A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Background and Significance The prevalence of pediatric hypertension (HTN) has increased in the past several decades and is projected to continue to rise.2 Because normal blood pressure (BP) values in children depend on age, sex, and height, HTN is difficult to recognize. If not diagnosed during childhood, HTN poses several long‐term health risks.4,10 Electronic medical records (EMR) have tools to help recognize elevated BP in children. Unfortunately, many clinicians are unaware of these support tools, and pediatric HTN is underdiagnosed. Research Question This study is designed to improve the detection of HTN in children. Methods This is a prospective quality improvement (QI) study completed at a teaching institution with rotating physicians. We reviewed the charts of 1697 children aged 3 to 18 years who were seen by physicians for well‐child visits in March, June, July, August, November 2014, and January 2015. We recorded children with elevated BP and determined if HTN was recognized (noted in the assessment/plan or BP repeated). We used March as our baseline detection rate and completed five interventions, one before each month. All interventions consisted of PowerPoint presentations for medical personnel (physicians, nurses, medical assistants). The last two interventions consisted of a change in the EMR (BP percentiles displayed in a summary page) and signs hung in the clinic. Pre‐ and post‐intervention data underwent analysis, and we examined factors that may impact early detection of HTN. Results Of the 1697 children, 188 (11.1%) had elevated BP. The prevalence of elevated BP declined from the pre‐intervention month to post‐intervention months (March 13.5%, June 10.3%, July 9.7%, August 9.2%, November 12.5%). The prevalence returned to baseline by January (13.5%). The recognition of elevated BP improved from 25% in March to 44% and 55% in June and July, respectively. There was a decline in detection from July to August and November (55% to 41% and 35%). There was improved detection again from November to January (35% to 48%). Factors that increased the detection of HTN were obesity (χ2=22.9, p=0.000002), systolic BP >120 (χ2=8.1, p=0.0045), and a past history of elevated BP (χ2=5.1, p=0.024). Conclusions Our educational interventions improved the absolute detection of HTN. Repetition of interventions and involvement of the whole care team were important for sustaining the improvements, especially for a teaching institution with rotating physicians. Repeated interventions may not be necessary for private practice clinics. The improved detection correlated with a steady decline in the prevalence of HTN, probably related to blood pressures that were falsely elevated due to patient anxiety and incorrect cuff sizing. Obesity, systolic BP>120, and past history of at least one elevated BP significantly improved the detection. This QI project was not intended to determine the efficacy of each intervention, but rather to improve the detection rate as a whole. We cannot conclude whether the monthly changes were due to chance, but we can conclude that we improved the overall detection.

Thesis (B.A.(Hons.))-- University of Adelaide, Dept. of History, 1974.

Published Article / A worldwide concern are focusing on the quality of postgraduate training in higher education institutions, the length of time it takes postgraduate students to complete their studies, and the high percentage of postgraduate students who terminate there studies. Furthermore the involvement in research is making increasing quality demands on higher education institutions in terms of sustaining high-level research capability and involvement on an efficient and effective basis. It is clear that the postgraduate environment will have certain expectations as well as obstacles for the students and therefore if the undergraduate students are prepared beforehand for the postgraduate environment, they will be able to bridge the gap between undergraduate and postgraduate studies more successfully.

This thesis is a broadly-based historical study of the 1954 Royal Tour of Australia. In presenting an anatomy of this important but neglected event, it attempts to restore its place in history, to explain the nature of the enduring popular attachment to the British Royal Family, to examine the self-portrait that Australia presented to its Royal visitors in the post-war era and to investigate the political and cultural processes by which it did so. The primary theoretical aim of this detailed case study is to interrogate the means by which the State (represented by the Parliament and the state and federal bureaucracies, with the cooperation of the media) was able to secure the willing participation of an overwhelming majority of the population. The elements of this study are drawn principally from government archives, the vast media coverage of the day, extensive oral history interviews with participants, and academic literature in the areas of Australian history (with particular reference to the nineteen-fifties), popular royalism, popular culture, public memory, civic ritual and spectacle. It was my final objective that these elements and aims might be synthesised into an enjoyable, 'popular' account of this chaotic, surprising and memorable event.

