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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Analysis of causes of death at home and in a public hospital Capricorn District of Limpopo Province

Ntuli, Sam Thembelihle January 2015 (has links)
Thesis (Ph. D. (Science)) -- University of Limpopo, 2015 / The objectives of the study were to examine the demographic profile and causes of death of people dying in a hospital and community; and to determine mortality rates, specifically age- and gender-specific mortality rates in a community. The study also compared causes of death assigned to hospital records with causes of death obtained from verbal autopsy reports. Methodology The data used in this thesis were collected in two phases. The first phase involved a retrospective review of all deaths that occurred in the Pietersburg/Mankweng Hospital Complex from 1st January, 2011 to 31st December, 2012. The second phase involved a community-based study using a verbal autopsyto determine cause of death in Dikgale HDSS for the same period. Results A total of 5402 deaths were reported in the hospital and 625 in the community. The majority of deaths in the hospital involved adults in the 15 to 49 year old age group, while in the community more deaths were recorded amongst adults aged 15 to 49 years of age and those in the 65+ year old age group. There were more male deaths in the hospital, while in the community a higher proportion of deaths occurred amongst females. v In children less than1 year old, the cause of death in the hospital was predominantly due to perinatal conditions, particularly preterm birth, low birth weight and birth asphyxia; while in the community, of the 5 deaths in this age group, infectious diseases were recorded as the main cause of death. Amongst children in the 1 to 4 year old age groups causes of hospital deaths were dominated by infectious diseases, injuries and malnutrition; while in the community infectious diseases were the main cause of death. Stillbirths were noted in the hospital with a stillbirth rate of 29.1/1000 deliveries. In the community no stillbirths were reported. More than half of the stillbirths were caused by unexplained intrauterine foetal causes followed by maternal hypertension in pregnancy and placenta abruption. For adults in the 15 to 49 year old age groups infectious diseases, such as HIV/AIDS and tuberculosis, were the leading causes of death in both the hospital and in the community. The proportion of deaths due to HIV/AIDS and tuberculosis was significantly greater in the community than in the hospital. Amongst adults in the 50+year old age group non-communicable diseases, particularly cardiovascular diseases and cancers were the most common causes of death. In this age group, the hospital recorded more cancer deaths than did the community; while the community recorded more cardiovascular deaths than did the hospital. vi The overall mortality rate in the community was 8.4 deaths per 1000 person-year, with more deaths occurring amongst males (8.9 deaths per 1000 person-year). The mortality rate was high amongst adults in the 65+ year old age group (48.9 deaths per 1000 person-year). When comparing cause-specific mortality between hospital cause of death notification forms and cause of death determined by verbal autopsy reviews, the same top five underlying causes of death were observed, namely: cardiovascular diseases, infectious diseases, diabetes mellitus, malignant neoplasms and respiratory infections. The agreement between causes of death reported on cause of death notification forms and cause of death as a result of a verbal autopsywas 48%. For individual causes, agreement of more than 80% was achieved between cause of death recorded on cause of death notification forms and from verbal autopsy reviews for respiratory infections, diabetes, malignancies and injuries. Infectious diseases (68.5%) and cardiovascular diseases (74.1%) achieved the lowest agreement. In other words, in only 68.5% and 74.1% respectively was the cause of death as recorded on the “cause of death notification” forms the same as the cause of death when reviewed verbally. Furthermore, 13 deaths were recorded as being due to cardiovascular diseases on the “cause of death notification” forms, however, in only 5 of these cases was the cause of death recorded as the same in the verbal autopsy report. In 21 cases cause of death was attributed to infectious diseases on the cause of death notification form, vii while in only 13 of these cases was the cause of death similarly ascribed after verbal autopsy review. Conclusion This study showed that the verbal autopsy instrument has the potential to identify causes of death in a population where deaths occur outside of health facilities. Procedures for death certification and coding of underlying causes of death need to be streamlined in order to improve the reliability of registration data. This will be achieved if medical students and trainee specialists are trained in the completion of cause of death notification forms. Foetal autopsies should be introduced at tertiary hospitals to determine the causes of stillbirths.Antenatal care education for pregnant women should be encouraged because the level of antenatal care has an influence on the health of mothers and their newborns. The government should continue to focus on improving the socio-economic status of the population, while adequate foetal monitoring by health workers may reduce neonatal deaths resulting from preterm births, low birth weight and birth asphyxia. Innovative injury prevention strategies, interventions to control infectious diseases, cancer screening and lifestyle program may reduce adult mortality.
22

