R??sum?? : La douleur lombaire (DL) est l???une des conditions musculosquelettiques les plus fr??quentes et co??teuses au Canada. La pr??valence annuelle de DL aig??e varierait de 19 % ?? 57 %, et un patient sur quatre souffrirait de r??currence dans la m??me ann??e. La pr??sente ??tude vise donc ?? produire une analyse descriptive de l?????pid??miologie de la DL r??currente ?? l?????chelle de la population. Une nouvelle approche m??thodologique est propos??e afin d???optimiser l???identification de vrais cas incidents de DL r??currente ?? partir d???une analyse secondaire de donn??es administratives. Puisque 10 % des patients ayant de la DL seraient responsables de 80 % des co??ts qui y sont associ??s, nous avons ??galement d??termin?? la tendance s??culaire des co??ts d???interventions m??dicales des patients r??currents incidents entre 2003 et 2008. En utilisant le fichier des services m??dicaux r??mun??r??s ?? l???acte de la R??gie de l???assurance maladie du Qu??bec, des cohortes pr??valentes ont ??t?? construites ?? partir de 401 264 dossiers de patients ayant consult?? au moins trois fois pour de la DL entre 1999 et 2008. Onze ans d???historique m??dical des 81 329 patients de la cohorte de 2007 ont ensuite ??t?? analys??s afin d???exclure les patients ayant eu des consultations ant??rieures de DL. Une valeur pr??dictive positive et un coefficient de Kappa ??lev??s ont permis d???identifier une clairance optimale pour r??cup??rer les cas v??ritablement incidents. Les co??ts de consultations ont ensuite ??t?? calcul??s pour tous les patients incidents de 2003 ?? 2007 ?? partir des manuels de facturation. Nous avons observ?? une pr??valence annuelle de la DL r??currente de 1,64 % en 2000 chez les hommes diminuant ?? 1,33 % en 2007. Cette baisse a majoritairement eu lieu dans le groupe d?????ge des 35-59 ans. Les femmes ??g??es (> 65 ans) ??taient 1,4 fois plus ?? risque de consulter un m??decin de mani??re r??currente que les hommes du m??me ??ge. L???incidence annuelle de la DL en 2007 ??tait de 242 par 100 000 personnes. Les hommes de 18 ?? 34 ans ??taient 1,2 fois plus ?? risque que les femmes de d??velopper un premier ??pisode r??current et les personnes ??g??es 1,9 fois plus ?? risque que les jeunes. L???incidence annuelle a diminu?? de 12 % entre 2003 et 2007 pendant que les co??ts totaux augmentaient de 1,4 %. La m??diane des co??ts ??tait la plus ??lev??e chez les femmes ??g??es et tendait ?? augmenter dans le temps. Ces analyses secondaires sugg??rent de s???int??resser particuli??rement ?? la DL chez les personnes tr??s ??g??es, et de d??terminer si la baisse de fr??quence de consultations r??currentes observ??e dans le temps est li??e ?? une meilleure gestion de la DL ou ?? un probl??me d???accessibilit??. Les co??ts devraient faire l???objet d???un suivi continu pour limiter les hausses. // Abstract : Low back pain (LBP) is one of the most frequent and costly musculoskeletal health conditions in Canada. Annual prevalence was found to vary between 19 % and 57 % and likely one out of four patients experience a LBP recurrence within one year. The body of knowledge on the prevalence of recurrent LBP is still limited. This study sought to present a descriptive analysis on the epidemiology of recurrent LBP in a medical population. A new methodology is also proposed to identify true cases of incident recurrent LBP. Since 10 % of LBP patients have been reported to generate 80 % of the costs, we will sought to determine the secular trend of medical costs for the incident cohorts of 2003 to 2008. Using the Canadian province of Quebec medical administrative physicians??? claims database, 401 264 prevalent claims-based recurrent LBP patients were identified between 1999 to 2008 for having consulted at least three times for LBP in a period of 365 days. The medical history of 81 329 prevalent patients in 2007 was screened for a retrospective period of 11 years. High positive predictive values and Kappa statistics were used to determine the optimal clearance period for capturing true incidence cases among patients with no prior encounters for LBP. Physicians??? claims manuals were then used to apply a price for every intervention provided to LBP incident patients in their index year and follow-up years. We observed a decrease from 1.64 % to 1.33 % in the LBP annual prevalence between 2000 and 2007 for men. This decrease was mostly observed between 35 and 59 years of age. Older women (??? 65 years) were 1.4 times more at risk to consult a physician for LBP in a recurrent manner than older men. The annual incidence in 2007 of adult claims-based recurrent LBP was 242 per 100 000 persons. Males of 18 to 34 years of age were found 1.2 times more at risk than their counterparts. Altogether, elderlies were 1.9 times more at risk than young adults to consult in a recurrent manner for LBP. The annual incidence decreased by 12 % between 2003 and 2007, while the direct costs increase by 1.4 %. The median cost for consultations was highest for elder women and increasing in time. These secondary analyses emphasize the importance to keep the watch on the elders in regards to LBP, and to determine if the timely decrease in morbidity is related to improvements in LBP management or to a medical accessibility issue. Also, costs will need to be surveyed on a regular basis to limit the impact of future increases.

