Thesis (M. Phil.)--University of Hong Kong, 2008. / Includes bibliographical references (leaf 53-54) Also available online.

Thesis--Helsinki University, 1989. / Includes bibliographical references (p. 50-55).

Thesis--Helsinki University, 1989. / Includes bibliographical references (p. 50-55).

Made available in DSpace on 2014-06-11T19:32:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-15Bitstream added on 2014-06-13T19:02:21Z : No. of bitstreams: 1 oliveira_fhs_dr_botfm.pdf: 1109354 bytes, checksum: 0cd1da052963c400f897bebd38a2f468 (MD5) / Universidade Estadual Paulista (UNESP) / O trauma torácico (TT) é uma situação bastante comum no politraumatizado nos dias de hoje. Uma das injúrias provocadas pelo TT é a perda da estabilidade torácica consequente a fraturas múltiplas do gradil costal (tórax instável). O paciente com tórax instável pode ser tratado clinicamente com intubação oro-traqueal e ventilação mecânica, como também pode ser submetido à cirurgia para fixação das fraturas costais. Na busca da melhor evidência para decisão do tratamento justifica-se a procura da resposta através de uma revisão sistemática. Avaliar a eficácia e segurança do tratamento cirúrgico quando comparado ao tratamento clínico em pacientes com trauma torácico fechado com tórax instável. Revisão sistemática de ensaios clínicos aleatorizados avaliando a eficácia e segurança do tratamento cirúrgico quando comparado ao tratamento clínico. Estudos relevantes foram identificados eletronicamente por meio de bases de dados MEDLINE, EMBASE, LILACS, Cochrane Controlled Trials register (CENTRAL). Referências bibliográficas também foram pesquisadas para encontrar estudos não indexados. A qualidade metodológica foi avaliada com formulários retirados do HANDBOOK (Higgins & Green 2009), e as análises estatísticas foram executadas através do REVNAN 5.0.2 fornecido pela Colaboração Cochrane. Nas bases eletrônicas de dados foram selecionados seis estudos, desses apenas dois estudos cumpriam os critérios de inclusão para se fazer uma metanálise. Nestes estudos foram analisados 77 pacientes, dos quais 38 foram tratados cirurgicamente e 39 tratados conservadoramente. Apenas quatro desfechos avaliados eram comuns aos dois estudos, mortalidade, incidência de pneumonia, tempo de ventilação mecânica (tVM) e tempo de internação em UTI (tUTI). Apenas para a mortalidade não houve diferença estatística após a metanálise. Já o tVM, tUTI e incidência... / The thoracic trauma (TT) is a common situation in polytraumatized today. One of the injuries caused by the TT is the loss of stability resulting in multiple fractures of thoracic rib cage (flail chest). The patient with flail chest can be treated medically with orotracheal intubation and mechanical ventilation, but also may undergo surgery to fix the costal fractures. In search of the best evidence for treatment decision justifies the search for an answer through a systematic review. To evaluate the efficacy and safety of surgical treatment compared to medical treatment in patients with blunt chest trauma with flail chest. A systematic review of randomized controlled trials evaluating the efficacy and safety of surgical treatment compared to medical treatment. Relevant studies were identified through electronic databases MEDLINE, EMBASE, LILACS, Cochrane Controlled Trials register (CENTRAL). References were also searched to find studies not indexed. Methodological quality was assessed with forms taken from the HANDBOOK (Higgins & Green 2009), and the statistical analyzes were performed by REVNAN 5.0 provided by the Cochrane Collaboration. The electronic databases were selected six studies, only two of these studies met the inclusion criteria for doing a meta-analysis. These studies analyzed 77 patients in whom 38 were treated surgically and 39 treated conservatively. Only four outcomes evaluated were common to both studies, mortality, incidence of pneumonia, mechanical ventilation time (MVt) and length of stay in ICU (ICUt). Just for mortality showed no statistical difference after the meta-analysis. Already MVt, ICUt and incidence of pneumonia showed a statistical difference favoring the surgical group. Based on the results of this systematic review and meta-analysis we can conclude that there is scientific evidence currently available providing surgical treatment for unstable chest... (Complete abstract click electronic access below)

