Obstructive sleep apnea (OSA) is underrecognized. Between 10% and 69% of preoperative patients have undiagnosed OSA. To reduce the risk of peri-operative complications related to undiagnosed OSA, patients planned to undergo bariatric surgery are screened for OSA. To understand the OSA detection rate with screening practices, the prevalence of OSA within patients who underwent publicly funded bariatric surgery in Ontario between 2010 and 2016 was measured. Secondly, to understand the effect of OSA screening practices on perioperative and longer-term health care costs, health care utilization and costs were compared between patients with OSA and matched patients without OSA in the 30 days post-bariatric surgery, as well as in the 1 year post-bariatric surgery. The Ontario Bariatric Registry (OBR) linked to the ICES health administrative databases were used. A diagnosis of OSA was identified if recorded in the OBR at time of initial bariatric consultation, or if recorded in ICES databases from the bariatric surgery admission records. Costs were calculated based on the “Guidelines on Person-Level Costing Using Administrative Databases in Ontario” using ICES costing algorithms. The overall prevalence of OSA was 47% (95% CI 46% to 47%). Total health care costs per patient, in the 30-day post-operative period, were 1% lower (95% CI 1% to 1%, p < 0.001) in patients with OSA compared to matched patients without OSA. Similarly, at 1 year postbariatric surgery, total health care costs per patient, were 1% lower (95% CI 1% to 1%, p < 0.001) in patients with OSA compared to matched patients without OSA. At 30 days and 1 year, this difference was driven by lower hospitalization-related costs. OSA screening practices at surgical centers in our network led to similar rates of OSA detection as reported in the literature. However, the literature suggests that screening practices lead to missed OSA diagnoses. Further study is required to understand the reduced post-bariatric surgery costs in patients with OSA compared to matched controls without OSA; and, we postulate that missed OSA diagnoses may be a contributor. / Thesis / Master of Science (MSc) / Obstructive sleep apnea (OSA) is underrecognized and a good proportion of patients with OSA are undiagnosed. To reduce the risk of peri-operative complications related to undiagnosed OSA, patients planned to undergo bariatric surgery are screened for OSA. To understand the performance of OSA screening practices, using a province-wide registry, the proportion of patients diagnosed with OSA within patients who underwent publicly-funded bariatric surgery in Ontario between 2010 and 2016 was measured at 47%. Furthermore, to understand the effect of OSA screening practices on peri-operative costs and longer-term health care costs, health care utilization and costs were compared between patients with OSA and matched patients without OSA in the 30 days and 1 year post-bariatric surgery. Total health care costs per patient were 1% lower in patients with OSA compared to patients without OSA, and this difference was driven by lower hospitalization-related costs.

Finding health information online continues to help patients understand new symptoms. However, incomplete information or advice that errs on the site of caution can cause distress or anxiety and prompt visits to a doctor. Cyberchondria, a new phenomenon, is defined as excessive compulsive searching for health information online that leads to distress and increase utilization of healthcare services. Grounded theory guided the conception of a mixed method study to investigate cyberchondria and symptom appraisal within Emergency Departments. A questionnaire and interviews were used to collect data from patients visiting a local Emergency Room. Results showed 63.3% of respondents looked up their symptoms online before their visit, and exhibited higher levels of cyberchondria and health anxiety than those who did not (p .001, p .004), and that health information consulted online can impact the decision to seek out immediate care. Strategies are needed to improve and promote quality online sources to benefit both seekers and services.

In our digital society, media platforms have become an essential tool for refugees as they flee their home and arrive in new countries. The ongoing war in Ukraine has forced millions of civilians to seek protection and to negotiate and rebuild their lives in unfamiliar cities. Uppsala, Sweden, has received approximately 1500 Ukrainian refugees since the beginning of the war. It is crucial to understand their communication pathways and the ways in which they utilize  media platforms, as this understanding can aid in supporting their integration process.  The purpose of this study is to enhance comprehension of how female Ukrainian refugees in Uppsala utilize media platforms, and to investigate how social media can be used as an asset in the integration processes. To address the research questions, a total of 5 Ukrainian women residing in Uppsala were interviewed, and a netnography was conducted. The collected data was analyzed using a thematic analysis, supported by the theoretical framework of Uses and Gratification and the model of Refugee Integration through Social Media.  The findings indicate that various media platforms are utilized by Ukrainian women for social, informational, cultural and entertainment-related purposes. Some of the most prominent social media platforms that emerged in the findings were Telegram, Facebook, Viber and Instagram. Other, traditional media, such as TV and radio, was also employed for obtaining information and learning the Swedish language. The results further demonstrate that social media can be an asset for integration within the dimensions of fostering social connections, exploring employment opportunities and supporting language learning. These were all identified themes in the Facebook group that was used for the netnographic investigation.

