Thesis (Master of Nursing)--Cape Peninsula University of Technology, 2019 / Background: Like other health care providers, nursing students are unprotected from occupational dangers such as sharp object injuries (SOIs) due to imperfect knowledge and experience. These students face a great risk of exposure to blood borne infections by pathogens such as HIV and the hepatitis B and C viruses while executing their clinical actions in hospitals. SOIs are a significant problem for nursing students, as they increase the risk of contracting blood-borne infections. Purpose: The purpose of this study was to determine nursing students' knowledge and practices related to SOIs and their management at a university in the Western Cape Province. Objectives: The objectives of this study include determining the occurrence of SOIs, and knowledge of risk of SOIs, as well as the reporting and management of SOIs at a university in the Western Cape. Method and sample: A cross-sectional descriptive survey was conducted with nursing students from the second to fourth year of study, registered at a university in the Western Cape Province for the 2017 academic year. Quota sampling was applied to select respondents who, after providing informed consent, then completed and handed the self- administered questionnaires back to the researcher on the same day that they were distributed. Data were obtained from nursing students about whether or not they had experienced an SOI, what they did after the SOI, their perception of the risk, and management of and preventive measures for SOIs. Validity and reliability were ensured, and all ethical principles were adhered to. SPSS was used for the quantitative data analysis. Results: A total of 252 nursing students from the second to fourth years participated in this study. The average age of respondents was 24 years, with a minimum of 19 and maximum of 46 years; 211 (83.7%) of them were females. During their course 63 (25%) respondents experienced SOIs; only 42 (66.67%; N=63) of them reported the occurrence of an SOI, most (25 or 59.52%) reporting it to the professional nurse in charge. The highest occurrence of SOIs was reported by fourth-year students (26 respondents, 41.3%). It was found that 21 (33.3%) of SOIs were not reported, and the main reason for this was because there was little or no perception of associated risk (15, 71.43%). Forty-six (73.02%) respondents experienced a single SOI, while 11 (17.46%) had two SOIs, 4 (6.35%) reported having had three SOIs, and one each (1.59%) had more than four and more than ten SOIs. The activity causing most of the SOIs was administration of medication by injection (48 cases, 76.2%), and in most cases (57, 90.47%) the instruments causing injury were needles or hollow-bore needles. Most of the affected respondents squeezed the puncture site after the SOI (42, 66.7%), followed by washing the area with water and soap (40; 63.5%), and cleaning the site with antiseptic (15, 23.8%). Among those students exposed to SOIs, only 22 (52.4%) had undergone blood tests, and very few of them took post-exposure prophylaxis or treatment (16, 25.40%). The emotion that most of them felt after the SOI was fear (42, 66.7%), and the main reason for not getting treatment was fear of side effects (18, 38.29%). Also, only 61 (24.2%) respondents reported recapping needles after use, while most reported incomplete vaccination against hepatitis B (195, 77.38%). The main reason for not using personal protective equipment (PPE) was noted as the unavailability thereof at the institution (43, 49.4%). Conclusion: This study documented a low rate of reporting SOIs among nursing students. It is plain that there are inadequate levels of knowledge and practice related to SOI management among these students at a university in the Western Cape. One would imagine that because the majority of nursing students had a measure for the practice of universal precautions and used PPE, their management after exposure to SOIs during work training in hospital would be efficient. This was not the instance in this study, where application of these actions in their practical training was poor.

With over half a century of medical ultrasound support, proven efficacy, and increased popularity, why is it that over half our planet’s population does not have access to ultrasound imaging? In 2015 when I joined the doctoral program, I embarked to not only understand this problem but to provide a solution. This document will walk you through this journey, detailing the challenge of creating my very own ultrasound system with the purpose of it being highly accessible to people who need it the most. I had the vision to take this further; not only did I aim to create an open-source portable ultrasound- I also wanted to see this in the hands of users. This dissertation will show you how collaboration between students of varying disciplines can help propel research to the point of product development. A full ultrasound system including both hardware and software has been developed and tested using commercial ultrasound phantoms. This document will present progress chronologically, starting with the first attempts at using audible piezoelectric buzzers to generate a signal, where the first proof of concept is met. In this dissertation, you will follow the continuous development of a 1) ultrasound analog circuit, 2) mechanical transducer probe, 3) analog signal acquisition system, and 4) imaging software coupled with the user interface. The open-source portable ultrasound research has been successful in providing both hardware and software solutions, combined as a single package in an end-to-end integrated system. This has never been done before. During a time when “data is gold”, this project has also created an open platform where users can collect and share data, enabling collaborations and propulsion of open-access medical screening technologies. This research has developed the lowest-cost 3D scanning ultrasound transducer that we know of at this time. This is inherently novel and transcendental.

