The purpose of this study was to examine the effects of event order on a cycling(C)/running(R) or R/C biathlon. Eight experienced male biathlete/triathletes with a mean age of 24.9 + 4.6 yr formed the sample of the study. Results show no significant interaction effects on oxygen consumption peak, oxygen consumption during steady-state, ventilation, and heart rate when C/R or R/C are performed at 70% oxygen consumption peak for subsequent R and C respectively. These results seem to indicate that the biathlete/triathlete is efficient in both C and R to the extent that event order does not significantly interact with metabolic response in submaximal cycling and running.

M.Cur. / Who am I? What am I doing here? What is the purpose of life? What is real? Individuals are intent on trying to find an answer to their questions about life, yet many may find that they remain in a quagmire of confusion and vacillating inner torment. In their own lives many individuals deal with pain, guilt and death, each having their own share of suffering where they may either withdraw into their own world or attempt to take from it whatever bit of happiness and pleasure they can, which often leaves them with a feeling of emptiness, futility and despair. What is it aU for? What is life about? According to what Waltos and Waltos (2002:16) have termed "a conscious revolution", individuals have entered an age of responsibility and empowerment. In both human life and healthcare this translates to individuals being more willing to take charge of their lives as well as responsibility for their overall health. Frankl (1984:15) posits mental health and stability to be dependent upon an individual's ability to perceive meaning. This quest for meaning is one of the greatest challenges facing individuals, families and nations (Wong & Fry, 1998:406). At certain points in life, everyone has questioned what sustains their being and what makes life worth living. With a focus on the family, the researcher to this study noticed that the first crack in many famUy structures developed during pregnancy, birth and parenthood due to an inability of the parents to communicate their differing views and perspectives of their reality. Consequently, this resulted in self-expression becoming compromised and inhibited, resulting in inner confusion and turmoil. Parenthood also brings about personal challenges of coping and making meaning out of life circumstances. This breakdown in relationships impacts on individuals' and families' ability to develop and grow holistically, with consequent negative ripple effects on family dynamics and structure. Such discord and disharmony further cascades out to include community and the work environment.

La simulation à événements discrets (SED) est une technique dans laquelle le simulateur joue une histoire suivant une chronologie d'événements, chaque événement se produisant en des points discrets de la ligne continue du temps. Lors de l'implémentation, un événement peut être représenté par un message et une heure d'occurrence. Le type du message n'est lié qu'au modèle et donc sans conséquences pour le simulateur. En revanche, les variables de temps ont un rôle critique dans le simulateur, pour construire la chronologie des événements, dans R+. Or ces variables sont souvent représentées pas des types de données produisant des approximations, tels que les nombres flottants. Cette approximation des valeurs du temps dans la simulation peut altérer la ligne de temps et conduire à des résultats incorrects. Par ailleurs, il est courant de collecter des données à partir de systèmes réels afin de prédire des phénomènes futurs, comme les prévisions météorologiques. Les résultats de cette collecte, à l'aide d'instruments et procédures de mesures, incluent une quantification d'incertitude, habituellement présentée sous forme d'intervalles. Or répondre à une question requiert parfois l'évaluation des résultats pour toutes les valeurs comprises dans l'intervalle d'incertitude. Cette thèse propose des types de données pour une gestion sans erreur du temps en SED, y compris pour des valeurs irrationnelles et périodiques. De plus, nous proposons une méthode pour obtenir tous les résultats possibles d'une simulation soumise à des événements dont l'heure d'occurrence comporte une quantification d'incertitude. / Discrete-Event Simulation (DES) is a technique in which the simulation engine plays a history following a chronology of events. The technique is called “discrete-event” because the processing of each event of the chronology takes place at discrete points of a continuous time-line. In computer implementations, an event could be represented by a message, and a time occurrence. The message data type is usually defined as part of the model and the simulator algorithms do not operate with them. Opposite is the case of time variables; simulator has to interact actively with them for reproducing the chronology of events over R+, which is usually represented by approximated data types as floating-point. The approximation of time values in the simulation can affect the time-line preventing the generation of correct results. In addition, it is common to collect data from real systems to predict future phenomena, for example for weather forecasting. When collecting data using metrological instruments and procedures, the measurement results include uncertainty quantifications, usually defined as intervals. However, sometimes, answering a question requires evaluating the results of all values in the uncertainty interval. This thesis proposes data types for handling representation of time properly in DES, including irrational and periodic time values. Moreover, we propose a method for obtaining every possible simulation result of DES models when feeding them events with uncertainty quantification on their time component.

