Thesis (Ed. D.)--University of Toronto, 2007. / Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: 2350. Includes bibliographical references (leaves 140-151).

Thesis (Ed. D.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains viii, 658 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 270-275).

Coronary artery disease is one of the most pernicious diseases around the world and early identification of vascular disease can help to reduce morbidity and mortality. Assessment of the degree of vascular obstruction, or stenosis, is critical for classifying the risks of the future vascular events. Automatic detection and quantification of stenosis are important in assessing coronary artery disease from medical imagery, especially for disease progression. Important factors affecting the reproducability and robustness of accuarate quantification arise from the partial volume effect and other noise sources. The main goal of this study is to present a fully automatic approach for detection and quantification of the stenosis in the coronary arteries. The proposed approach begins by building a 3D reconstruction of the coronary arterial system and then making accurate measurement of the vessel diameter from a robust estimate of the vessel cross-section. The proposed algorithm models the partial volume effect using a Markovian fuzzy clustering method in the process of accurate quantification of the degree of stenosis. To evaluate the accuracy and reproducibility of the measurement, the method was applied to a vascular phantom that was scanned using different protocols. The algorithm was applied to 20 CTA patient datasets containing a total of 85 stenoses, which were all successfully detected, with an average false positive rate of 0.7 per scan.

It is well known that the evolution of 4G-based mobile multimedia network systems will contribute significantly to future m-health applications that require high bandwidth and fast data rates. Central to the success of such emerging applications is the compatibility of broadband networks such as mobile WiMAX (IEEE 802.16e) and RSVP A, and especially their rate adaption issues combined with the acceptable real time medical quality of service requirements. The design of effective broadband mobile healthcare systems usmg emerging WiMAX and RSxP A networks is important from the medical perspective especially in applications such as remote medical ultrasound diagnostic systems. In this thesis, we introduce a new cross layer design approach for medical video streaming over mobile WiMAX and RSVP A networks. In particular, we propose an approach based on optimising medical Quality of Service (m-QoS) in mobile WiMAX network environments described in this work. Preliminary performance analysis of the proposed cross layer algorithm has been evaluated via simulation studies. These results show that the proposed cross layer optimizer achieves improved performance compatible with the necessary medical QoS requirements and constraints for the relevant clinical application. Furthermore, this work addresses the relevant challenges of cross layer design requirements for real time rate adaptation of ultrasound video streaming in Mobile WiMAX and RSVP A networks. The comparative performance analysis of such approach is validated in two experimental m-health testbed systems for both Mobile WiMAX and RSVP A networks. The experimental results show an improved performance of Mobile WiMAX compared to the RSVP A using the same cross layer optimisation approach. Additionally, we map the medical QoS to typical WiMAX QoS parameters in order to optimise the performance of these parameters in typical m-health scenarios. Preliminary performance analysis of the proposed multiparametric scenarios is evaluated to provide essential information for future medical QoS requirements and constraints.

M.Tech.

M.A. (Clinical Psychology) / South African paramedics are thought to be exposed to a high number of critical incidents as compared to paramedics elsewhere (Ward, Lombard & Gwebushe, 2006). Therefore, South African paramedics are at particular risk of suffering from negative effects associated from the exposure to critical incidents. This study aimed to gain an in-depth understanding of the meaning which paramedics attach to the experience of “critical incidents” (Mitchell, 1983). This information may be beneficial for those working in Emergency Medical Services in South Africa to further understandings of paramedics’ experience of work related trauma. Five paramedics, sourced from both public and private ambulance service, between the ages of 27 and 36 years old, who have had between 8 to 12 years of working experience were interviewed regarding their lived experiences of critical incidents. The semi-structured interviews were transcribed and analysed based on the Interpretative Phenomenological Analysis (IPA) framework suggested by Smith and Osborn (2008). The analysis of each of the participant’s transcripts provided four master themes, some of which are supported by superordinate themes. The master themes are: 1) Experiencing the trauma of critical incidents, 2) Experiencing in the “World” of EMS, 3) Intrinsic factors and active attempts of coping with stress, and 4)Personal consequence of being a paramedic. For most of the participants, their narratives highlighted that the organisational variables were considered to be more important than the nature of the critical incidents they experienced. Critical incidents were deemed traumatic as there was a disparity between the participant’s expectations of what was expected and what they were confronted with in “reality”. In addition, the participants described forming an emotional bond with their patients or the patient’s family, which added to their distress. The participants’ narratives emphasised the importance of the role of the EMS organisation in influencing their experiences. Despite employing a number of coping strategies to mediate the effects of organisational as well as critical incident stress, the participants reported experiencing longterm negative psychological symptoms that have impacted on their personal and familial lives. These findings support the growing body of knowledge that demonstrates that organisational variables play an important role in either mediating or exacerbating posttrauma outcomes.

No description available.

No description available.

No description available.

Due to an increase in the need for allied health professionals, there is a growing interest to assess the allied health workforce and its employment needs. This is especially true in medically underserved rural areas where there is a critical shortage of allied health professionals. A survey was sent to allied health administrators across a variety of allied health disciplines working in Tennessee hospitals in order to gauge opinions on retention and recruitment strategies. Overall successful strategies for recruitment and retention of allied health professionals were reported as well as differences between urban and rural areas, differences of perceptions of strategy effectiveness among allied health disciplines, and key strategies for rural allied health recruitment. Little is known about organizational policies impacting recruitment and retention practices of allied health professionals in Tennessee hospitals. Understanding of this problem is vital to the prevention of a critical shortage of allied health professionals. Therefore, this study sought to compare rural and urban hospital in Tennessee with respect to recruitment and retention needs.