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Frailty and Outcomes in Liver Transplantation: A DissertationDolgin, Natasha H. 04 April 2016 (has links)
In recent years, the transplant community has explored and adopted tools for quantifying clinical insight into illness severity and frailty. This dissertation work explores the interplay between objective and subjective assessments of physical health status and the implications for liver transplant candidate and recipient outcomes. The first aim characterizes national epidemiologic trends and the impact of Centers for Medicare and Medicaid quality improvement policies on likelihood of waitlist removal based on the patient being too frail to benefit from liver transplant (“too sick to transplant”). This aim includes more than a decade (2002–2012) of comprehensive national transplant waitlist data (Scientific Registry of Transplant Recipients (SRTR)). The second aim will assess and define objective parameters of liver transplant patient frailty by measuring decline in lean core muscle mass (“sarcopenia”) using abdominal CT scans collected retrospectively at a single U.S. transplant center between 2006 and 2015. The relationship between these objective sarcopenia measures and subjective functional status assessed using the Karnofsky Functional Performance (KPS) scale are described and quantified. The third aim quantifies the extent to which poor functional status (KPS) pre-transplant is associated with worse post-transplant survival and includes national data on liver transplantations conducted between 2005 and 2014 (SRTR). The results of this dissertation will help providers in the assessment of frailty and subsequent risk of adverse outcomes and has implications for strategic clinical management in anticipation of surgery. This research will also to serve to inform national policy on the design of transplant center performance measures.
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Analýza školních seznamů literárních děl k ústní části maturitní zkoušky z českého jazyka a literatury / The Analysis of school lists of literary works for oral maturity exam in the Czech language and literatureHoráková, Kristýna January 2021 (has links)
This thesis analyses reading lists composed by secondary schools in school year 2016/2017 for the purposes of common general part of maturity exam - oral exam from Czech language and literature. The thesis creates basic material for exploring the form and development of state maturity exam. Reading lists are put into context with literary theoretic conception of canon as the thesis touches upon literary science, pedagogy and didactics. The thesis proceeds from general analysis of literary canon to functions and forms of canon (school canon and maturity exam canon). Then it concentrates on documents, which were available to students taking the maturity exam. The thesis carries out research on collection of 461 secondary schools that offer studies completed by maturity exam. It is followed by presentation of obtained data, verification of its correspondence to binding criteria defined in Katalog požadavků zkoušek společné části maturitní zkoušky (document specifying requirements for common general part of maturity exam) and comparison of obtained data with available sources from school and literary background. The conclusions reveal the content of given part of maturity exam and are set into context of current knowledge of academic and professional society. Keywords Reading lists, maturity exam,...
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Fenomén akademické peregrinace jako téma moderní středoevropské historiografie: příklad českých a moravských studentů na vybraných kalvínských vzdělávacích institucích (1575-1620) / The "peregrinatio academica" Phenomenon as a topic of modern Middle-European Historiography: An Example of Czech and Moravian Students at Selected Calvinist Education Institutions (1575-1620)Píš, Ondřej January 2021 (has links)
The aim of this thesis is to present the phenomenon of academic peregrination from several points of view. It is first outlined as a specific topic of Czech historiography, which has been processed since the second half of the 19th century. Emphasis is placed on current research in a Central European perspective. Database projects that represent the current trend in the study of academic peregrination are presented in more details in the thesis. A separate part consists of a case study dealing with Czech and Moravian students at selected reformed institutes in the period 1575-1620. Detailed research was carried out on five institutes in present-day Germany and Switzerland - the universities of Basel, Heidelberg and Marburg, and the academies in Herborn and Geneva. The edited matrices of these institutions have become the main source of this part of the presented work. The student lists used so far proved to be insufficient and gap-free for the analysis. The work includes the updated and formally unified lists of Czech and Moravian students at selected schools in the selected period. The social origin of students in observed was also analyzed. Attention was also paid to trends in education at reformed schools and differences in Czech and Moravian academic peregrination. Key words Academic...