Thesis (MBA)--Stellenbosch University, 2014. / There is a growing trend towards the use of point of care testing in resource poor settings, in particular in the diagnosis and treatment of infectious diseases such as Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Malaria. The Alere PIMA CD4 counter is widely used as a point of care device in the staging and management of HIV. While the instrument has been extensively validated and shown to be comparable to central laboratory testing, little is known about the error rates of these devices, as well as the factors that contribute to error rates. This research was a retrospective analysis of error rates from 61 PIMA point of care devices deployed in nine African countries belonging to Medisciens Sans Frontiers. The data was collected between January 2011 and June 2013. The objectives of the study were to determine the overall error rate and, where possible, determine the root cause. Thereafter the study aimed to determine the variables that contribute to the root causes and make recommendations to reduce the error rate. The overall error was determined to be 13.2 percent. The errors were further divided into four root causes and error rates assigned to each root cause based on the error codes generated by the instrument. These error rates were found to be operator error (48.4%), instrument error (2.0%), reagent/cartridge error (1%) and sample error (4.3%). It was found that a high percentage of the errors were ambiguous (44.3%), meaning that they had more than one possible root cause. A systems-based knowledge management approach was used to create a qualitative politicised influence diagram, which described the variables that affect each of the root causes. The influence diagram was subjected to loop analysis where individual loops were described in terms of the knowledge type (tacit or explicit), the knowing type (know-how, know-who, know-what and know-why), and the actors involved with each variable. Where possible, the variable was described as contributing to pre-analytical, analytical or post-analytical error. Recommendations to reduce the error rates for each of the variables were then made based on the findings.

Combined atomic force microscopy-scanning electrochemical microscopy (AFM-SECM) is capable of providing simultaneous topographical and electrochemical imaging at sample surfaces. Integration of amperometric biosensors at tip-integrated electrodes recessed from the apex of the AFM tip further enhances the versatility of such bifunctional probes. Of particular interest to this work was the detection of adenosine triphosphate (ATP) at a cellular level, since ATP is involved in many biologically relevant processes. There are challenges concerning the integration of biosensors into bifunctional AFM-SECM probes. This thesis focuses on addressing and advancing several of these limitations. Thin insulation layers are important for AFM-SECM based applications to enhance AFM and SECM performance. Plasma-polymerized fluorocarbon membranes are introduced as novel thin film insulation materials for AFM-SECM probes. Insulation layers with a thickness of < 300 nm were found to exhibit excellent insulating properties and satisfying temporal stability for successful application in AFM-SECM experiments. Furthermore new approaches for increasing the electrode area in conventionally focused ion beam (FIB) fabricated AFM-SECM probes were implemented, since enhancement of the current response in conjunction with biosensing experiments is required. Ion beam induced deposition (IBID) was used to generate platinum carbon (PtC) deposits at AFM-SECM probes, thereby successfully increasing the tip-integrated electrode area. PtC composites were thoroughly characterized in terms of their physical and electrochemical properties. Since a high carbon fraction in the PtC composite was inhibiting the charge transfer kinetics at the electrode surface for certain analytes, several pre-treatment strategies were investigated including annealing, UV/ozone treatment, and FIB milling. FIB milling proved to be the most promising procedure improving charge transfer properties at the electrode along with fabrication compatibility at AFM-SECM probes. The last part of this thesis aimed at providing fundamental studies on AFM-SECM application at live epithelial cell monolayers. AFM was used in different imaging modes to characterize the topography of epithelial cells. ATP detection at epithelial cells was achieved with amperometric biosensors combined with non-invasive SECM. Biosensors were further miniaturized at batch-fabricated AFM-SECM probes enabling laterally-resolved detection of ATP at epithelial cells. Additionally, PtC composite materials were evaluated for applicability as transducer platforms for enzymatic biosensors.

