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Förbättrad vård efter bristning vid förlossning : En fallstudie om patientdelaktighet / Improved care after perineal tear : A case study about patient involvementGertsson, Sara-Marie January 2019 (has links)
Bakgrund. Att få en allvarlig bristning i samband med förlossning kan ge kvinnor smärta, lidande, och låg livskvalitet under lång tid. Syfte. Syftet med förbättringsarbetet har varit att förbättra eftervården genom att införa strukturerad uppföljning, öka kvalitén i bedömning och diagnostik, förbättra informationen till patienten och utveckla former för patientdelaktighet i förbättringsarbetet. Syftet med studien har varit att ur ett verksamhetsperspektiv beskriva erfarenheterna av patientdelaktigheten i förbättringsarbetet. Metod. Förbättringsarbetet har designats med hjälp av Förbättringstrappan och utgått från ett patientprocessorienterat perspektiv. Metod för studien var kvalitativ i form av en fallstudie. Resultat. Genom förbättringsarbetet följs kvinnorna upp via bristningsregistret, uppföljningsbesök med 3D- ultraljud görs på en specialinrättad mottagning. Vidare får kvinnorna individuell fysioterapeutinformation innan hemgång, en vårdkedja har införts och former för patientdelaktighet har utformats och använts. Dessa är frågeformulär, intervjuer, workshops och patientföreträdare i förbättringsnätverket. Resultatet från studien visar att formerna för patientdelaktighet ger skilda förutsättningar för delaktigheten. Resultatet visar på betydelsen av organisatoriska förutsättningar, värdet av patientdelaktighet, utmaningar vid införande och vilket reellt inflytande som patientdelaktigheten haft under processen och för resultaten av förbättringsarbetet. Slutsatser. Patientdelaktighet skapar värde i flera dimensioner. Patientdelaktighet behöver designas, anpassas till kontexten och förbättringsarbetets mål och dess syfte behöver vara tydligt uttryckt. / Background. Perineal tears during childbirth can lead to after-delivery complications that leads to great suffering and low quality of life for a long time. Purpose. The purpose has been to improve after-delivery care by systematic follow-up, increasing the quality of diagnostics and management of these women, improving the information for the patient and developing new ways of improving including patients in the improvement work. The purpose of the study has been to study the effect of patient participation in the improvement work. Method. "The improvement ramp" and patient process-oriented perspective has been used to design the improvement work. The method of the study was qualitative in the form of a case study. Results. Follow-up using 3D-ultrasound is introduced. A care chain has been introduced and ways of patient participation have been designed and used. These are questionnaires, interviews, workshops and patient representatives in the improvement network. The results of the study show that the ways of patient participation provide different conditions for participation. The result shows the importance of organizational conditions, the value of patient participation, challenges in the introduction and the real influence that patient participation has had during the process and on the results of the improvement work. Conclusions. Patient-participation in QI creates values in several dimensions. Patient-participation needs to be carefully designed in compliance with context, goals and purpose.
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Uso alogênico de células tronco e plasma rico em plaquetas no tratamento de ceratoconjuntivite seca em cãoGandolfi, Micaella Gordon. January 2019 (has links)
Orientador: Cláudia Valéria Seullner Brandão / Resumo: O objetivo deste estudo foi comparar e avaliar a aplicação de célula tronco mesenquimal de tecido adiposo (CTM-TA) e plasma rico em plaquetas aquecido alogênico (PRP-AA) perilacrimal em cães com ceratoconjuntivite seca (CCS), bem como, se há diferença na resposta segundo o grau de gravidade da afecção. Foram analisados 20 cães com produção lacrimal <15mm/min e distribuídos aleatoriamente em dois grupos (n=10). O grupo 1 tratado com CTM-TA (5x106 e 3x106 células) (GCTM-TA) e com grupo 2 PRP-AA (0,7mL e 0,3mL) (GPRP-AA), ambos injetados perilacrimal nas glândulas lacrimal principal e da terceira pálpebra, respectivamente. Todos os olhos foram avaliados em quatro momentos (M0 M15, M30, M60 dias). As variáveis avaliadas foram: osmolaridade da lágrima; teste lacrimal de Schirmer (TLS); sensibilidade corneal; tempo de ruptura do filme lacrimal (TRFL); pressão intraocular; espessura corneal; e biopsia da conjuntiva bulbar, além das variáveis clínico-oftalmológicas. Houve melhora nos dois grupos a partir de M15 (p<0,05) na qualidade do filme lacrimal, avaliada por meio da osmolaridade