Factor (VEGF) and PIGF. Placental FIt 1 and serum sFlt 1 were higher and serum PIGF was lower in the preeclampsia group compared to the other two groups. This could be responsible for the systemic manifestations of preeclampsia. This dysregulation in serum sFltl and PIGF was found as early as 24 weeks in pregnancies with abnormal uterine artery Doppler examination. The normotensive IUGR group had significantly elevated serum sFlU compared to controls. This could be due to an element of placental hypoxia in the IUGR group. To investigate the in-vivo effect of sFltl on impaired placental angiogenesis and trophoblast invasion, I examined the correlations between uterine artery Doppler resistance indices and serum sFIU and PIGF at 24 weeks. Significant correlations were found between these markers and uterine artery Doppler pulsatility index (pn and resistance index (Rn on both the placental and non-placental sides at 24 weeks. Fas and Fas ligand (FasL) are membrane proteins that mediate cellular apoptosis, and recently were related to cellular growth and migration. Using western blotting and immunohistochemistry, placental expression of Fas (western blotting) and (FasL) (immunohistochemistry) was assessed in the three study groups. No differences in placental Fas or Fas ligand were found between the groups. In addition, serum levels of Fas and FasL were measured at 24 weeks and within 24 hours of delivery in the same groups. Serum Fas was not different between the three study groups at 24 weeks and within 24 hours of delivery. Serum FasL was below the kit's detection threshold in the samples studied. In conclusion, placental FlU and its soluble form sFltl seem to play an important role in the pathophysiology of preeclampsia. In addition, sFltl correlated positively with the severity of impaired trophoblast invasion and could playa central role in blocking placental angiogenesis in these pregnancies. This needs further evaluation. Fas and FasL do not seem to have a role In impaired placentation and development of preeclampsia and IUGR.

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Robinson, Matthew M. "The Effect of Functional Electrical Stimulation (FES) Applied to the Gluteus Medius During Resistance Training." University of Toledo / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1525343063114996.

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Fischer, Lina, and Rebecka Jönsson. "Synligt- och osynligt stöd : Anhörigas upplevelser av stöd när en familjemedlem vårdas i sen palliativ fas." Thesis, Kristianstad University College, Department of Health Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-4293.

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When a family member is being cared for in palliative care relatives often need support to be able to support their family member. The purpose of the literature review was to illuminate the nursing staff’s support from the relatives’ perspective when a family member is being cared in a late palliative phase. The study is a literature review, there already existing research are surveyed. The findings were structured into two parts, tangible- and the intangible support. Tangible support is a one-way support; to receive information and that someone takes over. Intangible support is support within an interpersonal relation, when the nursing staff in one way or another respond to the relatives needs; that someone shows consideration, to be met with honesty, someone who gives time and to be given opportunity to feel hope. The support could make relatives feel secure and in control. Tangible- and intangible support are connected and form wholeness, but it is important to notice that there are two kinds of support and the relatives are in need of both.

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Milici, Stefano. "Analysis of Wireless Body-Centric Medical Sensors for Remote Healthcare." Doctoral thesis, Universitat Rovira i Virgili, 2019. http://hdl.handle.net/10803/667079.

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Aquesta tesi aborda el problema de trobar solucions confortables, de baixa potència i sense fils per aplicacions mèdiques. La tesi tracta els avantatges i les limitacions de tres tecnologies de comunicació diferents per la mesura de paràmetres del cos i mètodes per redissenyar sensors per avaluacions òptimes centrades en el cos. La tecnologia RFID es considera una de les solucions més influents per superar el problema del consum d'energia limitat, a causa de la presència de molts sensors connectats. També s'ha estudiat la tecnologia Bluetooth de baixa energia per resoldre els problemes de seguretat i la distància de lectura que, en general, representen el coll d'ampolla de RFID pels sensors de cos. Els dispositius analògics poden reduir dràsticament les necessitats d'energia a causa dels sensors i les comunicacions, considerant pocs elements i un mètode de transmissió simple. S'estudia un mètode de comunicació completament passiu, basat en FSS, que permet una distància de lectura raonable amb capacitats de detecció precises i confiables, que s'ha discutit en aquesta tesi. L'objectiu d'aquesta tesi és investigar múltiples tecnologies sense fils per dispositius portàtils per identificar solucions adequades per aplicacions particulars en el camp mèdic. El primer objectiu és demostrar la facilitat d'ús de les tecnologies econòmiques sense bateria com un indicador útil de paràmetres fisiopatològics mitjançant la investigació de les propietats de les etiquetes RFID. A més a més, s'ha abordat un aspecte més complex respecte a l'ús de petits components passius com sensors sense fils per trastorns del son. Per últim, un altre objectiu de la tesi és el desenvolupament d'un sistema completament autònom que utilitzi tecnologia BLE per obtenir propietats avançades mantenint baix tant el consum com el preu
Esta tesis aborda el problema de encontrar soluciones confortables, inalámbricas y de baja potencia para aplicaciones médicas. La tesis discute las ventajas y limitaciones de tres tecnologías de comunicación diferentes para la medición en el cuerpo y los métodos para elegir y remodelar los sensores para evaluaciones óptimas centradas en el cuerpo. La tecnología RFID se considera una de las soluciones más influyentes para superar el consumo de energía limitado debido a la presencia de muchos sensores conectados. Además, la baja energía de Bluetooth se ha estudiado se ha estudiado la tecnologia Bluetooth de baja energia para resolver los problemas de seguridad y la distancia de lectura que, en general, representan el cuello de botella de la RFID para los sensores de cuerpo. Los dispositivos analógicos pueden reducir drásticamente las necesidades de energía debido a los sensores y las comunicaciones, considerando pocos elementos y un método de transmisión simple. Se estudia un método de comunicación completamente pasivo, basado en FSS, que permite una distancia de lectura razonable con capacidades de detección precisas y confiables, que se ha discutido en esta tesis. El objetivo de esta tesis es investigar múltiples tecnologías inalámbricas para dispositivos portátiles para identificar soluciones adecuadas para aplicaciones particulares en campos médicos. El primer objetivo es demostrar la facilidad de uso de las tecnologías económicas sin batería como un indicador útil de dichos parámetros fisiopatológicos mediante la investigación de las propiedades de las etiquetas RFID. Además, se ha abordado un aspecto más complejo con respecto al uso de pequeños componentes pasivos como sensores inalámbricos para enfermedades del sueño. Por último, un resultado de la tesis es desarrollar un sistema completamente autónomo que utilice la tecnología BLE para obtener propiedades avanzadas que mantengan la baja potencia y un precio bajo.
This thesis addresses the problem of comfortable, low powered and, wireless solutions for specific body-worn sensing. The thesis discusses advantages and limitations of three different communication technologies for on body measurement and investigate methods to reshape sensors for optimum body-centric assessments. The RFID technology is considered one of the most influential solutions to overcome the limitated power consumption due to the presence of many sensors connected. Further, the Bluetooth low energy has been studied to solve security problems and reading distance that overall represent the bottleneck of the RFID for the body-worn sensors. Analog devices can drastically reduce the energy needs due to the sensors and the communications, considering few elements and a simple transmitting method. An entirely passive communication method, based on FSS is studied, enabling a reasonable reading distance with precise and reliable sensing capabilities, which has been discussed in this thesis. The objective of this thesis is to investigate multiple wireless technologies for wearable devices to identify suitable solutions for particular applications in medical fields. The first objective is to demonstrate the usability of the inexpensive battery-less technologies as a useful indicator of such a physio-pathological parameters by investigating the properties of the RFID tags. Furthermore, a more complex aspect regards the use of small passive components as wireless sensors for sleep diseases has been addressed. Lastly, an outcome of the thesis is to develop an entirely autonomous system using the BLE technology to obtain advanced properties keeping low power and a low price.

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Brend, O. "Implementation and experimental evaluation of multiple model switched adaptive control for FES-based rehabilitation." Thesis, University of Southampton, 2014. https://eprints.soton.ac.uk/364612/.

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Functional electrical stimulation (FES) is a well-established approach that is employed as a therapeutic tool for the restoration of motor control in individuals experiencing muscle impairment. Although its use as a rehabilitation tool is validated by clinical results, current control approaches limit the full exploitation of its potential due to the lack of accuracy with which the FES is applied. Research has thus focused on the use of advanced, closed-loop control algorithms to provide more accurate FES that is both task-oriented, and matches the rehabilitation needs of the patient. Experimental results have been reported for a variety of control schemes. However, the majority of approaches have failed to transfer to clinical practice due to the difficulties associated with identifying a model of electrically stimulated muscle that adapts as the true plant varies with time. Estimation-based multiple model switched adaptive control (EMMSAC) is a robust control approach that has the potential to overcome the problems associated with the uncertain, time-varying properties of electrically stimulated muscle. EMMSAC utilises optimal disturbance estimation to assess the respective performances of a set of candidate plant models. Then the controller associated with the model that has best performance is switched into closed-loop operation. This thesis details the algorithmic modifications that allow disturbance estimation to be performed in the time-varying setting for nonlinear Hammerstein structures. Then it is shown experimentally that a general plant model set can be identified that represents the time-varying, FES-induced muscle activation dynamics for the population of younger healthy adults. This finding is exploited to design an EMMSAC controller that achieves accurate trajectory tracking for multiple participants with minimal prior model identification. Results indicate that the use of EMMSAC reduces RMS tracking error when compared with a fixed controller; similar results are also reported for older healthy participants. Furthermore, initial results for a small sample of stroke-participants are shown, which confirms the potential for the proposed control approach to be applied in a clinical setting for FES-based rehabilitation.

