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Health information and its influence on the perception of tuberculosis (TB) patients: Current policies and practices at Brooklyn Chest HospitalNabie, Mubashir Goolam January 2018 (has links)
Magister Administrationis - MAdmin / HIV and TB are major problems in the South African context and the burden of these diseases is proving detrimental to the development of the country. These diseases have been evident in the country for many years and in recent times the infection rates of TB and HIV has been alarming. The World Health Organization (WHO) classified TB as a problem and the world was to actively implement strategies to combat this epidemic.
The issue with TB control strategies is the emergence of HIV which has been the largest contributing factor to the increase in the TB burden in South Africa and many countries like it. South Africa has made great strides in the control of HIV in areas such as mother to child transmission, awareness programs, initiation of ARVs and medical male circumcision which have proven to be successful. In contrast, the TB burden does not share the same fate. The number of deaths caused by TB is continuously rising, as well as the number of new Multi-drug resistant TB cases. Furthermore the emergence of Extreme –drug resistant TB is seen as a sign of a failing health system. Policy makers are now faced with fact that the Directly Observed Therapy Short course (DOTS) program for the prevention of TB is inadequate in an area with a high HIV prevalence, which is what South Africa is faced with.
The research objectives are therefore to identify if knowledge from South African TB policies are being disseminated to people who suffer from TB, also to measure if a lack of knowledge may have an impact on treatment success.
A policy analysis was done of 5 South African TB policies to identify areas of the policies which are patient specific. The TB policies emphasized a patient-centred approach and the researcher used this concept to motivate that patient-specific areas must be known by the
patients. The specific areas identified were: TB specific areas, Treatment specific areas, Adherence specific areas and information/education specific areas. Based on the policy analysis a case study was conducted at Brooklyn Chest Hospital to measure implementation of the policies on the ground.
The study found that education was adequate in areas around TB diagnosis, treatment length, signs and symptoms, and family education. The participants lacked knowledge in areas such as TB contacts, monitoring of TB disease, education of TB prior to diagnosis and a high prevalence of non-adherence and multiple cases of TB were found among the participants. Also, the Chi-Square test found no statistical significance between the length of admission to hospital and treatment outcome. The result also shows that of the participants studied, over 30% of the study had not adhered to TB treatment after discharge.
The study finds that there are significant shortfalls in the knowledge of participants based on South African TB policies, with a high non-adherence rate before and after discharge. The study shows a lack in the implementation of policy directives on education, following a patient-centred approach, which is evident in the lack of knowledge found in the participants in many facets of the TB disease and the processes to control TB.
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Does the spouse influence the individual’s retirement decision? : A quantitative study among older people SwedenNyström, Fredric, Andersson, Gustav January 2019 (has links)
The main objective of our essay is to analyze the influence of the spouse on the partner’s retirement decision. Drawing on a large sample of older citizens and a combination of a postal survey and register data, we use standard econometric techniques to identify the impact of the spouse’s characteristics on the partner’s decision to retire. The results of our estimations show that cohabiting/married males’ decision to retire was negatively affected by their partners’ health condition. On the other hand, cohabiting/married women were more likely to retire if their partner had already retired.
