tudies in teaching and non-teaching hospitals have shown that one- quarter to one-third of all patients receive an antimicrobial (AMC) drug during their hospital stay." 1-30 Many of these patients (ranging from 30 to 60%), particularly those on the surgical services, have no definite evidence of infection. Inquiry regarding the use of AMC drugs can be traced back more than two decades. In 1961, the Commission on Professional and Hospital Activities in its Professional Activity Study (CPHA-PAS) surveyed 24 hospitals." They found that approximately 27% of all patients were given an AMC drug; however, it was estimated by PAS that only about 12% of these patients should have received AMC therapy under the most conservative medical practice.

The increasing prevalence of substance use disorder (SUD) is a major public health crisis in the Unites States. Adolescence is an ideal period for early intervention to reduce the risk of SUDs in adulthood, as research has shown that up to 60% of adult SUD could have been avoided by early intervention in youth. Prior research has typically focused on urban metropolitan areas when describing adolescent substance use. However while the data is varied, several studies have shown that the prevalence of rural adolescent substance use is equal or greater than that of their urban peers, particularly alcohol, tobacco, and prescription drug use, and begin use at an earlier age. There are several methods of treatment for adolescent substance use and SUD, centered on evidence-based practices, which have been shown to be moderately effective at reducing substance use. Despite the existence of these treatment strategies, substantial disparities exists with respect to the number of adolescents who could potentially benefit and the number who actually enroll in treatment. It has been estimated that 90% of adolescents in need of treatment are not able to succeed in receiving it. This highlights the importance of understanding the circumstances in which youth initiate drug use and the unique barriers they must overcome to receive treatment when these behaviors develop into a pattern that impacts daily life. With this information, interventions can be targeted to reduce the magnitude of the most significant barriers in order to increase treatment utilization, especially in rural areas where adolescents face unique challenges to treatment access as a consequence of their remote locations. A literature review was conducted and found the major barriers in access to substance use treatment for adolescents to be a lack of available treatment programs, lack of treatment options including medication treatment, lack of perceived need or motivation for treatment, social stigma, socioeconomic status (SES), familial relationships, and referral services. These studies were all conducted in the United States and published from 2011-2020. The aim of this thesis is to propose a protocol for the completion of a systematic review to determine which barriers exist to adolescents receiving substance use treatment and to examine them in the context of rurality. Healthcare decisions and policy are informed by the best available evidence from systematic research and incorporated into evidence-based practices. A systematic review will summarize the findings of all relevant studies thereby making the key information more accessible to decision makers, including clinicians and policy makers, in order for substance use treatment to become more accessible to adolescents.

Assignment of the master's thesis is, to design winery, with possibility of accommodation. The aim, is to create a comprehensive urban - architectural project of area, which is based on the use of local resources to support rural, economic and social development in the region of South Moravia. The area is situated on the outskirts of the village Strachotín, which is part of the site Novomlýnska nádrž. The urban concept should attract people, not just domestic, but also international clients, because of the proximity to Austria, Slovakia borders, and because of a good connection to the highway D2. Important was, to create a supporting function_WELLNESS, which complements the lack of capacity of the accommodation and offers services that are not around. A prerequisite, for immediate gripping the concept in the country, is also the existence of several hiking, biking, wine routes which pass through the area. The good thing is a close proximity to water, which I use in eco - energy concept, but also for recreation, relaxation purposes. The core project is the integration of new technologies in wine production, architecture, town planning, to create facilities, operating with minimum power consumption and minimal burden on nature. From the operational point of view, I separated the two ongoing operation of buildings-WELLNESS-located at the bottom of the plot, with access from Sklepní street, and linked with water. -WINERY- with accessing comunication from the existing path, with the possibility to access directly to winery by 3m wide drivable pavement and with beautiful views . Buildings are connected with educational wine route. Visually, the project is built on the use of excavated soil, formed in the mounds, which should symbolize "volumes exserted from the ground" with the metaphorical meaning of interface with nature. Urban and architectural design is in a harmony with the country - respects terrain conditions, using solar energy, and natural material solution that is designed in its crude form.