e TRFL, sem diferença entre os grupos. A produção de lágrima aumentou, entretanto notou-se diferença significativa nos animais com CCS discreta no GPRP-AA a partir do M30, e nos cães com CCS grave no GCTM-TA a partir do M30 e no GPRP-AA a partir do M60. Verificou-se melhora dos sinais clínicos da inflamação em ambos os grupos. Aplicação única perilacrimal de CTM-TA e PRP aquecido alogênicos normaliza a ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of the study was to compare and evaluate the application of allogenic mesenchymal stem cell adipose tissue derived (MSCs-AD) and inativate platelet-rich plasma allogenic (PRP-IA), perilacrimal in dogs with keratoconjunctivitis sicca (KCS), and if there is difference in the response according to the degree of severity of the condition. Twenty dogs with lacrimal production <15mm/min randomly assigned to two groups were used. Group treated with MSCs-AD (5x106 and 3x106) (GMSCs-AD) and with PRP-IA (0.7ml and 0.3ml) (GPRP-IA), both intralacrimal in the main lacrimal glands and third eyelid, respectively. The eyes were evaluated in four moments after application (M0 M15, M30, M60). The variables evaluated were: tear osmolarity e; Schirmer's tear test (STT); sensitivity corneal; tear film break time (TBUT); intraocular pressure; corneal thickness; and biopsy of the bulbar conjunctiva, in addition to clinical-ophthalmologic variables. There was improvement in two groups at M15 (p <0.05) on tear film quality, assessed by osmolarity and TBUT, with there was no difference between groups. STT increased, however, statistical difference was only observed in animals with mild KCS in the GPRP-IA from the M30 and in the intense KCS at M30 in the G MSCs-AD and at M60 in the GPRP-IA. There was an improvement in the clinical signs of inflammation in both groups. The unique Intralacrimal application of MSCs-AD and PRP-IA normalizes tear film quality and improves clinical signs of inflamma... (Complete abstract click electronic access below) / Doutor
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Eine biomechanische Untersuchung der Einreihenrefixation im Vergleich zur Doppelreihenrefixation bei der Rekonstruktion von Rotatorenmanschettenrupturen unter Berücksichtigung des Nahtmaterials und der Nahttechnik / Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture materialPoppendieck, Björn 09 November 2011 (has links)
No description available.
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A study of communist thought in colonial India, 1919-1951Jan, Ammar Ali January 2018 (has links)
Despite having roots in 19th century Europe, Marxism had a deep impact on the trajectory of political ideas in the non-European world in the twentieth century. In particular, anti-colonial thinkers engaged productively with Marx’s ideas as part of their struggle against Empire. Yet, little attention has been paid to the displacements and innovations in political thought as a result of this encounter between anti-colonialism and Marxism. This dissertation aims to fill this gap by studying the history of Indian communism, focusing on the first three decades of the communist movement (1921-1950). I claim that this is an ideal time period to interrogate the formation of political ideas in India, since they presented themselves with particular intensity in the midst of an unfolding anti-colonial struggle, and arguably, the birth of the Indian political. The entry of communist ideas into the charged political environment of the 1920s had an impact on the ideological debates within the Indian polity, as well as stamping Indian communism with its own specific historicity. Through a tracing of debates among communist leaders, as well as their non-communist interlocutors, this work seeks to provide a novel lens to consider the relationship between ideas and their historical actualization, or between the universal and its instantiation in the particular. Moreover, the dissertation argues that the radically different socio-political and historical landscapes of Western Europe and colonial India necessitated a confrontation with the stagist view of history dominant in the history of Western Marxism, prompting novel theoretical work on the issue of political temporality. Consequently, the relationship between necessity and volition, central to enlightenment thought, was radically transformed in the colonial world, particularly in terms of its entanglement with the problem of subjective violence. Engagement with such questions not only impacted Indian political thought, but transformed global communism itself, putting into question the concept of an “originary site” for political ideas. Thus, this work intervenes in debates in three distinct registers: Global Intellectual History, Marxist theory and Indian political thought.
