This art project focuses in a voyeuristic way on the fatality and futility of war. With its accompanying emotional responses; the aim is to reflect on these issues through a cyclical process of construction and destruction. The motivation for this research is to generate a personal and intimate understanding of the experience of war by exploring notions of helplessness and loss through art making processes. The research presumes war exists as a continuous fatal and futile cycle. Within this investigation fatality is defined as accepting the conditions of death, dying and disaster while also alluding to the philosophical concept of fate: futility is defined as pointless, hopeless or useless. Through methods of construction and destruction this project seeks to initiate alternate ways of emotionally processing, responding to, and understanding the experiences of war from a distance. This thesis is constituted as practice based artwork 80% accompanied by an exegesis 20%.

This art project focuses in a voyeuristic way on the fatality and futility of war. With its accompanying emotional responses; the aim is to reflect on these issues through a cyclical process of construction and destruction. The motivation for this research is to generate a personal and intimate understanding of the experience of war by exploring notions of helplessness and loss through art making processes. The research presumes war exists as a continuous fatal and futile cycle. Within this investigation fatality is defined as accepting the conditions of death, dying and disaster while also alluding to the philosophical concept of fate: futility is defined as pointless, hopeless or useless. Through methods of construction and destruction this project seeks to initiate alternate ways of emotionally processing, responding to, and understanding the experiences of war from a distance. This thesis is constituted as practice based artwork 80% accompanied by an exegesis 20%.

Globally, construction is considered a hazardous industry with a disproportionate amount of fatal and non-fatal injuries as compared to other industries. Electrocution is named as one of the "fatal four" causes for construction injuries by the Occupational Safety and Health Administration (OSHA). In the United States, an average of 47.9% electrical fatalities occurred in the construction industry from 2003 to 2012, according to the U.S. Department of Labor. These fatalities include both electrical workers and non-electrical workers. Such a disproportionate rate suggests a need of research to improve construction safety and reduce injuries due to electrocution. However, there is a lack of understanding of causation mechanisms surrounding fatal accidents by electrocution using a systems approach; and there is a disconnection between the mechanism of fatal electrocution accidents and the associated control measures, which may lead to less effective prevention in construction. This dissertation has three objectives, including: (a) establishing a sociotechnical system model that reflects the electrocution occurrence in the U.S. construction industry and identify the associations among its internal subsystems; (b) determining specific electrocution patterns and associated mechanism constraints; and (c) examining hierarchy of control (HOC) measures and determining their appropriateness. Findings from his research include: (a) the identification of three system patterns of electrocution in construction work systems and the associations between personnel, technological, organizational/managerial subsystems, and the internal and external environment for each of the three patterns, using a macroergonomics framework; (b) the identification of five features of work, and map out their decision-making chains, critical decision-making points and constraints, as an interpretation of electrocution mechanisms in the workplace; and (c) revealing that behavioral controls remain prevalent in electrical hazard mitigation even though the knowledge of construction safety and health has increased in the past decades, and that the effectiveness of controls is not statistically different by construction type nor occupation. Based on these findings, the research also suggests corresponding mitigation recommendations that construction managers shall strictly follow HOC rules by giving priority to higher level of controls and upgrading the industry's prevention strategy by introducing more technological innovations and encouraging prevention through design (PtD) strategies. / Ph. D.

Shift work is a work schedule being the opposite of normal daytime work, often defined as working time outside normal daytime hours (06:00 to 18:00). In recent years, shift work has been associated with an increased risk of numerous chronic conditions including for example cardiovascular disease, some types of cancer, type II diabetes, and the metabolic syndrome. While some studies on the association between shift work and chronic disease have found results supporting it, others have not. Therefore, more research is needed to clarify potential associations.The aim of this thesis was to further study the proposed association between shift work and cardiovascular disease. This was addressed by performing two studies, one analysing if shift workers had an increased risk of ischemic stroke compared to day workers. The other study analysed whether shift workers had an increased risk of short-term mortality (case fatality) after a myocardial infarction compared to day workers. The studies were performed using logistic regression analysis in two different case-control databasesThe findings from the first study indicated that shift workers did not have an increased risk of ischemic stroke. The findings from the second study showed that male shift workers had an increased risk of death within 28 days after a myocardial infarction; the results did not indicate an increased risk for female shift workers. The results from both studies were adjusted for both behavioural and medical risk factors without affecting the results. The findings from this thesis provide new evidence showing that male shift workers have an increased risk of death 28 days after a myocardial infarction, however more research is needed to clarify and characterise any such potential associations.