In this dissertation, Noto-ya Masogana is described as a moral story. The moral story can be distinguished from the didactic story and from the picaresque. The picaresque deals with a picaro who is the only main character. He is not presented as being trustworthy and responsible. As a result of this, this type of narrative is known as a 'Schelmroman' in German. The development of the story is simple and deals with the escapades of the picaro who goes on a journey. The didactic story presents the reader with a lesson, while the moral story indicates that a life well led will be rewarded. A life not well led will, in turn, be punished. In this narrative, Lesibana pays for his unfaithfulness to Mamahlo. He repents and the narrative has a happy ending. The method used in this investigation is based on an adjusted narratological model. Only the content and structure levels feature. The topic is identified as an important concept with regard to level one, the reason for this being that it influences the four different elements of the narrative, namely: characters, events time and place. Two main characters are distinguished, and the mutual relationship between them and less important characters receives attention. Events are divided into three categories according to importance. Events are thus called either essential, appropriate or coincidental. Two issues are relevant with regard to time; namely the moment at which an event takes place and the time which is occupied by an event. Place has a bearing on the natural as well as the sociocultural place. The concepts theme and narrating strategies play an important role on a structural level. In the discussion of the structure of Noto-ya-Masogana attention is paid to the exposition, the development, the climax and the resolution. The following techniques are relevant in this regard: motif, foreshadowing, retardation and acceleration of time, contrast, complication, focus and cycle. The study is conducted by comparing this novelette to the story of the Prodical Son and to the picaresque. Attention is also drawn to the author's use of the 'Makgoweng' motif. / Dissertation (MA)--University of Pretoria, 2012. / Philosophy / unrestricted

The purpose of this study was to understand the governance of Olympic Games legacy. Legacy is broadly described as “all planned and unplanned, positive and negative, intangible and tangible structures created by and for a sport event that remain for a longer time than the event itself” (Preuss, 2007a, p. 86). The specific objectives of this study were: a) to map the historical evolution of legacy throughout the modern Olympic Movement (OM) (i.e., 1896-current day) in order to contextualize and conceptualize the major trends (e.g., changes in legacy, network actors/stakeholders, governance structures and processes) over time; b) to understand, explain, and compare/contrast the network governance of Olympic legacy, using Australian and Canadian case settings; and c) to critically analyze the overall structure and process of the governance of legacy within the OM focusing specifically on the aspects of performance, transparency, accountability, and participation to build a framework and provide policy recommendations for the governance of legacy in mega-events. In order to accomplish these objectives, a historical review of legacy within the OM and two descriptive case studies (Sydney 2000 and Vancouver 2010) were built using interviews and archival materials. Findings showed how the growth of the Games has culminated in the increased use and importance of legacy, leading to greater concept complexity. This resulted in the emergence of several trends including: new legacy themes, heightened interconnectedness, and formalization of governance mechanisms. Institutional theory was then applied to further explore the emergence of legacy and its habitualization, objectification, and sedimentation as an accepted norm in the Olympic Field. The examination of the legacy governance networks in the two cases showed four legacy network governance phases: legacy conceptualization, legacy planning and implementation, legacy transfer, and post-Games legacy governance, as well as a number of governance mechanisms (e.g., contracts, policies) that had an impact on the overall governance of the event’s legacy. Finally, a critical analysis of the governance of Olympic Games legacy was completed. The end result of the research project was a theoretical framework detailing the levels and fluidity of legacy governance in the OM.