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Impacto nas taxas de lacerações obstétricas do esfíncter anal com o uso restrito da episiotomia em um hospital escolaSchneider, Samanta January 2017 (has links)
Introdução: A laceração obstétrica do esfíncter anal (LOEA) está associado com incontinência anal. A episiotomia foi proposta como uma forma de proteção do esfíncter anal no parto, especialmente a episiotomia mediolateral; entretanto, diversos estudos mostraram que o uso de rotina da episiotomia não reduz o risco de LOEA. Objetivo: Este estudo tem por objetivo analisar se a redução na taxa de episiotomia em hospital escola no Brasil foi associada a um aumento na incidência de lacerações obstétricas do esfíncter anal, além de fatores associados a elas. Métodos: Estudo observacional, transversal e retrospectivo, realizado no Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brasil. Foram incluídos todos os partos vaginais de gestações únicas, apresentação cefálica, a partir de 34 semanas de idade gestacional, realizados em 2011-2012 (uso liberal da episiotomia) e 2015-2016 (uso restrito da episiotomia), e comparados em relação a taxa de episiotomia mediolateral e de LOEA. Resultados: foram analisados 4268 partos (2043 no período de 2011-2012, 2225 de 2015-2016), foram analisados 2043 partos. A taxa de episiotomia reduziu de 59.4% para 44.2% (p≤0.0001). No período 2011-2012, ocorreram 10 lacerações obstétricas do esfíncter anal em 2043 partos (0.48%), enquanto que no período 2015-2016, ocorreram 31 lacerações em 2225 partos (1.39%). Houve interação quando comparado os dois períodos em relação a realização de episiotomia e a ocorrência de LOEA (p≤0.0001). A episiotomia foi fortemente associada a não ocorrência de LOEA em 2011-2012 (59.5%), enquanto que não ter episiotomia foi associado ao grupo com (67.7%) e sem LOEA (55.7%) em 2015-2016. Fatores associados a LOEA foram indução do parto e distócia de ombro. Conclusão: Houve um aumento na taxa de lacerações do esfíncter anal com a diminuição da taxa de episiotomia. A episiotomia de rotina foi prote / Introduction: Obstetric anal sphincter tear (OAST) is associated with anal incontinence. Episiotomy was proposed as a form of protection of the anal sphincter at delivery, especially mediolateral episiotomy; however, several studies have shown that routine use of episiotomy does not reduce the risk of OAST. Objective: This study aims to analyse whether the reduction in the rate of episiotomy in a school hospital in Brazil was associated with an increase in the incidence of obstetric lacerations of the anal sphincter, in addition to associated factors. Methods: Observational, cross-sectional and retrospective study, conducted at Hospital de Clínicas, Porto Alegre, Rio Grande do Sul, Brazil. We included all vaginal deliveries of single pregnancies, cephalic presentation, from 34 weeks of gestational age, performed in 2011-2012 (liberal episiotomy) and 2015- 2016 (restricted episiotomy), and compared in relation to the rate of mediolateral episiotomy and OAST. Results: 4268 births were analysed (2043 in 2011-2012 and 2225 in 2015-2016). The episiotomy rate decreased from 59.4% to 44.2% (p≤0.0001). In 2011-2012, there were 10 obstetric anal sphincter lacerations in 2043 births (0.48%), while in the period 2015-2016 there were 31 lacerations in 2225 births (1.39%). There was interaction when comparing the two periods in relation to the episiotomy and the occurrence of OAST (p≤0.0001). Episiotomy was strongly related to 2011-2012 group with no OAST (59.5%), while not having an episiotomy was related to both OAST (67.7%) and no OAST (55.7%) group in 2015-2016. Factors associated with OAST were labor induction and shoulder dystocia. Conclusion: There was an increase in the rate of lacerations of the anal sphincter with a decrease in the rate of episiotomy. Routine episiotomy was protective.
