Trata-se de um estudo epidemiológico descritivo que busca analisar o tempo de tratamento da tuberculose de pacientes inscritos no Programa de Controle da Tuberculose de um serviço de saúde do município de Ribeirão Preto-SP, no período de janeiro de 1998 a dezembro de 1999. Os dados relativos a algumas variáveis sociodemográficas (sexo, idade, escolaridade e ocupação), ao diagnóstico (forma clínica), ao tratamento (condição, esquema, tipo, tempo e resultado de tratamento), a intercorrências "patológicas" e a doenças associadas (AIDS e alcoolismo) foram obtidos através de livros de registro e de prontuários. Utilizou-se o programa Epi-Info, versão 6.04d para o cadastramento, tabulação e análise dos dados. Observou-se que dos 140 pacientes em estudo, 105 (75%) pacientes curaram, 20 (14,29%) foram transferidos, 05 (3,57%) tiveram mudança de diagnóstico, 05 (3,57%) abandonaram e 05 (3,57%) foram a óbito. Em relação à cura, 39,05% curaram em até 6 meses; 39,05% entre 6,1 e 9 meses; 20% em mais de 9 meses e 1,9% foi ignorado. Identificou-se que a história de tratamento anterior, intercorrências patológicas, AIDS e alcoolismo contribuíram para o não-cumprimento correto da terapêutica, prolongando o tempo de tratamento entre os indivíduos curados. Quanto ao tempo de tratamento dos pacientes que não evoluíram para a cura, 09 (25,71%) não curaram após 6 meses de tratamento (03 abandonos; 03 óbitos; 02 mudanças de diagnóstico e 01 transferência). Pode-se verificar que as intercorrências podem acontecer ao longo do tratamento, ocasionando desvios como o não-cumprimento do esquema terapêutico, aumentando o tempo de tratamento, o risco de abandono e até mesmo o óbito. Além disso, o estudo possibilitou descrever o tempo de tratamento da tuberculose no Programa (diferença entre data da última e da primeira ingestão do medicamento) e o mês de término do tratamento registrado no prontuário (computado através do número de cartelas de medicamentos concluídos). Verificou-se que o dado registrado no prontuário altera o tempo real de tratamento da tuberculose, uma vez que essa anotação considera como 1 mês de tratamento, a contagem do término de 1 cartela de medicamentos concluída pelo paciente, que pode ter duração de mais de 30 dias. Constatou-se, neste estudo, o preenchimento incompleto das fichas de notificação e das folhas de evolução médica e de enfermagem, bem como o critério de registro correspondente ao mês de tratamento do doente, sugerindo uma maior atenção do serviço para esses fatos e melhor esclarecimento aos trabalhadores de saúde sobre os critérios e a precisão dos dados a serem informados. / This is a descriptive epidemiological study which aims at analyzing tuberculosis treatment in patients enrolled in the Tuberculosis Control Program of a health service in the city of Ribeirão Preto-SP from January 1998 to December 1999. Data concerning some social and demographic variables (sex, age, education and occupation), the diagnosis (clinical condition), treatment (condition, plan, type, period and treatment results), pathological intercurrences and associated diseases (AIDS and alcoholism) were obtained through records books and charts. The Epi-Info, version 6.04d was used for data recording, tabulation and analysis. It was observed that of the 140 patients under study, 105 (75%) patients were cured, 20 (14.29%) were transferred, 05 (3.57%) had their diagnoses changed, 05 (3.57%) quit treatment and 05 (3.57%) passed away. Concerning cure, 39.05% were cured in the period of 6 months; 39.05% in a period of 6.1 to 9 months; 20% in more than 9 months and 1.9% were ignored. It was identified that the history of previous treatment, pathological intercurrences, AIDS and alcoholism contributed to not following therapy adequately, which extended the time of treatment among cured individuals. Concerning the time of treatment of patients who did not develop to cure, 09 (25.71%) were not cured after 6 months of treatment (03 dropouts; 03 deaths; 02 diagnosis alterations and 01 transfer). It can be observed that intercurrences may occur during treatment, which causes deviances such as the non-adherence to the therapeutic plan and increase in the treatment period, risks of quitting and even death. In addition, the study enabled the comparison between the time of treatment of tuberculosis in the Program (difference between the dates of the last and first medication ingestion) and the month of completion of treatment recorded in the chart (calculated through the number of medication packages used). It was observed that the information recorded in the chart changed the real time of tuberculosis treatment, since this note considered as a month of treatment the counting of the consumption of one medication package consumed by the patient, which can take over 30 days. Incomplete report forms, medical and nursing development sheets and the recording criterion corresponding to the patient’s month of treatment were found in this study, which suggests greater attention from the service to these facts and a better clarification to health workers concerning the criteria and precision of the data to be informed.

