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Personal Health Records (PHRs) allow patients to access and in some cases manage their own health records. Their potential benefits include access to health information, enhanced asynchronous communication between patients and clinicians, and convenience of online appointment scheduling and prescription refills. Potential barriers to PHR use include lack of computer and internet access, poor computer or health literacy, security concerns, and provider disengagement. PHRs may help those living in rural areas and those with chronic conditions such as heart failure, monitor and manage their disease, communicate with their health care team and adhere to clinical recommendations. To provide some much needed actual research, a descriptive mixed methods study of the usability, usefulness, and disease management potential of PHRs for rural heart failure patients was conducted. Fifteen participants were enrolled. Usability issues fell into three categories: screen layout; applying consistent, standard formatting; and providing concise, clear instructions. Participants used PHR features that were more convenient than other methods or that had some additional benefit to them. There was no difference between rural and urban participants. A heart failure nurse promoted recording daily heart failure symptoms in the PHR. Most participants did so at least once, but many found it cumbersome. Reasons for recording included the comfort of having clinical staff monitor the data. Participants who were stable did not find recording as useful as did those who were newly diagnosed or unstable. Participants used asynchronous communication to send messages to the heart failure nurse that they would not otherwise have communicated. The study expands the knowledge of PHR use by addressing useful functionality and disease management tools among rural patients with heart failure. The patients were able to complete tasks they found useful. The increased communication and disease management tools were useful to some.

Project briefing presented at the CNI Spring 2015 Membership Meeting, April 13-14, 2015, Seattle, WA / The University of Arizona (UA) Libraries has an evolving strategy to steward the scholarly record of the institution. As a key component of this strategy the Libraries have a leadership role in implementing UA Vitae, a mandated online faculty activity reporting system with initial focus on supporting the faculty evaluation process. In partnership with the Office of the Provost and Campus Computing, the Libraries contribute expertise in support of this campus initiative. Leveraging the data from this effort to capture a more holistic view of the scholarly record provides opportunities for the Libraries to partner on approaches to utilizing, stewarding, and exposing the scholarly record. This presentation will describe the University and the Library’s evolving strategies in regard to defining and stewarding the scholarly record, our experiences with the build-out of the faculty activity reporting system, and next steps in bringing together information and systems that are transforming our University.

Magister Curationis - MCur / Background: Complete recording of information is the foundation of continuity of care. However, the quality of patient information recording is a major problem being experienced by health services institutions in many countries. In Burundi there is a lack of accurate information recording and processing of patient information. The quality of patient information recorded is unreliable for decision making and management of healthcare delivery. Aim: This study investigated the quality of patient information record-keeping among nurses in selected hospitals in Burundi. The objectives were as follows: (a) to describe the knowledge of nurses on the benefits of the quality of patient record-keeping in selected hospitals in Burundi, (b) to describes nurses’ attitudes on the benefits of the quality of patient record-keeping in selected hospitals in Burundi, c) to determine the association between sociodemographic characteristics and nurses’ knowledge and attitudes on the benefits of the quality of patient record-keeping in selected hospitals, and (d) to identify barriers influencing the quality of record-keeping in selected hospitals in Burundi. Methodology: The study employed a quantitative research approach using a descriptive survey design. The target population for this study was N=121 nurses; an all-inclusive sampling technique was used to include all 121 qualified nurses who were working in the selected hospitals. A self-administered questionnaire was used to collect the data. The data were analysed using SPSS version 24. Statistical variables such as knowledge, attitudes and barriers were analysed using descriptive statistics to generate frequency, and cross tabulation using chi square test was also adopted to determine the association between sociodemographic characteristics and nurses’ knowledge and attitudes on the benefits of the quality of patient record-keeping. The reliability and validity of the instrument were established and a pre-test was conducted to validate the questions. All ethical principles regarding the study were adhered to. The findings from this study provide relevant information about the benefits of quality of patient record-keeping for the management of the hospitals and all relevant stakeholders in Burundi.