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Impacto nas taxas de lacerações obstétricas do esfíncter anal com o uso restrito da episiotomia em um hospital escolaSchneider, Samanta January 2017 (has links)
Introdução: A laceração obstétrica do esfíncter anal (LOEA) está associado com incontinência anal. A episiotomia foi proposta como uma forma de proteção do esfíncter anal no parto, especialmente a episiotomia mediolateral; entretanto, diversos estudos mostraram que o uso de rotina da episiotomia não reduz o risco de LOEA. Objetivo: Este estudo tem por objetivo analisar se a redução na taxa de episiotomia em hospital escola no Brasil foi associada a um aumento na incidência de lacerações obstétricas do esfíncter anal, além de fatores associados a elas. Métodos: Estudo observacional, transversal e retrospectivo, realizado no Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brasil. Foram incluídos todos os partos vaginais de gestações únicas, apresentação cefálica, a partir de 34 semanas de idade gestacional, realizados em 2011-2012 (uso liberal da episiotomia) e 2015-2016 (uso restrito da episiotomia), e comparados em relação a taxa de episiotomia mediolateral e de LOEA. Resultados: foram analisados 4268 partos (2043 no período de 2011-2012, 2225 de 2015-2016), foram analisados 2043 partos. A taxa de episiotomia reduziu de 59.4% para 44.2% (p≤0.0001). No período 2011-2012, ocorreram 10 lacerações obstétricas do esfíncter anal em 2043 partos (0.48%), enquanto que no período 2015-2016, ocorreram 31 lacerações em 2225 partos (1.39%). Houve interação quando comparado os dois períodos em relação a realização de episiotomia e a ocorrência de LOEA (p≤0.0001). A episiotomia foi fortemente associada a não ocorrência de LOEA em 2011-2012 (59.5%), enquanto que não ter episiotomia foi associado ao grupo com (67.7%) e sem LOEA (55.7%) em 2015-2016. Fatores associados a LOEA foram indução do parto e distócia de ombro. Conclusão: Houve um aumento na taxa de lacerações do esfíncter anal com a diminuição da taxa de episiotomia. A episiotomia de rotina foi prote / Introduction: Obstetric anal sphincter tear (OAST) is associated with anal incontinence. Episiotomy was proposed as a form of protection of the anal sphincter at delivery, especially mediolateral episiotomy; however, several studies have shown that routine use of episiotomy does not reduce the risk of OAST. Objective: This study aims to analyse whether the reduction in the rate of episiotomy in a school hospital in Brazil was associated with an increase in the incidence of obstetric lacerations of the anal sphincter, in addition to associated factors. Methods: Observational, cross-sectional and retrospective study, conducted at Hospital de Clínicas, Porto Alegre, Rio Grande do Sul, Brazil. We included all vaginal deliveries of single pregnancies, cephalic presentation, from 34 weeks of gestational age, performed in 2011-2012 (liberal episiotomy) and 2015- 2016 (restricted episiotomy), and compared in relation to the rate of mediolateral episiotomy and OAST. Results: 4268 births were analysed (2043 in 2011-2012 and 2225 in 2015-2016). The episiotomy rate decreased from 59.4% to 44.2% (p≤0.0001). In 2011-2012, there were 10 obstetric anal sphincter lacerations in 2043 births (0.48%), while in the period 2015-2016 there were 31 lacerations in 2225 births (1.39%). There was interaction when comparing the two periods in relation to the episiotomy and the occurrence of OAST (p≤0.0001). Episiotomy was strongly related to 2011-2012 group with no OAST (59.5%), while not having an episiotomy was related to both OAST (67.7%) and no OAST (55.7%) group in 2015-2016. Factors associated with OAST were labor induction and shoulder dystocia. Conclusion: There was an increase in the rate of lacerations of the anal sphincter with a decrease in the rate of episiotomy. Routine episiotomy was protective.
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Análise das alterações do piscar, do filme lacrimal e da superfície ocular induzidas pelo uso de monitor de computador / Analysis of alterations in blinking, lacrimal tear film and ocular surface induced by the use of video terminal displayTania Mara Cunha Schaefer 26 March 2010 (has links)
A relação trabalho e visão é tão remota que determinou a adaptação da espécie humana ao meio em que está inserida. Demonstrou-se que trabalhar em um ambiente confortável, sem doenças ocular, favorece o desempenho visual e aumenta a produtividade. Conhecer os efeitos do monitor de computador (VDT) sobre o sistema visual significa planejar melhor o ambiente de trabalho e a atividade laboral para se obter máximo conforto e produtividade. Este estudo teve como objetivo geral analisar as alterações do piscar, do filme lacrimal e da superfície ocular induzidas pelo uso de monitor de computador (VDT). Para sua realização efetivou-se um estudo transversal, descritivo, observacional, analítico, realizado na Volkswagen do Brasil, São José dos Pinhais (PR), tendo como amostra, a população de funcionários do setor administrativo que utiliza VDT, com idade acima de 18 anos, sem doenças da superfície ocular, sistema palpebral e