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The politics of local policy variationBoyne, George A. January 1989 (has links)
No description available.
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Local finances in the Middle East economy : with special reference to Egypt, the Sudan and IsraelHamza, S. Maher January 1964 (has links)
No description available.
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A new fault-tolerant configuration for the Cambridge Ring : the Hierarchical Ring-StarChen, Thet-Ngian January 1985 (has links)
The primary objective of this research is to look at ways of resolving the reliability problems of the Cambridge Ring local area network system. The result is a novel design to enhance the Cambridge Ring with fault tolerance by introducing redundant communication paths with dynamic reconfiguration. The proposed Ring-Star system combines the advantages of ring and star networks to create a network which is topologically resilient while retaining the efficient communication advantage of rings.
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Adaptive logic network correlation techniques for optical code division multiple access systemsParham, M. J. January 1994 (has links)
Code Division Multiple Access (CDMA) techniques afford Local Area Networks (LANs) the support of concurrent, asynchronous communication between users without access delay. These properties are obtained by encoding users' data with high rate code sequences, so that data is spread over a much larger bandwidth than would usually be required for transmission. The necessary bandwidth is provided by using optical fibre both as the LAN medium and for incoherent optical signal processing. Conventionally, extraction of a desired user's signal is achieved by correlation using a single delay-line matched filter. Matched filters are optimal for the recovery of a known signal in the presence of additive noise. However, in a CDMA environment, their performance is limited by Multiple Access Interference (MAI), arising from the cross-correlation products of overlaid users, and degrades as the number of users increases. Adaptive Logic Networks (ALNs), a form of Artificial Neural System (ANS), are applied to the extraction of a single user's signal in a multi-user environment. In the approach taken, ALNs learn to incorporate the presence of interfering users' signals, in deciding the actual data bit received. Computer simulation is used to compare the error rates obtained by ALNs and the previously proposed correlation receivers; the performance of the latter providing a benchmark. Simulations are conducted assuming chip synchronism between users and no external sources of noise, i.e. MAI is assumed dominant. Consideration is given to systems employing both sparse optical codes and Gold-like codes as spreading sequences. In all the systems considered, ALNs are shown to enable significant reductions in error rate over the conventional correlation receivers. MAI effects, causing errors with the correlation receivers, are reduced by using additional temporal and intensity based information contained in the receiver input signal. This permits an ALN to extract details of the structure of interfering users' signals, to provide a better context for the classification of the desired user's signal. In the systems employing sparse codes, it is demonstrated that while a certain amount of MAI persists, it may be minimised by selection of the ALN input window, to provide the maximum possible information regarding the interfering users' signals. In the systems using Gold-like codes, it is shown that ALNs can be used to completely eliminate the effects of MAI. This is significant since, although this form of code sequence is suited to coherent CDMA systems, the cross-correlation products arising in incoherent optical environments are normally considered to be unacceptably high.
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Organisational excellence in the public sector, with special reference to the Portuguese local governmentFerreira Lopes de Moura e Sá, Patrícia Helena January 2002 (has links)
The primary aim of this thesis is to analyse the key drivers of Organisational Excellence in the Public Sector and integrate them in a comprehensive, reliable and valid performance measurement system. Within the movements for Public Sector reform and modernisation, Total Quality Management (TQM) has increasingly been regarded as a way to improve efficiency and effectiveness in the use of the resources available, deliver better public services, and bring Public Administration closer to its customers and citizens. However, too often the initiatives carried out are not integrated, nor they are part of a systematic and coherent strategy to guide public organisations towards Organisational Excellence (OE). The literature suggests that adopting TQM can lead to superior performance, in spite of the difficulties of statistically demonstrating such link. There is also a prevalent view that TQM principles and core concepts are universally valid, but need to be adapted to each context in particular. In this sense, they are applicable to the Public Sector, although the existence of multiple stakeholders, the need to balance individual