Smoking, obesity, depression and mortality in a Chinese elderly cohortin Hong Kong

Li, Zhibin, 李志斌 January 2006 (has links)
published_or_final_version / abstract / Community Medicine / Doctoral / Doctor of Philosophy
23

A profile of hanging deaths admitted to Polokwane and Lebowakgomo forensic pathology service laboratories, Limpopo Province

Matlala, Malekgopo Mologadi January 2022 (has links)
Thesis (M.Med. (Forensic Pathology)) -- University of Limpopo, 2022 / Introduction and background: Hanging deaths contribute to premature mortality locally and globally. Aim: The study aimed to provide a profile of hanging deaths in Polokwane and Lebowakgomo Forensic Pathology Service laboratories in the Limpopo Province. Method: A quantitative retrospective study was conducted using sample size of 141 hanging death victims that were selected using systematic random sampling from hanging deaths admitted to Polokwane and Lebowakgomo Forensic Pathology Service laboratories over a period of 2 years. Results: The study revealed that majority of hanging deaths were adults aged 20-29. There was male predominance and majority of the victims were unemployed. The hanging deaths victims were mostly discovered in the morning and the peak period was over the weekend. The peak season was summer. The post-mortem neck findings included visible ligature mark, located above the thyroid cartilage and there were few associated injuries on the internal neck structures. The alleged manner of death of the cases was predominantly suicide, few of the deaths were homicide hanging deaths and no there were no reported accidental cases. Conclusion: The profile of hanging deaths identified was similar to that of reviewed literature. .
24

Respiratory pathogens in cases of Sudden Unexpected Death in Infancy (SUDI) at Tygerberg forensic pathology service mortuary

