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.

A new trend in e-learning development is to have subject matter experts use rapid development tools to create training simulations. This type of training is called rapid e-learning simulation training. Though companies are using rapid development tools to create training quickly and cost effectively, there is little empirical research to indicate whether training created in this manner meets the needs of learners. The purpose of this study was to compare user responses to rapid e-learning simulation training to user responses receiving instructor-led training. The target population for this study was employees of a medium size private company in North America. Employees were divided into two groups and either received instructor-led training (comparison group) or received rapid e-learning simulation training (experimental group). The instrument used to measure user response was an adaptation of the technology acceptance model. Three variables were measured: training satisfaction, perceived ease of use, and perceived usefulness. Though no statistical significance was found between the two groups for training satisfaction and perceived usefulness, perceived ease of use was found to be statistically significant. Overall results fail to demonstrate the superiority of rapid e-learning simulation training over instructor-led training; however, this study indicates that rapid e-learning simulation training may be a viable substitute for classroom instruction based on user response.

archives@tulane.edu / Background: Prompt antiviral treatment of influenza virus infections can improve outcomes and reduce the likelihood of complications, particularly among children at high risk for complications. Recent, more stringent requirements for rapid influenza point-of-care test clinical sensitivity have implications for the impact and cost-effectiveness of outpatient influenza diagnosis and antiviral treatment. Objective: The objective of this research was to understand antiviral prescribing practices following and utilize these real-world probabilities to evaluate the cost effectiveness of rapid test-guided outpatient antiviral treatment in children. Methods: The analysis used data from patients presenting for outpatient care with influenza-like illness (ILI) collected through the Influenza Incidence and Surveillance Project (IISP). The first analysis used a retrospective case-control design to compare clinic, patient, and season characteristics that influenced the decision to prescribe influenza antiviral treatment following a negative rapid influenza detection test. The IISP data were then incorporated into cost-effectiveness analyses among high-risk and otherwise healthy children presenting for outpatient care with ILI. Results: The results from the first analysis demonstrated that clinicians prescribed influenza antivirals to 8.4% of all test-negative patients and that in age groups considered a proxy for high risk patients, prescribing was either less frequent among children aged <2 (aOR 0.4, 95% CI 0.3–0.6) or the same among adults aged ≥65 (aOR 0.9, 95% CI 0.7–1.3) compared with adults aged 18 to 64. The results from the antiviral cost-effectiveness analysis among healthy children showed that treatment guided by clinician judgement was cost saving compared to no treatment, but rapid testing produced the greatest benefit. Among high-risk children, test-guided treatment produced the greatest benefit and was cost effective. Results were sensitive to clinician diagnostic sensitivity, influenza prevalence and the probability a positive test or diagnosis would result in treatment. Conclusion: These studies indicated that clinical judgement continued to be used to prescribe antivirals for patients with suspected influenza, greatly impacting the associated costs of care. The decision to test for influenza should be contingent upon the results influencing treatment of the patient or high-risk contacts, or further costly diagnostic testing. / 1 / Ashley Fowlkes

Abstract Not Provided / Thesis / Bachelor of Science (BSc)

No description available.

No description available.