In 2014, the Child Protective Services received 3.6 million referrals alleging child abuse and neglect, of which, 702,000 children were victims of abuse and neglect and an estimated 1,580 children died due to maltreatment. In addition to this appalling toll, the welfare effects of child victimization are substantial. Evidence suggests that compared to demographically similar adults who were non-victims, adults with documented histories of maltreatment are more likely to engage in criminal behavior; have adverse mental and physical health problems such as depression, addiction and post-traumatic stress disorder; and have lower levels of education and earnings. These essays contribute toward the understanding of the consequences of two very distinctive policies – mandatory arrest and medical marijuana laws – and their impact on child maltreatment. An important and controversial question in criminal justice policy concerns whether aggressive sanctions, such as mandatory arrest policies, serve as effective deterrents to familial violence. Chapter 1 provides a theoretical framework that models child abuse in which I allow for a strategic interaction between the child and his or her abuser. The comparative statics yield clear predictions of the impact of sanctions on child maltreatment – as the cost and probability of external interventions rise, the probability of violence falls. I follow this theoretical analysis with an empirical investigation of the impact of mandatory arrest policies on child victimization. I find a statistically significant and positive relationship between states that have implemented mandatory arrest laws and reported child maltreatment rates. This may seem surprising; however there are two explanations for the results. The likely explanation is that reporting of maltreatment increased in states mandating arrest; alternatively, recidivism may have increased in these states. Evidence from the OLS estimates for the reporting of abuse and child fatality rates (a proxy for the true incidence of child abuse), demonstrates that the increase in maltreatment is not due to recidivism but, in fact, more people reporting abuse to the police and Child Protective Services. The most important result that emerges from the data, however, is that while reported abuse increases in states with mandatory arrest laws, the true incidence of maltreatment actually falls. The ultimate goal of this paper is to stimulate further theoretical and empirical research that focuses on child abuse and prevention, thus enhancing an understanding of how sanctions influence child victimization. The next chapter looks at one potential risk factor for child maltreatment –marijuana use and liberalization –using evidence from medical marijuana laws (MMLs). Chapter 2 begins by extending the current MML-crime literature by providing a comprehensive evaluation of the impact of MMLs implemented at the state level on reported child victimization rates. I show that specific modes of medical marijuana regulation differentially influence the magnitude of reported incidences of child abuse, a finding which sheds new light on the current literature. More specifically, using fixed effects analysis applied to data from the National Child Abuse and Neglect Database System (NCANDS) and the Uniform Crime Reports (UCR), I show that states that allow for home cultivation in addition to decriminalizing its use see a further increase in the magnitude of reported incidences of child maltreatment rates. Since completing my dissertation, I have continued to investigate into issues that have implications for both theory and practice in my field. To that extent, I plan to analyze the slowly developing public sphere –a platform where culture and social change rely on both media and conversation.

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. / Motor vehicle accidents involving pedestrians are some of the most common and lethal forms of injury for children in the United States. Among younger children, a common mechanism of action for severe trauma is when a vehicle runs over the child in a forward or backward motion at low speed resulting in a blunt crush injury. This typically occurs in non‐traffic settings including driveways, sidewalks, and roadways. Such incidents have been referred to in many different ways in the literature but for the purposes of this paper will be referred to as low speed vehicle run‐overs. This is a retrospective chart review carried out at Phoenix Children’s Hospital in affiliation with the University of Arizona College of Medicine‐Phoenix that categorizes and examines the injuries sustained by patients involved in low speed vehicle runovers occurring between December 2007 and August 2013. Fifty‐five pediatric patients were included with a median age of 24 months and 6 of these patients were fatally injured. Internal injuries were common overall and significantly more common in children ≤24months. Over half of the cohort sustained fractures, with a 24% incidence of skull fractures. All fatalities were the result of traumatic brain injury. Twenty percent of victims required operative intervention. It was concluded that the severity of these types of incidents varies from minimal to life threatening and best care requires close and thorough evaluation by the trauma and emergency department teams.