This thesis focuses on a time in the mid-1960s where practice in the studio changed from a formal arena where previously rehearsed songs were recorded, to a playground where sonic possibilities were explored and sound manipulation became normal practice. This abuse of technology and manipulation of reality became part of the creative process in the studio, providing soundscapes that resonated with the counter-cultural ethos of upsetting the established order, and were adopted by the mainstream during the 1967 ‘Summer of Love”. Following a discussion of current literature, practice as research is applied to demonstrate how interaction with historical technology reveals the performative nature of the tacit knowledge that created many of the aural effects under consideration. The research then focuses through the prism of two case studies, “Eight Miles High” recorded by The Byrds in Los Angeles in January 1966, and “Rain”, recorded by The Beatles in London in April 1966. Through re-enactment of these historical recording sessions, I recreate the closed envirnment of the 1960’s recording studio. By interacting with historical technology and following a similar structure to the original sessions, I investigate how the methodology was influenced by collaborative actions, situational awareness and the demarcation of roles. Post session video analysis reveals the flow of decision making as the sessions unfold, and how interaction with the technological constraints recreates ‘forgotten’ techniques that were deemed everyday practice at the time and were vital to the outcome of the soundscapes. The thesis combines theory and practice to develop an understanding of how the engineers interacted with technology (Polanyi, 1966), often abusing the equipment to create manipulated soundscapes (Akrich and Latour, 1992), and how the sessions responded to musicians demanding innovation and experimentation, circumventing the constraints of established networks of practice (Law and Callon, 1986) during the flow of the recording session (Ingold, 2013).

acase@tulane.edu / Relative Sea-Level (RSL) change influences surface processes and stratigraphic architecture of deltaic systems and has been studied extensively for decades. However, we still lack a quantitative framework to define what constitutes a small vs. large or short vs. long RSL cycle. We explore these questions with a suite of physical experiments that shared identical forcing conditions with the exception of sea-level. We utilize two non-dimensional numbers that characterize the magnitude and period of RSL cycles. Magnitude is defined with respect to the maximum autogenic channel depth, while the periodicity is defined with respect to the time required to deposit one channel depth of sediment, on average, everywhere in the basin. The experiments include: 1) a control experiment lacking RSL cycles, used to define autogenic scales, 2) a low magnitude, long period (LMLP) stage, and 3) a high magnitude, short period (HMSP) stage. We observe clear differences in the response of deltas to the forcing in each experiment. The RSL cycles in the HMSP stage induce allogenic surface processes and stratigraphic products with scales that exceed the stochastic variability found in the control stage. These include the generation of rough shorelines and large temporal gaps in the stratigraphy. In contrast, the imprint of LMLP cycles on surface processes and stratigraphy is found in properties that define the mean state of a system. These include the mean shoreline location and extraction of sediment inbound of the mean shoreline. This work demonstrates the effectiveness of defining RSL cycle magnitude and period through autogenic scales and provides insights for generation of forward stratigraphic models influenced by RSL change. / 1 / Lizhu Yu

Sol-gel matrices may be used to immobilise enzymes, facilitating retention of the catalyst while allowing a flow of substrates and products through the matrix. Candida antarctica lipase B (CALB), a commonly used industrial enzyme, has been shown to have a prolonged catalytic life and enhanced activity when encapsulated in these sol-gel materials. However, the molecular basis for this effect had yet to be elucidated. This study investigated the effect of encapsulating CALB in sol-gel matrices by comparison of CALB in solution with its encapsulated form. Use of complementary techniques revealed the presence of complex interactions between the enzyme and the evolving sol-gel material. 29Si Nuclear Magnetic Resonance (NMR) measurements demonstrated that CALB influenced sol-gel structure by altering silica speciation. Inclusion of CALB also altered the mesoporosity of the matrices as determined using nitrogen sorption and electron microscopy. Correlation of activity assays with 29Si speciation changes indicated that the catalytic activity of the enzyme in solution was directly involved in sol-gel hydrolysis and condensation reactions. Increased specific activity of CALB in the sol-gel aqueous precursor solution resulted in measurable changes in the gel structure of matrices containing 3.1mg of CALB/ml of gel. Small angle neutron scattering (SANS) was used to examine the structure of CALB in solution. The influence of the sol-gel reactants glycerol, sodium fluoride and isopropanol upon the radius of gyration of CALB in solution was determined. SANS was also employed in an investigation of encapsulated CALB molecules which utilised contrast matching of the sol-gel matrix. However, contrast variation studies found that the match point for the silica matrix, both with and without enzyme present, was lower than predicted (~35% vol% D2O). Consequently, the contrast match point of the protein was close to that of the encapsulating material. Scattering from the encapsulated protein at this point was therefore minimal; it is clear that the contrast match point of the protein should be moved through in vivo deuteration in future experiments of this type. These investigations advance the understanding of interactions between the matrix and the encapsulated enzyme in sol-gel biomaterials.