La Grange, Heleen 04 1900 (has links)
Thesis (MScMedSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background: Sudden infant death syndrome (SIDS) is considered the second most frequent cause of infant mortality worldwide. Research specifically pertaining to SIDS is limited in the South African setting. Identifiable causes for sudden infant death remain challenging despite full medico-legal investigations inclusive of autopsy, scene visit and ancillary studies. Viral infections could contribute to some sudden unexpected death in infancy (SUDI) cases, especially since a multitude of respiratory viruses have been detected from autopsy specimens. The specific contribution of viruses in the events preceding death, including the subsequent involvement of the immature immune response in infants, still warrants deciphering. Infancy is characterised by marked vulnerability to infections due to immaturities of their immune systems that may only resolve as infants grow older when these sudden deaths rarely still occur. In South Africa there is a lack of a standard protocol for investigations into the causes of SIDS, including the lack of standard guidelines as to which specimens should be taken, which viruses should be investigated and which laboratory assays should be utilised. Objectives: In this prospective descriptive study we aimed to investigate the prevalence of viruses in SUDI and SIDS cases at Tygerberg Forensic Pathology Service (FPS) Mortuary over a one year period. The primary aim was to explore possible respiratory viral infections in SUDI and SIDS cases and to determine the usefulness of molecular techniques to detect viruses from SUDI cases. To determine the significance of viruses, we assessed signs of infection from lung histology. The secondary objectives included collecting demographic data to investigate possible risk factors for SUDI and to look for possible similarities between viruses confirmed in living hospitalised infants at Tygerberg, during the study period compared to viruses detected from SUDI cases. Methods: Between May 2012 and May 2013 samples were collected from 148 SUDI cases presenting at Tygerberg FPS Mortuary. As part of the mandatory routine investigations into SUDI, shell vial culture (SVC) results were collected from lung and liver tissue specimens and bacterial culture results were collected from left and right lung and heart swabs at autopsy. To investigate the possibility of viruses implicated in some of the infant deaths we used the Seeplex® RV15 Ace detection multiplex polymerase chain reaction (PCR) assay to establish the frequency of 13 ribonucleic acid (RNA) respiratory viruses (influenza A and B, human parainfluenza 1-4, human coronavirus [OC43, 229E/NL63], human rhinovirus A, B and C, respiratory syncytial virus A and B, human enterovirus and human metapneumovirus) from RNA extracted from tracheal and lower left and right lung lobe swabs. Tissue from the lower left and right lung lobes were also assessed for histology signs of infection. Results: During our study we confirmed multiple known demographic risk factors for SIDS, such as the age peak around 1-3 months, the male predominance, bed-sharing, sleeping in the prone position, heavy wrapping in warm blankets, prenatal smoke exposure, and socio-economic factors. With the Seeplex® RV15 Ace detection assay between one and three viruses were detected in 59.5% (88/148) of cases. Of the 88 cases that had viruses detected, 75% (66/88) had one virus and 25% (22/88) had co-detections of two to three viruses. The most common viruses detected were HRV in 77% (68/88) of cases, RSV in 18% (16/88) of cases and HCoV in 14% (12/88) of cases. Many of the viruses we detected from our cases are included in the SVC test that forms part of the medico-legal laboratory investigation for all SUDI cases at Tygerberg FPS Mortuary. SVCs were positive in 9.5% (14/148) of all cases only. We showed that the SVC method is potentially missing most of the 13 respiratory viruses we investigated that could contribute to death in some of the SUDI cases. Conclusion: In some cases that had a Cause of Death Classification - SIDS, the PCR viruses detected cannot be ignored, especially when it is supported by histological evidence of infection. We thus propose that the use of PCR could alter a Cause of Death Classification from SIDS to Infection in some of these cases. Further research is needed to determine the significance of detecting viruses from SUDI cases wherein no significant histological evidence of infection was observed. This questions whether PCR may be too sensitive and is detecting past and latent viral infections that do not play any role in the cause of death. The histological picture also requires further characterisation to determine if it accurately predicts infections or lethal events and can truly support virology findings, especially in young infants whose immune systems are still maturing. Without determining the true prevalence of viruses in SUDI cases and the viral-specific immune response, the contribution of virus-specific infections to this syndrome will remain largely undetermined. / AFRIKAANSE OPSOMMING: Agtergrond: Wiegiedood (“SIDS/SUDI”) word beskou as die tweede mees algemene oorsaak van sterftes