A number of studies have examined variables associated with medical use. However, most of the studies deal with samples that are not easily generalizable to other populations. In particular, no study is known to have looked at general medical use among people seeking services for marital and family problems. In this study, medical use of participants from the marriage and family therapy services at Brigham Young University Comprehensive Clinic was investigated to determine the best predictors of general medical use. Best subsets multiple linear regression showed that the best overall predictors of general medical use were anxiety and hostility.

OpenStack is currently the most popular open source platform for Infrastructure as a Service (IaaS) clouds. OpenStack lets users deploy virtual machines and other instances, which handle different tasks for managing a cloud environment on the fly. A lot of cloud platform offerings, including the Ericsson Cloud System, are based on OpenStack. Despite the popularity of OpenStack, there is currently a limited understanding of how much resource is consumed/needed by components of OpenStack under different operating conditions such as number of compute nodes, number of running VMs, the number of users and the rate of requests to the various services. The master thesis attempts to model the resource demand of the various components of OpenStack in function of different operating condition, identify correlations and evaluate how accurate the predictions are. For this purpose, a physical OpenStack is setup with one strong controller node and eight compute nodes. All the experiments and measurements were on virtual OpenStack components on top of the main physical one. In conclusion, a simple model is generated for idle behavior of OpenStack, starting and stopping a Virtual Machine (VM) API calls which predicts the total CPU utilization based on the number of Compute Nodes and VMs.

To design a pedestrian crossing area reasonably can be a demanding task for traffic planners. There are several challenges, including determining the appropriate dimensions, and ensuring that pedestrians are exposed to the least risks. Pedestrian safety is especially obscure to analyze, given that many people in Stockholm cross the street illegally by running against the red light. To cope with these challenges, computational approaches of trajectory data visual analytics can be used to support the analytical reasoning process. However, it remains an unexplored field regarding how to visualize and communicate the street-crossing spatio-temporal data effectively. Moreover, the rendering also needs to deal with a growing data size for a more massive number of people. This thesis proposes a web-based interactive visual analytics tool for pedestrians' street-crossing behavior under various flow rates. The visualization methodology is also presented, which is then evaluated to have achieved satisfying communication and rendering effectiveness for maximal 180 agents over 100 seconds. In terms of the visualization scenario, pedestrians either wait for the red light or cross the street illegally; all people can choose to stop by a buffer island before they finish crossing. The visualization enables the analysis under multiple flow rates for 1) pedestrian movement, 2) space utilization, 3) crossing frequency in time-series, and 4) illegal frequency. Additionally, to acquire the initial trajectory data, Optimal Reciprocal Collision Avoidance (ORCA) algorithm is engaged in the crowd simulation. Then different visualization techniques are utilized to comply with user demands, including map animation, data aggregation, and time-series graph. / Att konstruera ett gångvägsområde kan rimligen vara en krävande uppgift för trafikplanerare. Det finns flera utmaningar, bland annat att bestämma lämpliga dimensioner och se till att fotgängare utsätts för minst risker. Fotgängarnas säkerhet är särskilt obskyrlig att analysera, eftersom många människor i Stockholm korsar gatan olagligt genom att springa mot det röda ljuset. För att klara av dessa utmaningar kan beräkningsmetoder för bana data visuell analys användas för att stödja den analytiska resonemangsprocessen. Det är emellertid ett oexplorerat fält om hur man visualiserar och kommunicerar gataövergången spatio-temporal data effektivt. Dessutom måste rendering också hantera en växande datastorlek för ett mer massivt antal människor. Denna avhandling föreslår ett webbaserat interaktivt visuellt analysverktyg för fotgängares gatöverföring under olika flödeshastigheter. Visualiseringsmetoden presenteras också, som sedan utvärderas för att ha uppnått tillfredsställande kommunikation och effektivitet för maximal 180 agenter över 100 sekunder. Vad beträffar visualiseringsscenariot, väntar fotgängare antingen på det röda ljuset eller tvärs över gatan; alla människor kan välja att stanna vid en buffertö innan de slutar korsa. Visualiseringen möjliggör analysen under flera flödeshastigheter för 1) fotgängarrörelse, 2) rymdutnyttjande, 3) korsfrekvens i tidsserier och 4) olaglig frekvens. För att förvärva den ursprungliga bana-data är Optimal Reciprocal Collision Avoidance (ORCA) algoritmen förknippad med folkmassimuleringen. Därefter utnyttjas olika visualiseringstekniker för att uppfylla användarnas krav, inklusive kartanimering, dataaggregering och tidsserier.