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EFL Teaching Materials for Students in Grade 6: A Corpus-Based InvestigationSkoglund, Rebecca January 2023 (has links)
Vocabulary is a crucial component for language acquisition and EFL lessons are often dictated by the usage of textbooks and workbooks. The current study therefore aims to investigate how effective textbooks are in helping learners acquire high, mid, and low-frequency words as well as to what degree high and mid-frequency words are repeated throughout the textbooks. Additionally, the study explores the types of exercises presented in the EFL teaching materials, with a particular focus on the extent to which they promote learners' active engagement and use of the vocabulary presented. The findings suggest that EFL teaching materials could benefit from more comprehensive and systematic approaches to vocabulary instruction, which emphasize the active use and recycling of high and mid-frequency words in meaningful contexts. The present study recommends that teaching materials and EFL teachers incorporate more varied and interactive exercises that promote learners’ active engagement and use of the target vocabulary. Additionally, the study uses corpus-based methods to investigate the frequency level of text bodies compiled from EFL textbooks targeting sixth-grade pupils in Sweden. Furthermore, the accompanying workbooks are examined to establish the types of exercises pupils are exposed to through their use. In addition, the study suggests that teachers using the included teaching materials should incorporate additional vocabulary exercises in their EFL instructions to promote the repetition of words found in the textbooks.
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The Influence of Emergency Department Wait Times on Inpatient SatisfactionWood, John, III 12 1900 (has links)
Patient satisfaction dimensions have a wide ranging and significant impact on organizational performance in the healthcare industry. In addition, the Centers for Medicare and Medicaid Services Hospital Value Based Purchasing (HVBP) Program links patient satisfaction to Medicare reimbursement, putting millions of dollars at risk for health systems. A gap in the literature exists in the exploration of how a patient's experience in the emergency department affects their satisfaction with inpatient services. In a multiple regression analysis, the relationship between HVBP Patient Experience of Care and hospital level factors including emergency department wait times are explored. Results indicate a statistically significant relationship between hospital level factors and standardized measure of patient satisfaction with a moderate adjusted effect size (p= <.0001, R2 adjusted= 0.184). Emergency department wait times post physician admit orders were most salient in predicting patient satisfaction scores (rs2= 0.434, β= -0.334, p= <.001). Recommendations to improve emergency department wait times include focusing on key decision points and implementation of electronic systems to support the movement of admitted patients out of the emergency department as quickly as possible.
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A Comparative Analysis of SecurityServices Using Identity and AccessManagement (IAM)Muddychetty, Nithya Sree January 2024 (has links)
Background: Identity and Access Management (IAM) is a critical IT securityframework for managing digital identities and resource access. With roots datingback to ancient civilizations, IAM has evolved from basic authentication to sophisticated methods. Okta, a leading cloud-based IAM platform founded in 2009, excelsin identity management, authentication, and access control. It is recognized for itscommitment to security and adaptability to cybersecurity challenges. As of October2023, Okta maintains its prominent position in the IAM market, acknowledged byGartner’s Magic Quadrant for Access Management, worldwide. Objectives: The objective of this thesis is to conduct a comprehensive comparative analysis of security services, specifically focusing on their integration with IAMsolutions. This investigation seeks to provide an examination of security serviceslike Multi-factor authentication (MFA) and Single Sign On (SSO) and evaluate theireffectiveness in conjunction with IAM. By doing so, we aim to determine which security approach offers the most robust protection in our digitally interconnected world. Methods: The primary goal of this methodology is to create a robust, secure,and user-friendly authentication and access management system using Okta withinan IAM framework. This involves the integration of both MFA and SSO features.To kickstart the process, we establish a controlled environment that mirrors thereal-world scenarios. Okta is chosen as the IAM tool, and its deployment involvesmanaging user identities, controlling access, and handling authentication. Results: The result of the study on the comparative analysis of security servicesusing IAM reveals distinct differences in the effectiveness and features among securityservices. Key findings highlight variations in authentication methods, authorizationmechanisms, and overall security robustness. This comprehensive examination provides valuable insights into the strengths and weaknesses of different IAM-basedsecurity services, offering a foundation for informed decision-making in selecting themost suitable solution for specific organizational needs. Conclusions: This thesis conclusively demonstrates the efficacy of integrating SSOand MFA into IAM. The incorporation of Biometric Authentication and Time basedOne Time-Password (TOTP) in MFA garnered strong user preference. SSO implementation streamlined authentication, reducing steps and enhancing ease of use.The overwhelmingly positive user feedback and robust security measures validateSSO+MFA as a valuable contribution to IAM, ensuring data security and user confidence.
