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Thesis (M.S.)--University of Michigan, 1971. / Typescript (photocopy). Includes bibliographical references (leaves 60-64). Also issued in print.

Thesis (M.S.)--University of Michigan, 1971. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 60-64).

Thesis (doctoral)--München, 1933.

Thesis (doctoral)--München, 1933.

Thesis (MSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Postoperative pain is still the most common and anticipated problem following surgery and inadequate post-operative pain management remains problematic. There is a significant variation in post-operative pain experience of patients following identical surgical procedures and this has been related to a variety of psychological factors. Depression has been considered a predictor of post-operative pain. The overall aim of the study was to determine the relationship between depressive symptoms and subjective pain experienced in dental surgery. The Beck Depression Inventory (BDI) was administrated to a sample of 35 patients presenting with dental impaction to assess general depression severity. Participants were assigned to one of two groups using a cutoff score of 10 on the BDI. Pain was measured by a Visual analog pain scale. The results showed that participants with pre-operative depressive symptoms had a trend to experience more pain pre-operatively but less pain post-operatively than participants without depressive symptoms this difference was however not statistically significant. No significant correlations were found between the presence of depressive symptoms pre-operative and pain perception pre-operatively and post-operatively. However significant relationships were found between the absence of depressive symptoms pre-operative and pain perception pre-operatively and post-operatively. Pre-operative depressive symptoms were also found to be predictive of post-operative depressive symptoms. The study concluded that pain and depression co-occur, but the direction of causality is not clearly understood. The use of psychotherapeutic tools for identifying pre-operative predictors for intense post-operative pain will enhance the quality of pain management and therefore has a positive impact on the quality of life of the patient. / AFRIKAANSE OPSOMMING: Post-operatiewe pyn is een van die mees algemene en verwagte probleme na afloop van chirurgie en onvoldoende behandeling van die pyn bly problematies. Daar is 'n beduidende verskil in die ervaring van post-operatiewe pyn van pasiënte na identiese chirurgiese prosedures en dit hou verband met 'n verskeidenheid van sielkundige faktore. Depressie word beskou as 'n voorspeller van post-operatiewe pyn. Die hoof doel van die studie was om die verhouding tussen depressiewe simptome en subjektiewe pyn ervaring in tandheelkundige chirurgie te bepaal. Die Beck Depression Inventory (BDI) is gebruik om die erns van algemene depressie onder ‘n steekproef van 35 pasiënte wat presenteer met tand impaksie te evalueer. 'n Afsny-telling van 10 is gebruik om die deelnemers toe te wys aan een van twee groepe. Pyn was gemeet deur 'n Visuele analog pynskaal (VAS). Die resultate het getoon dat deelnemers met pre-operatiewe depressiewe simptome 'n neiging het om meer pyn pre-operatief, maar minder pyn post-operatief te ervaar as deelnemers sonder depressiewe simptome. Die verskil was egter nie statisties beduidend nie. Geen beduidende korrelasies is gevind tussen die teenwoordigheid van pre-operatiewe depressiewe simptome en die persepsie van pyn pre-operatief en post-operatief nie. Beduidende verbande is egter gevind tussen die afwesigheid van pre-operatiewe depressiewe simptome en persepsie van pyn pre-operatief en post-operatief. Pre-operatiewe depressiewe simptome het ook post-operatiewe depressiewe simptome voorspel. Die studie het bevind dat pyn en depressie saam voorkom maar die rigting van oorsaak is nie uitgewys. Die gebruik van psigoterapeutiese instrumente vir identifisering van pre-operatiewe voorspellers vir intense post-operatiewe pyn sal die gehalte van pynbehandeling verbeter en sodoende 'n positiewe impak op die kwaliteit van lewe van die pasiënt hê.

Ces deux dernières décennies ont connu un réel bouleversement de l'exercice professionnel du chirurgien-dentiste. D'importants progrès scientifiques et technologiques ont été réalisés. La nature des actes de soins a elle aussi évolué, avec la mise en oeuvre de techniques et de matériels de plus en plus sophistiqués. La chirurgie-dentaire, qualifiée communément d'"art dentaire" est enfin reconnue comme une véritable spécialité médicale. Parallèlement à cette évolution, les contraintes administratives et règlementaires se sont multipliées, et le cadre juridique de l'exercice du chirurgien-dentiste en cabinet libéral s'est renforcé. Le patient lui-même, est passé du statut de celui qui subit, à celui d'un réel acteur dans la relation de soins, grâce à la volonté du législateur d'instaurer une véritable démocratie sanitaire. Mais le praticien voit peu à peu sa liberté de prescription ainsi que sa liberté thérapeutique se restreindre, notamment, par l'apparition de recommandations de bonnes pratiques et de références médicales opposables. Le "colloque singulier" qui caractérisait autrefois le contrat médical, s'est éloigné du paternalisme décrié, vers une relation de soins créant des devoirs mais aussi des droits, pour les deux parties. La question se pose de savoir si de nos jours, cette relation de soins entre le chirurgien-dentiste et le patient qu'il soigne, est encore de type contractuel. / During the last two decades, there has been a real upheaval in the profession of dental surgery. Important scientific and technological progress has been achieved. The nature of surgical procedure has also evolved, with the implementation of more and more sophisticated techniques and instruments. Dental surgery, commonly known as "dental art", has at last been recognised as a real medical speciality. Together with this evolution, administrative and regulatory constraints have been multiplied, and the legal background of the exercise of dental surgery in private practice has been reenforced. The patient himself has changed from the status of the one who incurs to that of a real actor with regards to healthcare, thanks to the wish of the legislator to establish a true healthcare democracy. But the practitioner is seeing his freedom of prescription as well as his therapeutic freedom restricted, especially by the publication of recommended good practice and binding medical references. The "special relationship", which previously caracterised the medical contract, has receded from the much decried paternalistic approach to a healthcare relationship creating duties but also rights for both parties. We can ask ourselves if nowadays, this healthcare relationship between the dental surgeon and the patient he cares for is still a form of contract.

