Per- and- polyfluoroalkyl substances (PFASs) are widely used in commercial and industrial products and leach into the environment from different applications. PFASs poses an issue to both wildlife and humans because of different toxic properties. Different PFASs have been found to effect different hormones, are possibly carcinogenic, or can affect metabolic function. Many initiatives have been started by countries, organisations, and companies to prevent PFASs from ending up in the environment. Aquatic environments are a sink for PFASs, and much research has been done on the marine environment and its residents to investigate the effects of these substances. In earlier research, the need for a time-line perspective combined with both a total fluorine analysis and mass spectrometry analysis has been pointed out. This study's objective was to investigate how the concentrations of known and unknown bioaccumulating organic fluorinated substances in pilot whales are evolving over time. The results show fluctuating levels of PFASs for the different whales, making it hard to view any trends. There is a pattern of the unknown organic fluorine, that is increasing after 2009 when the phase-out of perfluorooctane sulfonate (PFOS) happened. The highest amount of unknown fluorine is 77% in one of the samples. Short-chain PFASs seems to be a good short-term solution as a replacement for the long-chain PFASs but could pose a threat over a longer time perspective. Both pilot whales and humans risk getting high concentrations of PFASs through biomagnification, the acceptable daily intake (ADI) that are in place regarding PFASs should possibly be on total organic fluorine (TOF) instead, due to the high percentage of unknown organic fluorine.

Medicaid is a complicated system for educators to access. LEAs can access Medicaid funds by: billing through a contracted service, establishing their own billing system, or may choose not billing Medicaid. The purpose of this study was to investigate the Medicaid billing processes used in Arkansas public schools. The study considers processes some LEAs use to bill Medicaid for related services, and reasons why other LEAs do not access Medicaid. All LEA supervisors of special education in the state of Arkansas were sent a survey regarding Medicaid billing practices. A total of 87 supervisors responded to all or part of the survey (80%). The survey included three major parts. All supervisors were asked to complete the first section, which asked demographic information. Supervisors who currently bill Medicaid were asked to respond to the second section of the questionnaire, which sought information about the billing process. The third section of the survey was completed by supervisors of nonbilling LEAs. These supervisors were asked to rate a series of possible reasons LEAs do not bill as each pertained to their decision. They were also asked to list and rate any other reasons why they do not bill Medicaid. The respondents worked in systems where attendances usually ranged between 500 and 5,000 students with 106-525 of those students receiving special education. Most school systems in the sample have participated in Medicaid billing (80%). Most (76%) prefer billing Medicaid directly rather than using a billing service. Ninety-seven percent bill Medicaid for speech therapy, 72% for occupational therapy, and 79% for physical therapy. In addition, 31% bill Medicaid for Early Periodic Screening Diagnosis and Treatment (EPSDT). The data suggest that the billing procedures can be incorporated with relative ease into a clerical/secretarial assignment, taking less than four hours per week to transact. Various technologies were utilized for processing, but the most popular was the AEVCS machine. Almost half of the supervisors billing Medicaid experienced problems with other agencies. Suggestions for improvements fell into four categories. These were providing ongoing training for billing districts, simplifying billing requirements and paperwork, improving the software used to submit information, and dealing with DHS and Medicaid agency representatives. For the LEAs responding to the survey, total Medicaid reimbursement was $2,237,006.55. This is 78% of the statewide total. Nonbilling districts indicated that the complexity of the billing process, and personnel factors were reasons they decided against seeking Medicaid reimbursement. The findings of the study lead to recommendations for access to billing information, training, and communication with others involved in the process. / Ed. D.