A dissertation submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science, 2017 / Aim: The aim of this study was to quantify random and systematic setup errors in a population of head and neck cancer patients for the purposes of evaluating departmental positioning and immobilization techniques, verification and treatment protocols, as well as validating the treatment margins used. Methods and Materials: All patients had more than one phase of radiation, each consisting of different megavoltage photon field arrangements. Some phases were also treated with electron fields in addition to the photon fields. Random and systematic setup errors in all three principal directions were calculated for two groups of patients, using record and verify system couch position data. For one group (20 patients) the positioning and immobilization device system was mechanically localized to the treatment couch, and for the other group (38 patients), it was visually centered on the treatment couch. Within both groups of patients, the patient position was either verified online with portal imaging or verified offline on a conventional radiotherapy simulator. Results: For the patient group treated with the base plate visually centered on the treatment table the population random and systematic setup errors calculated for the photon fields were only indicative of setup uncertainties in the anterior-posterior direction. For the patient group treated with the base plate localized to the treatment couch, the population random and systematic setup errors were found to be within the 5 mm clinical to planning target volume expansion margin used at Livingstone Hospital. Due to treatment couch position differences from fraction to fraction, setup errors made during this study could not reliably be determined for electron field treatments Conclusions: Results indicate that the base plate should be localized to the treatment couch when calculating random and systematic setup errors for photon fields using the couch position as a surrogate for patient position. For this method to be used to calculate setup errors for electron fields, shielding should always be fastened to the same position at the endface of the applicator. Offline and online verification did not significantly influence systematic setup errors. / XL2018

Military service members are a subpopulation of the postsecondary student body. Many service members report symptoms of depression and posttraumatic stress disorder (PTSD). Yet, practical and stigma-related barriers prevent these service members from seeking treatment, often when treatment services are available as part of post-enlistment benefits. Using a variety of surveys, the present thesis assessed the demographics, self-reported symptoms of PTSD and depression, perceptions of treatment, and treatment utilization among military-affiliated students on a postsecondary campus. Correlational analyses revealed that severity of PTSD and depression symptoms were positively correlated with overall treatment utilization. However, practical and stigma-related barriers were not significantly associated with treatment utilization. Multiple regression analyses revealed that stigma-related and practical barriers did not moderate the relationship between symptoms of PTSD or depressive symptoms and treatment utilization. Post-hoc analyses showed a positive correlation between reported practical barriers and on-campus treatment utilization, and also revealed that on-campus treatment utilization was positively correlated with overall treatment utilization and positively correlated with utilization of community-based health services. The impact of these findings is discussed.