Researchers have approached the problem of designing context-aware systems, computer systems that can react intelligently to the context in which they are used, from both software engineering and human-centred perspectives. While engineered context-aware systems have found successful application in optimising technical settings without requiring mundane and explicit interaction from humans, challenges remain in furthering their application to more complex environments. In particular, when technical decisions and human actions are intertwined in sophisticated work environments (rather than, for example, the simple act of transferring a mobile phone call to receive a signal from the nearest tower), the problem of designing context-aware systems demands further examination and calls for a new approach. A natural extension of the software engineering approach in more challenging environments is to try to implement increasingly sophisticated algorithms for managing context in the hope that this will lead to autonomous application behaviour. In contrast, research from a human-centred perspective, grounded in the social sciences and philosophy, demonstrates that context is not entirely objective and measurable but rather is dynamic and created through human action. It may not be easily detected through technical sensing systems, and therefore simply employing more sophisticated algorithms within the technical sphere may not be effective. While engineering approaches have continued to evolve, the problem of how to design interfaces to context-aware applications still remains. The research reported in this dissertation investigated the problem of designing context-aware systems for the complex environment of a dental surgery. I undertook, though a participatory design approach (a) to better characterise the problem of designing context-aware systems, and (b) to understand how design methods could be employed to bridge the human and software engineering approaches. The gap in existing research on context-aware systems is evident in the way that the methods applied to designing systems don't provide an insight into how people actively create the context in which they work (in a practical rather than theoretical sense) they don‘t closely examine the behaviours of people, the role and arrangement of artefacts, and the dynamic relationships between people and artefacts. I found that an understanding of how these features of work and human behaviour are realised in practice in a given environment is fundamental to being able to design an effective context-aware system for that environment. The challenge is to design at the boundary between the technical and the social. The contribution of this thesis is an approach that explores context-aware design through synthesis. The synthetic approach leads to design opportunities and guidelines based on an understanding of the processes through which people actively co-create the context in which they work. I have applied and built upon a number of existing user-centred design and participatory design methods, in addition to creating some new methods in order to develop an understanding of how designers can examine the human aspects surrounding the co-creation of context and apply these in a way that progressively informs the design process. The methods collectively represent a novel approach to designing context-aware applications and differ from the more traditional technical approaches of developing software frameworks and infrastructures, and formal models of context, tasks, users, and systems. The techniques presented have focused primarily on developing an understanding of how humans find meaning in their actions along with their interaction with other people and technology. Participatory design methods help participants to reveal potential implicit technical resources that can be presented explicitly in technologies in order to assist humans in managing their interactions with and amidst technical systems gracefully. The methods introduced and the design approach proposed complement existing research on context-awareness from both a human-centred and software engineering perspective. This research builds on the notion of providing resources which allow users to manage their own context and also manage shifts in control while interacting with other people and with a variety of technical artefacts. It does this by examining a complex work environment, in particular looking at the kinds of resources people use and expect to use (and the constraints around these), the form(s) it is appropriate for them to take, and the patterns of interaction they will ultimately be used within.