Sjuksköterskors attityd till omvårdnadsforskning och forskningsanknytning i sitt omvårdnadsarbete är en del i omvårdnadens utveckling. Denna studie har för syfte att beskriva psykiatrisjuksköterskors attityd till omvårdnadsforskning och forskningsanknytning. Frågeformulär skickades till 40 slumpmässigt utvalda sjuksköterskor inom vuxenpsykiatrisk vård på ett universitetssjukhus i södra Sverige. Data har bearbetats i SPSS 11.5 och redovisas med frekvenstabeller och diagram. Resultat från 26 erhållna frågeformulär visar att psykiatrisjuksköterskorna hade en positiv attityd till forskning men att resultat från forskning inte används i någon större utsträckning. Vidare visade resultatet en begränsad forskningsmedvetenhet. Organisatoriska insatser såsom stöd och engagemang från chefer, utbildning i vetenskapliga metoder samt stöd i tillämpningen av forskningsresultat och utveckling mot evidensbaserad vård skulle främja sjuksköterskors forskningsanknytning. / Nurses` attitude to nursing research and research utilization in their field of work is a part of the nursing development. This studies aim is to describe psychiatric nurse’s attitude towards nursing research and research utilization. Questionnaires were sent to 40 randomly selected nurses within adult psychiatric care in a university hospital in the south of Sweden. Data was processed in SPSS 11.5 and described with frequency tables and diagrams. The result from 26 received questionnaire showed that psychiatric nurses have a positive attitude to research but they do not use the results of research to any large extent. Further more the results showed limited research awareness.Organizational efforts such as support from managers, education in research methods, support to bring research results into practice and development towards evidence based care would promote nurses research utilization.

This study examined the impact of injuries on the hospital resource utilization rate among trauma patients admitted to the Johnson City Medical Center (TN, USA), a rural Level I trauma center, due to accidents caused by farm animals. A total of 52 patients aged >3 years were studied, with the average age being 44 years. Patients above 65 years of age made up almost a quarter of the study population (23%); 63% of the patient population were male. All patients survived their injuries. Twenty-six percent of the patients required orthopedic intervention, with the majority of those patients being male (nine males, five females).

Wireless Sensor Networks (WSNs) experiences several technical challenges such as limited energy, short transmission range, limited storage capacities, and limited computational capabilities. Moreover, the sensor nodes are deployed randomly and massively over an inaccessible or hostile region. Hence, WSNs are vulnerable to adversaries and are usually operated in a dynamic and unreliable environment. Animal tracking using wireless sensors is one such application of WSN where power management plays a vital role. In this paper, an energy-efficient hybrid routing method is proposed that divides the whole network into smaller regions based on sensor location and chooses the routing scheme accordingly. The sensor network consists of a base station (BS) located at a distant place outside the network, and a relay node is placed inside the network for direct communications from nodes nearer to it. The nodes are further divided into two categories based on the supplied energy; such that the ones located far away from BS and relay have higher energy than the nodes nearer to them. The network performance of the proposed method is compared with protocols like LEACH, SEP, and SNRP, considering parameters like stability period, throughput and energy consumption. Simulation result shows that the proposed method outperforms other methods with better network performance.

This paper focuses on the major decision variables and appertaining decision makers in the selection of long term health care facilites. The literatures identifies principal decision makers as physicians and females between the ages of 45 and 65, and that the decision making process is usually rushed, haphazard, and guilt-ridden. The results of the study cite five decision factors perceived as most important by physicians and females age 45 to 65. The study concludes by comparing these results and recommending a more aggressive marketing communeiations effort by long term health care facilities.