According to the American Psychological Association (2006), three components should be equally considered in treatment decision-making: empirical research, clinical judgment, and the client’s values and preference. Swift, Callahan, and Vollmer (2011) defined client preferences as specific attributes that are desired in a therapeutic setting and are divided into three categories: role, therapist, and treatment-type. Currently, there is no treatment orientation scale that measures treatment type and magnitude of the relationship. For this initial phase of development, 5 treatment orientations are being used as the basis of the Client Treatment Orientation Scale (CTOS): psychodynamic, existential, cognitive-behavioral therapy, acceptance and commitment therapy, and multicultural. The purpose of this study is to begin development of a treatment orientation scale with 5-7 questions per subscale domain. A total sample of 651 participants completed the survey, was English speaking, and aged 18 or over, with the majority being male (n = 334, 51.3%). The mean age of participants was 31.91 (SD = 8.23), with an equal distribution of degree type (e.g. psychiatrist, clinical psychology, counseling psychology, and school psychology) with psychiatry the most endorsed at 26.6% (n = 173). Overall, results did not support the use of the CTOS in applied or research settings. Reliability analyses for the 5 subscales were: psychodynamic (α = .52), existential (α = .32), cognitive-behavioral therapy (α = .64), acceptance and commitment therapy (α = .46), and multicultural (α = .63). There were various limitations of the study, such as being self-report and the possibility of not being representative of the particular orientations being measured. Future research could re-examine items for latent variables or refine the current items for another factor analysis study.

Magister Artium (Psychology) - MA(Psych) / Substance use is a worldwide health concern that has received significant attention as it is often related to deleterious outcomes. Various treatment programmes have been made available to assist people and their families who misuse substances, to aid rehabilitation and equip people with the necessary tools with the aim of preventing possible relapse. The Western Cape Province has been identified as experiencing the highest increase of substance use, with Cape Town being disproportionately affected. Substance use treatment and prevention programmes are therefore an increasingly important means of addressing substance use and related harms. This study aimed to explore the lived experiences of individuals in relation to the treatment they received at a treatment facility in the Cape Town area. As such, the researcher made use of the phenomenological approach as a theoretical framework as it aims to describe the lived experiences of individuals in relation to a particular phenomenon. Furthermore, a qualitative methodological framework was utilised to explore the experiences of individuals who received substance use treatment. Ten participants were purposively selected from an outpatient substance use treatment facility in Cape Town. Focus group discussions were used to collect data and the data were analysed using Interpretive Phenomenological Analysis (IPA). Findings suggest that there were various reasons participants sought treatment. This includes the challenges they experienced in both their personal and occupational lives as well as the realization of the negative effects substance use had on them physiologically. Findings also revealed that the environmental setting individuals were in fostered their treatment; the various aspects of the programme provided by the treatment facility had a significant contribution to their recovery and improved relationships with others; receiving support from family and friends were important in service providers treatment retention as well as individuals ability to identify the changes within themselves since receiving treatment. Overall, results indicate that the treatment programme helped participants in their recovery and enhanced personal relationships, self-perception as well as personal and occupational growth. Findings suggest that there are various reasons as to why people seek treatment and although this may differ, the treatment modality they were provided with contributed substantially to their recovery. Furthermore, this study will contribute to the literature and understanding the ways in which treatment fosters recovery, personal growth and relationships.

No description available.

Very little work has been undertaken that explores pain as a part of human existence and the inherent knowledge that accompanies it. What pain means to people and how they know their own pain is the subject of this research study.The research sought to identify ways of knowing cancer pain of six participants, each receiving palliative care at the time of this study. The themes of, balancing conflict, living with threat, always there and making sense are identified and examined to provide understanding of the ways these people know their pain. A new model of pain assessment is offered that incorporates an ontological way of knowing, and the meaning that the findings have for nursing practice is explored. Implications for nursing practice and education that are derived from the study are offered. The rigour of the study is promoted through an audit process / Doctor of Philosophy (PhD)

