Thesis (M.S.), Biology--University of Central Oklahoma, 2009. / Includes bibliographical references (leaves 53-57).

Source: Masters Abstracts International, Volume: 46-03, page: 1492. Adviser: Robert E. Roberts. Includes bibliographical references.

Thesis (M. Phil.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 105-136).

Thesis (M.S.)--University of North Carolina at Wilmington, 2003. / Includes bibliographical references (leaves : [22]-26).

published_or_final_version / Nursing Studies / Master / Master of Nursing

Aims: To evaluate and compare the wound healing process following osteotomies performed with either conventional rotary burs or piezoelectric surgery in a rabbit model mimicking access to the maxillary sinus cavity for sinus floor augmentation. Materials and methods: On the nasal bone of 16 adult New Zealand white rabbits, two types of osteotomy window defects of nasal cavities were marked to critical size with a Trephine drill (ø 5 mm) and then prepared with either a conventional rotary bur or piezo-surgery (PIEZOSURGERY® Insert OT5 of PIEZOSURGERY® 3 unit, Mectron s.p.a., Genova, Italy). The defects were covered with a resorbable membrane (Bio-Gide®, Geistlich Pharma AG, Wohusen LU, Switzerland). Four animals were sacrificed at one, two, three and five weeks after surgical procedure, respectively. Histological and morphometric evaluations were performed to assess the volumetric density of various tissue components: the blood clot (BC), vascularized structures (VS), provisional matrix (PM), osteoid, mineralized bone (MB), bone debris (BD), residual tissue, old bone (OB). Results: at the 1 week, more BC detected after piezo- surgical preparation. However, the difference did not reach statistical significance. A tendency of higher proportions of osteoid in the conventional bur defects was noted, but not statistically significant. Significantly more BD was found in the conventionally compared to the piezo-surgically prepared defects. At two weeks, new bone formation was noted, and the process of modeling of the newly formed bone had started. More MB was detected in the defect prepared by piezo-surgery than by conventional bur, but without any statistically significant difference. In the marginal areas of defect, slightly more osteoblasts (Obl) were present in piezo-surgically prepared defect than in conventional prepared defect, although there is no significant difference. At 3 week, a newly formed hard tissue bridge mainly composed of woven bone was seen. A high volumetric density of mineralized bone (MB) presented in all the specimens, At the 5 week, the defects were completely filled with newly formed bone. Conclusion: the defect prepared by piezo-surgery showed a significantly decreased proportion of bone debris at one week compared to conventional rotary bur defect. Increased volumetric densities of mineralized bone were observed in the piezo-surgical compared to the conventional bur defect after two weeks, although not statistically significant. Irrespective of the preparation modality of the defect performed, the defect was almost filled with newly formed bone at three weeks. At five weeks, complete regeneration of the calvaria defects was achieved. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Surgical site infection not only brings morbidity and mortality to patients, but it also bring substantial financial burden to the hospital and the healthcare system. To minimize the clinical consequences of surgical site infection, it is crucial that all appropriate measures for reduction of surgical site infection should be implemented. Since patient’s skin is a potential source of pathogens, normal skin flora is a common cause of surgical site infections. Preoperative skin disinfection of the surgical site with an antiseptic agent is an effective method to remove the soil and transient organisms from the skin. Currently, there are different skin antiseptics available and the most commonly used agents are povidone iodine and chlorhexidine gluconate. Although povidone iodine has a long-standing recommendation and it is widely used in various surgical procedures, it has several limitations. On the other hand, there is an increasing interest of the use of chlorhexidine in indwelling catheter placement and care, surgical hand scrubbing, as well as wound dressing. In view of this, there is a potential of replacing povidone iodine by chlorhexidine as preoperative skin antiseptic agent. As there is no existing guideline supportingthis innovative movement, this dissertation aimed to review the currently available evidence on preoperative skin preparation and to develop an evidence-based guideline of using chlorhexidine in preoperative skin preparation for reducing surgical site infection in patients undergoing general surgery. Five randomized controlled studies were identified from MEDLINE, CINAHL and PUBMED and evaluated by a critical appraisal tool, the Scottish Intercollegiate Guidelines Network. All studies reported that preoperative skin preparation with chlorhexidine is more effective than the use of povidone iodine in reducing surgical site infection. An evidence-based guideline is developed according to the guideline development process from the Scottish Intercollegiate Guideline Network. Patient characteristics, local clinical setting, organizational infrastructure and staff competency is congruent with the proposed innovation. The new protocol not only can minimize the risk of postoperative surgical site infection but also save costs. The cost-benefit analysis showed that the new protocol can help to save $675,552 to $1,097,772 (HK dollars) in six-month period after implementation. To facilitate a more comprehensive plan in actual implementation of the proposed guideline, stakeholders at administrative, managerial, and operational levels would be invited to take part in the 12-week pilot test. Surgical site infection, staff satisfaction and compliance, as well as cost and benefit ratio of the guideline would be measured in the evaluation plan. The refined guidelines would then be implemented for one year. The effectiveness of the guideline would be determined by reduction in postoperative surgical site infection, increase in staff knowledge and satisfaction, and the overall expenditure. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Introduktion: Sjuksköterskor idag står inför en växande patientgrupp med diabetes, som har svårläkta fotsår. Patienterna finns i alla vårdformer som primärvård, specialistvård och kommunal hälso- och sjukvård. För att patienten ska kunna upprätthålla en god livskvalitet och ett bra socialt liv krävs det en säker och snabb sårläkning. Syfte: Arbetets syfte var att beskriva vad som påverkar sårläkning hos patienter med diabetes och svårläkt fotsår, vid undertrycksbehandling. Metod: Denna litteraturstudie har utgått ifrån Polit och Becks (2012) niostegsmodell. Sökningarna har gjorts i CINAHL och PubMed. Kvalitetsgranskning gjordes som resulterade i tio kvantitativa vetenskapliga artiklar. Artiklarnas resultatdel analyserades och grupperades utifrån syftet och efter gemensamma områden.  Resultat: Resultatet i litteraturstudien delades in i två kategorier: sårstatus och behandlingstid. I resultatet framkom att undertrycksbehandling sågs som mer effektiv behandlingsmetod än konventionell fuktighetsbevarande sårbehandling. Volym och sårdjup minskade mer effektivt vid undertrycksbehandling än med konventionell fuktig sårbehandling. Slutsats: Litteraturstudien visar att undertrycksbehandling kan bidra till snabbare sårläkning hos diabetiker med svårläkt fotsår. Alla studier valde mätvärden som storlek, djup och typ av vävnad för att beskriva sårstatus. Behandlingstiden varierade i studierna. Det visade sig även att det vetenskapliga underlaget var begränsat.

