No description available.

The purpose of this study was to determine how often smoking patients receive quit advice and if patient age, and number and type of clinical encounters are associated with odds of receipt. Behavioral Risk Factor Surveillance System (BRFSS) 2000 data were used to study 10,582 smokers (aged ³ 18) having ³ 1 of three types of clinical encounters in the past year: routine checkups, other physician encounters, or dental visits. Multivariate-adjusted odds ratios (ORs) for quit advice by patient age, encounter type, and number of doctor's visits were calculated. Almost 55% of patients were advised to quit smoking. There was a 4-23% chance of receiving quit advice at any given doctor's visit. Odds of receiving advice did not increase with increasing number of visits. With advancing age, men were more likely, women less likely, to receive quit advicebut only significantly for White men. Compared to those having dental visits, ORs for receiving quit advice for patients having checkups and other physician encounters were 3.35 (95% CI 2.ll, 5.31) and 3.03 (95%CI 1.32, 6.97) respectively. These cross-sectional data suggest that whereas a small majority of smoking patients are advised to quit at some clinical encounter, smoking patients are not advised to quit at the majority of encounters. Being young and male, or seeing dentists rather than doctors made patients less likely to receive quit adviceas did having lower education or BMI, no insurance or coverage other than military or private, not having asthma, or not having breast exams or follow-up Papanicolaou smears if female. Based on a previously-reported absolute quit difference of 1.9%, if smoking patients received quit advice just once at any of their encounters with physicians in a year, at least 800,000 more U.S. smokers would quit at an economic savings of $2.4 billion.

I varje projekt finns det brister i kommunikation som kan leda till att kostnad, tid och kvalitét påverkas. Varje projekt är en tillfällig organisation med olika företag och olika personer med varierande erfarenheter inom projektering. Detta medför att varje projekt är i sig unikt och hur alla ska kommunicera med varandra kan vara stora frågetecken under projekteringens förlopp. Denna rapport tittar närmare på vilka brister och svårigheter som kan uppkomma i projekteringskedet.

In Florida, the increased installation of non-traversable medians and directional median opening has produced an increased number of U-turns on multilane highways. Arguments have been advanced by some opponents of median modification projects that the increased numbers of U-turns may result in safety and operational problems on multilane highways. The primary objective of this study is to evaluate the operational effects of U-turn movement on multilane roadways. To achieve this research objective, extensive data were collected. Field measurements were conducted at 40 sites in the Tampa Bay area of Florida to collect traffic operations data. Besides, the crash histories of 179 selected roadway segments in central Florida were investigated. Statistical analysis was conducted based on the collected traffic operations data and crash data to quantitatively evaluate the operational performance of U-turn movement. Delay and travel time were compared for different driveway left- turn alternatives that are widely used in Florida and nationally. Crash rate models were developed to evaluate how the separation distance between a driveway exit and the downstream U-turn bay impacts the safety performance of vehicles making right-turns followed by U-turns (RTUT). With the crash data analysis results, the minimum separation distances under different roadway conditions were determined to facilitate driver use of RTUTs. The capacity of U-turn movement was analyzed under two different situations: (1) U-turns are provided at a signalized intersection; and (2) U-turns are provided at an unsignalized intersection. Adjustment factors were developed to quantify the impacts of the presence of U-turning vehicles on the capacity of a signalized intersection. The critical gaps and follow-up time for U-turn movement at unsignalized intersections were estimated. With the estimated critical gaps and follow-up time, the Harders model was used to determine the capacity of U-turn movem ent at an unsignalized intersection. This study also looks extensively at the minimum roadway width and median width required by vehicles to perform U-turn maneuvers on 4-lane divided roadways. It was found that a roadway width of 46 ft is generally sufficient for most types of design vehicles (except heavy vehicles) to perform a continuous U-turn maneuver without impedance.

No description available.

Les difficultés d’adaptation scolaire que peuvent développer les élèves dans une école secondaire entraînent bien souvent des conséquences. En effet, ces dernières peuvent mener au décrochage scolaire et parfois à l’adoption de comportements délinquants. L’instauration d’un suivi auprès d’élèves prend tout son sens lorsqu’il est question de difficultés d’adaptation. Ce suivi a été offert à cinq élèves présentant ces difficultés de l’école secondaire Honoré-Mercier de Montréal. Il y a deux objectifs à ce stage. Le premier vise une diminution des présences au local de retrait et le deuxième de diminuer les difficultés d’adaptation scolaire des élèves ciblés. L’atteinte de ces objectifs est considérée en fonction de données factuelles sur les présences au local de retrait, des résultats obtenus à un test standardisé, soit le Achenbach (Achenbach, 1991), mais également en fonction des perceptions des élèves et des professeurs sur le cheminement de l’élève. Les résultats illustrent que les élèves n’ont pas modifié significativement leur présence au local de retrait, que différentes problématiques définies dans le Achenbach ont été amplifiées tandis que d’autres ont été diminuées et que, finalement les élèves ont apprécié leur suivi puisque ce dernier les a amené à vivre des changements intrinsèques. Des conclusions découlent de l’analyse des résultats, soit concernant la durée des interventions et les problématiques présentes chez les élèves. Le rôle que peut assumer le criminologue dans le milieu scolaire est également abordé. Mots clés : adaptation, difficulté, scolaire, suivi, école, secondaire, adolescent / There can be many consequences when students have difficulties in adapting to the academic environment. They can lead to higher school dropout rates and to the adoption of delinquent behaviour. In the presence of adaptation difficulties, accompanying and monitoring the students is crucial. A monitoring program was offered to five Honoré-Mercier students presenting adaptation difficulties. The intervention program has two objectives. The first one is to decrease the number of classroom exclusions of those students. Another objective is to offer a place where they have the freedom to express their feelings openly. The results of the program are based on the number of classroom exclusion during the intervention. They are also measured on the results of an Achenbach test (Achenbach, 1991) and on the opinions of the students on their own progress. The results illustrate that the students did not significantly lower their number of classroom exclusion. They also show that some problems detected in the Achenbach test were amplified whereas types of problems decreased. Finally, the results show that students appreciated their follow-up because it allowed them to experience intrinsic changes. Based on these results, we can emit several hypotheses on the need to change the duration of the intervention or the problems experienced by the students. The potential contribution of a criminologist in an academic environment is also analyzed. Keywords: adaptation, difficulty, school, follow-up, secondary, teenager