Faults have a controlling influence on a variety of geologic processes includingfluid flow, the mechanical behavior of the crust, and seismicity. The geologic sciences have long recognized that faults generate earthquakes; however, few indicators of ancient earthquakes exist in fault-zones. This dissertation documents several indicators for the preservation of ancient earthquakes in fault-zones including frictional melt (pseudotachylyte), highly-polished fault slip surfaces, and hydrothermal alteration. These deformation products result from rapid generation of frictional heat during earthquakes.This dissertation also focuses on the seismic potential of continental low-angle normal faults (LANF). We document the preservation of voluminous pseudotachylyte along a LANF suggesting that the fault repeatedly nucleated large earthquakes. Additionally, a synthesis of reported occurrences of LANF pseudotachylyte indicates that LANF seismicity is common during extension. This has important implication for the mechanics and evolution of LANFs and for the assessment of seismic hazards.We also present a little used, high resolution, and low-cost 3D range camera for use in geolgy. The KinectTM is a 3D infrared range camera that can be used to collect high- resolution (± 1 mm), 3D data in both field and laboratory settings. We describe the use of the KinectTM in geologic appications and recommend more widespread use.

Coronary artery bypass grafting (CABG) is a procedure used to help improve and save the lives of thousands of coronary artery diseased patients every year. Measuring health-related quality of life (HRQL) significantly contributes to understanding patient perceptions of outcomes attributable to this surgery. Previous research on patient outcomes for CABG has included the evaluation of changes in HRQL at intervals of 3-6 mo postsurgery. There is a lack of research, however, that evaluates how physical fitness levels of CABG patients prior to surgery, may affect these HRQL outcomes. The purpose of this study was to develop a prediction equation, using fitness in addition to other combined variables, that predicts HRQL 3 mo after CABG. This study evaluated the influences of prior physical fitness, when these attributes are considered in combination with other clinical variables. Moreover, whether these variables would be possible predictors of health-related quality of life outcomes 3 mo after CABG were evaluated. These variables consisted of heart disease risk factors, physical fitness measures, and whether or not the patients had histories of various comorbid conditions, including that of prior history of myocardial infarction. The HRQL was assessed using the Medical Outcomes Study Short Form 36 (MOS SF-36), and concurrently, questionnaire data were collected with several other patient perceived measures expected to have potential confounding influences on HRQL; the MOS Social Support Scale; Beck Depression Inventory; Health Complaints Scale; the Life Orientation Test for optimism/pessimism. In all, 45 men and 10 women, were evaluated just prior to and 3 mo following CABG. Two of the eight subscales of the MOS SF-36 were predicted at an adjusted R 2 of greater than 50%. The sum of three skinfolds was the only physical fitness measure combined with current smoker, Beck Depression Inventory, presurgical General Health Perception and the Medical Outcomes Study Social Support Scale, that contributed most to predicting General Health Perception (R 2 =.68). Elbow flexion was the only physical fitness variable, combined with four presurgical MOS SF-36 subscales (Mental Health, Role Physical, Social Functioning and General Health Perception) that contributed to predicting the subscale of mental health (R 2 =.61). Physical fitness did contribute to predicting the global scope of health perception and mental health. Physical and social domains of HRQL, however, were not significantly predicted. Presurgical HRQL was most significant when predicting postsurgical HRQL. Therefore, in order to predict postsurgical HRQL, presurgical HRQL should be used. Physical fitness variables can be utilized to contribute to predicting certain aspects of HRQL. / Master of Science

No description available.

The forest contributes to many ecosystem services and Sweden places great hope in the forest for the green transition, which has created a debate in society concerning how the forest should be used. Based on the Theory of Planned Behaviour, attitudes, subjective norms, and perceived behavioural control were investigated amongst the Swedish foresters to evaluate their intention to continue with tract logging in favour of introducing alternative methods. Through a web-based survey, data was collected and analysed and the main results from the present study show that attitudes have the strongest influence on the intention. This finding can be explained by the fact that attitudes have been formed and developed over a long time, strengthened by the Forest Protection Act promoting high production, the culture, the market incentives towards bioeconomy and forestry education in Sweden.