In spite of their high abundance and importance, aqueous systems are enigmatic on the microscopic scale. In order to obtain information about their geometrical and electronic structure, simple aqueous solutions have been studied experimentally by photo- and Auger electron spectroscopy using the novel liquid micro-jet technique in conjunction with synchrotron radiation. The thesis is thematically divided into three parts. In the first part we utilize the surface sensitivity of photoelectron spectroscopy to probe the distributions of solutes near the water surface. In agreement with recent theoretical predictions we find that large polarizable anions, such as I- and ClO4-, display enhanced surface propensities compared to smaller rigid ions. Surface effects arising from ion-ion interactions at higher electrolyte concentrations and as function of pH are investigated. Studies of linear mono-carboxylic acids and benzoic acid show that the neutral molecular forms of such weak acids are better stabilized at the water surface than their respective conjugate base forms. The second part examines what type of information core-electron spectra can yield about the chemical state and hydration structure of small organic molecules in water. We demonstrate that the method is sensitive to the protonation state of titratable functional groups and that core-level lineshapes are dependent on local water hydration configurations. Using a combination of photoelectron and X-ray absorption spectroscopy we also show that the electronic re-arrangement upon hydrolysis of aldehydes yields characteristic fingerprints in core-level spectra. In the last part of this thesis we study ultrafast charge delocalization dynamics in aqueous solutions using resonant and off-resonant Auger spectroscopy. Intermolecular Coulombic decay (ICD) is found to occur in a number of core-excited solutions where excess energy is transferred between the solvent and the solute. The rate of ultrafast electron delocalization between hydrogen bonded water molecules upon oxygen 1s resonant core-excitation is found to decrease upon solvation of inorganic ions. The presented work is illustrative of how core-level photoelectron spectroscopy can be valuable in the study of fundamental phenomena in aqueous solutions.

In the present study, we compare factor analytic models of post-traumatic stress disorder (PTSD) in terms of their fit and predictive utility with regard to external correlates such as comorbid diagnoses and other psychosocial outcomes. Competing models were compared and validated in an epidemiological dataset (N = 23,936). Confirmatory factor analyses (CFA) using models from prior literature with four through seven factor solutions were conducted. The seven factor Hybrid model, the six-factor Anhedonia model, and the six-factor Externalizing Behaviors model were the first, second, and third best-fitting models, respectively; however, the inconsistency of associations with external correlates and high factor intercorrelations suggested that higher-factor solutions may sacrifice parsimony for minimal gains in utility. The Anhedonia and Hybrid models’ separate Anhedonia and Negative Affect factors (a core difference from other models) demonstrated limited utility in differentially associating with distinct constructs under the internalizing umbrella. Anhedonia and Negative Affect also correlated highly with each other and nearly perfectly with the factors composed of their combined symptoms (e.g. the Externalizing Behaviors model’s Numbing factor), suggesting a "lumped" factor would be more parsimonious. The Externalizing Behaviors model showed predictive utility in accounting for externalizing comorbidities as well as differentiating among constructs within the internalizing spectrum; however, it lacked robust associations with externalizing behavioral outcomes such as frequency and quantity of drinking. These results give reason for concern that predominant structural models of PTSD may not be adequate for discriminating among or predicting functional outcomes related to PTSD symptomatology in trauma-exposed populations.<br>