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Prestberg, Malin, and Josefin Persson. "En digital livsstilsplan : Gymnasieelevers och skolpersonals upplevelse av FMS modellen." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper (from 2013), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-78755.

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The aim of this master’s thesis is to interview school staff and pupils’ experiences and opinions of the FMS model in health prevention and promotion in one upper secondary school. This master´s thesis is based on qualitative data from three interviews, one individual interview with the principal of the school, and two focus interviews where there were one group from the school staff and one group with pupils. A semi-structured interview method was used. The interviews were recorded and transcribed word by word and analyzed with a qualitative content analysis. The analysis determines a theme where it was shown that FMS was a “Support for a meaningful school day and a better health”. The result contained two categories: Society accountableness and Content. The result show that FMS was a significant tool for both the principal, students and school staff. FMS made sure that the students got the possibility to work with structure and routine within their health work. Furthermore, FMS created relationships between both school personal as well as among students. In addition, FMS increased consciousness around health from a holistic perspective and created clarity around a good health. One important part of working with FMS was collaboration. In addition, the students wished that the school had an even bigger focus on health and helped them be free from performance anxiety. Moreover, the students had a wish about more health focus in school overall and they also wished for the FMS to be without encumbrance in the future. Their opinion today was that the students compared their results. The FMS online tool, lifestyle plan, was easy to understand and work with.

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Andreani, Lucia <1978&gt. "Development of an X-ray spectrometric system and feasibility tests of Silicon Drift Detector for medical and space applications." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amsdottorato.unibo.it/6220/.

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The thesis work concerns X-ray spectrometry for both medical and space applications and is divided into two sections. The first section addresses an X-ray spectrometric system designed to study radiological beams and is devoted to the optimization of diagnostic procedures in medicine. A parametric semi-empirical model capable of efficiently reconstructing diagnostic X-ray spectra in 'middle power' computers was developed and tested. In addition, different silicon diode detectors were tested as real-time detectors in order to provide a real-time evaluation of the spectrum during diagnostic procedures. This project contributes to the field by presenting an improved simulation of a realistic X-ray beam emerging from a common X-ray tube with a complete and detailed spectrum that lends itself to further studies of added filtration, thus providing an optimized beam for different diagnostic applications in medicine. The second section describes the preliminary tests that have been carried out on the first version of an Application Specific Integrated Circuit (ASIC), integrated with large area position-sensitive Silicon Drift Detector (SDD) to be used on board future space missions. This technology has been developed for the ESA project: LOFT (Large Observatory for X-ray Timing), a new medium-class space mission that the European Space Agency has been assessing since February of 2011. The LOFT project was proposed as part of the Cosmic Vision Program (2015-2025).

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Andrén, Karin, Lena Loubelo, and Mia Westerlind. "Barnmorskors bedömning av latensfas och aktiv fas i samband med förlossning : en viktig faktor för god vård." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-18986.

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Latensfasen är den första fasen i ett förlossningsarbete och är en normal process, trots detta är den komplex och svårdiagnostiserad. Det finns ingen direkt gräns mellan förvärkar och latensfasens början, däremot finns en tydligare beskrivning av när den aktiva fasen startar. Att latensfasen inte är väl definierad kan innebära problem för barnmorskor i deras möte med dessa kvinnor. En lång latensfas är relaterat till ett antal problem för den födande kvinnan, såsom trötthet, uppgivenhet, smärta, oro och olika förlossningskomplikationer. Även risken för interventioner ökar om kvinnan kommer in i ett tidigt skede till förlossningsavdelningen, och ännu inte är i aktivt fas. Syftet med studien är att belysa hur barnmorskan bedömer att kvinnan är i latensfas respektive aktiv fas. Metoden som använts är en enkätundersökning som har analyserats med kvalitativ innehållsanalys med deduktiv ansats. 78 barnmorskor som arbetar inom förlossningsvård i Göteborg samt Borås deltog i studien. De svarade på två öppna frågor om vilka parametrar de väger in i sin bedömning för att definiera latensfas respektive aktiv fas. I resultatet framkom att barnmorskorna beskriver 67 olika kriterier med små variationer för latensfasen som klassificerades i fem huvudkategorier. De definierade aktiv fas med 48 olika kriterier som även delades in i fem huvudkategorier. Huvudkategorierna delades in i underkategorier enligt analysprocess för kvalitativ innehållsanalys. I sammanställningen av resultatet visades sig att flertalet barnmorskor uppgav att oregelbundna värkar och ringa påverkan på livmodertappen är huvud- kriterier för latensfasen. Regelbundenhet och progress var huvudkriterier för aktiv fas. Tydligare riktlinjer är nödvändigt för att på allra bästa sätt hjälpa dessa kvinnor.

Program: Fristående kurs

Uppsatsnivå: C

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Molosky, Vincent. "The Influence of Identifiable Personality Traits on Nurses’ Intention to Use Wireless Implantable Medical Devices." Diss., NSUWorks, 2019. https://nsuworks.nova.edu/gscis_etd/1078.

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Technically-driven medical devices such as wireless implantable medical devices (WIMD) have become ubiquitous within healthcare. The use of these devices has changed the way nurses administer patient care. Consequently, the nursing workforce is large and diverse, and with it comes an expected disparity in personalities. Research involving human factors and technology acceptance in healthcare is not new. Yet due to the changing variables in the manner of which patient care is being administered, both in person and in the mechanism of treatment, recent research suggests that individual human factors such as personality traits may hold unknown implications involving more successful adoption of emerging technologies for patient care. The purpose of this research was to empirically investigate the influence of personality traits on a nurse’s intention to use WIMDs for patient care. One hundred and two nurses from a tertiary teaching hospital in Michigan were surveyed to determine if their identifiable personality traits statistically related to their intention to use a WIMD. A predictive model was developed by combining constructs from the unified theory of acceptance and use of technology (UTAUT) model and the Five Factor personality trait model (FFM). The model used moderated multiple regression (MMR) to statistically identify if the personality traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism, moderated one or more statistically significant relationships between 1) performance expectancy (PE) and intention to use (IU), 2) effort expectancy (EE) and IU, 3) and social influence (SI) and IU. It was predicted that PE, EE, and SI would show statistical significance on a nurse’s IU of a WIMD when moderated by one or more of the five personality traits. Results showed statistical significance between PE and IU, and EE and IU, but not between SI and IU, when moderated by extraversion. Results showed no statistical significance between PE and IU, EE and IU, or SI and IU when moderated by openness, conscientiousness, agreeableness, or neuroticism. This research has contributed by conducting an investigation on individual human factors that may impact nurses’ intention to use emerging technologies; and by providing statistical evidence that may help to better predict the role personality traits have on a nurse’s adoption of WIMDs for patient care.

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Coupaud, Sylvie A. F. "Development and assessment of methods for arm-cranking exercise assisted by functional electrical stimulation (FES) in tetraplegia." Thesis, University of Glasgow, 2005. http://theses.gla.ac.uk/1558/.

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In this pilot study, a new avenue for exercise in tetraplegia, involving FES applied to upper limb muscles, is suggested. The main motivation for developing methods for FES-assisted arm-cranking exercise is to provide an exercise modality specifically designed for tetraplegia that might address cardiopulmonary issues, as well as work with remaining voluntary control of upper body musculature. One primary aim of this thesis was to determine the feasibility of using these systems in tetraplegia. To investigate this, standard protocols for exercise training, and incremental and constant-load exercise testing, were adapted to make them suitable for this population and this exercise modality. These novel protocols are described here, and represent one of the contributions of the thesis. The implementation of these protocols for an experimental evaluation of the proposed systems for FES-assisted arm-cranking exercise makes up the main part of the thesis. Five volunteers with tetraplegia participated in this experimental evaluation, and their data are presented as two main case studies, and additional case reports. The first outcome of thesis evaluation is that it shows the feasibility of the proposed methods for FES-assisted arm-cranking exercise training and testing in tetraplegia. Secondly, benefits of regular use of the systems are illustrated for some individuals with tetraplegia, based on key indicators of cardiopulmonary fitness and measures of upper limb strength. Thirdly, the limitations of the current set-up for FES-assisted arm-cranking exercise in higher level tetraplegia are identified. In summary, this thesis describes new systems and protocols for FES-assisted arm-cranking exercise in tetraplegia, and provides a preliminary assessment of these methods.

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Kleinman, Joshua. "Polyphenol intake by food group in the ulcerative colitis population." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555457246762338.

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Hansson, Camilla, and Madelaine Pettersson. "Närståendes upplevelser av att vårda en närstående i palliativ fas eller i livets slutskede i hemmet." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-19806.

