Thesis (Ph. D.)--University of Michigan.

Dissertation (Ph.D.)--University of Michigan.

Dissertation (Ph.D.)--University of Michigan

Dissertation (Ph.D.)--University of Michigan

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry in the branch of Maxillofacial and Oral Surgery. Johannesburg, 2015 / Aim: The aim of this prospective study was to compare epidemiologic characteristics of maxillofacial fractures between Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Polokwane–Mankweng Hospital Complex (PMHC). Objective: To compare the patterns; aetiologies and incidences of maxillofacial fractures in patients of all ages between the two units. Materials and Methods: We present a prospective study of 194 patients with 226 maxillofacial fractures reported and treated between CMJH and PMHC from December 2013 to August 2014. These patients were clinically and radiographically assessed by registrars and a consultant in both units. Variables recorded included Patient’s age; file number; sex; socioeconomic status; population group; aetiology; time of injury; identity ( whether known or unknown ) of assailant; the site of the fracture and associated injuries. Results: Of the 194 total patients from both units, 159(82.0%) patients were males and 35(18.0%) patients were females, giving overall male to female ratio of 4.54:1. The minimum age was (2) two years and the maximum age was 61 years. In both males and females, the majority (75%) of patients were in the age group of 20-39 years with a peak frequency in the 3rd decade. The overall mean age was 30.6 (10.02). Assaults were by far the leading cause of maxillofacial fractures from our study accounting for 60.3% fractures of the total study population, followed by road traffic accidents accounting for 17.5%. Road traffic accidents accounted for 22.7% maxillofacial fractures in PMHC, a rate higher than CMJAH (14.8%) and overall rate (17.5%). Sport injuries accounted for more (6.1%) maxillofacial fractures in PMHC than CMJH (0.8%). In total, 127(65.8%) patients sustained maxillofacial fractures during the night and 66(34.2%) patients during the day. The mandible was the most frequently fractured facial bone (73.0%), followed by the zygoma. The angle of the mandible was the most common fractured site (35.0%). Conclusion: Interpersonal violence is by far the leading cause of maxillofacial fractures in South Africa. Prevailing factors like socioeconomic status of patient; industrialisation and geographic location have somewhat influenced the characteristics of maxillofacial fractures in the two units.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.S.P.H.)--University of Michigan, 1940.

No description available.

Historicamente, o Sistema de Informações de Doenças de Notificação Compulsória tem sido o principal instrumento da Vigilância Epidemiológica. As doenças que vêm compondo este Sistema têm sido aquelas que podem colocar em risco a saúde das coletividades e, tradicionalmente, vem se restringindo às doenças transmissíveis, ainda que no Guia vigente estejam incorporados outros agravos e algumas doenças crônico-degenerativas, como câncer e diabetes. As subnotificações se constituem em uma das principais dificuldades para a Vigilância Epidemiológica, com causas variadas que apontam sobretudo para a forma de organização dos serviços de saúde. A discussão e implantação de novos modelos assistenciais podem contribuir para esta problemática, à medida que atenderem à proposta de transformação dos atuais sistemas de atenção a doenças, num sistema de vigilância da saúde, conseqüentemente de atenção a vida. A rede básica de saúde, como o local que se constitui na principal porta do sistema de saúde, onde se destaca de forma crescente, não só a prestação de assistência médica, mas sua organização em modalidade de pronto- atendimento, se constitui também no local de atendimento das doenças de notificação compulsória. Assim, para a realização deste estudo, elegemos o trabalho na Unidade Básica de Saúde, buscando analisar como se conforma a prática da Vigilância Epidemiológica na Unidade Básica de Saúde no contexto do SUS, segundo o entendimento dos trabalhadores do nível local. Foram escolhidas cinco Unidades Básicas de Saúde, segundo o critério de produção de atendimentos e foram utilizadas entrevistas semi-estruturadas para apreensão do objeto de estudo junto aos trabalhadores escolhidos por sorteio, sendo um médico, um enfermeiro, um trabalhador do nível médio e o gerente de cada local de estudo escolhido, totalizando 20 sujeitos. Não houve agrupamento por categoria profissional. Os resultados evidenciaram dois significados para a prática da vigilância epidemiológica: controlar e prevenir, das doenças e agravos infecciosos, e a compreensão como uma prática de assistir e vigiar, quando a identifica como uma prática necessária aos serviços de saúde, que possibilita um outro modo de agir em saúde, contribuindo para a integralidade da atenção preconizada pelo Sistema Único de Saúde (SUS) e implicando numa mudança na forma de organização da atenção à saúde. Apontamos para a implementação da descentralização das ações de vigilância epidemiológica para o nível local, como perspectiva desse novo modo de agir em saúde, pautado num permanente “vigiar", para articular ações promocionais, preventivas e curativas, redefinindo o processo de trabalho em saúde. / Historically, the Information System of Compulsory Notification Diseases has been the main instrument of Epidemiological Surveillance. The diseases that are part of this system have been those that can cause risk to the collective health and, traditionally, are restricted to the transmissible diseases, even though that in the present Guide other circumstances and some chronic degenerative diseases such as cancer and diabetes are incorporated. The sub notifications are one of the main difficulties faced by Epidemiological Surveillance, with varied causes that especially indicate the organization of health services. The discussion and implementation of new care models can contribute to overcome this problem, while adopting the proposal of transforming the present health care system to a system of Health Surveillance, and consequently a system of life care. The Basic Health Network is the place that represents the main access to the health system and where is growing the emphasis not only on medical care but also on its organization as emergency care. Therefore, the Network is the place of care and compulsory notification of diseases as well. Thus, this study was developed in Basic Health Units. The purpose of this work is to analyze how the practice of Epidemiological Surveillance, in Basic Health Units, is performed according to the understanding of local workers. Five Basic Health Units were chosen in the Municipal Health System of the city of Ribeirão Preto, considering the criterion of care production. To achieve this goal, the author used semi-structured interviews conducted with the workers, such as a doctor, a nurse, a nursing assistant and a manager chosen at random in every place of the study, totalizing 20 subjects. They were not divided in professional categories. Results evidenced two meanings to the practice of Epidemiological Surveillance: to control and to prevent, when surveillance is understood as a restricted action to control infectious diseases; and the understanding of care and vigilance, when they are identified as necessary practices to health services, contributing to an integral care, as it is recommended by the Unified Health System in Brazil (SUS), implying a change in the organization of health care. The author recommended the decentralization of the epidemiological Surveillance actions in a local space, as a perspective for that new way of acting in health, guided by a permanent “vigilance" and the communication of promotion, prevention and curative actions, redefining the health work process.

Thesis (M.A.) in Mathematics--University of Maine, 2004. / Includes vita. Includes bibliographical references (leaf 51).