Climate change concerns have led to the settlement of agreements and policies that aim to bring nations and industries together to keep global warming under 1.5 degrees Celsius. Diverse strategies have been implemented in the last decades to achieve this goal, such as investment in near-zero emissions technologies and the implementation of carbon markets. This study explores the role of sustainable start-ups as project developers in the voluntary carbon market and provides guidance, through the structure of the business model and assessment of relevant stakeholders, for their successful entry into this emergent market. A case study about the voluntary carbon market and the perspective of start-ups was the approach given to this work. Twelve semi- structure interviews with key stakeholders were conducted and through a thematic analysis, key factors for start-ups to consider were identified. These factors include access to information, barriers to entry, financial resources, innovation and technology, market dynamics, motivation and perception, regulatory environment, and stakeholders’ engagement. The findings were the foundation to develop and structure a business model canvas as well as a technological roadmap to assist start-ups in navigating through the voluntary carbon market. Despite the challenges encountered, positioning in the voluntary carbon market enables start-ups to play a vital role in the decarbonization efforts and the transition to a low- carbon economy.

Zum 01.01.2004 wurden deutschlandweit verbindlich DRGs („Diagnosis-Related-Groups“) zur Krankenhausfinanzierung eingeführt. Psychiatrische und psychosomatische Kliniken blieben von diesem Konzept der Fallpauschalen vorerst ausgenommen und wurden weiter nach Tagessätzen bezahlt. Bisher veröffentlichte Studien zu den Effekten der DRG-Einführung in anderen Ländern konzentrierten sich hauptsächlich auf die Folgen für die somatischen Kliniken. Ziel der vorliegenden Studie war es, die Auswirkungen der geänderten Finanzierung somatischer Krankenhäuser mittels Fallpauschalen auf die Patientenpopulation der psychiatrischen Kliniken zu erforschen. Zu diesem Zweck wurden die Daten von 634 Patienten, die sich im Zeitraum vom 01.01.2001 bis 31.12.2006 im Krankenhaus für Psychiatrie, Psychotherapie und Psychosomatische Medizin des Bezirks Unterfranken in Lohr am Main in Behandlung befanden, erfasst. Dadurch konnten die Daten aus drei Jahren vor und drei Jahren nach Einführung der Fallpauschalen miteinander verglichen werden. Unsere Ergebnisse zeigen vor allem im Bereich der Krankheitsschwere hoch signifikante Veränderungen. Im Zeitraum von 2004 bis 2006 werden die Patienten bei Aufnahme als psychiatrisch schwerer krank eingestuft. Außerdem nahm im Zeitraum nach DRG-Einführung die Anzahl somatischer Nebendiagnosen signifikant zu. Im Zuge der Umstellung der Krankenhausfinanzierung auf ein DRG-System kam es nicht wie befürchtet zu dramatischen Veränderungen in der „Verlegungspolitik“ der Kliniken. Die Psychiatrien müssen wohl nicht als Auffangstationen für somatische Patienten mit langem Heilungsverlauf dienen. Allerdings finden sich trotzdem einige Veränderungen in der Patientenpopulation. Dies kann dem allgemeinen Wandel des Krankenhauswesens geschuldet sein. Aufgrund des finanziellen Drucks der Krankenkassen und der Politik entwickelt sich das gesamte Gesundheitswesen in Deutschland in Richtung kosteneffizienter Gesundheitsdienstleistungen. Das betrifft auch die Psychiatrie. DRGs stellen folglich nur einen Teil des Wandels dar und können nicht als alleinige Erklärung für die Veränderungen angesehen werden. Allerdings wäre es sicherlich interessant in der Zukunft weitere Studien betrachten zu können, die beispielsweise den Bereich der niedergelassenen Ärzte näher beleuchten und den Anteil der durch diese erbrachten ambulanten Leistungen. / The financing of hospitals by the use of a DRG system started in Germany at the 1st of January 2004. In the beginning psychiatric and psychosomatic hospitals were excluded from the payment by case-based lump sums. The funding was still based on day rates. Previously released studies about the effect of the implementation of a DRG system in different countries mainly focused on the consequences for somatic hospitals. Therefore this study aims to investigate the impact of the financing of somatic hospitals by the DRG system on the population of psychiatric patients. For this purpose data of 634 patients who received treatment in the psychiatric hospital of Lohr am Main (Krankenhaus für Psychiatrie, Psychotherapie und Psychosomatische Medizin des Bezirks Unterfranken) was collected during the period of six years form 01.01.2001 to 31.12.2006. Thereby data of three years prior to the beginning of the financing by case-based lump sums were compared with data of three years past the beginning. Especially the disease severity in the years 2004 to 2006 was significantly higher. Also the number of secondary diagnoses increased significantly after the implementation of the DRG system. The restructuring of the hospital financing system did not cause dramatic changes of the transfer policy of the somatic hospitals. Psychiatric hospitals do not have to serve as “rescue centers” for somatic patients with an interminable healing process. However there are some variations in the patient population. This might be because of the general reorganisation of the hospital system. Due to the financial pressure of the health insurance companies and the politics the whole public health sector in Germany develops to cost-effective health services. This also affects the psychiatric hospitals. The DRG system represents only a part of the transformation process and cannot solely be held responsible.