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Konceptgenerering av adaptiv kraftbegränsare / Concept development of adaptive load-limiterAndersson, Mattias, Sjövall, Anna January 2017 (has links)
In an accident, some seatbelt is let out by the seatbelt retractor in the vehicle. This is done to minimize the chest pressure and for the occupant to correctly impact the air bag. In an adaptive load limiter (LLA) the force in the seatbelt could be changed between different levels. In this way the chest pressure and the speed in to the air bag can be optimized and to minimize injuries.The work has been aimed at develop new concept of switching between the high and low force. The goal is to reduce the number of parts, the complexity and the size of the components. The LLA device today is made out of nine components.This work has included brainstorming for ideas of new concepts. The concept have been sketched. The three best concepts have been valued in a concept evaluation matrix. CAD- models have been done. Calculations have been done by hand to see which forces the components will be subjected to. FEM-calculations have also been done to see that components can handle the amount of stress they which they will be subjected to during the switching. Tests of components have also been made to verify the concept on Autolivs test center. The results were then evaluated. The work is ended by recommendations of further development.This thesis has been done on Autoliv Sweden AB in Vårgårda. Autoliv was founded in 1953 in Vårgårda of the two brothers Lennart and Stig Lindblad. Autoliv is world- leading in car safety. Autoliv is currently operating in 27 countries and has over 70 000 employees. They save over 30 000 lives and prevent over 300 000 injuries every year. Autoliv has made seatbelts since 1956. / Vid en krock släpper en bältesrulle i ett fordon ut lite bälte för att personen i sätet skall landa rätt i krockkudden och där med minska tryckskadorna på hen. I en bältesrulle med en adaptiv kraftbegränsare kan kraften i bältet varieras mellan två olika lägen av en växlingsmekanism. På det sättet minimeras trycket på bröstkorgen och hastigheten in i krockkudden kan optimeras.Arbetet har riktats mot att ta fram nya koncept för att växla mellan krafterna. Syftet med det har varit att försöka få ner antalet, minska storleken och komplexiteten på komponenterna i en adaptiv kraftbegränsare. Dagens konstruktion på kraftbegränsare innefattar nio komponenter.Arbetet har innefattat brainstorming för att ta fram nya koncept. Skisser av dessa koncept är gjorda. De tre bästa koncepten har sedan utvärderats i en konceptutvärderingsmatris. CAD- modeller är därefter framtaget. Handberäkningar för att se vilka krafter som komponenter utsätts har genomförts. FEM- beräkningar har gjorts för att se att delar inte går sönder. Provning av komponenter och funktioner är har gjorts på Autolivs test center i Vårgårda. Resultaten har även analyserats och arbetet avslutas med framtida rekommendationer för vidareutveckling.Detta examensarbete har gjorts på Autoliv Sverige AB i Vårgårda. Autoliv grundades 1953 i Vårgårda av de två bröderna Lennart och Stig Lindblad. Autoliv är världsledande inom säkerhet inom bilindustrin. Autoliv är verksamma i 27 olika länder med över 70 000 medarbetare. De räddar årligen 30 000 liv och förebygger över 300 000 skador. De har tillverkat säkerhetsbälten sedan 1956.
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Chronic traumatic encephalopathy and the locus coeruleusHealy, Ryan 12 June 2019 (has links)
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease that is associated with repetitive traumatic brain injury like those sustained in sport, military combat, and other activities with repetitive head impact exposure. Repetitive head impacts typically cause mild traumatic brain injury (mTBI) resulting in both concussive and subconcussive injury. Repeated mTBIs injuries appear to cause an abnormal accumulation of proteins, including hyperphosphorylated tau (p-tau) and TDP-43, progressive axonal failure with gradual structural degradation, microvascular disruption, breach of blood-brain barrier, neuroinflammation and microglial activation; each of these manifestations lead to axonal degeneration and neuronal death, which impairs neuronal pathways and are likely to give rise to CTE symptoms. CTE can be microscopically characterized mainly by p-tau accumulation in perivascular spaces and at the depths of the cortical sulci. Clinical presentation of CTE may include behavioral, mood, cognitive, or motor symptoms. Some of the common symptoms include impulsivity, aggression, anxiety, depression, memory impairment, dementia, and suicidality. The Locus Coeruleus (LC), a nucleus in the pons of the brainstem, is suspected to be involved in CTE. The LC provides the main source of norepinephrine to the entire brain and is critical for its control over arousal, behaviors, attention, and memory. Dysfunction of the locus coeruleus has shown to cause a wide array of symptoms, many of which are similar to those seen in CTE. Furthermore, the LC is affected in many other neurodegenerative diseases and is believed to be responsible for the progressive and widespread nature of the various diseases and their clinical symptoms. Although the LC has been implicated in CTE there have been no studies examining LC pathology in relation to the disease progression or its symptoms. We hypothesize LC CTE pathology should increase with the severity of CTE. Furthermore, increased CTE pathology in the LC should create disturbances to the LC and the LC-NE system and manifest clinically. Specifically, LC CTE pathology may be associated with age of onset of general behavioral and cognitive symptoms as well as individual symptoms and outcomes including impulsivity, depression, depressed mood and death by suicide. To determine this, a postmortem study was performed on 184 individuals with a history of RHI and no comorbid diseases examining the relationship between AT8-immunopositive tau density in the LC and various clinical variables. The study found that LC AT8 density showed a significant positive correlation with duration of repetitive head impact (RHI) exposure when controlled for age. There also was a significant increase in LC AT8-immunoreactive tau in cases with stage III and IV CTE compared to those with no CTE and stage I and II CTE, and AT8 density was predictive of CTE stage when controlled for age. There were no significant relationships found between density of LC AT8-immunoreactive tau and age of any CTE symptom onset or individual symptom (impulsivity, depressed mood, MDD, death by suicide) presence. Future studies should continue to evaluate CTE pathology in the LC and its effects on both the pathological and clinical characteristics of the disease.