Thesis (MPH.) --University of Limpopo, 2016 / Background: Malaria is one of the important communicable diseases transmitted by Anopheline mosquitos to humans and is endemic in 108 countries around the world. Most malaria epidemics in African highland countries are caused by Plasmodium Falciparum (P Falciparum) and people residing in highlands are said to be having low immunity to malaria and both children and adults are affected by the disease, whereas vivax malaria is common in lowlands African countries. The current study was undertaken with an aim to determine the spatial distribution of malarial cases during the period 2006 to 2015 in Mopani District of Limpopo Province, South Africa. Methods: Quantitative retrospective descriptive methodology was employed to review the malaria distribution in Mopani district. A total of 12 037 malaria cases were identified for the period of the study and the data was kept anonymously by not using the names of the patients. Ethical clearance was received from the Turfloop Research Committee of University of Limpopo in consideration of section 14, 15, 16, and 17 of National Health Act 61 of 2004. The data was exported to excel spreadsheet and cleaned before exported into SPSS 23.0 software which was used for data analysis. Results: The findings revealed that most malaria cases were found in 2006 and again in 2014 and 2015 respectively. Malaria cases were also seen to be seasonal and were very high during January, February, March and April. Malaria cases also hiked during the month of October. The results also show that most malaria cases were reported between the patients aged of 16 to 25 and 26 to 40 years. There were more males than females who were infected by malaria in Mopani district and the sub district which was found to be having high malaria cases is Greater Giyani with more than 50% of the population (51.1%); followed by Ba Phalaborwa (23.1%); then Greater Tzaneen 13.1%. Conclusion: Mopani district has halved its malaria transmission for the comparison years, however the slow reduction in numbers of deaths is still a cause for concern. Key words: Malaria prevalence, spatial distribution, case fatality rate, elimination.

Stroke is a major cause of death and disability worldwide. In Sweden, about 30 000 strokes occur each year. The aim of this thesis was to analyse survival, functional outcome and self-reported depression after stroke, and to explore possible differences between men and women in stroke care and outcome. These studies were based on Riks-Stroke, the Swedish national quality register for stroke care. Information on background variables and treatment were collected during the hospital stay. The patient’s situation and outcome after stroke were followed-up after 3 months. Long term survival was retrieved from the Swedish Population Register (Folkbokföringen). Possible sex-differences in stroke care and outcome 3 months after stroke were explored in 24 633 strokes, registered during 2006. In conscious patients, the proportions treated at stroke units were similar for men and women. Men and women had equal chance to receive thrombolytic therapy or secondary prevention with oral anticoagulants. Compared to men, women were less likely to develop pneumonia, but more likely to experience deep venous thromboses and fractures during hospital stay. Women had worse 3-month survival and functional outcome, differences that were explained by their higher age and impaired level of consciousness on admission. Women felt more depressed and perceived their health as worse than men did. Women were also less satisfied with the care they had received in the hospital. The agreement between self-reported functional outcome 3 months after stroke and the commonly used modified Rankin Scale (mRS) was explored in 555 stroke survivors from 4 hospitals during May-September 2005. Riks-Stroke’s self-reported questions classified 76% of the patients into correct mRS grade. The association between functional outcome 3 months after stroke and 3-year survival was assessed in 15 959 men and women who had had a stroke during 2001-2002. Patients with estimated mRS grades 3, 4 and 5 had hazard ratios for death of 1.7, 2.5 and 3.8, respectively, as compared with patients with lower grades, 0-2. Depressed mood, male sex, high age, diabetes, smoking, antihypertensive therapy at onset and atrial fibrillation were also identified as predictors of poor survival. Self-reported depression 3 months after stroke and use of antidepressants were analysed in 15 747 stroke survivors from 2002. Fourteen percent felt depressed 3 months after stroke. Female sex, age <65, previous stroke, living alone or in institution, or being dependent in activities of daily living (ADL) were factors associated with self-reported depression. At the follow-up, 22% of the men and 28% of the women were using antidepressant medication, which were approximately twice as many as in the general population. Still, 8% of all patients in Riks-Stroke reported depressive mood but no treatment with antidepressants. In conclusion, men and women with stroke in Sweden experience similar treatment and outcome in most aspects. Patient-reported functional outcome can be reliably transformed to a standard disability scale. Impaired functional outcome three months after stroke is an independent predictor of poor long-term survival. Depressive mood is common after stroke and is associated with poor survival and impaired functional outcome.