Objectives. To study whether birth weight (BW) was correlated to cardiovascular risk factors, coronary heart disease (CHD), cardiovascular disease (CVD), and prostate cancer (PCA) at adult ages, whether a possible relationship depended on mediating factors from birth time, hereditary circumstances, and adult life variables, and what importance possible associations might have for the rate of the complaint in the general population. Material and methods. Population-based cohorts of men born in 1913 and followed up until old age. Risk of outcome was estimated using Cox’s and Poisson regressions. The results were transformed to population attributable risk percentage (PAR%) of the complaint that could be attributed to low or high BW, given causality between exposure and outcome. Results. After adjustment for the influence of covariates, systolic blood pressure at age 50 decreased by 3.7 mmHg per 1000 g increase in BW, the prevalence of antihypertensive treatment decreased by 32%, diabetes by 53%, serum total cholesterol decreased by 0.20 mmol L-1, and being in top quintile of serum cholesterol decreased by 23%. The adjusted risks were somewhat more marked relative to the crude risks. CHD and CVD incidence and mortality were virtually unaffected by BW. In the general population, the risk percentage attributable to a BW ≤3000 g was 18% for diabetes, 2.5% for cholesterol, and ≤1% for antihypertensive treatment and CHD and CVD incidence and mortality. PCA incidence and mortality risk increased by 62% and 82%, respectively, among those whose BW was ≥4250 g compared with those whose BW was 3001-4249 g. The risk percentages attributable to a BW ≥4250 g in the general population for PCA incidence and mortality were 7.8% and 10.8%. Conclusions. Low BW seemed to affect cardiovascular risk factors but not incidence and mortality from CHD and CVD. A high proportion of diabetes on the community level could be attributed to low BW, while the proportional burden of other cardiovascular complaints that could be attributed to low BW was modest. PCA incidence and mortality seemed to be affected by high BW.

There is limited knowledge of cognitive outcome extending beyond 5 years after childhood traumatic brain injury, CTBI. The main objectives of this thesis were to investigate cognitive outcome at 6-14 years after CTBI, and to evaluate if advancements in the neurosurgical care, starting 1992, did influence long-term outcome and early epidemiology. An additional aim was to study the relationship between early brain injury parameters and early functional outcome. Study 1 evaluated cognitive progress during 14 years after CTBI, over three neuropsychological assessments in 8 patients with serious CTBI. Study 2 used patient records to investigate early epidemiology, received rehabilitation and medical follow up in two clinical cohorts, n=82 and n=46, treated neurosurgically for CTBI before and after 1992. An exploratory cluster analysis was applied to analyse the relation between early brain injury severity parameters and early functional outcome. In Study 3, participants in the two cohorts, n=18 and n=23, treated neurosurgically for CTBI before and after 1992, were subject to an extensive neuropsychological assessment, 13 and 6 years after injury, respectively. Assessment results of the two cohorts were compared with each other and with controls. Data were analysed with multivariate analyses of variance. Results and discussion. There were significant long-term cognitive deficits of similar magnitude and character in the two cohorts with CTBI, treated before and after the advancements in neurosurgical care. At 6-14 years after injury, long-term deficits in verbal intellectual and executive functions were found, and were discussed in terms of their late maturation and a decreased executive control over verbal memory-functions after CTBI. Visuospatial functions had a slightly better long-term recovery. The amount of rehabilitation received was equally low in both cohorts. The length of time spent in intensive care and the duration of care in the respirator may have a stronger relationship to early outcome than does a single measure of level of consciousness at admission. Main conclusions are that cognitive deficits are apparent at long-term follow up, 6-13 years after neurosurgically treated CTBI, even after advancements in the neurosurgical care in Sweden. Measures of verbal IQ, verbal memory and executive functions were especially low while visuospatial intellectual functions appear to have a better long-term recovery. / At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 3: Manuscript.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.