customer needs with wider collective purposes and the strong bureaucratic inheritance make their implementation particularly challenging. The exploratory survey conducted in the Portuguese municipalities - which constitute the focus of our study - revealed that TQM is raising considerable interest and diagnosed the main barriers and motivations for TQM implementation. Moreover, it gave support to the Critical Success Factors (CSFs) identified in the literature. Several organisational excellence models were reviewed. It is argued that Kanji's Business Excellence Model (KBEM) adequately covers the CSFs identified and, additionally, provides a sound methodology - based on the Structural Equation Modelling (SEM) approach and the Partial Least Squares (PLS) technique - to estimate the relationships between them and determine their impact on an aggregated measure of OE. To measure OE from the internal stakeholders' perspective, a few adjustments were made on KBEM and new scales developed to assess the Local Government's performance in each CSF. The model was empirically tested and validated using data collected from 85 Portuguese municipalities and the internal OE index calculated. Given the critical role of Leadership (the prime of KBEM), this construct was analysed in detail. The key leadership requirements in an organisation committed to TQM and OE were identified. A model was then developed and used to measure, according to leaders' and staff members' views, Leadership Excellence in the Portuguese municipalities. With the purpose of evaluating OE from the external stakeholders' perspective, a Business Scorecard (KBS) was created. Feedback from citizens - the key external stakeholders of a municipality - was collected in each dimension of the scorecard. Using similar procedures, the model was validated and the scores for each latent variable computed. The OE index thus calculated drew attention to possible gaps between internal and external perceptions and called attention to the need of measuring OE from different angles. The system of performance measurement proposed is grounded in the CSFs identified and assesses performance from a multiple perspective by integrating feedback from the various stakeholders of an organisation. Therefore, it provides a more realistic assessment of performance and is expected to support the Local Government in its quest for Organisational Excellence.
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Social care, contracts and voluntary sector providersTodd, Joseph Malcolm January 2001 (has links)
This thesis concerns the impact of purchase of service contracts on voluntary sector providers of social care. Voluntary agencies in Britain have traditionally received annual grant-aid from local authority social services departments in acknowledgement of the many different care and support services they have provided to the community. However, following the reorganisation of the personal social services in the early 1990s (National Health Service and Community Care Act 1990), this funding mechanism shifted increasingly towards a tighter, contractual, relationship in which expectations about service levels, monitoring arrangements, quality and costs were made explicit and formally agreed. This changes the way in which voluntary sector providers have to work, their relationship with statutory sector agencies and their interface with the wider community. Whilst interest in social care contracting is growing, policy analysts have done little to qualitatively study the contracting process from the voluntary sector perspective. This study aims to bridge this gap. It offers a close examination of twenty-three voluntary sector agencies in four local authorities in England. It sheds light on the impact of replacing grant-aid with contractual income, contributes to the understanding of how voluntary sector providers of social care services experience the contracting process and explores how the local authority-voluntary sector interface is developing. Understanding the voluntary sector perspective on social care contracting can assist statutory sector purchasers to develop systems that best meet both sectors' needs. Prominent amongst the findings are the following: (1) despite the introduction of a 'quasi-market' in social care there was little evidence of a competitive market for contracts between voluntary sector providers; (2) local authorities were inclined to offer service agreements to recognised and trusted voluntary sector providers; (3) the language and legal status of social care contracting is regarded as ambiguous by voluntary managers - different local authorities have adopted distinct language and definitions; (4) the notion that voluntary providers are the preferred providers of local authorities was questioned by a number of statutory sector respondents - there was evidence that statutory sector purchasers were willing to make use of the for profit sector for service provision; (5) whilst some voluntary providers had been able to negotiate successful contracts with purchasers many commented on the conflictual nature of this process; (6) the monitoring of contracts is very mixed and there were concerns over the robustness of local authorities in collecting relevant data.