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022. / Mental illness is a high burden of disease especially in Low- and Medium-Income Countries (LMICs) like South Africa. In many LMICs, there is a paucity of Mental Health Professionals (MHCPs). As a result, people with mental illness call their faith healers or religious/spiritual leaders (pastors in this study) when experiencing mental health problems. Pastors are more accessible, share the same religious/spiritual beliefs about mental illness with their congregants and often provide religious/spiritual solutions to those who consult with them. Thus, they are often preferred over MHCPs. However, pastors are rarely involved as partners in community based mental health programs. While mental illness is mainly clinically diagnosed and recognised by MHCPs using the DSM-5 and ICD-10 codes, less is known in South Africa with regards to the views of pastors with regards to their notions of what mental illness is. Thus, it may be complex for Pentecostal pastors to clearly distinguish between spirit possession and mental illness as much as it is complex for MHCPs who struggle with accommodating their patients’ religious/spiritual beliefs. Religious/spiritual beliefs are significant in many Africans seeking mental health recovery. However, less has been explored in South Africa in the area of religion/spirituality and its relevance in the practice of clinical psychology. Western based psychotherapeutic methods of intervention which exclude the religious/spiritual domain of African clients continue to dominate the practise of psychology in Africa. Given the above, this study aimed to explore and understand selected Pentecostal pastors’ perception and treatment of mental illness. The research objectives were, namely: (1) to establish the notions held by Pentecostal pastors’ regarding what mental illness is (2) to establish Pentecostal pastors’ perception of what causes mental illness; (3) to determine Pentecostal pastors’ perceptions of how and by whom mental illness can be recognised, diagnosed, treated and managed; (4) To determine Pentecostal pastors’ views regarding their own roles in the management of mental illness; and (5) To canvass and describe Pentecostal pastors’ perceptions about collaboration for purposes of an intervention programme aimed at providing a holistic care and treatment of religious/spiritual patients. The study was qualitative, and the exploratory research approach was adopted. The research was informed by the Bio-Psycho-Social-Spiritual (BPSS) model. Purposive sampling was used to select nineteen (19) participants. In-depth semi-structured interviews were conducted. Data were analysed using Thematic Analysis (TA). The following six major themes emerged from the analysed data: (i) Notions of mental illness; (ii) Causes of mental illness;(iii) Recognition and diagnosis of mental illness (iv) Notions on the treatment and management of mental illness; (v) Perceived roles in the treatment and management of mental illness; (vi) Views regarding collaboration with MHCPs. The participants held a multifactorial view of mental illness. They were limited in their understanding of mental illness and perceived it mainly to be madness (psychosis). The participants’ perception of mental illness was influenced by their theological (Pentecostal) as well as their cultural backgrounds (Black Africans). The participants indicated that they lacked training in mental health issues. As such, they were not opposed to collaborating with MHCPs. They mentioned that their roles included counselling, prayer, support, and referral. This study also discovered that Pentecostal pastors upheld three treatment approaches of mental illness namely: The Full-Collaborative Approach; The Partial-Collaborative Approach and the Non-Collaborative Approach. Findings of the study were discussed, and recommendations were made including the proposed intervention programme between pastors and MHCPs with the aim of facilitating a referral process and collaboration between the two professions. / National Institute for the Humanities and Social Sciences (NIHSS), and South African Humanities Deans Association (SAHUDA)