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Idag finns möjligheten för svårt sjuka människor att få dö i sitt hem, ofta med hjälp och stöd av närstående och av andra professionella vårdgivare. I den palliativa vården och vid vård i livets slutskede är närstående betydelsefulla i omvårdnaden och behöver stöd från distriktssjuksköterskan. För att det ska bli så bra som möjligt för de närstående att vårda i hemmet behöver distriktssjuksköterskan veta vilka stödåtgärder som de närstående behöver.Syftet med studien var att beskriva närståendes upplevelse av att vårda en närstående som är i en palliativ fas eller i livets slutskede i hemmet.Metoden som användes var en litteraturstudie. Tretton kvalitativa artiklar som motsvarade syftet analyserades med hjälp av kvalitativ innehållsanalys.Ur resultatet framkommer närståendes upplevelser som sammanställts i åtta kategorier. Dessa är att uppleva trygghet, att uppleva otrygghet, att bli bekräftad, att bli negligerad, att uppleva glädje och tillfredställelse i vårdandet, att uppleva vårdandet som en börda, att försöka bevara det invanda samt att uppleva förändrad livssituation.Resultatet visar att närståendes upplevelser av att vårda i hemmet kan skilja sig från individ till individ. För att närstående ska kunna få rätt stöd och support från distriktssjuksköterskan är det viktigt att kommunikationen fungerar mellan parterna. Kommunikation är grundläggande för att kunna bygga en bra relation mellan distriktssjuksköterskan och närstående för att möjliggöra att rätt stödåtgärder sätts in. Närståendes behov av stöd varierar, vilket kan ha många orsaker. En av dessa orsaker kan bero på vilket genus den närstående har. Därför vore det värdefullt att framtida forskning fokuserar på män respektive kvinnors upplevelser som närståendevårdare.
Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska

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Ferrario, Chiara. "Functional electrical stimulation (FES) leg cycling exercise in paraplegia : a pilot study for the definition and assessment of exercise testing protocols and efficacy of exercise." Thesis, University of Glasgow, 2006. http://theses.gla.ac.uk/1534/.

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A custom FES-cycling ergometer equipped with an electric motor and an integrated feedback system for accurate control of exercise workrate and cadence has been employed in this study. This experimental setup allowed the imposition of arbitrary workrate profiles with high precision and provided the potential for highly-sensitive exercise testing. One aim of the work described in this thesis was to propose and evaluate novel protocols for incremental exercise test (IET) and step exercise test (SET). Valid protocols would allow reliable estimation of the key markers of cardiopulmonary fitness in SCI subjects performing FES-cycling. Measures which can be used to evaluate the effect on cycling performance of changes in stimulation parameters, and which might therefore be used to optimise them, were also investigated. Thus, a second aim of this work was to determine whether oxygen uptake and a new measure of stimulation cost (i.e. the total rate of stimulation charge applied to the stimulated muscle groups during cycling) are sensitive enough to allow discrimination between the efficacy of different activation patterns during constant-power cycling. A discussion on the concept of metabolic efficiency in AB and SCI subjects is presented in this thesis. Efficiency of FES-cycling is much lower than that of voluntary cycling. Therefore, a third aim of this work was to define new efficiency measurements that are more appropriate for the SCI population. Two volunteer subjects took part in this study and the data obtained from the tests they performed are presented as case studies. The main outcome shows feasibility of the two exercise testing protocols. Moreover, the first report of a ventilatory threshold in SCI subjects during FES-cycling has been provided here. Oxygen uptake and stimulation cost measurements both allow discrimination between the efficacy of different muscle activation patterns. However, stimulation cost is more easily determined in real time, and responds more rapidly and with greatly improved signal-to-noise properties than oxygen uptake.

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Infantino, Angelo <1985&gt. "Advanced aspects of radiation protection in the use of particle accelerators in the medical field." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/6807/.

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In this work, the well-known MC code FLUKA was used to simulate the GE PETrace cyclotron (16.5 MeV) installed at “S. Orsola-Malpighi” University Hospital (Bologna, IT) and routinely used in the production of positron emitting radionuclides. Simulations yielded estimates of various quantities of interest, including: the effective dose distribution around the equipment; the effective number of neutron produced per incident proton and their spectral distribution; the activation of the structure of the cyclotron and the vault walls; the activation of the ambient air, in particular the production of 41Ar, the assessment of the saturation yield of radionuclides used in nuclear medicine. The simulations were validated against experimental measurements in terms of physical and transport parameters to be used at the energy range of interest in the medical field. The validated model was also extensively used in several practical applications uncluding the direct cyclotron production of non-standard radionuclides such as 99mTc, the production of medical radionuclides at TRIUMF (Vancouver, CA) TR13 cyclotron (13 MeV), the complete design of the new PET facility of “Sacro Cuore – Don Calabria” Hospital (Negrar, IT), including the ACSI TR19 (19 MeV) cyclotron, the dose field around the energy selection system (degrader) of a proton therapy cyclotron, the design of plug-doors for a new cyclotron facility, in which a 70 MeV cyclotron will be installed, and the partial decommissioning of a PET facility, including the replacement of a Scanditronix MC17 cyclotron with a new TR19 cyclotron.
In questo lavoro, il codice Monte Carlo (MC) FLUKA è stato utilizzato per simulare il ciclotrone GE PETtrace (16.5 MeV) installato presso l’azienda ospedaliera “S. Orsola-Malpighi” (Bologna, IT), quotidianamente utilizzato per la produzione di radiofarmaci PET. Le simulazioni sono state effettuate per valutare diversi fenomeni e quantità d’interesse radiologico tra cui l’equivalente di dose ambientale nell’intorno dell’acceleratore, il numero di neutroni emessi per protone incidente e la loro distribuzione spettrale, l’attivazione dei componenti del ciclotrone e delle pareti del bunker, l’attivazione dell’aria interna al bunker ed in particolare la produzione di 41Ar, la resa a saturazione di radionuclidi d’interesse in medicina nucleare. Le simulazioni sono state validate, in termini di parametri fisici e di trasporto da utilizzare nel range energetico caratteristico delle applicazioni mediche, con una serie di misure sperimentali. Il modello MC validato è stato quindi applicato ad altri casi pratici quali lo studio di fattibilità della produzione diretta in ciclotrone di 99mTc, la produzione di radionuclidi ad uso medico con il ciclotrone TR13 (13 MeV) installato presso il centro di ricerca TRIUMF (Vancouver, CA), la progettazione completa del nuovo centro PET dell’ospedale “Sacro Cuore-Don Calabria” di Negrar (Verona, IT), incluso il ciclotrone ACSI TR19 (19 MeV), lo studio del campo di dose nell’intorno di un sistema di selezione dell’energia (degrader) di un ciclotrone per terapia, la progettazione di specifiche “porte a tappo” per un sito di produzione di radionuclidi ad uso medico, in cui verrà installato un ciclotrone da 70 MeV e sei diverse beam line, e per il parziale decommissioning di un centro PET e la sostituzione di un ciclotrone Scanditronix MC17 (17 MeV), attualmente installato, con una nuova unità TR19.

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Johansson, Linnea. "Vilka potentiella behandlingsalternativ finns det mot bakteriella infektionssjukdomar som ligger i fas 2-3 studier eller som man bedriver forskning på?" Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-74368.

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Resistance against antibiotics has become a global world problem. The effect of antibiotics is affected by the resistant bacteria and they cause infections that are difficult to treat. This is a major burden on the healthcare and leads to increased mortality. Globally, about 700,000 people die each year because of antibiotic resistance. By the year 2050 death rates are estimated to have increased to 10 million deaths per year due to the lack of effective treatment methods against multiresistant bacteria. Pharmaceutical companies’ research to develop new antibiotics is steadily decreasing, while multiresistant bacteria increase in number and spread. Bacteria evolve fast and highly resistant bacteria seem to evolve almost at the same pace as new drugs are discovered. As more antibiotics are used, more resistance is developed, so the pharmacy industry keep having to find new antimicrobial agents that the bacteria haven´t figured out how to protect themselves against yet. The aim of this study was to investigate different treatment options available for infectious diseases that are currently in phase 2 or 3 clinical trials studies or research is being conducted on? This study is a literature study, five articles were selected from PubMed and analyzed. One study evaluates the effect of using new compounds to target a new potential pocket on DNA-gyrase. One study evaluates if silver can disturb the structure of the bacteria and thus increase the flow of antibiotics into the cell. Three studies evaluate the effect of nanoparticles containing metals such as silver or copper-zink-iron and the bacteriocin nisin. The current study shows that new compounds as well as new approaches to treating bacterial infections are expected to help stop this crisis. New strategies in the field of antibiotics include new drug targets, new drug delivery methods and new drug combinations. The compounds produced and directed against the new pocket on DNA-gyrase were stopped due to toxicity but opens a new path for further research. Cells treated with silver had different membrane permeability, destabilized the structure of the peptidoglycan layer and increased production of hydroxyl radicals. Nanoparticles seem to be a potential antibacterial agent, the advantage of nanoparticles is that substances can be combined within nanoparticles and provide synergistic effects. With the help of nanotechnology, drug delivery systems can be improved as well as drug administration. More studies are needed though to investigate the safety of taking nanoparticles and to verify the results of this literature review.
Resistens mot antibiotika har blivit ett globalt världsproblem. Effekten av antibiotika påverkas av de resistenta bakterierna och detta leder till att infektioner blivit svårare att behandla. Detta ger belastning på sjukvården och leder till ökad dödlighet. I världen dör ca 700 000 människor till följd av antibiotikaresistensen och år 2050 beräknas dödsfallen stigit till 10 miljoner per år p.g.a. att det saknas effektiva behandlingsmetoder mot de multiresistenta bakterierna. För att behandla bakteriella infektioner krävs nya föreningar riktade mot bakteriella patogener samt nya tillvägagångsätt för att stoppa denna kris. Inom detta område är framgången låg och även om kliniska försök med antimikrobiella medel är säkra och effektiva, dröjer det flera år innan de är tillgängliga för klinisk användning. Nya strategier inom antibiotikafrågor innefattar nya läkemedelsmål, nya leveransmetoder till läkemedelsmålet och nya läkemedelskombinationer. Syftet med denna studie var att undersöka vilka behandlingsalternativ som finns tillgängliga mot infektionssjukdomar som ligger i fas 2-3 studier, eller som man bedriver forskning på. Arbetet är en litteraturstudie och de vetenskapliga artiklarna är hämtade från databasen Pubmed. I detta arbete har fem studier analyserats. Studie I visar att föreningarna som framställts och riktades mot den nya fickan på DNA-gyras avbröts p.g.a. toxicitet. I resterande studier (II, VI och V) visade att nanopartiklar är ett potentiellt alternativ för att avdöda bakterier. Studie III visar att celler som behandlats med silver hade annan membranpermeabilitet, destabiliserade peptidoglykanlagret och ökad produktion av hydroxylradikaler. Mer forskning och studier krävs för att undersöka riskerna med att administrera nanopartiklar samt verifiera resultaten i denna litteraturstudie och framförallt krävs det mer forskning kring nya potentiella antimikrobiella medel i allmänhet.