in kinders jonger as een jaar wêreldwyd. Toegewyde SIDS-spesifieke navorsing in die Suid-Afrikaanse samelewing is beperk. Dit bly steeds „n uitdaging om oorsake te probeer identifiseer vir hierdie onverwagte sterftes in kinders (SUDI) ten spyte van volledige medies-geregtelike ondersoeke, insluitende die lykskouing, ondersoek van die doodstoneel en aanvullende ondersoeke. Virusinfeksies kan aansienlik bydra tot sommige onverwagte sterftes in kinders, aangesien verskeie respiratoriese virusse alreeds aangetoon is in monsters verkry tydens outopsies. Die spesifieke rol wat virusse speel in die prosesse wat die dood voorafgaan, asook die bydraende rol van „n onder-ontwikkelde immuunrespons in babas, regverdig verdere ondersoek. Die eerste jaar van lewe word gekenmerk deur verhoogde vatbaarheid vir infeksies weens die ontwikkelende immuunstelsels soos wat babas ouer word, en die voorkoms van SUDI neem stelselmatig af met „n toename in ouderdom. In Suid-Afrika bestaan daar tans geen standaard protokol vir die ondersoek van wiegiedood nie en daar is ook nie standaard riglyne oor die tipe monsters wat geneem moet word, watter virusse ondersoek moet word en watter laboratorium toetse uitgevoer moet word nie. Doelstellings: In hierdie prospektiewe beskrywende studie is gepoog om die virusse wat in gevalle van wiegiedood of SUDI voorkom te ondersoek. Die studie is uitgevoer by die Tygerberg Geregtelike Patologie Dienste lykshuis oor 'n tydperk van een jaar. Molekulêre tegnieke om virusse aan te toon in hierdie gevalle is gebruik om spesifieke virusinfeksies te ondersoek. Die resultate is met histologiese tekens van infeksie in longweefsel gekorreleer. Demografiese data is verder versamel om moontlike risikofaktore vir wiegiedood te ondersoek. Dit is verder vergelyk met virusse wat met dieselfde diagnostiese tegnieke in babas geïdentifiseer is wat tydens die studieperiode in Tygerberg Hospitaal opgeneem was met lugweginfeksies. Metodes: Monsters van 148 SUDI gevalle wat by die Tygerberg lykshuis opgeneem is, is versamel tussen Mei 2012 en Mei 2013. As deel van die roetine ondersoeke in SUDI gevalle, was selkultuur resultate verkry van long en lewer weefsel, asook bakteriële kulture van deppers wat van beide longe en hart geneem was tydens die lykskouings. „n Seeplex® RV15 Ace polimerase kettingreaksie (PKR) toets is gebruik om die teenwoordigheid van virusse te ondersoek wat moontlik by die babasterftes betrokke kon wees. Trageale- en longdeppers wat tydens die lykskouings versamel was, was getoets vir 13 ribonukleïensure (RNS) respiratoriese virusse (influenza A and B, human parainfluenza 1-4, human coronavirus [OC43, 229E/NL63], human rhinovirus A, B and C, respiratory syncytial virus A and B, human enterovirus and human metapneumovirus). Resultate: Ons studie het verskeie bekende demografiese risikofaktore vir SUDI bevestig, byvoorbeeld „n ouderdomspiek tussen een en drie maande ouderdom, manlike predominansie, deel van „n bed met ander persone, slaap posisie op die maag, styf toedraai in warm komberse, blootstelling aan sigaretrook voor geboorte en sosio-ekonomiese faktore. Die Seeplex® RV15 Ace toets het tussen een en drie virusse geïdentifiseer in 59.5% (88/148) van die gevalle. Uit die 88 gevalle waarin virusse opgespoor was, was selgs een virus in 75% (66/88) van gevalle gevind en twee en drie virusse in 25% (22/88). Die mees algemene virusse was HRV in 77% (68/88) van gevalle, RSV in 18% (16/88) van gevalle en HCoV in 14% (12/88) van gevalle. Baie van die virusse wat tydens hierdie studie ondersoek was, was ingesluit in die roetine selkultuur toets wat deel vorm van die standaard medies-geregtelike laboratoriumondersoeke in alle SUDI gevalle by die Tygerberg lykshuis, alhoewel die selkulture positief was in slegs 9.5% (14/148) van gevalle. Ons het gevind dat baie respiratoriese virusse potensieel gemisdiagnoseer word wat „n rol kon speel in of bydra tot die dood van sommige SUDI gevalle. Gevolgtrekking: In sommige gevalle waarin SIDS geklassifiseer is as die oorsaak van dood, kan die virusse wat met PKR toetse opgespoor is nie geïgnoreer word nie, veral waar die bevinding ondersteun word deur histologiese bewyse van infeksie. Ons stel dus voor dat die gebruik van PKR toetse die oorsaak van dood klassifikasie kan verander van SIDS na Infeksie in sommige van hierdie gevalle. Verdere navorsing is nodig om die waarde van gelyktydige opsporing van virusse in SUDI gevalle te bepaal wanneer daar geen noemenswaardige histologiese bewyse van infeksie gevind word nie. Dit bevraagteken of die PKR toets dalk te sensitief is en gevolglik vorige en latente virusinfeksies identifiseer wat nie noodwendig 'n rol in die oorsaak van dood speel nie. Die diagnostiese en kliniese waarde van die histologiese beeld in terme van die rol van virusinfeksies as bydraende oorsaak van dood moet verder ondersoek word, veral in jong kinders wie se immuunstelsels nog nie volledig ontwikkel is nie. Indien die werklike voorkoms van virusse in SUDI gevalle en die virus-spesifieke immuunrespons nie bepaal word nie, sal die rol van virus-spesifieke infeksies in hierdie sindroom grootliks onbekend bly. / Harry Crossley Foundation / Poliomyelitis Research Foundation (PRF) / National Health Laboratory Services Research Trust
25