Höghastighetsmanipulation av nacken är en manuell behandlingsteknik mot smärta i framförallt nacken och skuldrorna. Tekniken har enligt flera källor visats hänga samman med risken för att drabbas av skador på de kärl som försörjer hjärnan med blod, med bland annat stroke som följd. Andra källor har å andra sidan visat att de är en teknik som är säker att utföra. Den här litteraturstudien har sammanställt och utvärderat forskning som på olika sätt söker utreda om det påstådda sambandet är kausalt eller inte. Metoden som valdes var att genom en av SBU färdigställd mall värdera forskningsartiklar och sedan sortera dem efter relevans, för att på så sätt avgöra huruvida sambandet kan ses som kausalt eller inte. Studieresultatet visade att frågan är för komplex för att kunna besvaras i en enskild studie, och att mer forskning behövs inom flera delområden innan frågan kan besvaras fullt ut. Orsaken till detta är att det finns flera orsaksmekanismer, och flera riskgrupper, för denna typ av skada, där flera ännu är okända. Detta gör att en fullständig kartläggning av samband i frågan ännu inte är möjlig. Däremot är det sannolikt att tekniken kan verka som en utlösande faktor, en trigger, hos vissa personer i riskgrupperna. Därför kan det sägas finnas en risk med tekniken rent praktiskt, oavsett om ett kausalt samband mellan tekniken och stroke i sig existerar eller inte. / High Velocity Manipulation of the cervical spine is a manual treatment technique against pain in foremost the neck, shoulders. The technique has according to multiple sources been connected to the risk of injury to the blood vessels that supply the brain with blood, with among others stroke as a consequence.  Other sources have on the other hand shown it the technique to be safe to perform. This literature study has compiled and evaluated research that in various ways tries to find out if said connection is causal The method used was to evaluate articles through a pre-made form from SBU, and then to sort them according to relevance to see if the connection is causal or not. The result showed that the question is too complex to be answered in a single study, and that more research is needed to answer the question in full. This is due to the fact that there are multiple mechanisms behinds this form om injury, that the risk seems to exists in certain groups, and that some of these are not yet identifiable. On the other hand there is a high probability that the technique might act as an activating factor in these groups. Because of this there can be said that a risk exists with the technique in practice, no matter if there is a casual connection between the technique and stroke in itself or not.

<p>Clusters are finite ensembles of atoms or molecules with sizes in the nanometer regime (<i>i.e.</i> nanoparticles). This thesis present results on the geometric and electronic structure of homogeneous and heterogeneous combinations of atoms and molecules. The systems have been studied with synchrotron radiation and valence, core and Auger electron spectroscopic techniques.</p><p>The first theme of the thesis is that of mixed clusters. It is shown that by varying the cluster production technique both structures that are close to that predicted by equilibrium considerations can be attained as well as far from equilibrium structures.</p><p>Electronic processes following ionization constitute the second theme. The post-collision interaction phenomenon, energy exchange between the photo- and the Auger electrons, is shown to be different in clusters of argon, krypton and xenon. A model is proposed that takes polarization screening in the final state into account. This result is of general character and should be applicable to the analysis of core level photoelectron and Auger electron spectra of insulating and semi-conducting bulk materials as well.</p><p>Interatomic Coloumbic Decay is a process that can occur in the condensed phases of weakly bonded systems. Results on the time-scale of the process in Ne clusters and mixed Ar/Ne clusters are herein discussed, as well observations of resonant contributions to the process. In analogy to Auger <i>vis-à-vis</i> Resonant Auger it is found that to the ICD process there is a corresponding Resonant ICD process possible. This has later been observed in other systems and by theoretical calculations as well in subsequent works by other groups.</p><p>Delocalization of dicationic valence final states in the hydrogen bonded ammonia clusters and aqueous ammonia has also been investigated by Auger electron spectroscopy. With those results it was possible to assign a previously observed feature in the Auger electron spectrum of solid ammonia.</p>