Current detection methods require at least one 24-48 hour enrichment step for the detection of Salmonella. This poses a problem because product often needs to be shipped before microbial contamination levels can be adequately ascertained. Therefore, the need for more rapid methods of Salmonella detection becomes apparent. The purpose of this thesis was to determine if an immunologically-based method, Immunomagnetic Capture(IMC) -ELISA and molecular-based detection methods, PCR and Taqman® PCR employing IMC without enrichment, could detect at least 102 cfu/ml of S. Typhimurium in broiler carcass rinse fluid (CRF) samples. IMC-ELISA, IMC-PCR, and IMC-Taqman® PCR were initially tested using 0 to 106 cfu/ml of pure culture S. Typhimurium. Each detection method was tested using artificially contaminated CRF samples. Finally, standardized IMC-ELISA, IMC-PCR, and IMC-Taqman® PCR methods were tested using commercial CRF samples. Salmonella concentrations were verified using a traditional plate method. IMC-ELISA produced consistent results when detecting at least 104 to 106 cfu/mL of pure culture S. Typhimurium. IMC-ELISA was not able to produce repeatable results when testing artificially contaminated CRF samples. S. Typhimurium was not detected in commercial CRF samples which by virtue of direct plating on XLT-4 were found to contain essentially no Salmonella (<1 cfu/ml). IMC-PCR was able to consistently detect 102 cfu/ml, whereas IMC-Taqman® PCR was able to detect 101 cfu/ml of pure culture S. Typhimurium. IMC-PCR, required four hours to complete, and it consistently detected 104 cfu/ml of S. Typhimurium in artificially contaminated CRF samples. IMC-Taqman® PCR took 3 hours to perform and was able to detect 103 cfu/ml S. Typhimurium in artificially contaminated CRF samples. The sensitivity, as well as the decreased time requirements of these detection methods, would suggest their usefulness in a commercial processing setting. / Master of Science

This thesis presents a damage model developed for the rapid prediction of the vulnerability of a ship concept design to AIREX weapon effects. The model uses simplified physics-based and empirical equations, threat charge size, geometry of the design, and the structure of the design as inputs. The damage volumes are customized to the design being assessed instead using of a single volume defined only by the threat charge size as in previous damage ellipsoid methods. This methodology is validated against a range of charge sizes and a library of notional threats is created. The model uses a randomized hit distribution that is generated using notional threat targeting and the geometry of the design. A Preliminary Arrangement and Vulnerability (PAandV) model is updated with this methodology and used to calculate an Overall Measure of Vulnerability (OMOV) by determining equipment failures and calculating the resulting loss of mission capabilities. A selection of baseline designs from a large design space search in a Concept and Requirements Exploration (CandRE) are assessed using this methodology. / Master of Science

Published Article / RP and recently RM have been key factors in the development of the manufacturing industry in assisting in the development of new products. Fortunately, the application of these technologies has been realised in the medical industry. Surgeons all over the world use physical models created from CT or MRI data using some sort of additive manufacturing. The fabrication of these models has exploded into a popular research area combining engineering, material and medical expertise. Long-term growth in the additive fabrication industry will come from designs that are difficult, time-consuming, costly, or impossible to produce using standard techniques. Growth will occur with advances in current additive processes which are coupled with breakthroughs in new materials. The applications of RP and RM are as diverse as the medical issues that arise. RM of custom design medical prostheses proves to be economically viable solution, not only because it is faster to produce but it gives the designer freedom of creation too. The paper discusses some interesting medical case studies.

Published Article / Atkinson distinguishes between four types of prototypes, categorised through its end-use: •Design or aesthetic prototypes •Geometrical prototypes •Functional prototypes •Technological prototypes Shigley and Mitchell define the design process according to the following six phases: Recognition of need Definition of problem Synthesis Analysis and optimization Evaluation Presentation The Centre for Rapid Prototyping and Manufacture (CRPM) of the Central University of Technology, Free State was asked to assist in the development of a newly developed gynaecological cream applicator. Apart from needing a freeform fabrication system to give form fit and function to the very complex design, the product needed Rapid Tooling / Rapid Manufacturing support to enable a first batch production for medical trials and evaluation. The paper will describe the total product development process alongside prototype categories described by Atkinson and design phases defined by Shigley and Mitchell (including some iterations enabled through timeous prototyping, including various Rapid Prototyping (RP) Technologies, soft tooling and vacuum casting). More importantly, results from Rapid Tooling for limited run production (due to the complexity of the product the cycle time of the Prototype Tool is fairly long), as well as the economical impact made possible through the support of CAD / CAM and RP Technologies, will be discussed.