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Avaliação da reação do paciente durante a administração de anestesia local com seringa convencional ou com controle de punçãoCosta, Raquel Campelo Ferreira da January 2012 (has links)
COSTA, Raquel Campelo Ferreira da. Avaliação da reação do paciente durante a administração de anestesia local com seringa convencional ou com controle de punção. 2012. 51 f. Dissertação (Mestrado em Odontologia) - Universidade Federal do Ceará. Faculdade de Farmácia, Odontologia e Enfermagem, Fortaleza, 2012. / Submitted by denise santos (denise.santos@ufc.br) on 2013-02-15T15:46:30Z
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Previous issue date: 2012 / A anestesia local, utilizada como procedimento de rotina em Odontologia para permitir a realização de um tratamento indolor, por si já apresenta algum grau de dor/desconforto ao paciente, contribuindo para aumentar o medo e a ansiedade no tratamento odontológico em crianças e adultos. Este trabalho teve como objetivo avaliar a reação do paciente durante a anestesia local com seringa convencional e com um dispositivo que controla a punção inicial da agulha. Para tanto a amostra foi composta por 57 crianças, entre nove e 13 anos de idade, de ambos os gêneros, dividida por randomização em dois grupos: G1 e G2, de acordo com o dispositivo utilizado na primeira sessão: seringa convencional ou dispositivo com controle da punção inicial da agulha. A técnica anestésica utilizada foi a anestesia infiltrativa terminal no sulco vestibular da maxila. O mesmo operador, odontopediatra, anestesiou todas as crianças com os dois dispositivos perfazendo um total de 114 sessões anestésicas, sendo cada criança seu próprio controle. Ao final da segunda sessão anestésica solicitou-se que a criança escolhesse o dispositivo de preferência. A avaliação foi realizada utilizando-se os seguintes métodos: Dental Subscale of the Children’s Fear Survey Schedule CFSS-DS, média da frequência de batimentos cardíacos através do uso de um oxímetro de pulso, Escala Comportamental de Frankl, Escala de Ansiedade Facial, Escala Análoga Visual e Escala SOM (Som, Olhos e Movimentos), em quatro momentos do atendimento odontológico, previamente determinados: sala de espera (SE), cadeira odontológica (CO), início da anestesia (IA) e final da anestesia (FA). De acordo com os resultados 72% da amostra demonstrou baixo nível de ansiedade (CFSS-DS) e predominância do comportamento definitivamente positivo (Escala de Frankl) em todos os momentos avaliados (SE, CO, IA e FA) com os dois dispositivos. Não houve diferença estatisticamente significante (P> 0,05) nas médias de dor relatadas pelas crianças entre os dois dispositivos testados. No entanto, houve alta correlação entre dor e ansiedade relatadas pela criança (P< 0,0001) e entre a ansiedade relatada e a dor observada pela escala SOM (P=0,003). Apesar de não ter sido estatisticamente significante, houve maior preferência das crianças pelo dispositivo com controle da punção inicial da agulha. Concluiu-se assim que a utilização do dispositivo com controle da punção inicial da agulha não promoveu diferença na reação entre as crianças do presente estudo em relação à seringa convencional, quanto à dor/desconforto e à ansiedade.
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Avaliação da reação de crianças submetidas à anestesia odontológica local com seringa convencional e com desenho externo modificado / Evaluation of the reaction of children anesthetized with a traditional syringe and a modified syringeCarvalho, Fernanda Matias de January 2012 (has links)
CARVALHO, Fernanda Matias de. Avaliação da reação de crianças submetidas à anestesia odontológica local com seringa convencional e com desenho externo modificado. 2012. 53 f. Dissertação (Mestrado em Odontologia) - Universidade Federal do Ceará. Faculdade de Farmácia, Odontologia e Enfermagem, Fortaleza, 2012. / Submitted by denise santos (denise.santos@ufc.br) on 2013-10-24T12:59:27Z