Surgical resection is the best option for both liver and kidney cancers, which providing the long term survival. However intraoperative blood loss can be a significant challenge, and is clearly associated with morbidity and mortality. Radiofrequency ablation (RFA) precoagulation has been introduced into liver and kidney surgery. Promising results have already achieved in reduction of intraoperative blood loss. In this thesis, a detailed explanation on precoagulation by RFA has been given. Our group developed a novel bipolar multi-array RFA device ??? InLine (ILRFA). In this thesis, we have investigated the performance in a variety of fields. In the study of ILRFA-assisted laparoscopic liver resection, ILRFA was easily employed through a hand port and achieved significant decrease of blood loss compared to control group (p < 0.05). In the liver trauma study, ILRFA produced a 63.88% reduction of blood loss in peripheral injury and 53.57% in central injury respectively. In postoperative evaluation of ILRFA-assisted liver resection, animals underwent an uneventful recovery, no complications occurred. Histological examination revealed a typical post RFA evolution. In ILRFA-assisted partial nephrectomy, the mean intraoperative blood loss 35 ?? 7 ml in the ILRFA and 152 ?? 94 ml in the control, a 77.0% reduction (P = 0.024). The mean blood loss per centimetre resection area was 2.09 ?? 1.41 ml/cm2 in the ILRFA compared with 12.79 ?? 1.68 ml/cm2 in controls, the reduction was 79.0% (P = 0.019). In ILRFAassisted laparoscopic partial nephrectomy, the mean intraoperative blood loss was 32 ?? 15 ml in the ILRFA and 187 ?? 69 ml in the control group, a 77.0% reduction (P = 0.043). The mean blood loss per centimetre resection area was 2.27 ?? 0.95 ml/cm2 in the ILRFA compared with 26.46 ?? 8.81 ml/cm2 in controls, the reduction was 79.0% (P = 0.047). In the renal trauma experiment, ILRFA also achieved promising results in haemostasis. We believe that ILRFA is a useful device which may help in the treatment of patients with liver and kidney illness.

"April 2002" Bibliography: leaves 190-202. Examines the suitability of the [alpha] 2 adrenoreceptor agonist xylazine for providing safe and effective analgesia in 2 settings: for post-surgical pain in adult sheep used for biomedical research, and for routine husbandry procedures applied to lambs on farms, such as mulesing, tail-docking and castration. Concludes in setting 1 that intramuscular administration of xylazine was simple to perform yet was characterized by a rapid peak analgesic effect with a reasonable duration of action and minimal deleterious effects on cardiac output, blood pressure or arterial blood gases. In setting 2 the anti-nociceptive effects in lambs are of a similar magnitude and duration to those in adult sheep when the dose was scaled for body weight. A ranking of the relative painfulness of husbandry procedures was developed and used to assess the efficacy of intramuscular xylazine.

Heart failure is a cause of significant burden to both individuals and society. Individuals live with a disease where there is a decline in physical functioning, the experience of a range of symptoms including breathlessness and pain, frequent hospitalisations and death. The frequent hospital admissions that are usually precipitated by shortness of breath places an economic burden on the current health system. This burden of heart failure is expected to increase in the coming years due to factors such as the ageing population and improved survival from acute cardiac events. This current and predicted continuing burden has been recognised by the health system and has resulted in significant improvement in the pharmacotherapy and nonpharmacotherapy treatment of heart failure. Despite this improvement and with the exception of those few who receive cardiac transplantation, there is no cure for heart failure. Whist the advances in therapy have promoted significant improvements in heart failure management, symptoms including breathlessness (dyspnoea) remain a major issue. The Management of Dyspnoea in Advanced Heart Failure project explored and assessed the current therapeutic management of dyspnoea in advanced heart failure and examined two potential therapeutic options namely nebulised frusemide and long-term oxygen therapy. Following a comprehensive review of the nebulised frusemide literature, The Haemodynamic Effects of Nebulised Frusemide in Heart Failure study showed that nebulised frusemide did have an impact on the haemodynamic parameters of participants. Whilst many consider oxygen therapy as a common sense approach for breathlessness, the lack of scientific evidence for its use in chronic breathlessness with people who have normal or mildly low oxygen levels has prevented funding to supply oxygen therapy to this group of patients. The O2 Breathe Study is a palliative care study that is testing long-term home oxygen therapy versus medical air in patients who do meet the current funding arrangements. The analysis of the screening data showed that the symptom burden as a result of dyspnoea is similar to that seen in cancer and respiratory patients, and heart failure patients had lower levels of physical functioning than the respiratory group. Whilst the design of the studies in this thesis will not allow conclusions to be made regarding their efficacy for dyspnoea management in heart failure, they have provided preliminary data and hypotheses to be tested in the future. / Doctor of Philosophy (PhD)