Stroke is one of the leading causes of death and disability in Sweden and in the Western world. Despite this, stroke with focus on elderly is a field where few studies have been conducted from a gender and socioeconomic perspective. The objectives in this thesis were to analyse from a gender, age and socioeconomic perspective how women were affected by stroke compared with men. The focus was on what it meant for elderly women and men to live with stroke and to explore various gender constructions among men and women. The study also included aspects such as incidence, medical treatment and case fatality after stroke. Both quantitative and qualitative methods were used. During a two-year period (15 October 2000–14 October 2002), uniform information was collected for all cases of first-ever and recurrent (>28 days) stroke occurring in people of all ages living the region of Umeå, admitted to the University Hospital. Five different registers were used to achieve maximum coverage; the Riks-Stroke (RS) register, the Hospital Discharge Register (HDR), the Cause of Death Register, the northern Sweden WHO MONICA study, and one case-finding study in nursing homes and homes for elderly performed for this thesis. For the qualitative study a maximum variation sampling procedure was used to retrieve participants for in-depth interviews in a follow-up study. Nine women and seven men were interviewed about their experiences of treatment and care after suffering a stroke, as well as about their perceptions and experiences of help from others (health care personnel, relatives and home help personnel). The first-ever incidence of stroke was higher among low-educated than high educated men and women. Our study showed that there was an education-related age-dependent difference in stroke incidence, where elderly women had the highest incidence of stroke. The 28-day case fatality was shown to be associated with low educational level in patients above 75 years, after controlling for sex, risk factors and acute care variables. The elderly stroke patients experienced subordination in their contacts with health care personnel and the medical context. The participants used different ways to negotiate in the subordinate position, and some of these negotiations were interpreted as being gendered. We have also shown how the elderly stroke patients minimized their own needs of help, strove for independence and accepted help. The men and the women differed in their perceptions and experiences of help from others. Also, the participants expressed multiple types of needs. The elderly stroke patients’ perceptions and experiences of help from others must be studied in relation to their life circumstances and expectations from society. Further analyses of the patients’ perceptions and experiences of help from others were interpreted as being different examples of constructions of masculinities and femininities. Stroke with a focus on the elderly is a field where few studies have been conducted from a gender and socioeconomic perspective. With further community-based stroke incidence studies including elderly men and women and with the development of appropriately targeted interventions, the burden of stroke in the population could be reduced. More research is needed where both qualitative and quantitative methods are used, as this can provide a richer and perhaps more authentic description of the issue under investigation.

Aim To describe the epidemiology of tuberculosis in the city of Liepaja during the last 27 years and the management of patients with tuberculosis during the period 1993-2002; to identify problems in tuberculosis management relevant to increasing level of morbidity and the registered high levels of drug-resistance. Material and methods The cases were all persons reported with tuberculosis in 1975-2002. The data sources were the yearly Health Statistics books at the Latvian Office of Medical Statistics. The study used data from the available 655 individual patient records from Liepaja Tuberculosis Dispensery and TB Register of 1993 – 2002. Information was extracted selectively and extraction sheets containing the variables of interest were developed. The incidence differences according to sex and age, possible clustering of patients in high-risk living areas of the city, differences in occupation of the patients were studied. The differences of time from disease symptoms to diagnosis, as well as investigation data, treatment regimens, the proportions of treatment outcomes were analysed. Analysis was done using EPI-INFO programme for statistical analysis. Results In the 1980s tuberculosis was under control in Latvia and the incidence was at the European average level. After Latvia had regained independence in 1991, with economical and political disruption and changes in the health care system, TB incidence and mortality in the country increased rapidly as well as in Liepaja. Although not very high compared to global TB rates, there was great concern about TB control in Latvia. In addition, the emergence of drug resistance and multi-drug resistant bacteria made the TB epidemic more serious. The TB incidence increase in children suggested that there was quite a big number of undetected cases of TB. Tuberculosis control and early detection activities were not integrated into the PHC system. Treatment results of TB were quite poor and showed high proportions of interruptions, defaults, relapses. The tuberculosis control Programme in Latvia and Liepaja put much effort into the improvement of the epidemiological situation with TB, focusing on TB control activities and management during the period 1993-2002. The incidence of tuberculosis in Liepaja was higher than in Latvia, particularly in some living areas in the city, and above endemic level. Mortality rate in average was higher as in the whole country. The proportion of socially sensitive groups (children, unemployed, pensioners, disabled) comprised more than 50 % of the tuberculosis incidence. Incidence among medical staff was higher than in general population in the all professional groups. Medical delay of diagnosis decreased, but early detection of tuberculosis was not fully integrated in PHC system. There were quite big differences in numbers of MDR-TB in years 1993-2002. DOTS was introduced in Liepaja five years later than in Latvia –in year 2000 and strategy was not fully successful. The number of positive treatment outcomes increased, but the registered numbers of treatment relapses and defaults were higher than in Latvia . Conclusions The situation with regard to tuberculosis development and tuberculosis management in Liepaja during the period under study was unfavourable. Particularly : the incidence and mortality rates, much variation in the diagnostic process, results of treatment ,a high proportion of MDR-TB , unsatisfactory links between local government, family doctors and medical professionals and multi-sectoral collaboration in TB control activities , the objectives set up by WHO for DOTS treatment were not reached / <p>ISBN 91-7997-139-3</p>