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Previous issue date: 2012 / Despite advances in Odontology, fear and anxiety regarding dentistry still affect a large number of people who, because of their fears, fail to seek treatment; this can result in low levels of oral health. The physical appearance of the instruments used by dentists seems to be a major cause of such fear and anxiety with regard to dentistry. The anesthetic syringe is the instrument that causes the strongest feelings of fear. So, the prevention of dental anxiety and patients fear should be one of the dentist’s highest priorities, this study aims to compare the reactions shown when children were anesthetized with a modified device and when they were anesthetized with a traditional syringe, and examine the results to see if a change in the external design of the anesthetic syringe can influence the levels of anxiety, fear and pain of patients. Sixty-four children aged 4-10 years were randomly assigned into two groups according to the device to be used in the first session of anesthesia. G1 (Traditional Syringe) and G2 (Modified syringe). Participants underwent two sessions and each patient was anesthetized with both devices. A single researcher performed anesthetic procedures, which were videotaped and the procedure consisted of infiltrative anesthesia in the posterior area of the maxilla. Due to the multidimensional nature of fear, anxiety and pain, a combination of tests was used to access them: Child Fear Survey Schedule - Dental Subscale - CFSS-DS, Facial Anxiety Scale-FAS, heart rate, the SEM scale Sound, Eyes and Motor, the Visual Analogue Scale (VAS) and the Frankl scale. These tests were applied in predefined situations as the waiting room (WR), the dental chair (DC), during the onset of anesthesia (OA) and end of anesthesia (EA). After the second session of anesthesia, children chose the device that they preferred. The results showed that most 78% children were classified as having a low level of anxiety (CFSS-DS). No significant difference was observed when comparing the traditional and modified devices. The syringe with a change in design was preferred by (57.8%) of the children. The anxious children reported more pain than non-anxious (p = 0.001) and their emotional state varied in different situations: WR, DC, OA and EA. (P <0.05). Thus, it was concluded that the appearance of the syringe is important, but not essential in order to control the anxiety, fear and pain which children suffer when undergoing dental anesthesia. / Apesar dos avanços da ciência, o medo e ansiedade, por razões odontológicas, ainda acometem uma grande quantidade de pessoas, comprometendo a procura por tratamento e resultando, ocasionalmente, em baixos níveis de saúde oral. A aparência física dos instrumentos parece ser um dos principais causadores de medo e ansiedade no meio odontológico, e a seringa anestésica é o instrumental que mais desencadeia estes sentimentos. Assim, diminuir a ansiedade e o medo do tratamento odontológico deveria ser uma das prioridades do cirurgião-dentista. Para tanto, a presente dissertação teve por objetivo comparar as reações apresentadas por crianças que foram anestesiadas com um dispositivo em formato lúdico e com uma seringa tradicional, com a finalidade de analisar se uma mudança no desenho externo da seringa anestésica seria capaz de influenciar os níveis de ansiedade, medo e dor dos pacientes. Sessenta e quatro crianças, com idade ente 4-10 anos, foram distribuídas aleatoriamente em dois grupos, de acordo com o dispositivo a ser utilizado na primeira sessão anestésica. G1 (Convencional) e G2 (Design modificado). Os participantes submeteram-se a duas sessões anestésicas, e cada paciente foi anestesiado com ambos dispositivos. Um único pesquisador, odontopediatra, realizou os procedimentos anestésicos que foram filmados e consistiram de anestesias terminais infiltrativas, na região posterior da maxila. Devido ao caráter multidimensional do medo, ansiedade e dor, uma combinação de testes foi utilizada para avaliá-los, como: O teste de medo da criança (Child Fear Survey Schedule – Dental Subscale - CFSS-DS), escala de ansiedade facial (Facial Anxiety Scale- FAS), frequência cardíaca, escala som, olhos e movimento (Sound, Eyes and Motor-SEM), escala visual analóga – Visual Analogue Scale (VAS) e escala Frankl. As escalas foram aplicadas em momentos predeterminados, como: sala de espera (SE), cadeira odontológica (CO), início da anestesia (IA) e final da anestesia (FA). Após a segunda sessão anestésica, as crianças escolheram o dispositivo que mais as agradou. Os resultados mostraram que 78% da amostra foi classificada como pouco ansiosa (CFSS-DS). Nenhuma diferença estatisticamente significante pôde ser observada nas diferentes escalas, ao comparar o dispositivo tradicional com o modificado. A seringa com mudança no design foi a preferida por 57,8% das crianças. As crianças ansiosas relataram mais dor que as não ansiosas (p=0,001) e o estado emocional variou nas diferentes situações: SE, CO, IA e FA. (p<0,05). Assim, concluiu-se que a aparência da seringa é importante, mas não é fundamental no controle da ansiedade, medo e dor de crianças submetidas à anestesia odontológica.
