Chronic obstructive pulmonary disease (COPD) is expected to become the third most common cause of mortality in the world (GOLD Committee, 2009). COPD management continues to play a large role in everyday medical practice and inhalation therapy will continue to be a mainstay of COPD treatment. Very little is known about how prescribers choose drug-delivery devices for their clients with COPD. This study examined the current practice related to COPD inhalation devices among physicians working in a small rural community hospital. . Results showed that the most frequently prescribed device for patients was a DPI in the community setting and that nebulizers are most commonly prescribed in the emergency department. Physicians reported various factors that they consider when prescribing an inhalation device; ease of use for the patient, disease severity, cost to the patient, and therapeutic response. Physicians expressed that disease severity as the most important factor.

Continuous and pulsed voltage stressmg of metal oxide semiconductor (MOS) transistors and capacitors has been mvestigated. The expenmental work followed a survey of failure mechanisms in semiconductor devices which Identified Electrical Overstress Damage (EOS)/Electrostatic Discharge (ESD) damage as the most frequent cause of failure, accounting for over 50% of all damage observed. The survey itself, covered all aspects of semiconductor reliability including reliability modelling and quality assurance. A qualitative model of oxide breakdown in MOS structures was developed as a result of the experimental work. Two different mechanisms have been proposed for continuous and pulsed voltage breakdown. Continuous voltage breakdown simulating EOS conditions, was temperature and voltage dependent. The long time-scales involved, lead to a model whereby breakdown IS the result of conduction of charge earners through the oxide, via electron traps and impunty Sites with energies m the forbidden gap. Pulsed voltage breakdown simulating ESD, was voltage dependent but not temperature dependent. The very short time-scales involved indicate that breakdown is the direct result of electron transport m the oxide conduction band. Electrons are inJected into the conduction band via quantum-mecharucal tunnelling from the cathode. Both mechanisms were found to be dependent on the surface charge concentratiOn of the Silicon and, therefore, polanty dependent. The models explain this effect by analysing the charge injection process under high electric fields.

Background: In 2011, 45% of the 6.1 million pregnancies in the United States were unintended. Of the unintended pregnancies, 50% were attributed to contraceptive failure or method non-adherence. Long-acting reversible contraceptives (LARCs) are birth control methods consisting of intrauterine devices (IUDs) and the birth control implants that are the most effective forms of reversible contraceptives. LARCs are 20 times more effective than other birth control methods; yet only 5.6% of women are choosing LARCs. Despite multiple pharmacological and non-pharmacological interventions prior to the procedure, 35% of women reported having moderate pain and 42% of women had severe pain associated during the IUD placement Purpose: The purpose of this quality improvement project was to identify health care providers’ knowledge and practice of pain management methods for IUD insertion in iparous women at a military medical treatment facility (MTF). Methods: This DNP quality improvement (QI) project used a quantitative descriptive methodology with a pretest-posttest design and educational intervention to identify the current practice and knowledge primary care providers have regarding appropriate pain management for iparous women when placing an IUD. Results: The providers’ responses reflect a self-efficacy represented by a knowledge increase in the areas of the limited benefit of premedication with either oral analgesics or cervical softening agents, placing an IUD based on the patient’s menstrual cycle, incorporating the use of a local analgesic, and the connection between counseling and patient satisfaction. Limited provider knowledge can be suggested by the varied responses regarding the topic of a CPG. Self-efficacy stayed stable for the areas of post-procedural NSAID use and having the time for counseling regarding expected pain during the procedure. Conclusion: Improving provider knowledge, skill, and counseling techniques can help decrease the expected and perceived pain for iparous women having an IUD placed leading to an increase of women having IUDs placed. An ultimate goal is to increase IUD use and retention, leading to decreased unintended pregnancy rates, lower maternal and newborn mortality, and improving patient satisfaction when having an IUD placed.