The degree work is concentrated on basic characterization of nosocomial infections, on the prevention thereof and on the observance of antiepidemical measures in the sphere of stomatology. Although these infections were largely related to the mortality and morbidity in health service establishments in the past, their occurrence goes down significantly these days. The adoption and observance of fundamental hygienic principles and rules was of decisive importance in this sphare. The neglect of these principles can endanger the health and life of the patient seriously end bring about the increase of costs for further therapy of the patient. It is therefore necessary even at present time ot pay great attention to these diseases and to the prevention thereof. The research part of the work is devoted to the evaluation of preventive measures connected with nosocomial infections in stomatological practice. The literature search in the theoretical part follows therefore this orientation too. The theoretical part deals at first with the most frequent agents of nosocomial infections, that can be encountered. The attention is concentrated on brief characterization of these diseases, their sources and on the process of spreading. Then, the basic classification of these diseases and the concrete methods of prevention are mentioned. In the sphere of stomatology, the work resumes the basic historical relations and identifies particular sectors of this discipline. In conneciton with nosocomial infections, their impact upon the stomatology as well as the need of protection against these infections are discussed. It means epidemiological measures, importance of hand hygiene, necessity of sterilization, desinfection and of cleaning. The aim of the work is to point out the importance of prevention as to the origin and spreading of these infections and the necessity to observe the epidemical principles at the work in dental surgeries. The performed investigation resumes established facts about the observance of hygienic and epidemiological regimen and that not only as to the general judgement on problems, but in consideration of local differences, of differences in the duration of practice carried out by individual stomatologists and in relation to the frequency of conducted hygienic inspections as well. Problematic areas as to the nosocomial infections and as to the observance of decreed provisions by stomatologists are defined here. It refers also to the influence of the locality and to the frequency of inspections directed to the observance of these hygienic rules by physicians.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-06T14:11:31Z No. of bitstreams: 1 lucianodemellofonseca.pdf: 1602877 bytes, checksum: bb883b5f6533f44501e8e6cbd9f346ac (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-10-07T12:01:09Z (GMT) No. of bitstreams: 1 lucianodemellofonseca.pdf: 1602877 bytes, checksum: bb883b5f6533f44501e8e6cbd9f346ac (MD5) / Made available in DSpace on 2016-10-07T12:01:09Z (GMT). No. of bitstreams: 1 lucianodemellofonseca.pdf: 1602877 bytes, checksum: bb883b5f6533f44501e8e6cbd9f346ac (MD5) Previous issue date: 2009-03-30 / A ansiedade pré–operatória é um evento deletério que acomete um grande número de pessoas, nos mais variados graus e seu controle antes e durante os procedimentos cirúrgicos odontológicos torna-se então de fundamental importância na prática clínica, pois trará mais conforto tanto para pacientes quanto para o Cirurgião–Dentista. Avaliou comparativamente a efetividade clínica da acupuntura sistêmica e auricular no controle da ansiedade antes de cirurgias de terceiro molares inferiores. Os pacientes foram distribuídos em três grupos: grupo sistêmico, constituído de 12 indivíduos, tratados com acupuntura sistêmica, antes do procedimento cirúrgico; grupo auricular, constituído de 13 indivíduos, tratados com acupuntura auricular, antes do procedimento cirúrgico; grupo controle, constituído de 12 indivíduos, que não receberam tratamento antes da cirurgia. A avaliação da efetividade terapêutica fundamentou- se na mensuração da ansiedade, conduzida de forma objetiva, através da aferição da pressão arterial e freqüência cardíaca, e subjetiva, por intermédio de dois tipos de escalas visuais analógicas (EVA). Os resultados obtidos nos dois grupos, quanto à avaliação objetiva, não foram estatisticamente significativos as variações da pressão arterial (p>0,05), contudo houve diferenças estatisticamente significativa nas variações da freqüência cardíaca ( p<0,05) evidenciados pela diminuição dos seus valores, quando comparados antes e depois do tratamento. Quanto a avaliação subjetiva, resultados significativos foram obtidos pelos dois grupos tratamento (p<0,05), demonstrados pela diminuição dos escores, quando comparados antes e depois do tratamento com cada modalidade de acupuntura. Podemos concluir que a acupuntura sistêmica e auricular mostraram- se importantes métodos de tratamento da ansiedade pré- operatória em cirurgias odontológicas, visto terem alcançado uma confiabilidade significativa de efetividade, que nos faz indicá-la e sugerir o seu uso com esta finalidade. / Pre-operative anxiety is a deleterious event that affects a large number of people in different degrees and their control in the dental surgery then becomes of paramount importance in clinical practice, it brings more comfort for both patients and for the surgeon to evaluate the clinical effectiveness of auricular acupuncture and systemic control of anxiety before and during surgery of the third lower molars. The patients were divided at random into three groups: systemic group consisting of 12 subjects treated with systemic acupuncture before surgery; auricular group, consisting of 13 patients treated with auricular acupuncture before surgical procedures and control group, consisting of 12 individuals who received no treatment before surgery The assessment of therapeutic effectiveness was based on measurement of anxiety conducted in two forms: objective, through the measurement of blood pressure and heart rate, and subjective, through two types of visual analog scales (VAS). The results obtained from the systemic group and from the auricular group as to the objective evaluation in blood pressure were not statistically significant (p> 0.05) though there was a significant variation in heart rate (p <0.05) evidenced by the decrease in their values when compared before and after treatment. As to the subjective evaluation significant results were obtained by the two treatment groups (P <0.05), demonstrated by the decrease in scores when compared before and after treatment with each type of acupuncture. We conclude that the systemic and auricular acupuncture proved to be important methods of treatment of preoperative anxiety in dental surgery, since they have achieved a significant degree of reliability that makes us suggest its use for this purpose.