No description available.

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Introdução: Os avanços tecnológicos no desenvolvimento de medidas preventivas são indispensáveis no processo de manutenção da qualidade de vida dos seres humanos. O incremento de novos métodos avaliativos para estruturas complexas como a coluna vertebral e, mais especificamente a coluna lombossacral, é demanda constante no âmbito de pesquisa científica. Objetivo: Investigar a correlação e a concordância entre diferentes métodos radiográficos de avaliação da concavidade lombossacral e desenvolver um protocolo de avaliação dessa curvatura por meio de fotogrametria. Metodologia: A seleção da amostra ocorreu no município de Curitiba-PR, totalizando 58 indivíduos de ambos os sexos, com idades entre 18 e 28 anos. Nos procedimentos de tratamento de imagem e dos critérios de inclusão foram detectadas seis perdas técnicas, reduzindo a amostra para 52 indivíduos. Para o desenvolvimento da nova técnica utilizou-se: uma câmera fotográfica digital Samsung® de 14,2 Mega Pixels, um tripé da marca Midas® e marcadores adesivos circulares da marca Pimaco®. Os procedimentos relacionados às coletas da imagem radiográficas foram realizados em um centro diagnóstico por imagem. Os ângulos da concavidade lombossacral foram avaliados por sete técnicas diferentes (Centroide, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1, Cobb4T12-S1, Tangente Posterior e Trall) e ainda, por duas novas técnicas com imagens fotográficas (Cobb Foto e Trall Foto). Resultados: Durante a elaboração da nova técnica, detectou-se a necessidade do desenvolvimento de um marcador metálico proeminente, para ser observado nas fotografias e radiografias em vistas laterais. Apesar dos baixos valores de concordância entre os métodos radiográficos, foram constatados altos coeficientes de correlação entre algumas técnicas: Cobb4 T12i-S1s e Cobb1 L1s-S1s (0,893), Cobb4 T12i-S1s e Cobb2 L1s-L5i (0,820), Cobb3 L2s-S1s e Cobb1 L1s-S1s (0,810). As técnicas fotogramétricas para a análise da coluna lombossacral apresentaram correlações moderadas e fracas quando comparados aos testes radiográficos. As medidas de Trall Foto em relação às medidas de Cobb L1s-S1s e Cobb3 L2s-S1s apresentaram valores de r= 0,40 e 0,45, respectivamente. Adicionalmente, promoveu-se uma classificação categórica dos valores angulares obtidos através de cada método, tanto aqueles que são validados na radiologia, quanto àqueles desenvolvidos por fotogrametria. Com nos resultados obtidos, optou-se pela análise de uma nova variável, o ponto de inflexão entre a cifose torácica e a lordose lombar. Este ponto de inflexão apresentou maior incidência na região entre a décima segunda vértebra torácica e a primeira lombar (63,5%). Conclusão: Pode-se concluir que a diversidade de referências anatômicas utilizadas nas técnicas estudadas deve ser considerada no momento da escolha daquela a ser aplicada, em diferentes pacientes, dependendo do posicionamento referente ao ponto de inflexão toracolombar, pois o conhecimento de sua localização permite a escolha da técnica a ser empregada com mais exatidão. As técnicas de avaliação desenvolvidas a partir da fotogrametria (Cobb Foto e Tall Foto) não apresentaram valores estatísticos suficientemente compatíveis para a substituição do método radiográfico. / Introduction: Technological advances in the development of preventive measures are indispensable in the process of maintaining the quality of life of human beings. The rise of new methods of assessment of complex structures such as the spine, and more specifically the lumbosacral spine is in constant demand for scientific research. Objective: To investigate the correlation and agreement between different radiographic methods for evaluation of lumbosacral concavity and develop a protocol for assessment of curvature through Photogrammetry. Methodology: The sample selection was in Curitiba-PR, totaling 58 individuals of both sexes, aged between 18 and 28 years. In image processing procedures and criteria for inclusion were detected six technical losses, reducing the sample to 52 individuals. For the