With the need for the development of renewable sources of energy, organic photovoltaic (OPV) has been attracting researchers’ interest for the past decades. This solar technology utilizes carbon-based semiconductors instead of conventional inorganic materials which enables inexpensive, lightweight and flexible roll-to-roll fabrication of large area solar panels with a very short energy payback time. Device efficiencies have rapidly increased to above 18% within the last few years, becoming competitive with solar technologies available on the market. However, research has been focused on the maximization of efficiencies at all cost leading to synthetically challenging materials and processes with negligible commercial scalability. In this thesis, silicon phthalocyanines (SiPcs), synthetically facile molecules most known for their extensive use as dyes and pigments in the industry, were employed as low-cost and scalable active materials for OPV devices. We also report the use of layer-by-layer deposition of the donor and acceptor layer providing a more scalable process compared to the conventional blended heterojunction morphology. Different SiPc derivatives, both soluble and non-soluble, were used as acceptors, paired with different donor polymers (P3HT, PCDTBT, and PBDB-T) and integrated into hybrid evaporation-solution and all-solution layer-by-layer OPV devices. Significant device engineering and optimization was performed through the investigation of several processing conditions such as solvent choice, spin-speed, concentration and annealing temperature/time. In particular, all-solution processed SiPc-based bilayer OPV devices achieved PCEs above 3% with Voc above 1 V, which was similar to performances of corresponding BHJ OPVs. SiPc derivatives also demonstrated their ability to act as electron transport layers in perovskite solar cells. These results further establish the potential of SiPc derivatives as active materials in different solar technologies, while promoting the use of the bilayer structure in OPV devices.

As the population ages, the need for intelligent solutions to mobility concerns increases. Many existing products succeed in targeting the functional aspects of use but fail to address critical psychological and aesthetic elements in the design process. This thesis asks the question: can a walking device address concerns of dignity, beauty, and functionality? / Master of Science

Polymers are frequently utilized in blood-contacting biomaterials. Although, these materials exhibit generally favourable mechanical properties, the presence of these artificial surfaces in contact with blood initiates the mechanisms of thrombosis. This occurrence may, in turn, lead to a variety of serious clinical complications. A great deal of work has been done in this laboratory in the past to investigate the interactions of a variety of proteins (particularly coagulation proteins) with artificial surfaces. This interaction is believed to be the initial step in the physiological response to artificial surfaces in contact with blood. A secondary but equally important process is the adhesion and activation of blood platelets to artificial surfaces which may then lead to the formation of thrombi. The work performed here involves the investigation of platelet-surface interactions with a variety of surfaces, primarily a series of sulphonate ion-containing polyurethanes. Similar polymers have been shown by other researchers to exhibit favourable blood-contacting responses while retaining the attractive mechanical properties of polyurethanes in general. To perform the work outlined above, a novel cone and plate device was designed and built which enables the experimenter to investigate platelet-surface interactions under varying shear flow conditions. Collagen and albumin-coated test surfaces were utilized to investigate the platelet adhesion results generated in the device with varying fluid shear rate and time. A typical adhesion time response curve was generated with increasing levels of adhesion noted for increasing shear rate, as expected due to increased platelet transport to the surface. As well, effective platelet diffusion coefficients were calculated from the adhesion data collected using the collagen surface and was found to agree broadly with those found by other researchers. A series of sulphonated polyurethanes were synthesized and both the bulk and surface properties were characterized. A variety of polymer sulphonate concentrations were achieved by use of different constituent molecules (specifically chain extenders and polyols). The polymers, in general, showed high levels of water absorption and increased hydrophilicity in comparison to non-sulphonated analogs. The cone and plate device was used to investigate the platelet adhesion response in a shear flow environment to these surfaces. In general, sulphonate incorporation resulted in a dramatic increase in the level of adhesion to the polyurethane surfaces, indicating that platelets are able to form adhesive interactions with sulphonate functional groups. Platelet adhesion levels to the sulphonated polyurethanes exhibited both time and shear rate dependence. However, differences in adhesion levels between the sulphonated polyurethanes did not appear to be a simple function of the sulphonate concentration. This may indicate that the local environment of the incorporated sulphonate groups in the polyurethane can affect the ability of these groups to interact with the platelet membrane. / Thesis / Master of Engineering (ME)