lacrimal. O ambiente de trabalho foi caracterizado pela temperatura, grau de umidade, velocidade do ar e iluminamento. Preencheram os critérios de inclusão 108 funcionários (idade média 34,1±7,88 anos e tempo mínimo de utilização do VDT 6 horas/dia). Foram avaliados as sintomatologias, filmagem da face para mensuração do tempo entre piscadas na situação de conversação, exame do olho externo e biomicroscopia das pálpebras, conjuntiva e córnea, filmagem videoceratoscópica para determinar tempo de ruptura do filme lacrimal, avaliação da quantidade de lágrima do lago lacrimal pelo Zone-Quick Phenol Red Thread tear test, avaliação do epitélio corneano pelo teste da lissamina verde, filmagem da face dos sujeitos para mensuração do tempo entre piscadas em leitura de VDT. Ao final da jornada de trabalho, foram feitas a reavaliação do tempo de ruptura do filme lacrimal da quantidade de lágrima e a avaliação do epitélio corneano. Compararamse o tempo entre as piscadas em conversação e em uso de VDT e o tempo de ruptura do filme lacrimal, antes e ao final da jornada de trabalho. A comparação desses tempos classificou os sujeitos como expostos, com tempo médio de ruptura do filme lacrimal menor que o tempo médio entre piscadas e não expostos com tempo médio de ruptura do filme lacrimal maior que o tempo médio entre piscadas. Nas condições do estudo, em jornada de trabalho com tempo mínimo de 6 horas de uso de VDT, houve aumento da exposição da superfície ocular causada pelo aumento do tempo entre piscadas. O aumento da exposição da superfície ocular foi causado pela diminuição do tempo de ruptura do filme lacrimal constatado ao final da jornada de trabalho. O tempo entre piscadas na situação de leitura em VDT que foi significantemente maior que na situação de conversação. O tempo de ruptura do filme lacrimal, ao final da jornada de trabalho, foi significativamente menor que em seu início. A exposição ocular observada durante a jornada de trabalho com usuários de VDT, nas condições deste estudo, não causou alteração epitelial detectável ao teste da lissamina verde. Não houve alteração do volume lacrimal em olhos com exposição, antes da jornada de trabalho com VDT, nem houve alteração do volume lacrimal em olhos com exposição ocular, após a jornada de trabalho com VDT. / The relationship between work and vision is so remote that has determined the adaptation of human beings to the environment in which they are inserted. It has been demonstrated that working in a pleasant environment, without any ocular disease, has favored visual performance and increased productivity. Knowing the effects of video terminal display (VDT) on the visual system helps plan labor environments and labor activities more effectively so that optimal comfort and productivity are obtained. This transversal study, performed at Volkswagen do Brasil, São José dos Pinhais, PR, has the objective to investigate the influence of VDT labor activities on blinking, tear film and ocular surface, ocular exposure and amount of tear in the lacrimal lake. The population sample comprised VDT administrative department employees older than 18, without diseases on the ocular surface, tear film and blinking system. The evaluation of the working environment included measurements of temperature, humidity, air speed and lighting. One hundred and eight employees met the study criteria (mean age 34.1±7.88 and minimal VDT use time of 6 hours/day). Several evaluations were performed: the ocular surface symptomatology; the measurement of the blink time in conversation situations; the examination of the ocular surface and lacrimal film; a videokeratoscopy to establish the tear film break-up time; evaluation of the amount of tears of the lacrimal lake by means of the Zone-Quick Phenol Red Thread tear test; evaluation of the corneal epithelium by means of the lissamine green test; and determination of the blink time in VDT reading situations. At the end of the working period, the amount of tears and the corneal epithelium structure were re-evaluated. Comparisons between the blink time in conversation and VDT reading situations were performed before and at the end of the working day. The comparison data obtained classifies the subjects into two categories: exposed, with a tear film break-up time shorter than the mean time between blinks; and non-exposed, with tear film break-up time longer than the mean time between blinks. The findings obtained reveal that there was an increase in the ocular surface exposure caused by the increase in the time between blinks during the working period and increase of the ocular surface exposure caused by the decrease in the tear film break-up time determined at the end of the working day. The time between blinks at VDT reading situations was significantly longer than at conversation situations. The tear film break-up time at the end of the working day was significantly shorter than at the beginning. The ocular exposure during the VDT use has not caused epithelium alterations detectable at the lissamine green test. There were no alterations in the amount of tears in the eyes which underwent ocular exposure after VDT use situations.