Coronial inquiries into fatal adverse events in South Australian hospitals : from inquest to practice / Carol Grech.

Grech, Carol Margaret January 2004 (has links)
"October 2004" / Includes bibliographical references (leaves 313-337) / x, 337 leaves : ill. (col.), maps (col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2004
26

The impact of stigma and discrimination against people living with HIV and AIDS: An investigation into why family members attrbute death to other diseases

Mathavha, Thomas 12 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: This research paper is based on the perception of people over the death by HIV and Aids. It looks at the impact of culture and beliefs on the management of HIV and Aids in the community and also in the country as whole. This research aims to establish the root course of covering death of by HIV and Aids, often due to fear of discrimination and isolation. Communities need to be educated on discrimination and stigma that comes about with people living with HIV and Aids. This study was conducted at Mvelaphanda Primary School children, in Tembisa, Ekurhuleni Metropolitan Municipality in Gauteng, South Africa. The main focus was on the death of parents of the learners at the school and ultimately learners themselves, who some of them where born with HIV epidemic. Some of the children became orphans of the disease. The collection of data was in three fold: questionnaire, interview and observation and discussions. The information gathered was manipulated to bring about the expected results. Analysis of the data indicated that where there is no behavioral and attitude change, there would be more death by the pandemic than ever before. It is the responsibility of everyone, be it heads of families, religious leaders, politicians, business people and teachers to fight against the spread of HIV and Aids pandemic. This study has also discovered that medical report on the cause of death is concealed in order for policies to payout. This distortion of information does not help in the fight against the spread of HIV and Aids All stakeholders should work together in the support of those will disclose their status without fear of rejection, isolation and discriminated against. Schools, churches and community gatherings should be better used as a plat-form for that. If such conditions are created the spread of the HIV will be reduced and the prevention strategy will succeed. / AFRIKAANSE OPSOMMING: Die navorsing handel oor die persepsie van mense teenoor dood as gevolg van MIV/Vigs. Dit ondersoek die impak van kultuur en geloof op die bestuur van MIV/Vigs binne 'n gemeenskap in die besonder en binne die land in die algemeen. Die doel van die navorsing was om die grondoorsaak waarom daar dikwels gediskrimeer word teenoor persone wat sterf weens MIV te identifiseer en om te bepaal waarom mense wat met MIV leef dikwels “uitgewerp” word uit die gemeenskap. Die studie is gedoen by die Mvelaphanda Primêre Skool in Tembisa, in die Ekuhuleni Metropool van die Gauteng provinsie van Suid-Afrika. Die primêre fokus van die studie was op die invloed wat die dood as gevolg van Vigs op die kinders in die skool gehad het. Data is ingesamel deur middel van vraelyste en onderhoude asook deur waarneming en besprekings. Ontleding van die data het aangetoon dat indien daar nie positiewe gedragverandering plaasvind nie, daar meer sterftes as gevolg van Vigs verwag kan word. Daar word aanbevelings gemaak oor hoe belangroepe kan meehelp om stigma en diskriminasie te verminder en sodoende kan meehelp om die verdere verspreiding van die pandemie te beperk.
27

Post-mortem lessons : community-based model for preventing maternal mortality and newborn death in Ethiopia

Guta, Yonas Regassa 09 1900 (has links)
Ethiopia is one of the five nations that bear the global burden of nearly 50% maternal mortalities and newborn deaths. Cause-specific maternal mortality and newborn death information are vitally important for prevention, but little is known about the causes of deaths. Many maternal mortalities and newborn deaths occur at home, outside the formal health sector, and few are attended by qualified medical professionals. Despite the fact that, non-medical factors are often more important in determining whether a woman/newborn lives or dies than the medical cause of death itself. This study determines and explores factors contributing to maternal mortalities and newborn deaths in Ethiopia with the aim of developing a community-based model for averting maternal mortalities and newborn deaths in Ethiopia. The study was organised in three phases. In Phase 1, a community-based-retrospective approach using explorative, descriptive and contextual study design, combining both qualitative and quantitative methods (mixed methods) were used to make an in-depth investigation and analysis of the circumstances and events surrounding individual cases of maternal mortality and newborn deaths. The result of the study revealed various direct and indirect as well as possible contributing factors to maternal mortalities and newborn deaths which outlined bases for forwarding Phase 2 of the study called concept analysis. In Phase 3, a prototype model was developed according to Chinn and Kramer’s approach to theory generation: initially, based on the empirical perspectives of the study, concept analysis was conducted. The structure and process of a model to avert maternal mortality and newborn death were described; and, six survey list; namely, agent, recipient, context, procedure, dynamic and terminus of Dickoff, James and Wiedenbach (1968) form the basis for development and description of a model for averting maternal mortality and newborn deaths in Ethiopia. Impediment in receiving prompt, adequate and appropriate care were common problems encountered even after reaching an appropriate medical facility. For any attempt to attain a significant reduction in maternal mortality and newborn death, the health care system in Ethiopia must assume its tasks to institute critical changes in both the structure and process of health care delivery services. / Health Studies / D. Litt. et Phil. (Health Studies)
28

Development of guidelines for post care management at selected hospitals of KwaZulu-Natal Province, South Africa