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Edberg, Jon, and Andreas Trillelv. "Att möta oroliga barn preoperativt : Anestesisjuksköterskans erfarenheter." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17951.

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Ett stort antal barn opereras årligen i Sverige och cirka hälften av dem upplever oro i samband med operation. Barn som är oroliga preoperativt har större risk att få besvär postoperativt i form av sömnproblem, ökad smärta, svårt att få i sig mat och ökad oro. Oroliga barn samarbetar också mindre vid preoperativa förberedelser och vid anestesiinduktion. En minskad oro hos barnet leder till bättre samarbete och en mera följsam perioperativ process. Anestesisjuksköterskan har vanligtvis bara en kort stund på sig att minska barnets oro innan operationsstart och måste därför snabbt etablera en kontakt som bygger på förtroende. Syftet var att beskriva anestesisjuksköterskans erfarenheter att möta barn med oro i den preoperativa fasen. Kvalitativ metod tillämpades och sju stycken djupintervjuer genomfördes. Informanterna var verksamma anestesisjuksköterskor som arbetade på barnoperation. I resultatet beskrivs anestesisjuksköterskans erfarenheter att möta oroliga barn preoperativt utifrån kategorierna som framkom; medicinska omvårdnaden, anestesisjuksköterskans föreställningar, föräldrar, vårdmiljön och anestesisjuksköterskans omvårdnad. Existens framkom som övergripande tema. Mötet med oroliga barn handlar inte bara om åtgärder utan bör ses i ett bredare sammanhang som även omfattar tankar om det existentiella. Oro är en naturlig känsla som kan ses utifrån patientens uppfattning om existens. Preoperativ information till föräldrar är viktigt för att förbereda dem inför vad som ska hända och vad som förväntas av dem. Föräldrar kan då känna sig tryggare i sin stöttande roll till barnet. Det stärker även föräldrarnas självförtroende och anestesisjuksköterskan får en mindre stressig miljö att arbeta i. Öppenhet och ärlighet framkom som betydelsefulla strategier för att upprätthålla förtroendet för barnet och skapa bättre förutsättningar för framtida möten.
Program: Specialistsjuksköterskeutbildning med inriktning mot anestesisjukvård

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Wecke, Maria. "Anestesisjuksköterskors upplevelser av trygghet och patientsäkerhet i den preoperativa fasen." Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-75081.

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Anestesisjuksköterskan ska kunna värdera information om sjukdomar och medicinska faktorer som ska resultera i att korrekta omvårdnadsåtgärder och medicinska beslut tas i samarbete med anestesiologen för att öka patientsäkerheten. Begränsad mängd tidigare forskning finns om anestesisjuksköterskors känsla av trygghet och hur patientsäkerhet i den preoperativa fasen upplevs. Syftet med denna studie var att beskriva anestesisjuksköterskors upplevelser av trygghet och patientsäkerhet i det preoperativa omvårdnadsarbete. För att besvara syftet användes en kvalitativ metod. Totalt intervjuades sex anestesisjuksköterskor, alla från olika sjukhus över hela Sverige. Intervjuerna analyserades med kvalitativ innehållsanalys. Analysen resulterade i sju kategorier; Behov av tydliga rutiner och kontroller, Skapa en lugn miljö, Vikten av god kunskap och erfarenhet, Möjlighet till egen reflektion, Vikten av teamarbete, Organisationens inverkan på patientsäkerheten samt Informationsinhämtning och planering för att skapa rätt förutsättningar. Teamarbete och Organisationens inverkan på patientsäkerheten framkom som två områden där anestesisjuksköterskan inte känner trygghet och där tydliga brister inom patientsäkerheten identifieras. Anestesisjuksköterskan upplever att det finns en tveksamhet hur organisationen värderar patientsäkerheten och hur anestesisjuksköterskan skall förhålla sig till detta, vilket orsakar en minskad känsla av trygghet. Även vid problem i teamet med samarbetet, påverkades anestesisjuksköterskans trygghet vilket kunde ses påverka patientsäkerheten negativt. Förslag på fortsatt forskning är att vidare undersöka anestesisjuksköterskans upplevda trygghet utifrån organisation och teamarbete.

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Valdenaire, Simon. "Mise en place et utilisation des faisceaux FFF en radiothérapie : radiobiologie, caractérisation physique, contrôles qualité, modélisation et planification de traitement." Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0037/document.

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Les faisceaux de photons produits par les accélérateurs d'électrons linéaires médicaux sont plats, grâce à un cône égalisateur. Les technologies ont évolué et la présence d'un cône n'est plus indispensable. On parle alors de faisceaux FFF (flattening filter free). Les faisceaux FFF présentent des débits de dose plus élevés, des profils de dose hétérogènes, des spectres énergétiques différents et une diminution de la dose hors-champ. Cette thèse a eu pour but d'étudier les caractéristiques des faisceaux FFF, ainsi que l'impact de leur utilisation thérapeutique. Plusieurs thématiques ont été. Des expériences d'irradiation in vitro ont tout d'abord permis de s'assurer que les débits de dose FFF n'ont pas d'impact radiobiologique sur la réponse des cellules irradiées. Une large revue de la littérature a permis de corroborer ces résultats. Afin de maitriser les caractéristiques physiques des faisceaux FFF, des mesures ont été faites avec différents détecteurs. Les effets du spectre et du débit de dose sur la calibration en dose ont aussi été étudiés. Les faisceaux FFF ont été modélisés dans deux TPS. Les modèles ont été comparés entre les deux types de faisceaux et entre les deux TPS. La mise en place des traitements stéréotaxiques a aussi été l'occasion d'appréhender la dosimétrie des petits faisceaux. Nous avons étudié des cas VMAT de cancer de la prostate et des cas de stéréotaxies 3D de tumeurs pulmonaires. La comparaison donne un avantage aux faisceaux FFF. La maitrise de la physique et de la biologie des haut débits a permis de débuter les traitements FFF à l'IPC. Des études comparatives nous permettent aujourd'hui d'adapter leur utilisation au cas par cas
In medical linear electron accelerators, photon beams profiles are homogenised using flattening filters. Technologies have evolved and the presence of this filter is no longer necessary. Flattening filter free (FFF) beams exhibit higher dose rates, heterogeneous dose profiles, modified energy spectra and lower out-of-field dose. This PhD aimed at studying the characteristics of unflattened beams, as well as their impact in clinical utilization. Several subjects were thoroughly investigated: radiobiology, dosimetry, quality controls, modelling and treatment planning. In vitro experiments ensured that the high dose-rate of FFF beams had not a radiobiological impact. A wide review of the literature was conducted to corroborate these results. In order to understand thoroughly the characteristics of FFF beams, measurements were conducted using several detectors. The effect of the spectra and dose rates of unflattened beams on dose calibration were also studied. FFF beams were modeled in two TPSs. The methods, results and model parameters have been compared between the available beam qualities as well as between both TPSs. Furthermore, the implementation of stereotactic treatments technique was the occasion to investigate small beam dosimetry. Prostate cancer cases treated with VMAT and pulmonary tumors treated with stereotactic 3D beams were also studied. The comparison of dose distributions and treatment metrics give advantage to FFF beams. Mastering physical and biological aspects of flattening filter free beams allowed the IPC to start FFF treatments. Comparative studies have since resulted in a deeper understanding on the pertinent use of these beams

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Shareef, Zeinab. "Ordflöde och läsförmåga hos studenter med och utan dyslexi : En undersökning av FAS, djurflöde och verbflöde." Thesis, Uppsala universitet, Logopedi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-369667.