In most of today's operating system architectures, device drivers are tightly coupled with other kernel components. In such systems, a fault caused by a malicious or faulty device driver often leads to complete system failure, thereby reducing the overall reliability of the system. Even though a majority of the operating systems provide protection mechanisms at the user level, they do not provide the same level of protection for kernel components. Using virtualization, device drivers can be executed in separate, isolated virtual machines, called driver domains. Such domains provide the same level of isolation to device drivers as operating systems provide to user level applications. Domain-based isolation has the advantage that it is compatible with existing drivers and transparent to the kernel. However, domain-based isolation incurs significant performance overhead due to the necessary interdomain communication. This thesis investigates techniques for reducing this overhead. The key idea is to replace the interrupt-based notification between domains with a spinning-based approach, thus trading CPU capacity for increased throughput. We implemented a prototype, called the Isolated Device Driver system (IDDR), which includes front-end and back-end drivers and a communication module. We evaluated the impact of our optimizations for a variety of block devices. Our results show that our solution matches or outperforms Xen's isolated driver domain in most scenarios we considered. / Master of Science

The Medical Device Excise Tax (MDET) was developed as a funding source to help cover the cost of expanded health care coverage through the Affordable Care Act (ACA). The excise tax is a 2.3% tax on sales of certain medical devices and is paid by the manufacturer of the device (Bolka, 2014). This thesis reflects on the theoretical and conceptual framework that the analysis is based on, including concepts such as success/failure, policy actors, and efficiency/equity. It underlines the importance of framing the argument in the policy making process by analyzing the four main arguments that are developed by the medical device industry including: innovation, jobs, patient care, and loss of global leadership. It also looks at the arguments that were translated into the actions, which were followed by the medical device industry: campaign contributions, lobbying, and interest groups. In conclusion, the importance of unofficial actors, their framing of the issues, and how that framing develops into action are recognized and understood. / Master of Arts

Objectives: Discuss use of a linear incision for placement of a magnetically coupled bone anchored hearing implant. Methods: Case series. Results: Two patients underwent placement of magnetically coupled bone-anchored hearing implants (BAHI) through linear incisions. The first, a 40-year-old female with congenital single-sided deafness, previously had successful implantation of a percutaneous bone anchored hearing implant through a linear incision; unfortunately, she developed pain and intermittent drainage at her abutment site with time, resulting in a request for removal of her device. As an alternative to complete removal, we offered to replace the percutaneous implant with a magnetically coupled BAHI, employing the same linear incision previously. The second patient, a 53-year-old obese female with limited neck mobility and mixed hearing loss, underwent primary placement of a magnetically coupled BAHI through a linear incision. Limitations in neck mobility and patient body habitus precluded use of a traditional C-shaped incision. Both patients underwent surgery successfully, healed without incident, had their devices activated 6 weeks after their procedures, and are able to wear their implants more than 8 hours per day without discomfort. Conclusion: Surgical techniques for bone-anchored implants continue to evolve. Though manufacturers of magnetically coupled devices recommend using C-shaped incisions with large skin flaps, our first reported cases suggest that a small linear incision immediately overlying the implant magnet may be an acceptable alternative. Potential benefits include a smaller incision, less hair removal, smaller flap, decreased surgical time, and less postoperative pain.

Developing full-wave simulators for high-frequency circuit simulation is a topic many researchers have investigated. Generally speaking, methods invoking analytic pre-processing of the device¡¦s V-I relations (admittance or impedance) are computationally more efficient than methods employing numerical procedure to iteratively process the device at each time step. For circuits providing complex functionality, two-port or possibly multi-port devices whether passive or active, are sure to appear in the circuits. Therefore, extensions to currently available full-wave methods for handling one-port devices to process multi-port devices would be useful for hybrid microwave circuit designs. In this dissertation, an efficient scheme for processing arbitrary multi-port devices in the finite-difference time-domain (FDTD) method is proposed. The device¡¦s admittance is analytically pre-processed and fitted into one grid cell. With an improved time-stepping expression, the computation efficiency is further increased. Multi-port devices in the circuit can be systematically incorporated and analyzed in a full-wave manner. The accuracy of the proposed method is verified by comparison with results from the equivalent current-source method and is numerically stable.