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The petrology and geochemistry of the impactite sequence and selected target rocks from the Yaxcopoil-1 borehole, Chicxulub Impact Structure, Yucatan Peninsula, MexicoTuchscherer, Martin Guillaume 14 October 2008 (has links)
Geological and geophysical investigations of the Chicxulub meteorite
impact structure have been ongoing since its scientific recognition in 1991
Hildebrand et al. 1991). The structure is of important significance because it is
currently the only known impact crater that is linked to a global catastrophe, the
Cretaceous/Tertiary boundary that occurred 65 Ma years ago. Major climatic and
biological changes occurred at this interval that include the disappearance of
70% of all living species, in particular the dinosaurs. A global iridium anomaly
along with the occurrence of shocked quartz grains characterize a thin clay layer
this interval that led to the search for a large meteorite impact crater on
continental crust. A large “volcanic” igneous province identified by oil
exploration boreholes on the NW region of the Yucatán Peninsula was eventually
recognized as a vast impactite deposit associated with a 180 km wide crater. Until
2002, only small grab and chip samples had been described from Chicxulub. This
lack of sampling and, thus, poor understanding of the cratering conditions at
Chicxulub led the International Continental Drilling Program (ICDP) to fund and
drill the Yaxcopoil-1 borehole.
The Yaxcopoil-1 (Yax-1) borehole was drilled 60 km south-southwest
from the center of the Chicxulub meteoritic impact. It intersected 794.63 m of
post-impact cover rocks, 100.31 m of impactites, and 616.03 m of Cretaceous
target rocks, terminating at a final depth of 1510.97 m. The impactite interval, as
well as several selected samples from the Cretaceous target rocks, is the focus of this scientific investigation. In conjunction with this work, the Yax-1 core was
studied by numerous international research groups and is, thus, currently one of
the best studied continuous diamond drill core from an impact crater. This
petrographic and geochemical investigation provides further understanding on the
primary and secondary conditions that influenced the formation of the Yax-1
impactites and selected target rocks.
Five units have been recognized in the impactite interval. These
subdivisions are based on macro- and microscopic observations and are
complemented by geochemical characteristics. Unit 1 (795-822 m) comprises
subrounded melt rock particles that are poorly sorted, yet show a progressive gradation with height, are self supported, show perlitic devitrification texture, and
are generally fine-grained. Unit 2 (823-846 m) and Unit 3 (846-861 m) are
relatively similar, as they both consist of a groundmass-supported breccia with
melt rock particles that are angular, fluidal, and vesiculated in texture. The
groundmass in both units is pervaded by numerous carbonate-veinlets and
decreases in volume towards Unit 3 because of compaction. Unit 2 and Unit 1 are
both altered to a predominantly green colour by the pervasive conversion of
silicate phases from clay minerals. Unit 3 is of a variegated character and is
suggested to be the less altered unit bove Unit 4. Unit 4 (861-885 m) comprises a
massive yet brecciated microcrystalline impact melt rock. It is primarily of a
silicate composition and contains only minor secondary carbonate crystals. All
lithic fragments are of silicate compositions. Unit 5 (885-895 m) shows the
greatest variation in the proportion of melt rock particles and lithic fragments.
The melt rock particles contain numerous microlites that crystallized below the
glass-transition temperature. These are suspended in a carbonate groundmass that
is either of a primary impact melt origin or of a secondary nature. Units 1 and 5
both contain foraminifera fossils and greater proportions of carbonate clasts than
any other units. All unit show shock metamorphic characteristics, i.e., planar
deformation features, ballenquartz, and checkerboard feldspar.