development of the new technique was used: a digital camera Samsung ® 14.2 Mega Pixels, a tripod Midas ® and markers adhesives of brand Pimaco®. During construction of the new technique, we detected the need to develop metallic marker of prominence to be seen in the photographs and radiographs in lateral views. The procedures related to collect radiographic image were carried out in partnership with a diagnostic imaging center of a hospital in the capital of Curitiba. The angles of the concavity lumbosacral were evaluated seven different techniques (Centroid, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1, Cobb4T12-S1, Posterior tangent and Trall) and also by two new techniques with photograph (Cobb Photo e Trall Photo). Results: Despite the low values of correlation between radiographic methods, high correlation coefficients were found between some techniques: Cobb4 T12i-S1s e Cobb1 L1s-S1s (0,893), Cobb4 T12i-S1s e Cobb2 L1s-L5i (0,820), Cobb3 L2s-S1s e Cobb1 L1s-S1s (0,810). The techniques the photogrammetric analysis of the lumbosacral spine demonstrated correlation moderate to weak when compared to radiographic tests. The Measures of Trall Photo in 0, 45, respectively. Additionally, we promoted a categorical classification of angle values obtained by each method, both those validated in radiograph, and developed by photogrammetry. With these results, we opted for the analysis of a new variable, the tipping point between the thoracic kyphosis and lumbar lordosis. This inflection point presented higher incidence in the region between the twelfth thoracic vertebra and the L1 (63,5%). Conclusion: It was concluded that the diversity of anatomical references used in the studied techniques should be considered when choosing to appli in different patients, depending on the position assigned to the inflection point thoracolumbar, because knowledge of its location allows choice of technique to be used more accurately. Assessment techniques developed from photogrammetry (Cobb Photo e Tall Photo) showed no statistical values sufficiently compatible to replace the radiographic method.

Introdução: Os avanços tecnológicos no desenvolvimento de medidas preventivas são indispensáveis no processo de manutenção da qualidade de vida dos seres humanos. O incremento de novos métodos avaliativos para estruturas complexas como a coluna vertebral e, mais especificamente a coluna lombossacral, é demanda constante no âmbito de pesquisa científica. Objetivo: Investigar a correlação e a concordância entre diferentes métodos radiográficos de avaliação da concavidade lombossacral e desenvolver um protocolo de avaliação dessa curvatura por meio de fotogrametria. Metodologia: A seleção da amostra ocorreu no município de Curitiba-PR, totalizando 58 indivíduos de ambos os sexos, com idades entre 18 e 28 anos. Nos procedimentos de tratamento de imagem e dos critérios de inclusão foram detectadas seis perdas técnicas, reduzindo a amostra para 52 indivíduos. Para o desenvolvimento da nova técnica utilizou-se: uma câmera fotográfica digital Samsung® de 14,2 Mega Pixels, um tripé da marca Midas® e marcadores adesivos circulares da marca Pimaco®. Os procedimentos relacionados às coletas da imagem radiográficas foram realizados em um centro diagnóstico por imagem. Os ângulos da concavidade lombossacral foram avaliados por sete técnicas diferentes (Centroide, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1, Cobb4T12-S1, Tangente Posterior e Trall) e ainda, por duas novas técnicas com imagens fotográficas (Cobb Foto e Trall Foto). Resultados: Durante a elaboração da nova técnica, detectou-se a necessidade do desenvolvimento de um marcador metálico proeminente, para ser observado nas fotografias e radiografias em vistas laterais. Apesar dos baixos valores de concordância entre os métodos radiográficos, foram constatados altos coeficientes de correlação entre algumas técnicas: Cobb4 T12i-S1s e Cobb1 L1s-S1s (0,893), Cobb4 T12i-S1s e Cobb2 L1s-L5i (0,820), Cobb3 L2s-S1s e Cobb1 L1s-S1s (0,810). As técnicas fotogramétricas para a análise da coluna lombossacral apresentaram correlações moderadas e fracas quando