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High blood pressure is associated with decreased sensitivity to pain in humans and animals. Interestingly, hypoalgesia has also been observed in normotensive organisms at risk for hypertension, suggesting that it may be related to processes involved in the development of hypertension rather than with elevations of blood pressure per se. Sensitivity to laboratory and naturalistic daily aches and pains was assessed in young normotensive women and men with or without a parental history of hypertension and varying degrees of resting blood pressure. In women, risk for hypertension, as defined by a parental history of hypertension, relatively elevated systolic blood pressure, or a combination of the two, was associated with decreased pain reports and increased pain threshold for mechanical finger pressure, but not for the cold pressor test. Offspring of hypertensives also exhibited a reduced response to the pain stimuli compared to offspring of normotensives as assessed by the objective physiological measure of respiratory sinus arrhythmia (RSA). Group differences observed in the laboratory were generally maintained in reports of daily pain, with significant correlations emerging between laboratory and naturalistic pain reports. To assess the role of cardiopulmonary baroreceptor stimulation in blood pressure-related hypoalgesia, young men varying in risk for hypertension were exposed to finger pressure during a period of passive leg elevation and two control periods. Men with relatively elevated systolic blood pressure exhibited reduced pain during the period of leg elevation but not while in a supine position, nor following the valsalva manoeuver. The results of these studies support an association between risk for hypertension and pain sensitivity. This relation appears to extend to naturalistic pain encountered in daily life. Further, there is promising evidence suggesting that this relationship is influenced by cardiopulmonary baroreceptor activity.

In joint human-automation systems, operators must often supervise the automation and adapt their reliance on it based on judgments of its context-specific reliability. For this to occur, operators should trust the automation appropriately. In the design of a water monitoring decision aid’s display, Ecological Interface Design was used to satisfy design guidelines for supporting appropriate trust. Design focused upon a visualization that made the aid’s use of the Dempster-Shafer theory directly perceptible. The display was evaluated using a signal detection theory-based approach that measured reliance on automation. Results indicated that the ecological display yielded less appropriate reliance and poorer performance than a conventional display for a highly reliable decision aid. However, the experimental task prevented participants from adapting to the aid’s context-specific reliabilities, reducing the validity of the findings. A subsequent study is proposed to further study the effects of ecological displays on automation reliance.

In joint human-automation systems, operators must often supervise the automation and adapt their reliance on it based on judgments of its context-specific reliability. For this to occur, operators should trust the automation appropriately. In the design of a water monitoring decision aid’s display, Ecological Interface Design was used to satisfy design guidelines for supporting appropriate trust. Design focused upon a visualization that made the aid’s use of the Dempster-Shafer theory directly perceptible. The display was evaluated using a signal detection theory-based approach that measured reliance on automation. Results indicated that the ecological display yielded less appropriate reliance and poorer performance than a conventional display for a highly reliable decision aid. However, the experimental task prevented participants from adapting to the aid’s context-specific reliabilities, reducing the validity of the findings. A subsequent study is proposed to further study the effects of ecological displays on automation reliance.

This study examined the location decisions of family physicians in Saskatchewan by determining the factors that influence family physicians’ location decisions, and identifying the major themes from the factors. The research employed a rational choice model as a basis to design the methodology and explain how Saskatchewan family physicians make their practice location and re-location decisions. A mixed method approach, including an on-line questionnaire survey and interviews with key health agencies, was used to collect and analyse data. Data from the survey were summarised using summary statistics and cross tabulation. Responses from stakeholder interviews were transcribed and analyzed using interpretive description method. The mixed method approach elicited a rich and detailed description of family physicians’ location decisions. Participants of the study ranked family concern, work-life balance and community influence as the most influential factors of family physicians’ location decisions. The fourth factor of locations decisions according the study was compensation. Although compensation was mentioned as a factor, it was recorded as the least influential factor among the participants of this research. Other factors that were identified as having some influence on practice location choices were respect and appreciation, and scope of practice. To conclude, the study found that location decisions are not only about identifying the major influential factors of practice location choices, but also involve finding a good match between family physicians and potential practice locations and communities. That is, family physicians’ preferences must match the characteristics of the potential communities. Based on the conclusion, the study made two policy recommendations regarding the matching between family physicians and communities. The first policy recommendation is strategic matching between family physicians and communities for more efficient and effective recruitment and retention. The second recommendation is providing strategic incentives to ensure access to family physician services for the population in communities that do not meet the requirements of the strategic matching.

A growing literature has reported a significant reduction in pain sensitivity among hypertensioe animals and humans. One of the key questions about this finding is whether a reduced sensitivity to pain can be observed in normotensive individuals who go on to develop high blood pressure. Blood pressure was re-assessed in one hundred and fifteen 19 year-old boys initially tested at age 14, when they were also presented with a pain stimulus (mechanical finger pressure). Analyses indicated that information regarding pain sensitivity improved prediction of changes in blood pressure beyond that afforded by differences in blood pressure at age 14, parental history of hypertension, and body mass index. Similar results were found in comparable analyses predicting 24-hour blood pressure recorded in one hundred and seventeen of the young men at age 22. Significant associations were also observed between pain sensitivity in 14 year-olds and 24-hour heart rate variability in various frequency bands at age 22, suggesting increased sympathetic and reduced parasympathetic tone among individuals less sensitive to pain. In order to further assess the relationship between autonomic function and pain sensitivity, one hundred and sixteen adolescent boys were assessed for pain sensitivity and autonomic responses to orthostatic challenge. Analyses indicated that exaggerated autonomic responses to postural change were associated with reduced pain sensitivity. Finally, to examine the potential role of endogenous opioids in blood pressure-related hypoalgesia, a group of young normotensive men were administered low-frequency transcutaneous electrical nerve 5 stimulation (TENS), which has been demonstrated to elicit endogenous opioid release, prior to being presented with two painful stimuli (electric shock and arm ischemia). A negative association between pain and resting blood pressure was significantly strengthened by administration of low-frequency TENS. The resu