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Bakgrund och syfte. Ordflödestest undersöker en persons förmåga att generera så många ord som möjligt under en minut. Orden kan börja på en viss bokstav eller tillhöra en särskild kategori. FAS är ett vanligt ordflödestest där orden som ska genereras börjar på bokstäverna F, A och S. Exempel på kategoriska ordflödestest är djurflöde, som går ut på att säga så många djur som möjligt, samt verbflöde där instruktionen är att säga så många saker man kan göra (handlingar). Forskare har undersökt vilka mentala färdigheter som ligger till grund för ordflödesförmågan, framför allt planerande och reglerande (exekutiva) funktioner samt språklig förmåga. I forskning används ofta FAS och djurflöde för att undersöka olika delar av den språkliga förmågan. Även verbflöde har undersökts i dessa sammanhang, men inte i lika stor utsträckning. Däremot har verbflöde en större roll i forskning på planerande och reglerande funktioner hos äldre personer som har exempelvis Alzheimers eller Parkinson. Forskningen har lett till att ordflödestest används i kliniska sammanhang som en del i utredningen av dessa sjukdomar. I praktiken används även FAS och djurflöde vid utredningar av dyslexi, språkstörning och koncentrations-/hyperaktivitetssvårigheter (ADHD). Forskning har visat motstridiga resultat om vilka typer av ordflödestest som är nedsatta vid dyslexi och språkstörning, eller vilka mentala förmågor som är viktiga vid genomförande av ordflödestest. I denna studie undersöks FAS, djurflöde och verbflöde hos studenter inom högre utbildning med och utan dyslexi. Syftet är att utreda om ordflödesförmågan är nedsatt hos studenter med dyslexi. Studien undersöker om ordflöde kan bidra till att förklara spridningen i läsförmåga. Metod. I undersökningen deltog 42 studenter, varav 16 hade dyslexidiagnos och 26 kontroller utan dyslexidiagnos. Deltagarna genomförde test som undersöker läsförmåga, fonologisk förmåga, snabb benämning samt ordflöde av FAS, djur och verb. Resultat. Prestationen på ordflödesförmåga var signifikant nedsatt hos studenter med dyslexi jämfört med kontrollgruppen. En multipel regression med bakåteliminering genomfördes för att undersöka om FAS, djurflöde och verbflöde kunde förutsäga spridningen i läsförmåga när fonologisk medvetenhet och snabb benämning kontrollerades för. Regressionsanalysen visade att verbflöde, tillsammans med fonologisk medvetenhet, kunde förutsäga läsförmåga hos studenter med och utan dyslexi. Diskussion. Den nedsatta ordflödesförmågan hos studenter med dyslexi diskuteras utifrån faktorer som utbildning och andra mentala förmågor. Resultatet pekar på ett unikt samband mellan verbflöde och läsförmåga hos studenter med och utan dyslexi. De strukturer i hjärnan som aktiveras vid verbflöde är även strukturer som ligger till grund för andra mentala förmågor. Dessa mentala förmågor har även visats vara nedsatta hos personer med dyslexi. Generellt indikerar dessa nya fynd att verbflöde har en betydelse i förhållande till läsförmåga och dyslexi som behöver undersökas vidare. Resultatet diskuteras även utifrån ett kliniskt perspektiv.
Verbal fluency is commonly measured in cognitive assessments and has been shown to measure aspects of verbal ability and executive function, as well as to involve specific cortical areas during performance. Verbal fluency tasks, in which participants generate words during a given time limit, have been used in research and assessments of neurobiological disorders and impairments. Dyslexia is a neurobiologically based reading disorder that is characterized by difficulties in word decoding and spelling. Research on verbal fluency in individuals with dyslexia shows that semantic and letter fluency is impaired. However, studies show inconsistent results. This study examines performance on semantic fluency (animals), action fluency (verbs), and letter fluency (FAS) in 42 students with developmental dyslexia (DD, n = 16) and a control group with typical reading development (TD, n = 26). Participants also perform a test battery that measures reading and phonological abilities, amongst others. Additionally, it is examined if verbal fluency performance can contribute to predicting reading ability, when phonological awareness and rapid automatized naming (RAN) are taken into account. Results show that verbal fluency performance was impaired in the DD group, and that action and letter fluency were relatively more impaired than semantic fluency. A backward elimination regression showed that action fluency and phonological awareness were significant predictors of reading ability, together explaining 48 % of the variance. The impaired verbal fluency ability is discussed in relation to factors such as education and cognitive abilities. Further, the findings point to a possible unique connection between action fluency and reading ability in students, in addition to phonological awareness. The possibility that the relationship between action fluency and reading may be partly explained by common neurocognitive underpinnings is discussed. These novel findings indicate that action fluency has a pertinent role in reading ability and dyslexia, which should be further examined.

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Irisarri, MagdalenaSotto. "Etude des mécanismes de résistance à l'apoptose induite par la voie CD95 dans les lymphomes malins non-hodgkiniens." Université Joseph Fourier (Grenoble), 2001. http://www.theses.fr/2001GRE10089.

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Des alterations au niveau de l'homeostase des cellules b, comme l'augmentation de la proliferation ou la diminution de la mort cellulaire sont a l'origine du developpement clonal des cellules b tumorales. L'apoptose mediee par le systeme cd95/cd95l joue un role essentiel dans la regulation de la reponse immune des cellules b. Des anomalies dans le processus apoptique pourraient etre impliquees dans la lymphomagenese. Afin d'etudier les mecanismes moleculaires impliques dans la resistance des lmnh a l'apoptose induite par cd95, nous avons utilise comme modele, deux lignees cellulaires derivees de lmnh et etablies dans le laboratoire, b593 et br97. Nous avons montre que les deux lignees expriment cd95, mais b593 est sensible a l'induction de l'apoptose par cette voie tandis que la br97 est completement resistante. La lignee cd95-resistante, en presence des inhibiteurs de la synthese proteique ou de la transcription, devienne sensible a cd95, les caspases-8 et -3 sont activees et l'expression de l'inhibiteur apoptotique c-flip est diminuee. Enfin, nos resultats montrent que dans la lignee br97 il y a formation du complexe disc avec incorporation de fadd, caspase-8 et c-flip. L'ensemble de nos resultats nous permette donc de conclure que dans la lignee br97, la resistance a l'induction de l'apoptose par la voie cd95 est due au blocage de l'activation de la caspase-8 par c-flip au niveau du disc. La resistance a cd95 due a une forte expression de c-flip endogene dans la lignee br97, nous a suggere que le meme mecanisme puisse etre implique dans des cellules tumorales fraiches de lmnh. Nos resultats montrent que les lmnh de differents types histologiques et les lymphocytes b normaux expriment cd95 mais sont resistants a l'apoptose induite par cette voie. Les proteines fadd et les caspases-8 et -3 sont exprimees dans les cellules b tumorales et normales, cependant la caspase-8 n'est pas activee dans ces cellules. En ce qui concerne c-flip, il est present dans les lymphocytes b normaux mais absent dans la majorite des lmnh. Par ailleurs l'analyse de la formation du disc, dans plusieurs lymphomes, a indique une absence du complexe tandis qu'il est present dans les cellules b normales. Enfin, les cellules tumorales, a difference des cellules normales, ne sont pas sensibilisees a cd95 apres stimulation par cd40l en presence d'un inhibiteur de synthese proteique. Ces observations indiquent l'existence d'un mecanisme complexe de resistance a l'apoptose induite par cd95 dans les cellules tumorales : d'une part, l'absence de formation du disc et d'autre part, un autre blocage de la voie cd95, sans l'intervention de c-flip. En definitive, dans les cellules tumorales plusieurs anomalies pourraient s'additionner conduisant au blocage de la voie de signalisation-cd95.

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Johansson, Sara, and Emelia Olausson. "Att vara partner till en person med obotlig cancer i en tidig palliativ fas : -En narrativ studie med ett partnerperspektiv." Thesis, Blekinge Tekniska Högskola, Institutionen för hälsa, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-17531.

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Bakgrund: Att vara partner till en person med obotlig cancer i den tidiga palliativa fasen, kan bli en omfattande livsförändring, associerat med en lång sorgeprocess. Cancern kan leda till bland annat en känsla av begränsad tid, sorg och ökad risk för ohälsa, om stöd inte erbjuds. Syfte: Syftet var att beskriva hur det är att vara partner till en person med obotlig cancer, i en tidig palliativ fas. Metod: Narrativ design med litteraturstudie som datainsamlingsmetod och dataanalys i form av en kvalitativ innehållsanalys enligt Graneheim och Lundman (2004). Resultat: Innehållsanalysen ledde fram till tre huvudkategorier med tillhörande tolv underkategorier. Den första huvudkategorin – ”Partnern hyser egna tankar och känslor” – avser partnerns egna tankar och känslor under sjukdomsförloppet, som inbegriper underkategorierna ”En pendel ensam mellan hopp och hopplöshet”, ”En oviss framtid”, ”Varför händer det här mig?” och ”Viktigt att ha någon”. Den andra huvudkategorin – ”Partnern ser den vårdade personen på olika sätt” – beskriver partnerns perspektiv till den vårdade personen, och omfattas av underkategorierna ”Jobbigt att stå bredvid obotlig cancer”, ”Känner inte igen personen”, ”Relationens upp- och nedgångar” och ”Kan ibland se förbi sjukdomen”. Den tredje, och slutgiltiga, huvudkategorin – ”Partnern och den vårdade personen bär på tankar och känslor tillsammans” – utgår från partnern och den vårdade personens gemensamma tankar och känslor, och innefattar underkategorierna ”En kamp tillsammans”, ”En gemensam pendel mellan hopp och hopplöshet”, ”Viktigt att ta tillvara på de bra stunderna” och ”Vara den bärande väggen för varandra”. Slutsats: I den tidiga palliativa fasen av obotlig cancer, genomgår partnern många känslomässiga påfrestningar, varpå stöd blir en nödvändighet för att underlätta bearbetningen under sjukdomsförloppet. Ett av målen med palliativ vård, är att partnern får stöd och information. Emellertid, får partnern sällan det stöd som erfordras. Av den anledningen, behövs mer kunskap och spridning av den om partnerns upplevelser.

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Engelmark, Malin. "Identifying Risk Genes for Cervical Cancer : Using Affected Sib-Pairs and Case-Control Materials from Sweden." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6826.

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Painter, Jacob T. "CHRONIC OPIOID USE IN FIBROMYALGIA SYNDROME: CHARACTERISTICS AND OUTCOMES." UKnowledge, 2012. http://uknowledge.uky.edu/pharmacy_etds/5.