In the late twentieth century international trade moved from a political multi-polar system based on the nation-state to a system featuring unified regional trading regimes. An inevitable feature of increased cooperation through bilateral, regional and international arrangements is the emergence of disputes over the interpretation and implementation of the agreed upon commitments. Accordingly, reliable mechanisms for the settlement of trade related disputes have become necessary to ensure the effective and continued functioning of these arrangements. Over the years these dispute settlement mechanisms have evolved from the relatively simple, diplomacy based structures called for in the GATT, to the detailed, legalistic, adjudication based mechanism found in the WTO. Bilateral and regional initiatives, such as NAFTA and MERCOSUR, as well as the EU, have similarly adopted dispute settlement mechanisms which adopt, in varying degrees, legalistic adjudicatory processes. Since 1967 ASEAN has spearheaded the creation of a regional trading bloc in the South East Asian region. As in other trading blocs, this has inevitable led to the need to develop effective and workable dispute settlement mechanisms. This thesis examines the development of trade dispute settlement mechanisms in ASEAN tracing its development from a model based on pragmatic diplomacy to a legalistic adjudicatory system with particular reference to the ASEAN context. It examines the extent to which the ASEAN context has influenced the content and the adoption of trade dispute settlement mechanisms in the region, as well as the extent to which the recently adopted 2004 Enhanced Protocol on Dispute Settlement can adequately address trade disputes in the region while remaining sensitive and responsive to the ASEAN context. Based on a comparative examination of dispute settlement mechanisms in other trade agreements, a range of key procedural issues are identified and examined with a view to identifying the prospects and challenges which ASEAN faces in the implementation of its dispute settlement mechanism. The thesis analyses the prospects and challenges of implementation the 2004 Enhanced Protocol on DSM.

The continental shelf off South Australia is incised by some of the largest known submarine canyons. Extensive observations of submarine canyons in other parts of the world have shown submarine canyons can result in locally persistent upwelling regions. Along the southern coastline, westward slope currents including anticyclonic eddies and the Flinders Current (FC) can result in favourable conditions for upwelling in the vicinity of these canyons. Little data is available to describe the FC and so we review three global ocean circulation models and their representation of the FC. Though there are considerable differences between the outputs of these three models, this analysis provides a range of potential scales for the structure and transport of the FC. The reasons for the differences between the output of the three models are extensive, but to a first approximation, climatological surface wind stress products are compared. Dynamical descriptions of the flow past submarine canyons are reviewed and in part extended, in particular the vertical scale of the induced motion is estimated as the Rossby height RH. A description of upwelling and downwelling flow incorporating vorticity stretching is also presented. An idealised model of the southern Australian continental shelf and the submarine canyons reveals the circulation is heavily modified by the presence of the canyons, inducing persistent upwelling of dense water onto the downstream shelf. In addition, one prominent feature of the induced circulation ??? a coastal jet ??? is found to be peculiar to flat inner shelf topographies. More realistic topography including a sloped inner shelf results in reduced shoreward transport within the canyon and hence reduced upwelling.