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Avaliação comparativa em relação a dor de crianças submetidas à anestesia odontológica com e sem vibraçã / Comparative analysis regarding the pain of children under the dental anesthesia with and without vibrationMelo, Emanuelle Albuquerque Carvalho January 2014 (has links)
MELO, Emanuelle Albuquerque Carvalho. Avaliação comparativa em relação a dor de crianças submetidas à anestesia odontológica com e sem vibração. 2014. 67 f. Dissertação (Mestrado em Odontologia) - Universidade Federal do Ceará. Faculdade de Farmácia, Odontologia e Enfermagem, Fortaleza, 2014. / Submitted by denise santos (denise.santos@ufc.br) on 2014-02-14T16:23:48Z
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Previous issue date: 2014 / The fear and anxiety during dental treatments are often related to pain regarding local dental anesthetic procedures. As there are many studies about the effect of vibration on pain analgesia, this thesis aimed to compare whether children anesthetized with a dental anesthetic device that produced micro-vibrations during the anesthetic procedure would behave differently when compared to the regular procedure. Thirty children, aged between 7 and 12 years underwent two sessions of local dental anesthesia each, with and without the vibration device. A single researcher, pediatric dentist, managed the anesthetic procedures that consisted of maxillary infiltration anesthesia and which were recorded on video. Due to the multidimensional nature of fear, anxiety and pain, multiple tests were used to evaluate them, such as Child Fear Survey Schedule – Dental Subscale – CFSS-DS, Facial Anxiety Scale – FAS , the SEM Scale Sound, Eyes and Motor, the Visual Analogue Scale (VAS) and the Frankl Scale. The scales were applied twice, before and after anesthesia. After the second anesthetic session, the preference of the children regarding the use or not of vibration was assessed and it was found that 90% of children preferred anesthesia using vibration. There was a statistically significant difference considering the Visual Analogue Scale (VAS) in the comparison of means (p = 0,04) considering a significance level of 5%. As a result, we concluded that the use of vibration seemed to result in a positive influence on the perception of the children regarding the anesthetic procedure, as almost the totality opted by the device with vibration, which lead us to the conclusion that the use of vibration resulted in a less painful local dental anesthesia. / O medo e a ansiedade durante os tratamentos odontológicos estão na maioria das vezes relacionados à dor do procedimento da anestesia local odontológica. Considerando que existem muitos estudos sobre a atuação da vibração na analgesia, esta dissertação teve por objetivo comparar as reações apresentadas por crianças ao serem anestesiadas com um dispositivo de anestesia local odontológica que produzia microvibrações durante o procedimento anestésico. Trinta crianças, sendo 15 do sexo feminino e 15 do sexo masculino, com idade entre sete e 12 anos submeteram-se a duas sessões anestésicas, e cada paciente recebeu dois tipos de anestesia: com e sem vibração. Um só pesquisador, odontopediatra, realizou os procedimentos anestésicos, que foram filmados e consistiram de anestesias terminais infiltrativas, na região posterior da maxila. Em razão do caráter multidimensional do medo, ansiedade e dor, utilizou-se uma combinação de testes avaliá-los, como: O Teste do Medo da Criança (Child Fear Survey Schedule – Dental Subscale – CFSS-DS), Escala de Ansiedade Facial (Facial Anxiety Scale – FAS), Escala Som, Olhos e Movimento (Sound, Eyes and Motor – SEM), Escala Visual Analóga – Visual Analogue Scale (VAS) e Escala Frankl. Aplicou-se as escalas em momentos prederteminados, os quais ocorreram antes e após o procedimento anestésico. Após a segunda sessão anestésica, buscou-se saber a preferência das crianças quanto ao uso ou não de vibração e verificou-se que 90% das crianças preferiram a anestesia utilizando-se vibração. Houve diferença estatisticamente significante na Escala Visual Análoga – Visual Analogue Scale (VAS) na comparação das médias (p = 0,04) para um critério de seleção a um nível de significância de 5%. Dessa forma, conclui-se que o uso da vibração pareceu exercer influência positiva sobre a percepção das crianças durante o procedimento de anestesia local, pois a maioria dos participantes da pesquisa optou pelo dispositivo com emprego da vibração, atrelando ao fato de que foi verificado que a anestesia local com vibração provoca menos dor, segundo a diferença estatisticamente significante da Escala Visual Análoga.