Geochemical results have been obtained by various analytical techniques
in order to constrain cratering and alteration processes at various sampling scales.
Main results reveal that samples from units 1 and 2 have been leached of their
alkali elements, show negative Ce anomalies on a microscopic scale, and show
less major element variation on a bulk sample scale than lower units. The
groundmass in units 1 to 3 comprises a microcrystalline calcite and altered alkali
element-, Ca- and Si- rich cement. In units 2, 3, and 5 melt rock particles are of a
heterogeneous composition. In Unit 1, melt rock particles are highly altered,
therefore volatile rich, and are of a more homogeneous composition than those of
other units. On a bulk sampling scale, the silicate component for the whole
impactite sequence shows remarkable homogeneity. Major and trace element
compositions show that this component and Unit 4 are typical of the upper
continental crust. The carbonate component is more calcite rich than dolomitic and most likely represents strong secondary alteration. No significant sulfur
content was measured compared to published known target rock values. The
contents of the siderophile elements, including Ni, Co, Ir, and Cr, do not indicate
the presence of a significant extraterrestrial component in the Yax-1 impactites.
Cretaceous rocks were also sampled in order to provide compositional
constraints with the impactites and observe any shock related metamorphic
features. Petrographic observations indicate that the Cretaceous rocks in the
Yaxcopoil-1 drill core likely register a multistage deformation history that spans
the period from pre- to post-impact. Contrary to previous studies that claimed
evidence for the presence of impact melt breccia injection veins, no evidence was
found from samples located between 1347–1348 m depth for the presence of melt
breccia.
An emplacement mechanism for the impactite sequence is proposed with
regards to cratering. Unit 5 is interpreted as an early ejecta deposit that was
emplaced following the passage of the initial ejecta curtain during the excavation
stage of cratering. Unit 4 is an allogenic siliceous melt rock body that originated
primarily from the fusion of the silicate crystalline basement. The origin of Unit 4
is based on geochemical and petrographic arguments, i.e., no carbonate
component to the melt could be detected and only igneous/metamorphic
mineral/rock fragments were observed in it. It is suggested Unit 4 was emplaced
as an outward flow of fused crystalline basement rocks from the collapsing central uplift or it may have also been deposited from the fallback of a large melt bomb.
Brecciation occurred post-deposition as fragments fit together like pieces of a jigsaw
puzzle. Units 2 and 3 represent unreworked fallback suevite deposits.
Vesiculated melt rock particles are a testimony of the volatile rich nature of the
collapsing impact plume. Volatiles are believed to have helped disperse the
suevite and inhibited the melt rock particles from undergoing compositional
homogenization. Unit 1 represents a reworked fallback deposit that formed from
the resurge of seawater into the impact basin. Unit 2 is the altered equivalent of
Unit 3 and along with Unit 1 underwent significant post-depositional
phyllosilicate alteration from circulating fluids at the top of the suevite pile.
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The perceptions of first year students on the impact of relocation on their adjustment at university : a relocation study.Nkuna, Joy Manini 13 February 2009 (has links)
The research aims to establish the perceived impact of relocation on first year student’s
ability to cope with academic demands at University.
The research intends to answer the following questions: How do first year students
perceive their adjustment at University? Has the relocation impacted on the students
functioning on any level? For example: -Academically, Emotionally, Physically and
Socially.
A large number of young adults relocate due to the need to pursue their chosen careers at
the University. However, this happens at a time in their life when there is a lot of turmoil
around social and individual identity and the pressures from society to achieve, including
pressures to secure their future. This happens independently from parents and relevant
social ties when students study away from home.
A qualitative methodology was used for the research. The sample consisted of 10 Black
female post matric first year students at University. The age range of participants was
between 17 and 20. Data was collected through the use of semi structured interviews.
Gathered data was analyzed using thematic content analysis. This involves organizing the
data into categories on the bases of the themes and concepts. The concepts were then
linked up in the form of a sequence. Eight steps were then followed when analyzing the
data, which forms part of the criteria for thematic content analysis.