This thesis work has focused on the study of itaconate monomers and photo-initiation processes in acrylate, methacrylate and itaconate monomer systems. Novel information pertaining to photo-initiator derived radical species and their reactivity, as well as the behaviour of itaconate polymerization systems is presented in detail. The knowledge gained from the photo-initiation studies is utilized as a precursor to mark polymer chains using nitrones as radical spin traps and the applicability of this technique discussed. The sterically hindered monomers dimethyl itaconate (DMI), di-n-butyl itaconate (DBI) and dicyclohexyl itaconate (DCHI) were polymerized via reversible addition fragmentation chain transfer (RAFT) free radical polymerization. The RAFT mediated polymerization of these monomers displayed hybrid living behaviour (a mix of conventional and living free radical polymerization characteristics) of varying degrees depending on the molecular structure of the RAFT agent employed. DCHI was also polymerized using atom transfer radical polymerization (ATRP). The resulting molecular weight distributions are broad for the RAFT mediated systems (1.2 ≤ PDI ≤ 3.4). The molecular weight distributions generated via the ATRP of DCHI are narrower (1.2 ≤ PDI ≤ 1.5). Chain transfer to monomer constants for the itaconate monomers DMI, DBI and DCHI have been determined at 60 ??C (CDMI = 1.4⋅10-3, CDBI = 1.3⋅10-3 and CDCHI = 1.0⋅10-3) and are relatively large in comparison to similar 1,1-disubstituted systems, suggesting that the transfer to monomer reaction is significant. PREDICI?? simulations confirm that a significant chain transfer to monomer step results in broad molecular weight distributions. Viscosity of the polymerizing system has also been shown to be an important factor in the resulting width of the molecular weight distributions. Chain extension of RAFT capped pDCHI and pDBI yield molecular weight distributions that progressively shift to higher molecular weights. Thermogravimetric analysis (TGA) of pDCHI-block-pStyrene copolymers indicates thermal degradation in two separate steps for the pDCHI and pStyrene blocks. Conventional pulsed laser polymerization coupled with size exclusion chromatography (PLP-SEC) as well as multi-pulse pulsed laser polymerization (MP-PLP) has been employed to study the depropagation kinetics of DMI, DBI DCHI and di(4-tert butylcyclohexyl) itaconate (DBCHI). The effective rate coefficient of propagation, kp eff, was determined for DMI, DBI and DCHI in bulk and solution of cyclohexanone (DCHI), N-methylformamide (DMI and DBI) and anisole (DBCHI) for monomer concentrations between 0.7 &lt cM 0 &lt 7.1 mol L-1 in a wide temperature range (0 &lt T &lt 90 ??C). The resulting Arrhenius plots (i.e. ln kp eff vs. 1/RT) displayed a significant curvature in the higher temperature regimes and were analyzed in their respective linear and curved sections to yield the activation parameters of the forward and reverse reaction. Mark-Houwink-Kahn Sakurada parameters for pDBI and pDBCHI were determined in tetrahydrofuran at 40 ??C using triple detection gel permeatation chromatography. High resolution Electrospray Ionization - Quadrupole Ion Trap Mass Spectrometry (ESIMS) was applied to study the polymeric product spectrum generated by the pulsed laser polymerization (PLP) of methyl methacrylate (MMA), methyl acrylate (MA), butyl acrylate (BA) and DMI at temperatures ≤ 0 ??C in the presence of various photo-initiators including 2,2-dimethoxy-2-phenylacetophenone (DMPA), benzoin, benzil, benzoin ethyl ether (BEE) 2,2-azobisisobutyronitrile (AIBN) and bis(2,4,6-trimethyl-benzoyl)- phenylphosphinoxide (Irgacure 819) to study the reactivity of primary and potential secondary derived radical fragments from photolytically induced fragmentation. Termination products, both combination and disproportionation, were identified with high accuracy. Results have been compiled in a user friendly table presenting the reactivity of the various photolysis product fragments towards the different monomers. Energy deposition into the MA/photo-initiator systems is found to have no influence on the product distributions of the MA polymers produced via photo-initiation under the conditions examined. For various photo-initiators employed, products congruent to that of chain transfer to monomer species in the DMI photo-polymerizations are observed, conclusively illustrating that chain transfer to monomer is a significant reaction pathway in itaconate free radical polymerizations. Both the benzoyl and acetal fragments generated as a result of DMPA photo cleavage were found to initiate and highly likely terminate polymerization. Under the conditions studied, the acetal radical produced upon DMPA photolysis fragment further to yield methyl radicals which seem to act predominantly as terminating moieties. Both the benzoyl and ether fragments produced as a result of benzoin photo cleavage were found to act as initiating and probable terminating species, indicating that the ether radical fragment does not act exclusively as a terminating species. Additionally, increasing laser intensity and/or irradiation repetition rate (i.e., energy deposition into the system) results in more complex product distributions of the MMA polymers produced via photo-initiation (with the exception of AIBN). Temperature was determined to have a minor influence on the resulting product distribution under the conditions examined. Polymerization systems utilizing Irgacure 819 give complex product spectra due to the formation of second generation radical species resulting in several initiator fragments incorporated into a single polymer chain. A novel method utilizing PLP in free radical polymerization has been developed for marking of polymer chains with radical spin traps. By introducing a so-called “marker” (nitroxide derived from a nitrone), which specifically terminates propagating radicals via combination, a polymer subdistribution is generated which can be measured by ESI-MS and may potentially be utilized to determine propagation rate coefficients of ultimate accuracy. The general methodology of the technique in which such marker radicals are generated via reaction of an initiating radical with a nitrone is demonstrated on the examples of butyl acrylate (BA) and vinyl acetate (VAc).