Incineration of municipal solid waste (MSW) is common for energy recovery, and management of municipal solid waste incineration (MSWI) ashes has received a growing attention around the world. In the U.S., generation of MSW has increased up to 65% since 1980, to the current level of 251 million tons per year with 53.8% landfilled, 34.5% recycled and composted, and 11.7% incinerated with energy recovery. In the process of incineration, MSWI ash is being produced as byproducts; about 80 to 90% of the MSWI ash is bottom ash (BA) and 10 to 20% is fly ash (FA) by weight. The current practice of the U.S. is to combine both BA and FA to meet the criteria to qualify as non-hazardous, and all combined ashes are disposed in landfills. European countries have utilized MSWI BA as beneficial construction materials by separating it from FA. The FA is mostly limited to landfill disposal as hazardous material due to its high content of toxic elements and salts. BA has been actively recycled in the areas of roadbed, asphalt paving, and concrete products in many of European and Asian countries. In those countries, recycling programs (including required physical properties and environmental criteria) of ash residue management have been developed so as to encourage and enforce the reuse of MSWI ashes instead of landfill disposal. Moreover, many studies have demonstrated the beneficial use of MSWI ashes as engineering materials with minimum environmental impacts. On the other hand, the U.S. has shown a lack of consistent and effective management plans, as well as environmental regulations for the use of MSWI ashes., Due to persistent uncertainty of engineering properties and inconsistency in the Federal and State regulations in the U.S., however, the recycling of the MSWI ashes has been hindered and they are mostly disposed in landfills. In this research work, current management practice, existing regulations, and environmental consequences of MSWI ashes utilization are comprehensively reviewed worldwide and nationwide with an emphasis of the potential area of its utilization in asphalt paving and concrete product. This research also entails a detailed chemical and microstructural characterization of MSWI BA and FA produced from a Refuse Derived Fuel (RDF) facility in Florida so that the MSWI ash is well characterized for its beneficial uses as construction materials. The material characterization includes Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDS), and X-ray Diffraction (XRD) techniques. In addition, leaching experiments have been conducted to investigate the environmental properties (e.g. leachate concentration) of BA and ash-mixed hot mix asphalt (HMA) and Portland cement concrete (PCC). Leaching results reveals the reduced leaching potential of toxic material from MSWI ashes while incorporated in HMA and PCC. Lastly, a preliminary experimental approach has been devised for the vitrification of FA which is a promising thermal process of transferring material into glassy state with higher physical and chemical integrity to reduce toxicity so that utilization of FA can be possible.

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The asymptotic scaling properties of conservative algorithms for parallel discrete-event simulations (e.g.: for spatially distributed parallel simulations of dynamic Monte Carlo for spin systems) of one-dimensional systems with system size $L$ is studied. The particular case studied here is the case of one or two elements assigned to each processor element. The previously studied case of one element per processor is reviewed, and the two elements per processor case is presented. The key concept is a simulated time horizon which is an evolving non equilibrium surface, specific for the particular algorithm. It is shown that the flat-substrate initial condition is responsible for the existence of an initial non-scaling regime. Various methods to deal with this non-scaling regime are documented, both the final successful method and unsuccessful attempts. The width of this time horizon relates to desynchronization in the system of processors. Universal properties of the conservative time horizon are derived by constructing a distribution of the interface width at saturation.

The pressing needs for cost effective electric power that provides both high reliability and high quality is creating an opportunity for alternative energy distributed generation (DG). To determine the economic and technical feasibility of such alternative energy distributed generation facilities, electric power customers must understand their electric usage patterns, economic considerations, local alternative fuel supplies and available DG technologies. This thesis discusses the economic and technical feasibility of establishing a distributed generation installation. As a part of technical feasibility, an evaluation has been done to compare DG size and location impact on the operation of the I 13 node test distribution systems. This evaluation was carried out by performing the distribution power flow that provides the information about voltage profile, losses in the system and feeder power factor. This information was used to determine the optimal location of DG in the test distribution system. Additionally, this part focuses on the importance of power utilization assessment in distributed generation planning. It also discussed the load utilization assessment that focus on step-by-step analysis of load profiles of different facilities such as Choctaw Laundromat, Choctaw Geyser Falls (water park) and Golden Moon Casino. The second part of this thesis?s work resulted in an informative and useful economic analysis tool, DG-ECON with which the user can document the study results and analyze them for economic feasibility with minimal effort. The economic feasibility of a biomass-based renewable energy installation is clearly shown by developing a user interface spreadsheet in Microsoft Excel. The spreadsheet calculates project-screening information in the form of a 20-year life cycle cost analysis. This cost analysis that enables users to define projects that are most energy efficient and offer the greatest financial benefit. The emphasis is on the user interface features of the application to make the application as user friendly as possible. The application has both numerical and graphical data representation using some of the features of Microsoft Visual Basic.

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