Objectives: This thesis included 6 manuscripts which focused on the analysis of adverse events following immunization (AEFIs), including general health services utilization (emergency room (ER) visits and hospital admissions) and specific diagnoses (e.g. febrile convulsions). The main objectives of this research were: 1) To demonstrate the utility of the self-controlled case series (SCCS) design coupled with health administrative data for studying the safety of vaccines; 2) Introducing an innovative approach using relative incidence ratios (RIRs) within an SCCS analysis to identify risk factors for AEFIs and to overcome the healthy vaccinee bias; and 3) To demonstrate how SCCS and RIR analyses of health services outcomes in health administrative data can provide important insights into underlying physiological and behavioural mechanisms. Data Sources: This work utilized Ontario health administrative data housed at the Institute for Clinical Evaluative Sciences (ICES). The study included all children born in Ontario, Canada between 2002 and 2011 (over 1 million children). Vaccinations were identified using OHIP fee for service billing codes for general vaccination. Admissions and ER visits for any reason were identified in the Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS). Primary reasons for admissions and ER visits were investigated using ICD-10-CA codes reported in the DAD and NACRS databases. Statistical Methods: The self-controlled case series design (SCCS) was used to calculate the relative incidence of admissions, ER visits and other AEFIs. To investigate relative incidence for AEFIs across risk groups of interest, as well as addressing the healthy vaccinee effect bias, RIRs were calculated. RIRs are the ratio of incidence ratios in a subgroup of interest relative to a designated reference group. Results and Conclusions: The combined approach of using the SCCS design and RIRs to identify risk factors and overcome the healthy vaccinee bias proved to be a powerful approach to studying vaccine safety. Future work will be important to characterize the performance and validity of the SCCS + RIR approach in the presence of increasing levels of confounding and differing manifestations of the healthy vaccinee bias, as well as to elucidate the biological and behavioural mechanisms underlying our findings.

Simulation of rare events can be costly with respect to time and computational resources. For certain processes it may be more efficient to begin at the rare event and simulate a kind of reversal of the process. This approach is particularly well suited to reversible Markov processes, but holds much more generally. This more general result is formulated precisely in the language of stationary point processes, proven, and applied to some examples. An interesting question is whether this technique can be applied to Markov processes which are substochastic, i.e. processes which may die if a graveyard state is ever reached. First, some of the theory of substochastic processes is developed; in particular a slightly surprising result about the rate of convergence of the distribution pi(n) at time n of the process conditioned to stay alive to the quasi-stationary distribution, or Yaglom limit, is proved. This result is then verified with some illustrative examples. Next, it is demonstrated with an explicit example that on infinite state spaces the reversal approach to analyzing both the rate of convergence to the Yaglom limit and the likely path of rare events can fail due to transience.

Climate change studies are crucial to assist decision-makers in understanding future risks and planning adequate adaptation measures. In general, Global/Regional Climate Models (GCMs/RCMs) achieve coarse resolutions, and are thus unable to provide sufficient information to conduct local climate assessments. Downscaling, defined as a method that derives local to regional-scale (10 to 100 km) information from larger-scale models or data analyses, is used to address this deficiency. In this thesis, a particular downscaling technique, known as the Quantile-Quantile transformation, was used to adjust the statistical distribution of RCM variables to match the statistical distribution of the observed variables generated by two RCMs: the Canadian Regional Climate Model version 3.7.1 and the ARPEGE model, on the historical period (1961-2001). The analyses presented in this study were applied to daily precipitation and maximum and minimum temperatures in the South Nation watershed in Eastern Ontario, Canada. The two-sample Kolmogorov–Smirnov test indicated that the Quantile-Quantile transformation improved the shape of the PDF of RCM-simulated climate variables. The results suggest that, under the A1B scenario, temperatures in the watershed would rise significantly and there would be an increment in precipitation occurrence and intensity. Trend analysis was performed on the 1961 to 2001 and 2041 to 2081 timeframes, using the Mann-Kendall test and the Sen's slope estimator. Discernible, often significant, increases of maximum and minimum temperatures were found for the 1961 to 2001 period, and stronger ascending slopes for the 2041 to 2081 period. However, there was marginal evidence of changes in the time series of maximum and accumulated annual precipitation for both periods. The study also outlined how the frequency and intensity of some extreme weather events will evolve in the 2041-2081 period in response to the rise in atmospheric GHG concentrations. Projected impacts were investigated by tracking future changes in four extreme temperature indices and three precipitation indices. It was predicted that heavy precipitation events and warm spells will occur more frequently and intensely, while extreme cold events will be weaker, and some will be hardly observed.

