Objective: I sought to determine the systolic intensification threshold, time-to-intensification and time-to-follow-up associated with the lowest risk of cardiovascular events or death in primary care patients with hypertension. Methods: A retrospective cohort study of 88,756 patients was performed. Systolic intensification threshold, time-to-intensification and time-to-follow-up were analyzed with respect to risk of acute cardiovascular event or death. The Cox model was adjusted for age, sex, smoking status, socioeconomic deprivation, history of diabetes, cardiovascular disease or CKD, Charlson Comorbidity Index, BMI, medication possession ratio, and baseline blood pressure. Results: During median follow-up of 37.4 months, 9,985 participants experienced acute cardiovascular event or death (11.3%). Systolic intensification thresholds of 130-150 mmHg were associated with no difference in risk, while higher thresholds were associated with progressively greater risk. Risk increased progressively from the lowest (0-1.4 months) to the highest quintile of time to medication intensification. The highest quintile of time to-follow-up (>2.7 months) was also associated with increased risk. Conclusions: Systolic intensification threshold higher than 150 mmHg, delays of greater than 1.4 months before medication intensification following systolic blood pressure elevation, and delays of greater than 2.7 months before blood pressure follow-up following medication intensification were associated with increased risk for acute cardiovascular events or death.

Rorschach records of children tend to contain a high percentage of percepts which pertain to animals and animal details. Since teachers of primary grades deal with many animal pictures and stories in their daily work routine, it may be possible that the records of these persons may show a higher percentage of animal responses than might ordinarily be expected of intelligent adults in the normal population.

Despite popular and professional concerns with schools as institutions where socialization occurs, there are few empirical studies of classroom behaviour. The problem set for the study reported here was to observe classroom behaviour and to provide a theoretical description of what was observed in terms relevant to sociologists' interest in socialization. The thesis is thus a description of "normal form" behaviour in the classroom, with an analytic interest in how that relates to a useful conception of socialization. Socialization is first discussed with respect to some aspects of common culture, taken for granted by adults, but "taught" explicitly in first grade. Following that, the study reports upon the ways in which children acquire membership in the class, rule-learning associated with such membership, and the import of membership acquisition for the goal of socialization as conceived here, i.e. the production of social actors competent to handle "normal environments". It is argued that the classroom is one such environment encountered by children in early life, and that the work of the school as a "socializing agent" cannot be appreciated without some understanding of these matters. / Arts, Faculty of / Sociology, Department of / Graduate

M.Tech.

This study examined differences in oral reading behaviour of 58 grade one children attending achool in Richmond, B.C. Half the subjects received initial reading instruction through a phonics approach; half the subjects received initial reading instruction through a language experience approach. Among the findings were that subjects taught by the phonics approach, which emphasized letter-sound correspondence, produced more oral reading errors, more nonwords, and more substitutions with graphic and sound similarity to the response word than did children instructed by the language experience approach. Subjects taught by the language experience approach produced fewer errors and more substitutions syntactically and semantically acceptable, and more substitutions that did not alter the meaning of the sentence than the children instructed by the phonics approach. An analysis of the children's substitution errors for high, middle and low achievement groups was also discussed. / Education, Faculty of / Graduate

This thesis is a study of primary Abelian groups and height.

No description available.

Includes bibliographical references. / Most patients with type 2 diabetes in Cape Town are attending at primary care community health centers (CHCS) and have unsatisfactory glycaemic control. Insulin therapy is indicated in patients with type 2 diabetes, with inadequate metabolic control on maximum oral therapy. Insulin can be initiated in these CHCs.

The aim of this study was to explore factors contributing to the success of health communication strategies and supporting visual communication tool(s) designed to explain antiretroviral medication (ART) adherence, and motivate young people who live with HIV to follow an adherence regime. The study drew from the social sciences, including psychology, health sciences and communication. Currently there are an estimated 6.8 million people living with HIV in South Africa, making it the site of the largest HIV epidemic in the world (UNAIDS, 2014). Antiretroviral Therapy (ART) is the only effective treatment for HIV and is one of the most demanding medicine regimes, requiring a 90% compliance. Various studies have documented worryingly poor levels of adherence to ART, especially amongst adolescents and young adults in South Africa. The empirical research consisted of a qualitative case study in Khayelitsha, a periurban township on the edge of Cape Town. It focused on young people from Khayelitsha and health care professionals - doctors, nurses, HIV counsellors and pharmacists. Using grounded theory data collection was carried out during two phases of fieldwork, interspersed with periods for data processing and analysis. The principal methods used were focus groups, semi-structured interviews and participant observation. Two key factors emerged from the data that form the basis of a new theoretical understanding: first, concerning how young people become motivated to learn about treatment and adhere to it, and second, concerning how information about treatment can best be communicated to them. In relation to the first of these, findings showed that young people were traumatised by an HIV diagnosis, fearing both that they would get sick and suffer an early death and also that they would be rejected by their belonging groups. This meant that they could not take in the factual information offered, and in addition, had no motivation to do so because the diagnosis resulted in a loss of hope for their present and future lives. According to young people, motivation was an outcome of re-connecting to one or more trusted significant other(s) from within their belonging group, who accepted and supported them. This in turn affirmed their prior belonging identities of son, daughter, cousin or close friend and then reconnected them to their present and future hopes. This renewed motivation to live was the basis for their becoming motivated to learn about treatment and adhere to it. In relation to the second factor, this study found that current communications about treatment were not effective. Specifically, the use of metaphors, which was seen among clinicians as a method of simplifying the complexity of ART adherence messages, was in fact creating confusion. Also, the use of printed information in isolation was not effective; communication was much more effective when it provided a space for discussion. These two key factors form the basis of a health communication strategy for young people who live with HIV and need to adhere to ART. Following on from these findings the study included the production of a film and animation that were identified as the visual communication media that would best support young people's understanding and motivation to adherence. The film presents a case study of a young person who overcame their initial diagnosis shock and, through the acceptance and support of his family, learned to live a normal life with HIV. Young people had said that they wanted to be able to view a film of this kind soon after their diagnosis. The animation, which was designed using a participatory process, used 'iso-type' as the central visual language. It was piloted, and this showed that the best use of a visual communication tool was in a setting that allowed young people to talk about prior losses to HIV within their families and community and about their confusion about treatment, and to ask questions about the meaning of complex biomedical concepts such as an undetectable viral load. All young people who visited the clinics, irrespective of test results, said that they wanted to learn about ART so that they could support friends and family members who lived with HIV, change perceptions about HIV among peers and better prepare in the case of becoming HIV positive themselves. Therefore it is recommended that communication strategies should target patients, their belonging groups and the wider community. This substantive theory contributes knowledge relevant to how ART adherence is communicated to young people. More broadly, this thesis argues that an interdisciplinary approach is required if communication practitioners are to properly understand the meaning that a population attributes to a health challenge; especially in the context of motivation and understanding. It is only when those meanings are fully identified through consolidated social science research that a communication strategy and supporting visual tools can be successfully designed.

Many people seem to agree that arithmetic is hard. Because of this difficulty, there has been a movement to postphone the beginning to arithmetic teaching from first grade to second or third grade. This movement presents an opposing view in relation to other subject matter areas. The actual teaching of other subjects is moving into the lower grades rather than out of the lower grades as teachers realize more and more the importance of these subjects in relation to younger children. Each first grade teacher should realize the resonsibility involved in developing the number readiness that will affect the child's future understanding of the various extensions of the initial concept of number. / Typescript. / "August, 1958." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Science." / Advisor: Sarah Lou Hammond, Professor Directing Paper. / Includes bibliographical references (leaf 39).