Cochlear implants are devices, which are implanted into the cochlea to aid hearing via stimulation of the cochlear nerve. For this study, we were interested in understanding the age-related changes in the impedances of the electrodes implanted with a cochlear implant system. The impedances of the electrodes reflect the integrity of the implanted system in the inner ear, and the efficiency of transmission of information from the externally worn device to the implanted system. Thus, monitoring cochlear impedances is important for the patient's rehabilitation. Our hypothesis was that cochlear implant impedances would decrease as an effect of age. Current systems record the impedances via a telemetry system when the patient’s cochlear implant is connected to the programming software. This data is saved within the system and can be retrieved and de-identified within the software. In our investigation, we collected the de-identified impedance data from this system to understand the effects of age. This data was collected from the ETSU Audiology Clinic at the Nave Center. The de-identified data was reviewed and sorted between 3 different age brackets. Data was averaged and compared between age brackets and electrodes. Overall, we found in this study that there are no significant differences between age brackets when comparing cochlear implant impedances across the different electrodes. The slight differences between impedances across electrodes and age brackets could be due to many contributing factors, however, the differences were not considered statistically significant. This study could indicate future directions for further research including, comparing impedance differences between male and female subjects, longitudinal case studies, and comparing across implant manufacturers and device type.

Potato has played a major role as staple food in Sweden since Jonas Alströmer brought it intothe country in the 18th century and is considered by many to be one of the essences of”swedishness”. About 826.000 tonnes are produced yearly on an area of approximately 20.000 –25.000 ha today and potatoes are mostly grown in the southern parts of Sweden(www.jordbruksverket.se). Potato is best grown in light textured soils with good drainage, but thisalso leads to irrigation being necessary to provide enough moisture for the sensitive potato duringa normal Swedish year. Normally, drip irrigation is used since it enables the farmer to control theexact volumes of water and nutrition being applied.This study was conducted in 2007-2008 (the report was finished in spring 2022 though) at whatwas then known as The Department for Soil Sciences (today Department of soil and environment)at SLU, Uppsala. There was an ongoing project aimed at finding suitable strategies for irrigatingpotato, and the aim of this study was to investigate which one of the following strategies is bestsuited for the soils used in the experiments:• 1 hour every day or 4 hours every four days• Placing the dripperlines on the soil surface or bury them 30 cm into the soil.The study was conducted in two parts, where the first part tested the two time intervals with thedripperlines on the soil surface and the second part with the dripperlines buried into the soil.Measurements of soil water content and infiltration were performed during both parts and for thesecond part, soil water tension was also measured. When the measurements were finished, thesame strategies were modelled in Hydrus-2D with similar soil parameters to see if the programcould be a useful tool when simulating similar scenarios. Water content was measured after thefirst part of the experiment was finished, but no distinct wetting front could be seen and nodifference in water content could be seen since measurements were delayed due to bad weatherconditions. The water content was measured throughout the second part and a water front couldbe detected directly after an irrigation event, but all signs of irrigation were gone 24 hours later.The results of the Hydrus2D simulations did not agree completely with the experimental datasince the sand used in the model differ from the ones used in the experiments.Conclusions that could be drawn were that soils with water holding capacities as poor as the onesused in the experiments should rather be irrigated often than with longer intervals. Also, themodelling with Hydrus2D did not give the same results for these soils and therefore, no directconclusions about the program’s applicability could be drawn in this study.Key words: potato, drip irrigation, strategies, sand, simulations, Hydrus-2D, infiltration, water holdingcapacity.