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Influence of filler /polymer interface on reinforcement, strain-induced crystallization and tear resistance in reinforced natural rubber / Influence de l'interface charge / polymère sur le renforcement, la cristallisation induite sous étirement et la résistance à la déchirure dans le caoutchouc naturel renforcéVieyres, Arnaud 07 February 2013 (has links)
Cette étude vise à mieux comprendre les mécanismes physiques à l'origine des propriétés mécaniques et des propriétés ultimes des caoutchoucs renforcés. Des échantillons de caoutchouc naturel dans lequel sont dispersés des agrégats de Silice précipitée ou de Noir de Carbone et vulcanisés au Soufre ont étés mis en oeuvre. Les principaux paramètres étudiés sont la densité de réticulation et l'interface charge-caoutchouc modifiée au moyen de différents traitements de surface de silice. L'impact des charges et du type d'interface sur les propriétés mécaniques dans le domaine des faibles déformations (effet Payne) et des grandes déformations est présenté. Le phénomène de cristallisation sous étirement dans le caoutchouc naturel est étudié par diffraction des rayons X in-situ au cours d'essais de traction quasi-statiques ou d'essais dynamiques couplés à un système d'acquisition stroboscopique. Nous montrons une corrélation des mesures du module, du degré de gonflement à l'équilibre, de l'orientation des chaînes mesurée par diffusion de rayons X et de la densité de réticulation mesurée par RMN dans le caoutchouc naturel non chargé. Dans le caoutchouc naturel renforcé, les corrélations établies à l'aide de ces mêmes mesures permettent de préciser les mécanismes de renforcement aux faibles et aux grandes déformations. Enfin, la résistance à la déchirure est évaluée en géométrie cisaillement pur sur les matériaux non-renforcés et renforcés. Les effets du type d'interface, de la densité de réticulation et de la vitesse d'essai sur la résistance à la déchirure sont présentés. Nous discutons également les profils de déformation locale obtenus par corrélation d'image / This study aims at better understanding the physical mechanisms responsible for the mechanical and ultimate properties in reinforced rubber materials. Sulfur vulcanized samples made of a Natural Rubber matrix in which aggregates of precipitated Silica or Carbon Black are dispersed have been manufactured. The main control parameters are the crosslink density and the filler/rubber interactions through different silica surface treatments. The effect of fillers and interface type on the mechanical properties in the small strain regime (Payne effect) and large strain regime is presented. X-ray diffraction experiments have been performed to study the phenomenon of strain-induced crystallization (SIC) both during quasi-static tensile tests and dynamical tests coupled to a stroboscopic acquisition device. Mechanical measurements have proved to correlate fairly well to the crosslink density measured by NMR, to equilibrium swelling degree and to the average chain segment orientation measured by X-ray scattering in unfilled natural rubber in agreement with the rubber elasticity theory. In reinforced materials, the correlation of those different measurements of local chain stretching give new insights on the reinforcement mechanisms at small and large strain. Tear experiments have been performed on Pure Shear pre-notched unfilled and filled samples. The influence of interface type, crosslink density and test drawing speed on tear resistance are presented. Local strain profiles obtained from digital image correlation and the crystallized fraction profiles from in-situ X-ray diffraction are also discussed
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Testes diagnósticos oftalmológicos em sagui de tufo preto (Callithrix penicillata)Sessa, Mariana January 2020 (has links)
Orientador: Cláudia Valéria Seullner Brandão / Resumo: O estudo objetivou descrever valores de referência para importantes testes diagnósticos oftalmológicos, como sensibilidade corneal, produção lacrimal, pressão intraocular, espessura corneal e microbiota conjuntival em saguis de tufo preto (Callithrix penicillata) saudáveis e sem alterações oculares. Foram utilizados 13 saguis de tufo preto, totalizando 26 olhos, provenientes do CEMPAS da Faculdade de Medicina Veterinária e Zootecnia - UNESP, Botucatu, São Paulo, Brasil. Os saguis foram submetidos a contenção química com anestesia dissociativa à base de cetamina e midazolam, para realização dos exames. Os resultados obtidos para sensibilidade corneal com estesiômetro Cochet-Bonnet foi de 5,8 ± 0,6cm; produção lacrimal com ponta de papel absorvente endodôntica estéril de 13 ± 3mm/min; pressão intraocular com tonômetro de rebote Tonovet Plus Icare® de 22,2 ± 2,9mmHg; espessura corneal 340,7 ± 25,5µm; e predomínio de bactérias Gram-positivas nas amostras de microbiota conjuntival. Não