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Stellenbosch University

1. Schoonraad, Leilah. Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015.

Degree: MMed, Paediatrics and Child Health, 2018, Stellenbosch University

ENGLISH ABSTRACT: Background: In 2011, the American Academy of Paediatrics (AAP) published revised guidelines for health supervision of children with Down syndrome (DS). In the absence of South African guidelines, we described the health supervision received by children with DS at a regional (level 2) Western Cape Hospital and compared it to the AAP guidelines. Methods: This was a 5 year retrospective description of implementation of the 2011 AAP recommendations at the DS clinic at Worcester Provincial Hospital (WPH), specifically related to cardiac, thyroid, hearing and haematological disorders. Data was extracted from patient medical folders and the National Health Laboratory Database. The proportion receiving screening components was compared between the children using WPH as their primary care facility and children referred from peripheral hospitals. Results: Sixty-two children received care at WPH DS clinic during the study period. Thirty-six (58%) children lived in Worcester while 26 (42%) were referred from peripheral hospitals. The median age at first clinic visit was 0.5 years (interquartile range (IQR) 0.2-1.2), there was a total of 177 person-years of follow up with a median duration of follow up of 1.8 years (IQR 0.3-4.8) and 2 deaths occurred in the study period. Forty nine children (79%) had a screening echocardiogram performed, the median age at first echocardiogram was 0.8 years (IQR 0.2-1.4). Five (13.9%) children from WPH compared to no children from the peripheral hospitals received the echocardiogram within the first month of life (p =0.056). Those requiring cardiac surgery were operated on at a median age of 2years (IQR 0.9-2.3). Compared to the AAP recommendations, within the first month of life 17 (27.4%) children had a thyroid screen, 20 (32.3%) children had a full blood count and 7 (11.3%) children had a hearing assessment. Conclusion: AAP recommendations for health supervision in DS are challenging to achieve within our local health system. The development and advocacy for a South African DS health supervision guideline might improve the care of children with DS.

AFRIKAANSE OPSOMMING: Agtergrond: In 2011 het die Amerikaanse Akademie vir Pediatrie (AAP) gewysigde riglyne oor gesondheidtoesig vir kinders met Down sindroom (DS) gepubliseer. In die afwesigheid van Suid-Afrikaanse riglyne het ons die gesondheidtoesig omskryf wat kinders met DS op streekvlak (vlak 2) by ‘n Wes-Kaapse-hospitaal ontvang het en dit met die AAP se riglyne vergelyk. Metodes: ’n Vyfjaar- retrospektiewe beskrywing van die implementering van die 2011 AAP-aanbevelings by die DS-kliniek van die Worcester Provinsiale Hospitaal (WPH), spesifiek met betrekking tot kardiologiese, tiroïed-, gehoor- en hematologiese versteurings, is gedoen. Data is uit pasiëntlêers en die Databasis van die Nasionale Gesondheidslaboratorium ingewin. Die proporsie van pasiënte wat siftingskomponente ontvang het, is vergelyk tussen die kinders wat WPH as hulle primêresorgfasiliteit gebruik het en kinders wat…

Advisors/Committee Members: Slogrove, Amy, Engelbrecht, Arnold, Urban, Mike, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health..

Subjects/Keywords: American Academy of Paediatrics (AAP); Down syndrome  – South Africa  – Worcester Provincial Hospital; Children with Down syndrome  – Medical care  – Guidelines; Children with mental disabilities  – Medical care; UCTD

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Schoonraad, L. (2018). Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015. (Thesis). Stellenbosch University. Retrieved from http://hdl.handle.net/10019.1/105219

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Schoonraad, Leilah. “Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015.” 2018. Thesis, Stellenbosch University. Accessed October 31, 2020. http://hdl.handle.net/10019.1/105219.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Schoonraad, Leilah. “Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015.” 2018. Web. 31 Oct 2020.

Vancouver:

Schoonraad L. Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015. [Internet] [Thesis]. Stellenbosch University; 2018. [cited 2020 Oct 31]. Available from: http://hdl.handle.net/10019.1/105219.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Schoonraad L. Descriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015. [Thesis]. Stellenbosch University; 2018. Available from: http://hdl.handle.net/10019.1/105219

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. Nano, Tomi F. An apodized-aperture x-ray detector design for improved image quality in mammography.

Degree: 2019, University of Western Ontario

X-ray imaging for early cancer detection, such as screening mammography, requires images with high signal-to-noise ratio (SNR) using low levels of radiation exposure. Conventional detectors consist of a matrix of sensor elements, producing images where each pixel corresponds to a single sensor element. This imposes a fundamental limitation on image contrast and SNR for imaging fine detail for a given exposure. The work presented here reconsiders x-ray image formation using a new x-ray detector design that synthesizes image pixels from a large number of very small sensor elements with the goal of optimizing contrast and SNR. Our new detector design, called apodized-aperture pixel (AAP), makes use of recent technology developments to produce images from an “over-sampled” sensor signal while suppressing both signal and noise aliasing to improve the modulation transfer function (MTF) and detective quantum efficiency (DQE). Signal and noise performance of the AAP approach is described theoretically using a cascaded-systems analysis. This approach preserves the MTF of the small sensor elements up to the image sampling cut-off frequency where the MTF is increased by up to 53%. Frequencies above the cut-off are suppressed, eliminating both signal and noise aliasing artifacts and corresponding to a high-frequency DQE increase by 2.5x. X-ray interactions in a scintillator introduce signal and noise correlations, including x-ray reabsorption and converter blur, resulting in reduced aliasing and decreased improvement in DQE. Best results with the AAP design were obtained using a high-resolution converter, such as selenium (Se), with little impact from reabsorption. Implementation on a Se/CMOS micro-sensor prototype with 7.8μm element size with image pixel size approximately 50μm showed a flat DQE curve (ideal) up to 10cycles/mm. AAP images of resolution test patterns, mammography phantoms, and specimen imaging of micro-calcifications from biopsies showed the expected improvements in SNR and visibility of fine-detail. It is concluded that synthesizing image pixels from small physical sensor elements can increase MTF and DQE, and eliminate aliasing artifacts, for a desired image pixel size. The resulting increase in SNR may benefit all forms of radiography, and in particular mammography, where accurate visualization of fine detail is important for early cancer detection.

Subjects/Keywords: Apodized aperture pixel (AAP); x-ray detector design; detective quantum efficiency (DQE); noise aliasing; signal to noise ratio; cascaded system analysis; Medical Biophysics

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Nano, T. F. (2019). An apodized-aperture x-ray detector design for improved image quality in mammography. (Thesis). University of Western Ontario. Retrieved from https://ir.lib.uwo.ca/etd/6233

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Nano, Tomi F. “An apodized-aperture x-ray detector design for improved image quality in mammography.” 2019. Thesis, University of Western Ontario. Accessed October 31, 2020. https://ir.lib.uwo.ca/etd/6233.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Nano, Tomi F. “An apodized-aperture x-ray detector design for improved image quality in mammography.” 2019. Web. 31 Oct 2020.

Vancouver:

Nano TF. An apodized-aperture x-ray detector design for improved image quality in mammography. [Internet] [Thesis]. University of Western Ontario; 2019. [cited 2020 Oct 31]. Available from: https://ir.lib.uwo.ca/etd/6233.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Nano TF. An apodized-aperture x-ray detector design for improved image quality in mammography. [Thesis]. University of Western Ontario; 2019. Available from: https://ir.lib.uwo.ca/etd/6233

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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