This thesis is a broadly-based historical study of the 1954 Royal Tour of Australia. In presenting an anatomy of this important but neglected event, it attempts to restore its place in history, to explain the nature of the enduring popular attachment to the British Royal Family, to examine the self-portrait that Australia presented to its Royal visitors in the post-war era and to investigate the political and cultural processes by which it did so. The primary theoretical aim of this detailed case study is to interrogate the means by which the State (represented by the Parliament and the state and federal bureaucracies, with the cooperation of the media) was able to secure the willing participation of an overwhelming majority of the population. The elements of this study are drawn principally from government archives, the vast media coverage of the day, extensive oral history interviews with participants, and academic literature in the areas of Australian history (with particular reference to the nineteen-fifties), popular royalism, popular culture, public memory, civic ritual and spectacle. It was my final objective that these elements and aims might be synthesised into an enjoyable, 'popular' account of this chaotic, surprising and memorable event.

No description available.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

The diploma thesis concerns in two aspects which are the description of internet users and internet media. I show the ways of measuring visits, which is closely related to the operation of web sites and especially its economic aspect, the advertisement. I specify the indicators in view. I concentrate really carefully on the amount of real users, which is one of the most important indices. I apply the usage of these indices to practical examples. I point to sociodemographic user's profile of particular portals and compare them with other chosen servers. Consequently I determine specific recommendations for the advertisement submitters in the term of targeting their campaign accurately. By using many-variable statistical methods, I try to find out suitable groups of internet users based on their relation to advertisement. I consequently describe these groups of people and determine again certain recommendations.

The Coronavirus disease-2019 (COVID-19) pandemic has affected countries all over the world and impacted many areas of our lives. Research studying psychosocial issues caused by Covid-19 addressed that during the pandemic well-being was lower. Well-being integrates mental health, clinical and developmental theories to provide a better understanding of positive psychological functioning. An abundance of studies demonstrated that natural environments, both wild and managed, have a positive effect on people’s being. In the present study, the changes in people’s nature visits as well as the links between nature visits and well-being has been investigated. The current sample (1902 participants) was from the corona survey, a subsample of the SLOSH. During the Covid-19 pandemic, some people started visiting nature more, while others reduced their visits. Well-being was lower than before. The observed directions of the associations were: nature visits were positively linked with the quality of life, while depressive moods from 2020 and 2021 were linked negatively. Change in forest visits (<65 female group) was the best well-being predictor from all types of nature exposure.

PhD Thesis / Background: Overcrowding in emergency departments (EDs) due to avoidable visits places a significant strain on health systems. There is no known valid classification to identify avoidable ED visits in Canadian administrative data. Research Questions: Which physician interventions and patient characteristics are important to classify avoidable ED visits, and does a novel classification (the Emergency Department Avoidability Classification; EDAC), which incorporated these features, demonstrate validity? Methods: Two independent modified Delphi consensus studies determined ED physician interventions and patient characteristics that classified avoidable ED visits. These studies involved emergency and family medicine physicians across Ontario, Canada. Binary logistic regression was used to examine ED physician interventions in the National Ambulatory Care Reporting System (NACRS) database for associations with patient characteristics. These results constructed the EDAC criteria. ED physicians from an academic hospital evaluated randomly selected retrospective ED visits (n=320) which were also evaluated using the EDAC to assess their avoidability. The primary outcome of this thesis was correlation between the classification and ED physician judgements, measured using a Spearman rank correlation and ordinal logistic regression. The secondary outcome was to compare the correlations of previously published classifications with ED physician judgements. The tertiary outcome was to compare prevalence estimates of avoidable ED visits for all classifications. Results: Consensus showed strong evidence on 146 of 150 (97.3%) ED physician interventions, with 103 (68.7%) deemed suitable for non-ED care. Consensus was established on eight of nine patient characteristics, with four characteristics identified as useful in specifying avoidable ED visits: age (18-70 years), triage acuity (non-emergent), specialist consult in the ED (none) and ED visit outcome (discharged). An adjusted retrospective cohort study found the ED interventions had a strong association with patient characteristics determined in the consensus study: not aged over 65 years, having a non-emergent triage acuity and not being admitted to hospital. The classification was highly correlated with ED physician judgements (r=0.64, p<0.01), with a significant association to classify avoidable ED visits (OR=80.0, 95% CI=17.1-374.9) and strong accuracy (82.8%). The EDAC was the most accurate classifier of avoidable ED visits compared to previously published classifications. The EDAC identified a prevalence of 25.1% ED visits as avoidable and common patient conditions associated with such visits as traumatic injuries, symptoms/signs/abnormal findings, diseases of the musculoskeletal system, mental and behavioural disorders, and diseases of the respiratory system. Conclusion: My thesis developed and established the EDAC as an accurate classifier of avoidable ED visits with supporting evidence of validity and superior performance to previously published classifications. The EDAC can be easily integrated with administrative ED data and has strong potential for use in defining avoidable ED visits by health policy stakeholders. / Thesis / Doctor of Philosophy (PhD)