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Fibromyalgia syndrome (FMS) is a chronic pain condition with significant societal and personal burdens of illness. Chronic opioid therapy in the treatment of chronic nonmalignant pain has increased drastically over the past decade. This is a worrisome trend in general, but specifically, given the pathophysiologic characteristics seen in fibromyalgia syndrome patients, the use of this class of medication deserves special scrutiny. Although the theoretical case against this therapy choice is strong, little empirical evidence exists. In order to supplement this literature, retrospective analysis methods are utilized to examine the association of state-, provider-, and patient level characteristics with the prevalence of chronic opioid use in this disease state. Data gathered through this analysis is then used to develop a propensity index for the identification of an appropriate control group for fibromyalgia patients, a task that has proven difficult in the literature to date. Using propensity stratification and matching techniques analysis of the impact of fibromyalgia, chronic opioid use, and the interaction of these two variables are undertaken. Several key findings and updates to the understanding of chronic opioid use and fibromyalgia syndrome are reported. Wide geographic variation in chronic opioid utilization between states is seen. The role of diagnosing provider type in the rate of chronic opioid prescribing is significant and can be aggregated at various levels. Demographic characteristics, comorbid conditions, and concurrent medication use are all important associates of chronic opioid use in fibromyalgia syndrome. Additionally, chronic opioid use in fibromyalgia patients, independent of propensity to receive that therapy choice is a significant correlate with healthcare costs. A diagnosis of fibromyalgia is a statistically significant source of healthcare costs, though the clinical significance of its impact when compared to a closely matched control group is minimized. Despite the minimization of the role of this diagnosis the impact of the interaction of chronic opioid use with fibromyalgia, despite control for myriad regressors, is significant both statistically and clinically.

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Mårtensson, Jesper. "Handbollsspelares effektutveckling i olika riktningar." Thesis, Malmö universitet, Fakulteten för lärande och samhälle (LS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-34627.

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The purpose of this dissertation is to analyze Swedish male handball players power in the lower limbs, dependent on position, in different anatomical planes. Previous studies has examined vertical and horizontal power but not medial lateral power. This study used previous studies as theory. Power was examined through vertical, horizontal and medial lateral CMJAS, unilateral and bilateral, in a laboratory setting. The vertical jumping performance was measured with ‘My Jump 2’ and the vertical power (W; W/kg) was calculated with Lewis formula. Only the jumping performance (cm) was noted in the horizontal and medial lateral CMJAS. No significance difference was observed (p>0.05) in power between the positions. A strong correlation between the vertical and horizontal CMJAS was observed (p<0.05; r=0.860-0.883). Conclusion, handball players, independent position, possesses similar power, bilateral and unilateral, in vertical, horizontal and medial lateral CMJAS. Medial lateral power needs to be examine to create a better profile of the player.

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Zaro, Maren Lothyan. "Breast Cancer Risk Assessment: Evaluation of Screening Tools for Genetics Referral." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/8824.

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Purpose: This study assessed effectiveness of five tools recommended by the US Preventive Services Task Force (USPSTF), designed to help primary care clinicians determine which unaffected patients to refer to genetics specialists for breast cancer risk assessment based on concerning family history. Design: This descriptive secondary analysis included 85 women aged 40-74. All participants had a first-degree female relative previously diagnosed with breast cancer who also had uninformative negative BRCA1/2 tests. Methods: Each pedigree was evaluated using the five tools including the Family History Screen-7 (FHS-7), Pedigree Assessment Tool (PAT), Manchester Scoring System, Referral Screening Tool (RST), and Ontario-Family History Assessment Tool (Ontario-FHAT). All five tools were applied to each study participant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to describe each tool’s ability to identify women with elevated risk as calculated by the Claus model. Receiver operating curves (ROC) were also plotted. Differences between areas under the curve (AUCs) for all possible pairs of tools were estimated through logistic regression to assess for differences in tool performance. Results: Claus calculations identified 14 women out of 85 whose lifetime risk of breast cancer was elevated at > 15%. Only two tools, the Ontario-FHAT and FHS-7, identified all 14 women with elevated risk, a sensitivity of 100%. The FHS-7 tool flagged all 85 participants, meaning its specificity was zero. The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a negative predictive value (NPV) of 100%, indicating that if a woman was not found to need a referral to a genetics professional, it is likely she did not have an elevated lifetime risk of developing breast cancer. AUC values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. Conclusion: In this population, the Ontario-FHAT out-performed other tools in terms of sensitivity and negative predictive value; however, low specificity and positive predictive value must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to a genetics specialist.

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Seoane, Antonio Ferreira. "A percepção de médicos e enfermeiros da Atenção Básica sobre a humanização nos serviços de saúde." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-06112012-103201/.

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O conceito de humanização é muito amplo e abrange um conjunto de conhecimentos, práticas, atitudes e relações. Envolve a efetiva participação de profissionais, gestores, usuários e movimentos sociais para que as experiências compartilhadas possam proporcionar melhorias na qualidade do atendimento na área da saúde. O objetivo foi analisar, à luz da bioética e políticas de humanização, a percepção de médicos e enfermeiros sobre humanização nos serviços de saúde. Optamos pela pesquisa qualitativa, de corte transversal, realizada mediante entrevistas com questões abertas, iniciada após prévia aprovação do Comitê de Ética em Pesquisa. O critério de representatividade da amostra para o encerramento da coleta de dados foi o da saturação do discurso. A interpretação do material coletado seguiu os preceitos da análise de conteúdo. Os sujeitos foram médicos e enfermeiros de unidades com Estratégia Saúde da Família (ESF) e Assistência Médica Ambulatorial (AMA) da região da Capela do Socorro, município de São Paulo. De acordo com os resultados encontrados, os entrevistados apreendem a humanização em aspectos comuns como integralidade, direito dos usuários, dificuldades nas relações, valorização profissional e ambiência. Demonstram, porém, que essa percepção sofre influência quando considerado o serviço onde prestam atendimento, surgindo então novas categorias particulares a cada serviço. Alteridade, trabalho em equipe, acesso ininterrupto, avaliação de risco e respeito à autonomia na AMA e prevenção e promoção à saúde, cuidado, vínculo e respeito à privacidade na ESF. Concluímos que a percepção sobre humanização dos profissionais tem distintos sentidos e significados variados. Situações comuns e particulares a cada tipo de serviço são vividas no cotidiano, influenciando a percepção sobre humanização. Essas ocorrências podem afetar a preservação dos direitos de usuários e profissionais, tornando-se fundamental a efetiva participação de todos para a consolidação de políticas públicas que busquem melhorias na área da saúde e amplo respeito aos direitos
The concept of humanization is very wide and comprehends a group of knowledge, practices, attitudes and relationships. It involves the effective participation of professionals, managers, users and social movements so that the shared experiences are able to offer improvements to the quality of reception on the healthcare area. The objective was to analyze, in light of bioethics and policies of humanization, the perception of doctors and nurses on humanization in healthcare services. We decided to apply a qualitative research, cross-sectional, carried out through interviews with open questions, started after prior approval of the Research Ethics Committee. The representativeness criterion of the sample for the closure of data collection was the saturation of the discourse. The interpretation of collected material was based on the precepts of content analysis. The subjects were doctors and nurses of units with Family Health Strategy (ESF) and Outpatient Medical Care Units (AMA) in the region of Capela do Socorro, municipality of São Paulo. According to the results found, the respondents perceive the humanization in common aspects such as integrality, right from the users, difficulties in relationships, professional value and ambience. They demonstrate, however, that this perception is influenced when the service is considered according to the place they are done, emerging, then, new particular categories to each service. Alterity, team work, uninterrupted access, risk analysis and respect to the AMA autonomy and prevention and health promotion, care, bond, and respect for privacy in the ESF. We conclude that the perception of the humanization of professionals have different senses and varying meanings. Common and particular situations to each type of service are experienced in daily life, influencing the perception of the humanization. These occurrences can affect the preservation of the rights of users and professionals, becoming essential to the effective participation of all for the consolidation of public policies that seek improvements in the area of health and broad respect for the rights.

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Genberg, Malin, and Helen Ahlgren. "Avparaffinering med Xylen versus Ttissue- clear för vävnadsmaterial vid flödescytometrisk analys av DNA ploidi." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Biomedicinsk plattform, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-36539.

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Alvino, Christopher Vincent. "Multiscale Active Contour Methods in Computer Vision with Applications in Tomography." Diss., Georgia Institute of Technology, 2005. http://hdl.handle.net/1853/6896.

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Most applications in computer vision suffer from two major difficulties. The first is they are notoriously ridden with sub-optimal local minima. The second is that they typically require high computational cost to be solved robustly. The reason for these two drawbacks is that most problems in computer vision, even when well-defined, typically require finding a solution in a very large high-dimensional space. It is for these two reasons that multiscale methods are particularly well-suited to problems in computer vision. Multiscale methods, by way of looking at the coarse scale nature of a problem before considering the fine scale nature, often have the ability to avoid sub-optimal local minima and obtain a more globally optimal solution. In addition, multiscale methods typically enjoy reduced computational cost. This thesis applies novel multiscale active contour methods to several problems in computer vision, especially in simultaneous segmentation and reconstruction of tomography images. In addition, novel multiscale methods are applied to contour registration using minimal surfaces and to the computation of non-linear rotationally invariant optical flow. Finally, a methodology for fast robust image segmentation is presented that relies on a lower dimensional image basis derived from an image scale space. The specific advantages of using multiscale methods in each of these problems is highlighted in the various simulations throughout the thesis, particularly their ability to avoid sub-optimal local minima and their ability to solve the problems at a lower overall computational cost.