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Estratégias de aprimoramento do acesso à assistência: estudo de caso em nível municipal / Strategies to improve access to care: a case study on municipal levelGomes, Rodrigo França 03 May 2013 (has links)
A presente dissertação, inserida na área temática da Saúde Pública de Regulação e Fiscalização em Saúde (categoria SP1.011.127), destacou aspectos relacionados à política nacional de regulação em saúde. Com base na revisão da literatura relacionada com o tema, o estudo teve como objetivo principal apresentar e discutir os desdobramentos da realização de intervenção no sistema de regulação do acesso à assistência às especialidades médicas de um município de 250 mil habitantes no período de 2009 a 2011. Teve também, como objetivo secundário, analisar estratégias de desenvolvimento e operacionalização de protocolos de regulação do acesso à assistência ambulatorial em perspectiva municipal. Como referencial metodológico foi adotado o estudo de caso com abordagem descritiva predominantemente qualitativa. O capítulo de introdução versou sobre o cenário relacionado com a regulação do acesso à assistência e as intervenções aplicadas. Como resultados foram apresentadas as ações desenvolvidas no município no campo de infraestrutura e tecnologia da informação, aperfeiçoamento logístico e de processos, educação permanente e o desenvolvimento de protocolos de regulação do acesso. Na discussão, foram analisados os processos desenvolvidos, escolhas e ferramentas adotadas para o aperfeiçoamento do acesso à atenção ambulatorial, suas características e vulnerabilidades, discutindo-se as potencialidades desta implementação e o impacto no acesso aos serviços de saúde municipal / This dissertation, inserted in the thematic area of Health Care Coordination and Monitoring (SP1.011.127 category), emphasized issues related to national policy health regulation in Brazil. Based on a review of literature related to the topic, the study had, as main objective, present and discuss the unfolding of intervention performed in the medical specialties accessibility settled in a city of 250 000 inhabitants in the period from 2009 to 2011. Also sought, as a secondary objective, examine strategies to develop and manage regulatory access protocols in that city. The methodological framework was a case study with predominantly qualitative descriptive approach. The introductory chapter was about the scenario related to the regulation of access to care and interventions applied. Results presented the actions developed in the field of municipal infrastructure and information technology, logistics and process improvement, Public Health Professional Education and the development of regulatory access protocols. In the discussion were analyzed the processes developed, choices and tools used for the improvement of Health Services Accessibility, their characteristics and vulnerabilities, discussing the potential of this implementation and the impact on local health services
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Living SMART : an Internet course for adults with ADHDMoëll, Birger January 2013 (has links)
ADHD affects executive functions and pharmacological treatment is the most common intervention. Medication is ineffective for some and psychosocial interventions are scarcely available. CBT that teaches organizational skills for managing ADHD-symptoms has shown promising results. Smartphones can help individuals perform executive tasks such as planning and organization and they could be efficacious as a support tool for ADHD patients. The current study is a RCT that compares an online course (n=29) based on previously effective CBT treatments for ADHD to a wait-list control (n=29). The intervention focused on teaching the use of an online calendar and smartphone apps. The intervention brought significant improvement (p < 0.001) to participants regarding ADHD symptoms and 38% of participants were considered clinically significantly improved. This indicates that online treatments using IT-tools for ADHD is effective and that smartphones can be used as a tool for aiding individuals with impairments in executive functions.