Netshinombelo, Muthuphei 20 September 2019 (has links)
Department of Advanced Nursing Science / PhDH / Background: Despite measures to curb unwanted pregnancies and to sustain and expand abortion services, a high number of complications and deaths still occur. The failure of these measures is evidenced by the high number of women who are admitted to the public hospitals of KwaZulu-Natal Province with complications from induced abortions. KwaZulu-Natal Department of Health has repositioned Family Planning to a key priority in its health program in order to improve the situation for women. However, in order to improve the situation, it is necessary to understand the underlying causes. This study sought to identify challenges that affect women's access to Post Abortion Care (PAC) services in KwaZulu-Natal Province, South Africa. It also sought to shed light on the challenges faced by those who render PAC services, as well as assess the skills of those workers as observed while they provided PAC services. After conducting the research on challenges related to access and rendering of post abortion care services, the researcher identified a need to develop guidelines for management of unsafe and induced abortion complications, with the aim to improve the life expectancy of women and prevent maternal deaths. Therefore, an outcome of the study was the development of a PAC management guideline. Purpose: The purpose of the study was two-fold: Phase 1: to explore the challenges faced by women when accessing PAC, and the health care workers who render PAC services, and to assess the PAC skills of the health care workers; Phase 2: to use the findings of Phase 1 to develop guidelines for post abortion care management at selected Hospitals of KwaZulu-Natal Province, South Africa. Methods: The design of the study was guided by the Andersen model of Health Care Utilization. The model focuses on the contextual factors - enabling factors, predisposing factors and need factors - that influence the individual's utilization of health care services. Five districts of KwaZulu-Natal Province, South Africa were selected for the study. A convergent parallel mixed method was used to collect and interpret the data. A qualitative study was used to explore perceptions and challenges of women when accessing PAC; this was carried out by means of in-depth interviews with 23 women who accessed PAC services. Five Focus Group Discussions (FGD) were carried out with 50 health care workers to explore the challenges they experienced when managing abortion complications. A quantitative approach was used for direct skills observation of 92 health care workers. Thematic analysis was used to analyse the qualitative data; descriptive statistics were used to analyse the quantitative data. Results: From the in-depth interview data, several main themes were identified. Women who accessed PAC identified a lack of facilities that offered PAC service, distance from the community to the hospital that provided PAC service, lack of transport, shortage of staff, unskilled staff, shortage of equipment, long waiting queues, stigma and discrimination as challenges associated with delay or avoidance of access to post abortion care services. The main themes raised by the health care providers were lack of support from the management, shortage of staff, lack of training, burnout, unavailability of the guidelines or protocols and shortage of equipment. The quality of PAC services was perceived as poor by both the women seeking care and the health care workers. The main concerns raised by the women were lack of respect, lack of privacy, sharing of bed and insufficient time with the health care provider. The results confirmed that guidelines are needed for the management of post abortion care services. The findings from the qualitative and quantitative parts of the study were used by an expert group to develop PAC management guidelines. The development of the guidelines was in accordance with the WHO models, PICOS & GRADES. The guidelines were validated by the group using a close-ended checklist, analysed with simple descriptive statistics. Conclusion: This study concludes that access to comprehensive quality post abortion care must be provided for all women at times of need. Quality PAC services should be rendered by skilled health care workers in a facility which is accessible and well equipped with functional equipments and updated guidelines. Recommendations: The study therefore recommends that measures should be taken to ensure the provision of quality PAC services. The PAC services should be accessible with the increased number of facilities, adequate trained health care workers with functional equipment and guidelines. Health care workers must receive training and management support to enhance quality PAC services. Privacy and respect must be maintained during provision of PAC services to ensure quality of care and increase demand. There must be continuous community awareness about PAC services which will encourage early-seeking behavior, and reduce fear of stigma and discrimination by the providers of PAC services before the complications arises. This study did not cover all the districts to identify the challenges on delaying PAC service. Therefore, this study recommends additional clinical, operations and community research which will give broader details and understanding on the challenges that cause delay for seeking immediate post abortion care services. / NRF
29

Estudo post mortem através da técnica do pink teeth em vítimas de mortes violentas em Curitiba e Região Metropolitana