Results obtained indicate that students find relocation to be a perturbing experience
which pushes one out of their comfort zone into the unknown. This experience forces one
to make numerous adjustments. The move taps into one's ability to deal with ambiguities,
function independently and implement a task to deal with unanticipated challenges. Thus
students are expected to take on the role of young adulthood. This brings with it the
reality that they now have to be independent. As a result of this, most students get
involved in what is called goal modification, namely focusing on what they would like
instead of focusing on what their parents would want.
The process is challenging as one is going through a process of loss and, in other ways,
gain. The loss of social capital is felt as having a negative impact on academic
performance. This is because students loose their source of motivation, support and
reliable company. They now have to source it within themselves, an attribute which has
proven to be difficult. Relocation is viewed as a compounding variable to other
challenging factors to students. Hence the students’ relocation is perceived to be a
variable which tends to have a negative affect on students’ academic performance. This is
due to the fact that relocation tends to create a sense of discontinuity from known
academic structures, social support ties and familiar surroundings. The loss of the above
mentioned factors tends to aggravate the process of academic adjustment.
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A systematic review of available information concerning the economic impact of HIV/AIDS on SwazilandMuwanga Fred Tusuubira 08 November 2006 (has links)
A research report submitted to The Faculty of Health Sciences, University
of Witwatersrand, in fulfillment of the requirements for the degree
Of
Masters in Public Health
Johannesburg 2005 / ABSTRACT
Swaziland is currently faced with a deepening HIV/AIDS epidemic. A systemic
review of available information concerning the economic impact of HIV/AIDS on
Swaziland was undertaken to collate data and document this impact in order to
inform decision makers and planners. The methodology for the systematic review
was based on the guidelines described in the Cochrane Reviewers’ handbook.
HIV/AIDS has significantly increased the vulnerability of affected Swaziland rural
households to environmental shocks. There is an increased burden of orphans
due to HIV/AIDS, reduced household labour and income as adults die of AIDS.
HIV/AIDS has reduced farm productivity leading to worsening of food insecurity
and poverty in affected households.
Due to HIV/AIDS, absenteeism in Swaziland organizations has increased by 20-
fold. HIV/AIDS is currently the leading cause of death accounting for over 60
percent of all employee deaths. Organisations that have implemented HIV/AIDS
workplace responses have been less affected.
The micro-sector is the worst affected and it is recommended that policy makers
ensure that this sector is protected from the negative impact of HIV/AIDS. The
epidemic of negative impacts of HIV/AIDS in Swaziland has not yet reached the
peak.
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Efeitos da orientação das fibras de colágeno nas propriedades mecânicas de flexão e impacto dos ossos / Collagen fiber orientation effects on the bone mechanical properties of bending and impactHolanda, Adriano de Jesus 08 October 1999 (has links)
A relação entre as propriedades mecânicas de fêmures de celhos obtidas nos ensaios de flexão em três pontos e impacto, e a orientação das fibras de colágeno foi estudada, bem como a relação entre a energia absorvida nos dois ensaios. O limite máximo, limite proporcional, rigidez, resiliência e tenacidade foram obtidos a partir de ensaio de flexão em três pontos de 20 fêmures esquerdos de coelhos. A energia absorvida (tenacidade) no impacto foi obtida utilizando os 20 fêmures direitos. A orientação das fibras de colágeno foi estimada utilizando a técnica de polarização da luz incidente. A análise de regressão mostrou que no ensaio de flexão, a rigidez teve correlação positiva (R=0,43) e a resiliência, correlação negativa (R=-0,46) com a orientação das fibras de colágeno. A energia absorvida no impacto não apresentou índice de correlação significativo (p<0,05). A energia absorvida no ensaio de impacto pelos fêmures foi 4,73 vezes a energia absorvida ensaio de flexão, havendo diferença significativa entre os dois valores / The relationship between the mechanical properties of rabbit femurs in three-point bending and impact tests and collagen fiber orientation was studied, as well as the proportion between absorbed energy in both tests. Maximum limit, proportional limit, stiffness and resiliency were measured in 20 left rabbit femurs by three point bending tests and the absorbed energy was measured in 20 right rabbit femurs by impact tests. Collagen fiber orientation was estimated using polarized light. Regression analysis showed that in bending, stiffness has significant positive correlation (R=0,43) and resiliency has significant negative correlation (R=-0,46) with collagen fiber orientation. Absorbed energy in impact showed no significant correlation with collagen fiber orientation. The absorbed energy in impact tests was 4,73 times the absorbed energy in three point bending tests, with significant difference between the two values