Clusters are finite ensembles of atoms or molecules with sizes in the nanometer regime (i.e. nanoparticles). This thesis present results on the geometric and electronic structure of homogeneous and heterogeneous combinations of atoms and molecules. The systems have been studied with synchrotron radiation and valence, core and Auger electron spectroscopic techniques. The first theme of the thesis is that of mixed clusters. It is shown that by varying the cluster production technique both structures that are close to that predicted by equilibrium considerations can be attained as well as far from equilibrium structures. Electronic processes following ionization constitute the second theme. The post-collision interaction phenomenon, energy exchange between the photo- and the Auger electrons, is shown to be different in clusters of argon, krypton and xenon. A model is proposed that takes polarization screening in the final state into account. This result is of general character and should be applicable to the analysis of core level photoelectron and Auger electron spectra of insulating and semi-conducting bulk materials as well. Interatomic Coloumbic Decay is a process that can occur in the condensed phases of weakly bonded systems. Results on the time-scale of the process in Ne clusters and mixed Ar/Ne clusters are herein discussed, as well observations of resonant contributions to the process. In analogy to Auger vis-à-vis Resonant Auger it is found that to the ICD process there is a corresponding Resonant ICD process possible. This has later been observed in other systems and by theoretical calculations as well in subsequent works by other groups. Delocalization of dicationic valence final states in the hydrogen bonded ammonia clusters and aqueous ammonia has also been investigated by Auger electron spectroscopy. With those results it was possible to assign a previously observed feature in the Auger electron spectrum of solid ammonia.

Aqueous solutions were studied using photoelectron and Auger spectroscopy, based on synchrotron radiation and a liquid micro-jet setup. By varying the photon energy in photoelectron spectra, we depth profiled an aqueous tetrabutylammonium iodide (TBAI) solution. Assuming uniform angular emission from the core levels, we found that the TBA+ ions were oriented at the surface with the hydrophobic butyl arms sticking into the liquid. We investigated the association between ions and their neighbors in aqueous solutions by studying the electronic decay after core ionization. The (2p)−1 decay of solvated K+ and Ca2+ ions was studied. The main features in the investigated decay spectra corresponded to two-hole final states localized on the ions. The spectra also showed additional features, related to delocalized two-hole final states with vacancies on a cation and a neighboring water molecule. These two processes compete, and by comparing relative intensities and using the known rate for the localized decay, we determined the time-scale for the delocalized process for the two ions. We compared to delocalized electronic decay processes in Na+, Mg2+, and Al3+, and found that they were slower in K+ and Ca2+, due to different internal decay mechanisms of the ions, as well as external differences in the ion-solute distances and interactions. In the O 1s Auger spectra of aqueous metal halide solutions, we observed features related to delocalized two-hole final states with vacancies on a water molecule and a neighboring solvated anion. The relative intensity of these feature indicated that the strength of the interaction between the halide ions and water correlated with ionic size. The delocalized decay was also used to investigate contact ion pair formation in high concentrated potassium halide solutions, but no concrete evidence of contact ion pairs was observed. / Felaktigt tryckt som Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology 726

Depressive disorder, etiology, objective criteria for identifying depression, depression and suicide, depression in ICD-10, treatment, chemicals in the brain and transmission of information, action mechanism of antidepressants, cutting depression, comorbidity, biological and psychotherapeutic treatment options, pharmacotherapy, ATC classification drugs, antidepressants,classification according to the distribution of the ATC, guidelines for the treatment of depression. Identifying the trend and volume of consumption of antidepressants - the code N06A in the Czech Republic in the period 2003-2008 using data from the Všeobecná zdravotní pojišťovna ČR and a comparison based on specific criteria: regional (consumption by region), gender (consumption by gender), age (consumption by age groups), season and month (consumption in different seasons and months) and ATC groups (consumption by chemical / therapeutic / pharmacological subgroups N06A * - 4th level ATC class and consumption by subgroups of chemical substances N06A ***, ie . active substances - 5th level ATC classification). A rough estimate of possible share of depressive and neurotic disorders found in consumption, based on additional data from the database of the Všeobecná zdravotní pojišťovna ČR.

This diploma thesis is concerned with possibilities of patient data transfer from a pacemaker or implantable cardioverter-defibrillator to physician over GSM. Theoretical part describes options of data transfer in GSM networks, data appropriate for sending and a structure of message is proposed. A device, that is able to send medical data in a form of SMS messages is designed and constructed. The device uses a Freescale MC68HC908GP32 microcontroller, character display with a Hitachi HD44780 controller and a cell phone Sony CMD-J70. The program for microcontroller is written in assembler for HC08. For tabular view of received messages, an application software for PC was created.