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Essays in immigration economics and political economySajons, Jörg Christoph 20 February 2012 (has links)
This thesis revolves around two themes. The first is whether granting citizenship to immigrant children at birth affects their parents’ return migration decisions and integration into the host-country society. Evaluating the introduction of birthright citizenship in Germany in 2000, I show in chapter 1 that migrant families are less likely to return to their home countries if their children automatically obtain the German citizenship. Chapter 2 continues the analysis of the same reform and finds that it has different effects across integration dimensions. Finally, chapter 3 is dedicated to the second theme. It examines whether stating the profession of candidates in open-list elections influences voter satisfaction and voting behavior. The results of a field experiment conducted in Barcelona indicate that voters are more satisfied if they know the profession of the candidates and that candidates working in high-skill occupations enjoy an electoral advantage. / Esta tesis estudia dos temas. El primero es si otorgar la nacionalidad a los hijos de inmigrantes afecta las decisiones de sus padres de retornar a su país y la integración en el país de destino. En el primer capítulo muestro que las familias migrantes tienen menos probabilidad de volver a sus países de origen si sus hijos automáticamente obtienen la nacionalidad alemana. El capítulo dos sigue analizando la misma reforma y encuentra que sus efectos varían entre diferentes dimensiones de integración. Finalmente, el capítulo tres se dedica al segundo tema, el efecto de incluir la profesión de los candidatos en elecciones con listas abiertas. Los resultados de un experimento de campo en Barcelona indican que los votantes están más satisfechos si conocen la profesión de los candidatos y que los candidatos que trabajan en ocupaciones cualificadas disfrutan de una ventaja electoral.
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Estratégias de aprimoramento do acesso à assistência: estudo de caso em nível municipal / Strategies to improve access to care: a case study on municipal levelRodrigo França Gomes 03 May 2013 (has links)
A presente dissertação, inserida na área temática da Saúde Pública de Regulação e Fiscalização em Saúde (categoria SP1.011.127), destacou aspectos relacionados à política nacional de regulação em saúde. Com base na revisão da literatura relacionada com o tema, o estudo teve como objetivo principal apresentar e discutir os desdobramentos da realização de intervenção no sistema de regulação do acesso à assistência às especialidades médicas de um município de 250 mil habitantes no período de 2009 a 2011. Teve também, como objetivo secundário, analisar estratégias de desenvolvimento e operacionalização de protocolos de regulação do acesso à assistência ambulatorial em perspectiva municipal. Como referencial metodológico foi adotado o estudo de caso com abordagem descritiva predominantemente qualitativa. O capítulo de introdução versou sobre o cenário relacionado com a regulação do acesso à assistência e as intervenções aplicadas. Como resultados foram apresentadas as ações desenvolvidas no município no campo de infraestrutura e tecnologia da informação, aperfeiçoamento logístico e de processos, educação permanente e o desenvolvimento de protocolos de regulação do acesso. Na discussão, foram analisados os processos desenvolvidos, escolhas e ferramentas adotadas para o aperfeiçoamento do acesso à atenção ambulatorial, suas características e vulnerabilidades, discutindo-se as potencialidades desta implementação e o impacto no acesso aos serviços de saúde municipal / This dissertation, inserted in the thematic area of Health Care Coordination and Monitoring (SP1.011.127 category), emphasized issues related to national policy health regulation in Brazil. Based on a review of literature related to the topic, the study had, as main objective, present and discuss the unfolding of intervention performed in the medical specialties accessibility settled in a city of 250 000 inhabitants in the period from 2009 to 2011. Also sought, as a secondary objective, examine strategies to develop and manage regulatory access protocols in that city. The methodological framework was a case study with predominantly qualitative descriptive approach. The introductory chapter was about the scenario related to the regulation of access to care and interventions applied. Results presented the actions developed in the field of municipal infrastructure and information technology, logistics and process improvement, Public Health Professional Education and the development of regulatory access protocols. In the discussion were analyzed the processes developed, choices and tools used for the improvement of Health Services Accessibility, their characteristics and vulnerabilities, discussing the potential of this implementation and the impact on local health services
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