comparados aos testes radiográficos. As medidas de Trall Foto em relação às medidas de Cobb L1s-S1s e Cobb3 L2s-S1s apresentaram valores de r= 0,40 e 0,45, respectivamente. Adicionalmente, promoveu-se uma classificação categórica dos valores angulares obtidos através de cada método, tanto aqueles que são validados na radiologia, quanto àqueles desenvolvidos por fotogrametria. Com nos resultados obtidos, optou-se pela análise de uma nova variável, o ponto de inflexão entre a cifose torácica e a lordose lombar. Este ponto de inflexão apresentou maior incidência na região entre a décima segunda vértebra torácica e a primeira lombar (63,5%). Conclusão: Pode-se concluir que a diversidade de referências anatômicas utilizadas nas técnicas estudadas deve ser considerada no momento da escolha daquela a ser aplicada, em diferentes pacientes, dependendo do posicionamento referente ao ponto de inflexão toracolombar, pois o conhecimento de sua localização permite a escolha da técnica a ser empregada com mais exatidão. As técnicas de avaliação desenvolvidas a partir da fotogrametria (Cobb Foto e Tall Foto) não apresentaram valores estatísticos suficientemente compatíveis para a substituição do método radiográfico. / Introduction: Technological advances in the development of preventive measures are indispensable in the process of maintaining the quality of life of human beings. The rise of new methods of assessment of complex structures such as the spine, and more specifically the lumbosacral spine is in constant demand for scientific research. Objective: To investigate the correlation and agreement between different radiographic methods for evaluation of lumbosacral concavity and develop a protocol for assessment of curvature through Photogrammetry. Methodology: The sample selection was in Curitiba-PR, totaling 58 individuals of both sexes, aged between 18 and 28 years. In image processing procedures and criteria for inclusion were detected six technical losses, reducing the sample to 52 individuals. For the development of the new technique was used: a digital camera Samsung ® 14.2 Mega Pixels, a tripod Midas ® and markers adhesives of brand Pimaco®. During construction of the new technique, we detected the need to develop metallic marker of prominence to be seen in the photographs and radiographs in lateral views. The procedures related to collect radiographic image were carried out in partnership with a diagnostic imaging center of a hospital in the capital of Curitiba. The angles of the concavity lumbosacral were evaluated seven different techniques (Centroid, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1, Cobb4T12-S1, Posterior tangent and Trall) and also by two new techniques with photograph (Cobb Photo e Trall Photo). Results: Despite the low values of correlation between radiographic methods, high correlation coefficients were found between some techniques: Cobb4 T12i-S1s e Cobb1 L1s-S1s (0,893), Cobb4 T12i-S1s e Cobb2 L1s-L5i (0,820), Cobb3 L2s-S1s e Cobb1 L1s-S1s (0,810). The techniques the photogrammetric analysis of the lumbosacral spine demonstrated correlation moderate to weak when compared to radiographic tests. The Measures of Trall Photo in 0, 45, respectively. Additionally, we promoted a categorical classification of angle values obtained by each method, both those validated in radiograph, and developed by photogrammetry. With these results, we opted for the analysis of a new variable, the tipping point between the thoracic kyphosis and lumbar lordosis. This inflection point presented higher incidence in the region between the twelfth thoracic vertebra and the L1 (63,5%). Conclusion: It was concluded that the diversity of anatomical references used in the studied techniques should be considered when choosing to appli in different patients, depending on the position assigned to the inflection point thoracolumbar, because knowledge of its location allows choice of technique to be used more accurately. Assessment techniques developed from photogrammetry (Cobb Photo e Tall Photo) showed no statistical values sufficiently compatible to replace the radiographic method.