houve diferença significativa considerando lateralidade e sexo dos animais (P>0,05). Os resultados obtidos nos testes diagnósticos oftalmológicos poderão auxiliar médicos veterinários oftalmologistas a diagnosticar e tratar doenças oculares em saguis de tufo preto, além de contribuir para pesquisas na área de visão. / Abstract: The study aimed to describe reference values for important ophthalmic diagnostic tests, such as corneal sensitivity, tear production, intraocular pressure, corneal thickness and conjunctival microbiota in black tufted marmosets (Callithrix penicillata). Thirteen black tuft marmosets were used, totaling 26 eyes, followed by CEMPAS by the Faculty of Veterinary Medicine and Zootechnics - UNESP, Botucatu, São Paulo, Brazil. The procedures were used for chemical containment with dissociative anesthesia based on ketamine and midazolam, to perform the exams. The results obtained for corneal sensitivity with a Cochet-Bonnet esthesiometer were 5.8 ± 0.6 cm; tear production with sterile endodontic absorbent paper tip of 13 ± 3mm / min; intraocular pressure with Tonovet Plus Icare® rebound tonometer of 22.2 ± 2.9mmHg; corneal thickness 340.7 ± 25.5 µm; and predominance of Gram-positive bacteria in conjunctival microbiota. There was no significant difference considering the laterality and sex of the animals (P> 0.05). The results obtained in ophthalmological diagnostic tests can help veterinary ophthalmologists to diagnose and treat eye diseases in the black tufted marmosets, in addition to contributing to research in the field of vision. / Mestre
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Erfarenhet av eftervård vid uppkommen grad II-bristning : En intervjustudie med kvinnor som nyligen fött barn / Experiences of post partum care after the onset of a second degree perineal tear : An interview study with woman who have recently given birthGustafsson, Maria, Karlsson, Therése January 2021 (has links)
Bakgrund: Grad II-bristningar är vanligt förekommande efter vaginal förlossning och kan medföra komplikationer. Svenska myndigheter och föreningar rapporterar brister i eftervården av förlossningsbristningar. Forskning kring kvinnors erfarenheter av eftervård efter uppkommen grad II-bristning är begränsad. Syfte: Att undersöka kvinnors erfarenhet av eftervård vid uppkommen grad II-bristning. Metod: Strukturerade telefonintervjuer med öppna frågor genomfördes. Femton kvinnor deltog. Intervjumaterialet analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat: I resultatet framkommer tre huvudkategorier: ”Stöd postpatum”, ”När eftervården brister” och ”Eftervårdens förändring”. Kvinnornas erfarenheter av eftervården efter uppkommen grad II-bristning är överlag positiva och resultatet visar att eftervården har förbättrats de senaste åren. Kvinnorna tenderar dock att vara otrygga under läkningsprocessen och osäkra på vart de ska vända sig för att få hjälp. Slutsats: Studiens resultat indikerar att eftervården behöver utvecklas och bygga på bekräftelse och delaktighet. Kvinnorna behöver tydlig information efter uppkommen grad II-bristning eftersom de saknar kunskap. Det finns brister i eftervården under läkningsprocessen och kvinnorna är i behov av en tydlig vårdkedja. Bäckenbottenmottagningen ger kvinnorna en given instans att vända sig till och har en betydande roll i eftervården av grad II-bristningar. / Background: Second degree perineal tears after vaginal childbirth is common and can lead to complications. Swedish authorities and associations report shortage in the postpartum care after perineal trauma. Research about postpartum care after a second degree perineal tear is limited. Aim: To explore women´s experiences of postpartum care in the event of a second degree perineal tear. Method: Data was collected through structured phone interviews with open-ended questions. Fifteen women participated. Inductive qualitative content analysis was applied to the data. Outcome: The result shows three main categories: ”Support postpartum”, ”When aftercare fails” and ”The change of aftercare”. Women’s experiences of post partum care after the onset of a second degree perineal tear are generally positive and the results show that the post partum care has improved in recent years. However, women tend to be insecure during the healing process and unsure of where to turn for help. Conclusion: The results of the study indicate that post partum care needs to be developed and based on confirmation and participation. The women need clear information after the onset of a second degree perineal tear because they lack knowledge. There are shortcomings in the post partum care during the healing process and women are in need of a distinct care chain. The pelvic floor clinic gives women a given instance to turn to and has a significant role in the post partum care of a second degree perineal tear.
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