Gavrilko, Oleg 12 April 2013 (has links)
Os dentes rosados são um fenômeno que pode ocorrer em vida ou post-mortem. Ele resulta na pigmentação do dente pela hemoglobina que se difunde através dos túbulos destinatários. Vários pesquisadores vêm analisando esse fenômeno a fim de elucidar seu mecanismo e tentar relacioná-lo com a causa da morte e do tempo decorrido da morte, com o objetivo de auxiliar e agilizar o trabalho de investigação criminal na descoberta da real situação da morte. Nesse trabalho o autor procurou correlacionar o aparecimento de dentes rosados com a hora aproximada e a causa da morte, mensurando a coloração. Foi realizado um trabalho de campo no Instituto Médico Legal da cidade de Curitiba onde foram analisados 15 cadáveres, com diferentes causas da morte. Para estabelecer a coloração foi utilizada a escala de cores RGB Hex Triplet Color Chart e realizada a comparação visual dos dentes. Ficou constatado que os dentes da bateria labial, ou seja, de canino a canino, foram os dentes mais afetados e a região cervical dos dentes – colo do dente ou na região da junção cemento-esmalte, ou anda pescoço do dente, é a que apresenta uma coloração mais exuberante. É proposto o desenvolvimento de um colorímetro eletrônico como trabalho futuro, com o objetivo de automatizar a aquisição de cor nos dentes rosados. / Pink teeth are a phenomenon that can occur in life or post-mortem. It is resulted by pigmentation tooth by hemoglobin, which diffuses through the dentinal tubules. Several researches have analyzed this phenomenon, in order to elucidate its mechanism and try to relate to the cause of death and the time elapses from death, to assist and make faster the word of criminal investigation in discovering the real situation of death. In this work the author tried to correlate the appearance of the pink teeth with time and cause of death, measuring the color. Were conducted a field study at the Institute of Forensic Medicine of Curitiba, where were analyzed 15 specimens with different causes of death. For the staining was used to measure the color gamut of RGB Hex Triplet Color Char and held visual comparison of the teeth. It was verified that the teeth of the battery lip, i.e. from canine to canine were the most affected teeth and the neck of the teeth – or the tooth neck region of the cementum-enamel junction, or neck of the tooth, it shows one more exuberant color. Is proposed the development of a electronic colorimeter as future work, with the subject to automate the capture the color in the pink teeth.
30

Estudo post mortem através da técnica do pink teeth em vítimas de mortes violentas em Curitiba e Região Metropolitana

Gavrilko, Oleg 12 April 2013 (has links)
Os dentes rosados são um fenômeno que pode ocorrer em vida ou post-mortem. Ele resulta na pigmentação do dente pela hemoglobina que se difunde através dos túbulos destinatários. Vários pesquisadores vêm analisando esse fenômeno a fim de elucidar seu mecanismo e tentar relacioná-lo com a causa da morte e do tempo decorrido da morte, com o objetivo de auxiliar e agilizar o trabalho de investigação criminal na descoberta da real situação da morte. Nesse trabalho o autor procurou correlacionar o aparecimento de dentes rosados com a hora aproximada e a causa da morte, mensurando a coloração. Foi realizado um trabalho de campo no Instituto Médico Legal da cidade de Curitiba onde foram analisados 15 cadáveres, com diferentes causas da morte. Para estabelecer a coloração foi utilizada a escala de cores RGB Hex Triplet Color Chart e realizada a comparação visual dos dentes. Ficou constatado que os dentes da bateria labial, ou seja, de canino a canino, foram os dentes mais afetados e a região cervical dos dentes – colo do dente ou na região da junção cemento-esmalte, ou anda pescoço do dente, é a que apresenta uma coloração mais exuberante. É proposto o desenvolvimento de um colorímetro eletrônico como trabalho futuro, com o objetivo de automatizar a aquisição de cor nos dentes rosados. / Pink teeth are a phenomenon that can occur in life or post-mortem. It is resulted by pigmentation tooth by hemoglobin, which diffuses through the dentinal tubules. Several researches have analyzed this phenomenon, in order to elucidate its mechanism and try to relate to the cause of death and the time elapses from death, to assist and make faster the word of criminal investigation in discovering the real situation of death. In this work the author tried to correlate the appearance of the pink teeth with time and cause of death, measuring the color. Were conducted a field study at the Institute of Forensic Medicine of Curitiba, where were analyzed 15 specimens with different causes of death. For the staining was used to measure the color gamut of RGB Hex Triplet Color Char and held visual comparison of the teeth. It was verified that the teeth of the battery lip, i.e. from canine to canine were the most affected teeth and the neck of the teeth – or the tooth neck region of the cementum-enamel junction, or neck of the tooth, it shows one more exuberant color. Is proposed the development of a electronic colorimeter as future work, with the subject to automate the capture the color in the pink teeth.

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