Orientador: Vera Lúcia da Silveira Nantes Button / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-16T23:21:30Z (GMT). No. of bitstreams: 1 Oliveira_EduardoJorgeValadares_D.pdf: 36894396 bytes, checksum: 09b65cc50b4dadf0dcdbfc05e59d0414 (MD5) Previous issue date: 2018-08-16T20:21:18Z / Resumo: A saúde configura um complexo de atividades produtivas de bens e serviços que alavanca segmentos-chave da sociedade contemporânea. Além de sua dimensão social vinculada à própria cidadania, a saúde possui uma dimensão econômica própria, articulando entidades públicas e privadas em uma ampla rede de assistência à saúde - pelo Sistema Único de Saúde (SUS) e Sistema Nacional de Saúde Suplementar - além de um parque industrial responsável pelo fornecimento de uma vasta cadeia de produtos destinados aos cuidados da saúde humana. É uma oportunidade única para o desenvolvimento nacional no contexto das políticas de saúde e de desenvolvimento. Os conhecimentos e as ferramentas em Engenharia Clínica aqui utilizados, permitiram realizar uma análise diferenciada do contexto sócio-econômico do setor, a sistematização e a percepção dos fatores e atores que induzem ou retardam o crescimento tecnológico do setor. Acredita-se que a atuação da Engenharia Clínica permite propor uma abordagem desenvolvimentista para o setor diferente daquelas de cunho estritamente economicista, tecnológica ou sanitarista. O trabalho busca mostrar a inter-relação entre os diversos atores do Sistema Nacional de Inovação de Produtos Médicos (SNIPM) e como intervenções em pontos específicos deste sistema podem gerar inflexões promotoras do setor de produtos médicos. A motivação para a elaboração e execução deste trabalho recaiu sobre a necessidade de se definir uma estratégia para promover o desenvolvimento do SNIPM considerando as atuais políticas desenvolvimentistas e a constante expansão do mercado brasileiro de produtos médicos que, nos últimos anos, posicionou o Brasil como o segundo maior produtor mundial entre os países emergentes. Esta conjuntura promove no Ministério da Saúde o surgimento de o novo contexto institucional, onde o conceito de Complexo Industrial da Saúde surge como um dos pilares da atual política de saúde onde as ações assistenciais do SUS podem ser utilizadas como indutor da produção local de produtos estratégicos. Desta forma, pretende-se que o Programa proposto se constitua como uma das ferramentas no âmbito do SUS destinadas a fortalecer e modernizar o setor de equipamentos e materiais de uso em saúde, visando à ampliação da capacidade inovadora das empresas e mudança do seu patamar competitivo. / Abstract: The health configurates a complex set of productive activities of goods and services that leverage key segments of the modern society. Beyond its social dimension linked to citizenship, health has its own economic dimension, articulating public and private entities in a wide network of health care - through the Brazilian Unified Health System (SUS) and the Brazilian Health Insurance System - besides an industrial park that provides a wide chain of products designated to health care activities, including medical devices. It is a unique source of opportunity to promote national development in the context of both the health and development policies. The Clinical Engineering knowledge and the tools used here, allowed performing a differentiated analysis of the secto socio-economic context, the systematization and the perception of factors and actors that induce or retard the technological growth of the sector. It is believed that the role of Clinical Engineering allows the proposition of a developmental approach for the sector different than those of strictly economistic, technological or sanitarist nature. The work seeks to show the interrelationship between the various actors of the Brazilian National Medical Devices Innovation System (SNIPM) and how interventions at specific points of this system can generate inflections to promote the medical devices sector. The motivation for the development and execution of this work fell on the need to define a strategy to promote the development of SNIPM, considering the current national development policies and the constant expansion of the Brazilian market for medical devices which, in recent years, ranked Brazil as the second largest producer among the developing countries. This conjuncture promoted in the Ministry of Health the emerge of a new institutional context, where the concept of Health Industrial Complex appears as one of the pillars of the current health policy where SUS healthcare actions can be used as an inducer for local production of strategic products. Thus, it is intended that the proposed program constitutes one of the tools within the SUS to strengthen and modernize the sector of equipment and materials for health use, aiming the increase the innovative capacity of firms and change in its competitive standing. / Doutorado / Engenharia Biomedica / Doutor em Engenharia Elétrica

No description available.