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Gomes, Bruno Silva de Moraes. "Análises espaciais em saúde para os municípios brasileiros: ciclos eleitorais e partidários, estratégia saúde da família e migração médica." Universidade Federal de Juiz de Fora (UFJF), 2017. https://repositorio.ufjf.br/jspui/handle/ufjf/5457.

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Essa tese busca analisar as questões espaciais de saúde nos municípios brasileiros. Dessa forma, o artigo 1 investiga as evidências de ciclos eleitorais e partidários e interação espacial nas despesas com saúde e saneamento. O modelo de painel dinâmico espacial propiciou observar se ocorre o aumento das despesas com saúde e saneamento nos anos de eleição municipal e quais os partidos que mais gastam com saúde e saneamento. Identificou que o padrão dessas despesas é influenciado pelo comportamento das despesas nos municípios vizinhos. Nota-se a presença do efeito spillovers, pois os governantes reduzem suas despesas com saúde e saneamento ao observarem que os vizinhos aumentam as despesas. O artigo 2 analisa as questões espaciais da Estratégia Saúde da Família (ESF) capazes de influenciar a taxa de mortalidade infantil e de crianças de 1 a 4 anos nos municípios brasileiros entre 1998 e 2012. A estimação se dá por dados por painel espacial. Como resultado, observa-se a presença dos efeitos do tipo feedback, em que os efeitos diretos da ESF passam para os vizinhos e retornam e o espraiamento da razão de cobertura dos vizinhos na redução da mortalidade infantil e de 1 a 4 anos. Assim, conclui-se que um aumento da ESF em um município reduz as taxas de mortalidade infantil e de 1 a 4 anos nos vizinhos, sendo esse efeito maior para mortalidade infantil. E o artigo 3 analisa a migração médica identificando se há efeito gotejamento nos municípios brasileiros para médicos generalistas e especialistas. Utiliza-se os dados do Censo 2010 e o modelo hierárquico espacial de dois níveis, o primeiro com os dados individuais e o segundo com os dados municipais (incorporando as defasagens espaciais). Como resultados confirma-se a importância da inclusão das variáveis individuais, municipais e espaciais e verifica-se a inexistência do efeito de gotejamento para migração médica tanto de generalistas (que estão dispersos pelos municípios aleatoriamente) quanto de especialista nos municípios brasileiros.
This thesis aims to analyze spatial health issues in Brazilian municipalities. Thus, article investigates the evidence of electoral and partisan cycles and spatial interaction in health and sanitation expenditures. The spatial dynamic panel model allowed us to observe whether there is an increase in health and sanitation expenses in the years of municipal elections and which parties spend the most on health and sanitation. Identified that the pattern of these expenditures is influenced by the behavior of expenditures in neighboring municipalities. The spillovers effect is noticeable, as governors reduce their health and sanitation expenditures by observing that neighbors increase expenditures. Article 2 analyzes the spatial issues of the Family Health Strategy (FHS) that can influence the infant and child mortality rate of 1 to 4 years in Brazilian municipalities between 1998 and 2012. The estimation is given by data per space panel. As a result, the effects of the feedback type are observed, in which the direct effects of the FHS pass to the neighbors and return and the spreading of the coverage ratio of the neighbors in the reduction of the infant mortality and from 1 to 4 years. Thus, it is concluded that an increase in FHS in one municipality reduces infant and 1 to 4 year mortality rates in neighbors, and this effect is higher for infant mortality. And article 3 analyzes the medical migration, identifying if there is trickle down effect in Brazilian municipalities for general practitioners and specialists. Data from the Censo 2010 and the two-level spatial hierarchical model are used, the first with the individual data and the second with the municipal data (incorporating spatial lags). As a result, the importance of including individual, municipal and spatial variables is confirmed and there is no trickle down effect for medical migration, either by generalists (who are dispersed by the municipalities at random) or by specialists in the Brazilian municipalities.

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Fenollosa, Artés Felip. "Contribució a l'estudi de la impressió 3D per a la fabricació de models per facilitar l'assaig d'operacions quirúrgiques de tumors." Doctoral thesis, Universitat Politècnica de Catalunya, 2019. http://hdl.handle.net/10803/667421.

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La present tesi doctoral s’ha centrat en el repte d’aconseguir, mitjançant Fabricació Additiva (FA), models per a assaig quirúrgic, sota la premissa que els equips per fer-los haurien de ser accessibles a l’àmbit hospitalari. L’objectiu és facilitar l’extensió de l’ús dels prototips com a eina de preparació d’operacions quirúrgiques, transformant la pràctica mèdica actual de la mateixa manera que en el seu moment ho van fer tecnologies com les que van facilitar l’ús de radiografies. El motiu d’utilitzar FA, en lloc de tecnologies més tradicionals, és la seva capacitat de materialitzar de forma directa les dades digitals obtingudes de l’anatomia del pacient mitjançant sistemes d’escanejat tridimensional, fent possible l’obtenció de models personalitzats. Els resultats es centren en la generació de nou coneixement sobre com aconseguir equipaments d’impressió 3D multimaterials accessibles que permetin l’obtenció de models mimètics respecte als teixits vius. Per facilitar aquesta buscada extensió de la tecnologia, s’ha focalitzat en les tecnologies de codi obert com la Fabricació per Filament Fos (FFF) i similars basades en líquids catalitzables. La recerca s’alinea dins l’activitat de desenvolupament de la FA al CIM UPC, i en aquest àmbit concret amb la col·laboració amb l’Hospital Sant Joan de Déu de Barcelona (HSJD). El primer bloc de la tesi inclou la descripció de l’estat de l’art, detallant les tecnologies existents i la seva aplicació a l’entorn mèdic. S’han establert per primer cop unes bases de caracterització dels teixits vius -sobretot tous- per donar suport a la selecció de materials que els puguin mimetitzar en un procés de FA, a efectes de millorar l’experiència d’assaig dels cirurgians. El caràcter rígid dels materials majoritàriament usats en impressió 3D els fa poc útils per simular tumors i altres referències anatòmiques. De forma successiva, es tracten paràmetres com la densitat, la viscoelasticitat, la caracterització dels materials tous a la indústria, l’estudi del mòdul elàstic de teixits tous i vasos, la duresa d’aquests, i requeriments com l’esterilització dels models. El segon bloc comença explorant la impressió 3D mitjançant FFF. Es classifiquen les variants del procés des del punt de vista de la multimaterialitat, essencial per fer models d’assaig quirúrgic, diferenciant entre solucions multibroquet i de barreja al capçal. S’ha inclòs l’estudi de materials (filaments i líquids) que serien més útils per mimetitzar teixits tous. Es constata com en els líquids, en comparació amb els filaments, la complexitat del treball en processos de FA és més elevada, i es determinen formes d’imprimir materials molt tous. Per acabar, s’exposen sis casos reals de col·laboració amb l’HJSD, una selecció d’aquells en els que el doctorand ha intervingut en els darrers anys. L’origen es troba en la dificultat de l’abordatge d’operacions de resecció de tumors infantils com el neuroblastoma, i a la iniciativa del Dr. Lucas Krauel. Finalment, el Bloc 3 té per objecte explorar nombrosos conceptes (fins a 8), activitat completada al llarg dels darrers cinc anys amb el suport dels mitjans del CIM UPC i de l’activitat associada a treballs finals d’estudis d’estudiants de la UPC, arribant-se a materialitzar equipaments experimentals per validar-los. La recerca ampla i sistemàtica al respecte fa que s’estigui més a prop de disposar d’una solució d’impressió 3D multimaterial de sobretaula. Es determina que la millor via de progrés és la de disposar d’una pluralitat de capçals independents a fi de capacitar la impressora 3D per integrar diversos conceptes estudiats, materialitzant-se una possible solució. Cloent la tesi, es planteja com seria un equipament d’impressió 3D per a models d’assaig quirúrgic, a fi de servir de base per a futurs desenvolupaments.
La presente tesis doctoral se ha centrado en el reto de conseguir, mediante Fabricación Aditiva (FA), modelos para ensayo quirúrgico, bajo la premisa que los equipos para obtenerlos tendrían que ser accesibles al ámbito hospitalario. El objetivo es facilitar la extensión del uso de modelos como herramienta de preparación de operaciones quirúrgicas, transformando la práctica médica actual de la misma manera que, en su momento, lo hicieron tecnologías como las que facilitaron el uso de radiografías. El motivo de utilizar FA, en lugar de tecnologías más tradicionales, es su capacidad de materializar de forma directa los datos digitales obtenidos de la anatomía del paciente mediante sistemas de escaneado tridimensional, haciendo posible la obtención de modelos personalizados. Los resultados se centran en la generación de nuevo conocimiento para conseguir equipamientos de impresión 3D multimateriales accesibles que permitan la obtención de modelos miméticos respecto a los tejidos vivos. Para facilitar la buscada extensión de la tecnología, se ha focalizado en las tecnologías de código abierto como la Fabricación por Hilo Fundido (FFF) y similares basadas en líquidos catalizables. Esta investigación se alinea dentro de la actividad de desarrollo de la FA en el CIM UPC, y en este ámbito concreto con la colaboración con el Hospital Sant Joan de Déu de Barcelona (HSJD). El primer bloque de la tesis incluye la descripción del estado del arte, detallando las tecnologías existentes y su aplicación al entorno médico. Se han establecido por primera vez unas bases de caracterización de los tejidos vivos – principalmente blandos – para dar apoyo a la selección de materiales que los puedan mimetizar en un proceso de FA, a efectos de mejorar la experiencia de ensayo de los cirujanos. El carácter rígido de los materiales mayoritariamente usados en impresión 3D los hace poco útiles para simular tumores y otras referencias anatómicas. De forma sucesiva, se tratan parámetros como la densidad, la viscoelasticidad, la caracterización de materiales blandos en la industria, el estudio del módulo elástico de tejidos blandos y vasos, la dureza de los mismos, y requerimientos como la esterilización de los modelos. El segundo bloque empieza explorando la impresión 3D mediante FFF. Se clasifican las variantes del proceso desde el punto de vista de la multimaterialidad, esencial para hacer modelos de ensayo quirúrgico, diferenciando entre soluciones multiboquilla y de mezcla en el cabezal. Se ha incluido el estudio de materiales (filamentos y líquidos) que serían más útiles para mimetizar tejidos blandos. Se constata como en los líquidos, en comparación con los filamentos, la complejidad del trabajo en procesos de FA es más elevada, y se determinan formas de imprimir materiales muy blandos. Para acabar, se exponen seis casos reales de colaboración con el HJSD, una selección de aquellos en los que el doctorando ha intervenido en los últimos años. El origen se encuentra en la dificultad del abordaje de operaciones de resección de tumores infantiles como el neuroblastoma, y en la iniciativa del Dr. Lucas Krauel. Finalmente, el Bloque 3 desarrolla numerosos conceptos (hasta 8), actividad completada a lo largo de los últimos cinco años con el apoyo de los medios del CIM UPC y de la actividad asociada a trabajos finales de estudios de estudiantes de la UPC, llegándose a materializar equipamientos experimentales para validarlos. La investigación amplia y sistemática al respecto hace que se esté más cerca de disponer de una solución de impresión 3D multimaterial de sobremesa. Se determina que la mejor vía de progreso es la de disponer de una pluralidad de cabezales independientes, a fin de capacitar la impresora 3D para integrar diversos conceptos estudiados, materializándose una posible solución. Para cerrar la tesis, se plantea cómo sería un equipamiento de impresión 3D para modelos de ensayo quirúrgico, a fin de servir de base para futuros desarrollos.