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O impacto da vegetação nos microclimas urbanos / The Impact of vegetation in urban microclimatesShinzato, Paula 24 April 2009 (has links)
O objeto desta pesquisa são os efeitos da vegetação nas condições microclimáticas urbanas, partindo-se da premissa que a presença da vegetação influencia o microclima do seu entorno imediato. A partir de diferentes formas de distribuição das áreas verdes na cidade e com o uso de espécies locais, o objetivo é quantificar a intensidade e a distribuição espacial dos efeitos microclimáticos da vegetação, principalmente as alterações de temperatura do ar e superficial no nível do pedestre, utilizando-se modelos de balanço de energia e ferramentas computacionais. Foram feitas simulações paramétricas no ENVI-met a fim de investigar o efeito da distribuição de áreas verdes (linear, grandes massas verdes concentradas ou pequenos agrupamentos distribuídos em diferentes distâncias) e por meio das medições de campo pode-se quantificar a importância da vegetação (gramíneas, arbustos e arbóreas) nos aspectos climáticos. Os resultados mostram que o efeito da vegetação é local e não ocorre uma influência significativa muito além dos limites das áreas verdes. Em relação à intensidade do efeito da vegetação, a diferença média entre as temperaturas do ar nas áreas verdes arborizadas e as ruas adjacentes é de 1.5ºC. Já o sombreamento pelas árvores de copa densa (LAI=10), mostrou diferenças médias de 23ºC, nas temperaturas superficiais do solo, embaixo da copa. Esse resultado indica que o uso das árvores é uma estratégia para amenizar o efeito de ilha de calor nas metrópoles, pois evita o aquecimento de materiais como asfalto e concreto e a liberação da radiação de onda longa acumulada durante a noite. / The main purpose of this research is the effects of vegetation in urban microclimate conditions, under the premise that the presence of vegetation influences the microclimate and its surroundings. Considering different forms of green space distribution and using native species, it could quantify the intensity and spatial distribution for the microclimate effects by a vegetated area. The modifications of air temperature and the surface temperature at the level of the pedestrians were analyzed based on energy balance and computer models. Parametric simulations on ENVI-met were done to investigate the effect of green areas distribution (linear forms, large mass of vegetation and small groups of trees) and were compared with on-site measurement data. The simulation results showed the impact of urban vegetation for climatic aspects. The outputs indicated that the vegetation effect is local and do not have a significant influence beyond the limits of the green area. Regarding to the intensity of vegetation effect, the average difference between air temperature under the trees and above the streets is 1.5ºC. While the shadowing of a dense tree (LAI=10) showed an average difference of 23ºC for superficial temperatures between green spaces and the street. This result pointed out that green area is an important strategy to mitigate the heat island effect in city centers, as it can prevent asphalt and concrete from heating and releasing long wave radiation during night time.
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The Economic Impact of the 2002 Olympic Winter Games in Salt Lake CityWallman, Andrew January 2006 (has links)
Thesis advisor: Christopher F. Baum / This paper seeks to estimate the impacts generated from the Salt Lake City 2002 Winter Olympic Games. Using a data set representing 76 metropolitan statistical areas in the western United States, and later 31 metropolitan statistical areas in Utah and its bordering neighbors, I construct an Arellano-Bond dynamic panel data regression that seeks to model metropolitan employment growth had the Olympics never taken place. With this logic I apply the Arellano- Bond regression to real personal income and real average wages, in a vector autoregression framework, estimating gains to those variables over a reasonable timeframe. The predictions from these variables are then compared to actual figures in which a picture of the economic impact of the 2002 Games is generated. Using out of sample predictions I estimate Salt Lake City's Olympic impact in employment is roughly between 20,487 and 36,150 job-years, between $ 381 and $ 2,470 to real per-capita personal income, and a decrease of $ 273 to $ 2004 in real average wages. / Thesis (BA) — Boston College, 2006. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Economics Honors Program.
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