No description available.

Many researchers have failed to find a relationship between experience and judgment accuracy. In this study the purpose was to understand the relationship between experience and expertise in clinical judgment. Common sense suggests that experienced subjects make better quality judgments, compared to novices. Clinical judgments, however, are ill-structured and characterized by uncertainty; they take place in a dynamic context, with delayed or nonexistent feedback and are difficult to learn. Cognitive operations that translate "cues" (such as risk factors, signs, and symptoms) into judgments are not fully understood. Cognitive constructs (conceptual structure, sensitivity to patterns in data, and judgment process) and individual differences in age, education, and experience were explored to identify their relationship to judgment expertise. Indicators of judgment quality were: accuracy, consistency, latency, confidence, calibration, and knowledge accessibility. In phase 1 of this study, cues were identified that best predicted healing time for 258 surgical patients with abdominal incisions. In Phase 2, the subjects were 36 nurses with a range of experience caring for surgical patients. Generating both quantitative and qualitative data, subjects made judgments about incisional healing on the basis of information from actual patients. Multidimensional scaling was used to reveal conceptual structure, and lens modeling was applied to assess sensitivity to broad patterns. An information board task with think-aloud protocols demonstrated judgment process. The selection of tasks was based on their analysis- or intuition-inducing features, using K. R. Hammond's (1990) cognitive continuum theory. Experience accounted for a only a small proportion of variance in performance, whereas confidence in judgment was more strongly related to experience. Taken together, these findings replicated previous research. Protocol data showed that metacognition, knowledge accessibility, and reflectivity increased with experience. Conceptual structure predicted judgment accuracy under intuitive conditions. Support was found for Dreyfus and Dreyfus' (1986) hypothesized transition in cognition, from deliberate processing of discrete cues, to intuitive processing of patterns of cues encoded in memories for specific cases. This study has theoretical significance by adding to knowledge about clinical judgment, and by increasing understanding of cognitive changes associated with expertise. This study has practical significance in providing direction for the development of teaching methods aimed to increase learning from experience in probabilistic contexts.