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Symes, Juliane C. "Fas-mediated apoptosis in prostate cancer: Gene therapy and synergism with chemotherapy /." 2008. http://proquest.umi.com/pqdlink?did=1659896191&sid=4&Fmt=2&clientId=12520&RQT=309&VName=PQD.

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Dada, Ebrahim. "Community awareness of GOBI-FFF and its implementation in two urban communities." Thesis, 1985. http://hdl.handle.net/10413/7508.

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The health picture in the developing world is still very bleak. The varlOUS Black populations of South Africa (be they Africans, Indians or Coloureds) are part of this developing world. In a total world population of 4,607 million (of which 75 % are in the developing world); there are 10.3 million annual infant deaths (0-11 months) (of which 97 % are ln the developing countries); and 4.3 million annual child deaths (1-4 years) (of which 98 % are in the developing countries).*l The infant mortality rate (IMR) (infant deaths per 1,000 live births) in 1980 for the developing countries as a whole, and for Southern Africa specifically is 100; as compared to the IMR of 20 for developed countries. South Africa has an IMR of 90 (1982). However, a few relatively simple and inexpensive methods could enable parents themselves to bring about a revolution ln child survival and development. The idea that could make this revolution possible is primary health care. The vehicles that could make this revolution achievable are the spread of education, communications and social organization. The techniques which could make this revolution affordable even with very limited resources, are growth monitoring, oral rehydration therapy, breast-feeding and immunization (GOBI). These four principle life line techniques are low-cost, available now, achieve rapid results and a l most universally relevant. They involve people in taking more responsibility for their own health, and thus promote primary health care. In combination they offer an even greater degree of protection against the synergistic alliance of malnutrition and infection which is the central problem of child health and child development today. *3 In addition, three other changes-female education, family spacing and food supplementation (FFF) are also among the most powerful levers for raising the level of child survival and child health. Although more costly and more difficult to achieve, these changes in the lives of women are of such potential significance that they must also now be count ed among the breakthrough in knowledge which could change the ratio between the health and wealth of nations. *3 However, against this information is the stark reality that only up to 15 % of the world's families are using oral rehydration therapy (ORT), the revolutionary low-cost technique for preventing and treating diarrhoeal dehydration, the biggest single killer of children in the world. *4 This then rai ses the vital question that although the potential for child survival and a healthy and normal child development is there, to what extent is the average mother aware of and implementing these cost-effective methods of GOBI-FFF in her own situation? These questions are thus addressed in this study in an African and an Indian urban communities ln Natal/Kwa Zulu.
Thesis (M.Med.)-University of Natal, Durban, 1985.

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"Emerging Role Of Mir-223 And Mir-185 In Liver Diseases." Tulane University, 2014.

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Wieczorek, Anna. "Neuropsychologische Profile bei Patienten mit Creutzfeldt-Jakob-Krankheit (CJD) und anderen Demenzen." Doctoral thesis, 2012. http://hdl.handle.net/11858/00-1735-0000-0006-B2BE-E.

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Pinho, Cláudia de Oliveira. "Avaliação do Programa Curricular de Segurança do Doente da Faculdade de Ciências da Saúde da Universidade da Beira Interior." Master's thesis, 2016. http://hdl.handle.net/10400.6/5340.

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Introdução: O desenvolvimento de programas curriculares de Segurança do Doente no ensino pré-graduado de futuros profissionais de saúde tem vindo a ser uma preocupação crescente a nível mundial, no sentido de aumentar a qualidade dos cuidados de saúde. Contudo, poucas foram as escolas que criaram ou implementaram um programa deste tipo. Em Portugal, a Segurança do Doente já faz parte dos currículos de algumas escolas médicas e, nesta iniciativa, a FCS-UBI foi uma pioneira. Desde 2010/2011 que o programa de Segurança do Doente da FCS-UBI tem vinda a ser construído e implementado com o apoio do “WHO Patient Safety Curriculum Guide for Medical Schools.” Com a formação FCS-UBI Open School Chapter, em 2012, o programa iniciou a aplicação de cursos on-line disponibilizados pela IHI complementados por estudos de caso em contexto de Small Group Teaching, usando um sistema de Peer-Assisted Learning. Objetivos: Os principais objetivos deste trabalho foram apresentar e avaliar o Programa de Segurança do Doente da FCS-UBI usando e comparando a perspetiva dos estudantes e dos docentes desta faculdade. Métodos: Com o objetivo de avaliar o programa foram selecionados 6 estudantes e 6 docentes, um estudante e um docente representativo de cada ano curricular do MIM para participar em duas sessões de focus group realizadas nas instalações da FCS-UBI no decorrer deste ano letivo 2015/2016. Resultados: Embora pouco familiarizados com a estrutura do Programa de Segurança do Doente da FCS-UBI, a maioria dos docentes e estudantes da FCS-UBI consideram pertinente a implementação deste tipo de programa no ensino pré-graduado na área da saúde. Relativamente às estratégias de integração do programa no currículo do MIM (Mestrado Integrado em Medicina), assim como relativamente às metodologias de ensino e avaliação, as opiniões divergem tendo sido sugeridas algumas alterações a esse nível. Discussão: Comparando os resultados obtidos com a literatura que suporta a implementação deste tipo de programa no ensino pré-graduado, foi possível fazer um balanço da adaptação do Programa de SD ao currículo do MIM da FCS-UBI. Este trabalho permitiu elaborar um plano de reforma curricular que objetiva melhorar o futuro deste programa.
Introduction: The development of a patient safety curriculum for undergraduate medical students has emerged as a global concern for providing quality health care. However, few medical schools all over the world have created and/or implemented such program. In Portugal, patient safety is known to be part of some medical school’s curricula, and FCS-UBI is one of those pioneers. Since 2010/2011, “WHO Patient Safety Curriculum Guide for Medical Schools” supported the construction and implementation the FCS-UBI Patient Safety Program. When FCS-UBI Open School Chapter was formed, in 2012, the program applied online courses delivered by this institute, embedded in Small Group Teaching activities through Peer-Assisted Learning. Aim: The main goals of this work were to present and assess the FCS-UBI patient safety program using and comparing FCS-UBI students and teacher perceptions of this program. Methods: An assessment, using focus group research method, was applied to 6 students and 6 teach of FCS-UBI, on faculty facilities during 2015/2016 school year. Results: Although unfamiliar with FCS-UBI Patient Safety Program structure, students and teachers agree about its relevance for the undergraduate curricula of health-care courses. About the integrative strategy on MIM as the teaching and assessing methods applied, opinions diverged, and changes were proposed by all participants. Discussion: Comparing focus group results with Patient Safety programs implementation supportive literature on undergraduate curricula, it was possible to take conclusions about FCS-UBI Patient Safety Program adaptation to FCS-UBI MIM’s curricula. This work allowed us to draw up a curriculum reform plan that aims to improve the future of this program.

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Kowalczewski, Jan. "Upper extremity neurorehabilitation." Phd thesis, 2009. http://hdl.handle.net/10048/755.

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Thesis (Ph.D.)--University of Alberta, 2009.
A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Neuroscience, Centre for Neuroscience. Title from pdf file main screen (viewed on October 18, 2009). Includes bibliographical references.

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