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Avaliação da dor de crianças submetidas a anestesia local odontológica com seringa convencional e com seringa controlada por computador / Evoluation of pain in children who received local anesthesia delivered by a conventional syringe and a syringe controlled by computerPereira, Mirella de Sousa January 2014 (has links)
PEREIRA, Mirella de Sousa. Avaliação da dor de crianças submetidas a anestesia local odontológica com seringa convencional e com seringa controlada por computador. 2014. 58 f. Dissertação (Mestrado em Odontologia) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2014. / Submitted by denise santos (denise.santos@ufc.br) on 2016-03-17T11:21:58Z
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Previous issue date: 2014 / ABSTRACT
The pain is mult
ifatorial
phenomenon and it can have psychological and cultural
nature. Studies have related that local anesthesia used in Denti
stry is the greatest
cause of pain and anxiety for the patients in the dental office. The aim of this study
was to evaluate the child pain
-
related who received local anesthesia, delivered by a
conventional syringe and a syringe controlled by computer.
Thir
ty children aged 7
–
12
years attended two clinical sessions and received two local
anesthesias
:
with
conventional syringe and syringe controlled by computer. Only one researcher
carried
out the anesthesia procedures, and those consisted buccal infiltration
to anesthetize
maxillary molars. Pain and discomfort were analyzed by scales: Facial Anxiety Scale
(FAS), Sound, Eyes and Motor Scale (SEM), Visual Analogue Scale (VAS), Frankl
Scale and e Child Fear Survey Schedule Dental Subscale (CFSS
-
DS). The scales
we
re applied in specific moments, before, during and after the anesthesia. After the
second clinical session, the child was asked if she preferred to be anesthetized with
conventional syringe or syringe controlled by computer. We observed that syringe
contro
lled by computer was less uncomfortable and painful.
The
re was a significantly
difference between
F
AS and SEM scales
and that 100% of children in the SEM scale,
showed grade 1 (comfort) when using the device, and with the anesthetic syringe
exhibited grade
1 (comfort
-
73.3%), 2 (mild discomfort
-
16.6%) and 3 (moderate pain
-
10%). More than half of children (73.3%) reported a preference of anesthesia
with
computer
-
controlled
syringe
.
We concluded the performance characteristics of the
com
puter
-
controlled
anesthesia didn’t
modify the child's behavior after application,
demonstrating a minimum of discomfort and pain, showing better resul
ts
than
anesthesia using
conventional
syringe. / A dor constitui fenômeno multifatorial, podendo ter caráter psicológico e cultural. Estudos apontam que a anestesia local odontológica é a maior causadora de dor e ansiedade em pacientes no consultório odontológico. Desta forma, o objetivo deste estudo foi avaliar as reações em relação a dor de crianças com necessidade de realização de tratamento odontológico submetidas a anestesia local odontológica, com seringa convencional e com seringa controlada por computador (dispositivo). Trinta crianças com idade entre 6-13 anos foram submetidas a duas sessões anestésicas com intervalo de uma semana, recebendo dois tipos de anestesia: com seringa convencional e com seringa controlada por computador. Um só pesquisador realizou os procedimentos anestésicos, que consistiram de anestesias terminais infiltrativas na região posterior da maxila. As medidas de dor e desconforto foram avaliadas por meio de escalas: Escala de Ansiedade Facial (Facial Anxiety Scale - FAS), Escala Som, Olhos e Movimento (Sound, Eyes and Motor – SEM), Escala Visual Análoga (Visual Analogue Scale – VAS), Escala Frankl e Teste do Medo da Criança (Child Fear Survey Schedule Dental Subscale – CFSS-DS). As escalas foram aplicadas em momentos específicos predeterminados, antes, durante e após a anestesia. Após a segunda sessão anestésica, foi perguntado à criança se ela preferiu ser anestesiada com seringa convencional ou com seringa controlada por computador. As escalas FAS e SEM apresentaram diferença estatisticamente significante, sendo que, na escala SEM, 100% das crianças apresentaram grau 1 (conforto) quando do uso do dispositivo, e com a seringa carpule exibiram graus 1 (conforto - 73,3%), 2 (desconforto leve - 16,6%) e 3 (dor moderada - 10%). Mais da metade das crianças (73,3%) relatou a preferência da anestesia com seringa controlada por computador para realização do procedimento odontológico. Com este trabalho, pode-se concluir que as características funcionais da anestesia controlada por computador não modificaram o comportamento da criança após sua aplicação, demonstrando um mínimo de desconforto e dor e, apresentando resultados melhores, em relação a estes aspectos, do que a anestesia usando seringa carpule.
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