The widespread use of modern media of mass communication, the growth of the profession of social work and the direct impact of voluntary and government welfare programs on individual and family life have made the ordinary citizen aware of the existence of health and welfare services in his community. This awareness, however, is often generalized and may not prove sufficient to enable a person, at the point of human need, to communicate with that agency best fitted to serve him. To overcome these barriers in communication and to provide a continuing demonstration of the existence of and the co-operation between social agencies, governmental and voluntary, many communities have developed central information and referral services. This study seeks first to trace the development of central information services on the North American continent and in Great Britain. The process of community organizations leading to the inauguration of a "Community Information Service" in Vancouver, British Columbia, is described and evaluated, as is the pattern of administration and practice in the Vancouver Information-referral office during the first year of operation on an experimental basis. To evaluate the role of the Community Information Service, Vancouver, a compilation of inquiries according to source, nature and disposal during an eight month period is presented and analysed. The program of the Community Information Service is studied against six developed criteria. From this basis and from the replies received from eight organizations in response to a questionnaire, reasons for and against the continuation of the service beyond the agreed period of experimentation are presented and equated. Some modifications and simplification of agency structure may be anticipated. Schools of Social Work may lay greater emphasis on generalized preparation for practice. These factors may minimize the need for referral between agencies and with it the need for central referral services. But until the movements described above become more visible, the ordinary man living in a metropolitan area may still benefit from the existence of central information-referral offices. / Arts, Faculty of / Social Work, School of / Graduate

The accurate exclusion of myocardial ischemia as the cause of acute chest pain is a clinically demanding and resource intensive process. An estimated three to five million patients present to emergency departments in the United States each year with chest pain of uncertain etiology. Emergency departmente valuation of patients presenting with acute chest pain has traditionally involved patient history, physical examination, electrocariography, and cardiac enzyme evaluation. Unfortunately these methods suffer from suboptimal sensitivity and specificity. The majority of these patients will not have myocardial ischemia as the cause of their chest pain. Out of concern for the potential complications and legal consequences of a missed diagnosis of AMI, emergency physicians commonyl recommend hospital admission for all patients at risk of acute ischemia. Resulting in unnecessary admissions and tremendous cost. The goal of this project is to develop a research-based approach to the assessment and management of chest pain patients presenting to the Emergency Department. A chest pain observation unit will be designed for out-patient evaluation of those patients at moderate to low risk of acute coronary ischemia to rule out occult cardiovascular disease. The chest pain center model presented in this project will guide this unit structure. A community outreach educational program to and a continuous quality management program was also developed.

No description available.

published_or_final_version / Computer Science / Master / Master of Philosophy

Pectus excavatum (PE) is a congenital deformity that is characterized by a sunken chest. Children with PE often experience embarrassment and shame over their physical appearance and can undergo the Nuss procedure, a minimally invasive surgery, to correct their deformities. Because a child's characteristics can affect the well-being and experiences of hisiher parents, one might expect that children with PE would impact the lives and behaviors of their parents. The present study employed phenomenology to investigate the experiences, perceptions, and recommendations of three fathers and six mothers whose children have undergone the Nuss procedure. Interviewers were conducted, transcribed verbatim, and thematically analyzed. Results indicate parents were most concerned about their child's well-being when hisher pectus became severe and symptomatic, and when helshe recovered fiom surgery. Moreover, many of the children's pediatricians were unaware of the Nuss procedure; as such, parents suggested that medical professionals are informed about this corrective procedure.

Changsha city in Hunan province, China. Place: Changsha Center Hospital, Hunan province. City Area: 11,819 square kilometers City population: 714.66 million   I watched the whole process of chest drainage surgery, introduced by Yang Jicheng, who is a thoracic surgeon attending doctor at this capital. During the field research in China, I also had research opportunity of chest drainage management, mostly performed by nurses, where I found out lots of design opportunities about the Chong canister, which was the most popular chest drainage canister used all over the  China Then I went back to Umea, Sweden, met Fredrik Homner who is a thoracic surgery doctor working in Norrlands University Hospital for almost 30 years. I told him what I saw in China and we exchanged lots of opinion about chest drainage. I realized that Chinese chest drainage patients were suffering unnecessary pain from outmoded equipment, which in Sweden they had already updated since 20 years ago. Whit help of Fredrik Holmner, I had opportunity to watch the whole process of pulmonary resection and endoscope technical, the focus of this process was the insertion of chest drainage tube at the end of this 5 hours surgery. After I had seen so many materials related to chest drainage, I found out my design focus, which was the Maquet Oasis Drain,  that had been recognized as the most advanced chest drainage equipment in the world and had been widely used in Europe and United States.