Evaluation of quality of surgical care begins with the Donabedian triad focusing on structure, process, and outcomes. Outcomes, which are inherently patient-centered, are most easily and commonly measured, and are indeed fundamental to evaluating the quality of surgical care. Specifically, post-operative adverse events (AEs) remain the most frequently measured and reported outcomes, as they represent harm to the patient; and thus, are often used as a means for comparing institutional, as well as, individual surgeon performance. The importance of rigorous recording of clearly defined AEs, although widely recognized, is poorly performed in practice. In previous work, created in accordance to the Clavien-Dindo classification, we developed and integrated a classification of Thoracic Morbidity & Mortality (TM&M) within The Ottawa Hospital’s Division of Thoracic Surgery allowing objective and standardized assessment of all post-operative AEs following all surgeries. In this thesis, the complementary studies that were conducted surrounding the continued clinical application and critical appraisal of the TM&M classification system as a means toward quality improvement are described. Using standardized reporting of both incidence and severity of post-operative complications, we first provide an overview of the burden and distribution that the two most pervasive post-operative AEs have on the thoracic surgical patient population, including prolonged alveolar air leak and atrial fibrillation (Chapter I and II). Next, we explore the inter-system reliability of reported AEs following thoracic surgery from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP), which is widely considered the most prominent surgical quality improvement effort, and the TM&M classification system in order to better understand to what extent the methods used to collect data may be impacting results (Chapter III). The disparity between the two systems and the duplicate participation indicates distinct value to the two quality reporting systems. An absence of evidence in the literature regarding individual surgeon outcome reporting and its impact on the quality of care prompted us to create risk-adjusted, surgeon-specific outcome reports to enable individualized performance measurement and feedback (Chapter IV). A priority for the division has been to ensure such measurement translates into reproducible improvements in surgical performance. To do so, we implemented complementary continuous quality improvement seminars to provide an additional forum for discussion regarding collective results, utilizing positive deviance, to unmask best performers as a catalyst for discussing practice measures to improve specific AEs. Lastly, an evolutionary understanding of the heterogeneity of TM&M data was considered as a critical next step to following improvements in care (Chapter V). Recognizing that software was necessary to efficiently record and review TM&M data, iterative development led to an evolution of a real-time, web-based, point-of-care Thoracic Surgery Quality monitoring, Information management, and Clinical documentation (TSQIC) software system. The TSQIC system has enabled bedside data recording and storage, and automated dynamic analysis and reporting of surgical volume and quality. We observe that measurement of TM&M data alone, while necessary, is not sufficient for quality improvement. We suggest that in addition to implementing a complementary point-of-care, interactive, web-based quality monitoring system, key factors for improving quality and patient safety include a combination of temporal analyses of AEs, effective surgeon-specific feedback mechanisms, actionable information based on best practice measures, standardization of case reviews, and a unit-based approach conducive of team-work and safety culture, led by open and collegial dialogue.

The general purpose of this thesis is to evaluate the state of certain chosen aspects of the management of voluntary aid during the floods in the Czech Republic. It also aims at identifying the weaknesses of the system of management of voluntary aid. The processed data are divided into five logical groups. The thesis is primarily divided into a theoretical part, generally dealing with voluntary work as a significant and an indispensable element of the society and also with emergency events in particular the floods which affected the Czech Republic and which without the notable and distinctive voluntary aid could not have been coped with. The practical chapters are devoted to certain chosen aspects of the management of voluntary aid and focus on their specifics during the crises and character of concrete activities non-profit organisations which have taken a considerable part in coping with the recent floods over the last few years. The pivotal chapter of the thesis is the empirical research whose objective was the detection of single aspects of the volunteers' work and the management of voluntary aid during the floods in the Czech Republic. The adopted technique in collecting the data is the standardized questionnaires designed for two groups of volunteers and voluntary fire brigades, which are included in the appendixes of the thesis. The research has showed that there are certain drawbacks and deficiency in managing voluntary aid. Conclusion: The thesis proposes certain recommendations to improve the situation.