Background: Many risk factors for venous thromboembolism have been identified, but two particular exposures - the use of combined oral contraceptives and long-distance air travel - have generated considerable concern in recent years. In contrast, a possible link between venous thromboembolism and a third exposure - the use of psychotropic drugs - was first raised in the 1950s, but has received surprisingly little attention. Information about all three exposures and the risk of fatal events is limited. These risks were examined in three inter-related national population-based studies. Methods: The underlying study population included all men and women aged 15 - 59 years who died in New Zealand between 1990 and 2000, for whom the underlying cause of death was pulmonary embolism. The potential associations between fatal pulmonary embolism and the use of oral contraceptives and psychotropic drugs were explored in a general practice records-based case-control study. Non-users were the reference category for all analyses. Contraceptive supply data were used to estimate the absolute risk of death from pulmonary embolism in users of oral contraceptives. A second case-control study, in which computer-assisted telephone interviews were undertaken with the next of kin of cases who had been resident in New Zealand, and with sex and age-matched controls randomly selected from the electoral roll, investigated the possible association between long-distance air travel and fatal pulmonary embolism. Finally, the absolute risk of dying from pulmonary embolism following a long-distance flight was estimated in a descriptive study based on official migration data and deaths in recent air travellers. Results: The adjusted odds ratio for use of any oral contraceptive in the three months before the index date (the onset of the fatal episode) was 13.1 (95% CI 4.4 - 39.0). The odds ratio for formulations containing desogestrel and gestodene was about three times higher than the point estimate for levonorgestrel products; preparations containing cyproterone acetate appeared to carry the highest risk. The estimated absolute risk of fatal pulmonary embolism in current users of oral contraceptives was 10.5 (95% CI 6.2 - 16.6) per million woman-years. The adjusted odds ratio for current use of any antipsychotic was 13.3 (95% CI 2.3 - 76.3). Low-potency antipsychotics carried a 20-fold increase in risk; thioridazine was the main drug involved. Antidepressant use was also associated with a significantly increased risk (adjusted odds ratio 4.9 [95% CI 1.1 - 22.5]). Compared with non-travellers, people who had undertaken a flight of more than eight hours� duration in the preceding four weeks were eight times more likely to die from pulmonary embolism (odds ratio 7.9 [95% CI 1.1 - 55.1]). The absolute risk of fatal pulmonary embolism following air travel of more than eight hours was 1.3 (95% CI 0.4 - 3.0) per million arrivals. Conclusions: The present research was the first to have estimated the relative risks of fatal pulmonary embolism in relation to three exposures: oral contraceptive use in a population in which preparations containing desogestrel and gestodene preparations were widely used, conventional antipsychotics, and long-distance air travel. The findings were consistent with previous, and subsequent, studies of non-fatal events. Increased risks of fatal pulmonary embolism in users of antidepressants, and in people with an intellectual disability, have not been described previously and warrant further investigation. Referral and diagnostic biases are very unlikely in these studies of fatal events, and other types of bias and possible confounding are considered unlikely explanations for the findings.

Under the title 'Performative Architecture', this thesis draws on theories from performance studies and phenomenology in order to look beyond humanist practices that see the body as fixed and static. This thesis addresses two questions that I will be arguing are of increasing significance to contemporary architecture: Firstly, in the context of emerging digital and digitised spaces, how does the living body interact with the surrounding environment?; and secondly, what do these changing forms of human inhabitation and movement mean for the practice of architecture? The time frame spans from the work of Oskar Schlemmer in the 1920s to contemporary built works, examining the different ways that performativity has infiltrated architectural design. The case studies are divided into architectural performances that highlight the living body, and performative drawings that explore how to bring that body into the design process. In doing so a number of emerging paradigms become apparent that find built form in contemporary architectural examples. This approach is used to describe and analyse recent projects by Daniel Libeskind, Peter Eisenman, Diller and Scofidio and Lars Spuybroek, and to identify a common orientation through very different types of built environments. Acknowledging the change in both bodies and spaces in the Information Age, this research seeks to make room for the living body in the design of emerging, multidimensional, built environments.

Background: As a multifactorial disease glaucoma may be associated with pressure-dependent and -independent factors. Ocular hypertension (OHT) may develop into primary open angle glaucoma (POAG) for many patients. We compared groups with OHT and POAG for pressure-dependent and -independent risk factors. A high prevalence of any factor(s) could indicate a contribution to progression from OHT to POAG. Method: A sample of patients with POAG (n 438) and with OHT (n 301) were selected from those attending a tertiary referral private glaucoma practice, and data were collected regarding age and intraocular pressure at the time of diagnosis, gender, family history of glaucoma, systemic hypertension, diabetes, Raynaud's phenomenon, migraine and myopia. Results: After multivariate analysis, older age at time of diagnosis (P<0.001), myopia (odds ratio (O.R) 1.5, 95percent confidence interval (C.I)1.0-2.2; P 0.05), a family history of glaucoma (O.R 1.6, 95 percent C.I 1.1-2.3; P 0.01) and a high intraocular pressure (P 0.002) were associated with POAG. No other significant differences were found between the two groups. Conclusion: Patients who have OHT may be at higher risk of developing POAG if they also have myopia, a family history of glaucoma or are of older age.