Background: Previous literature has found mixed results concerning the relationship between depression, and anxiety, and length of hospital stay among cardiac surgical patients. Given the high prevalence of these psychiatric illnesses and cardiovascular disease in Canada, a better understanding of the relationship between these variables has the potential to influence medical and psychiatric outcomes for countless individuals. Objectives: The objectives of this manuscript style thesis are to (a) describe the prevalence of mild and moderate-to-severe symptoms of depression and anxiety disorders in a sample of cardiac patients (Manuscript 1) and (b) analyze the effects of these symptoms on post-operative length of stay while controlling for potential confounding variables (Manuscript 2). Methods: This secondary analysis used data collected from a consecutive series of consenting patients attending Foothills Hospital Pre-operative Assessment Clinic (August 1998-March 2002). Patients completed the Zung Self-Rating Depression and Anxiety scales, and a questionnaire assessing potential confounders. Manuscript 1: Prevalence values and 95% intervals were calculated for mild and moderate-to-severe depression and anxiety while logistic regression was used to determine predictors of these conditions. Manuscript 2: The relationship between symptoms of depression, anxiety and length of stay was analyzed using multiple linear regression. Results: Manuscript 1: We estimated that moderate-to-severe symptoms of depression and anxiety were present in 10.66% and 3.42%, respectively. Mild depression (21.90%) and anxiety (32.89%) were also present. Common predictors of both conditions included sex, general health, and a recent myocardial infarction. Depression was further associated with co-morbid illness, as was type of surgery with anxiety. Manuscript 2: Patients with depression experienced a significant increase in length of stay compared to mentally healthy patients. Age, general health, type of surgery and education also predicted hospital stay, while anxiety did not. Conclusions: Manuscript 1: The prevalence of depression and anxiety in our sample demonstrates the need to address the burden of psychiatric illness in this population. Predictors of these disorders may assist in determining risk groups that would benefit most from psychiatric testing and interventions. Manuscript 2: The elevated length of stay observed among patients with depression supports the implementation of screening and treatment in this population. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2010-11-03 19:01:58.445

The chlorophyll degradation pathway is central to a number of plant processes including senescence and fruit ripening. However, the regulation of the chlorophyll degradation pathway enzymes is not well understood. The aim of this thesis was to elucidate the genetic mechanisms that control changes in pigment composition leading to fruit flesh yellowing in kiwifruit. Actinidia deliciosa and A. chinensis fruit, which are green and yellow, respectively, provide an opportunity to study the regulation of chlorophyll levels. The expression of genes that code for enzymes of the chlorophyll and cytokinin metabolic pathways was measured using qRT-PCR. Candidates for chlorophyll degradation regulatory points were then characterised for functionality by transient transformation in N. benthamiana. The endogenous cytokinin levels were measured in kiwifruit and transient activation assays were carried out with the promoters of key candidate genes. Overall, expression of the chlorophyll degradation genes was elevated in yellow fruit and expression of biosynthetic genes was higher in green fruit. The chlorophyll degradation-associated protein, STAY-GREEN2 (SGR2), was more highly expressed in yellow fruit, and transient over-expression of SGR was sufficient to drive chlorophyll degradation. Expression of isopentenyl transferase (IPT), the rate-limiting step for cytokinin biosynthesis, showed an increase towards maturity in green fruit, but not in yellow fruit. However, both fruit had similar high levels of cytokinin nucleotides and free bases. A gene coding for O-glucosylation was also highly expressed in green fruit. Green fruit contained higher levels of cytokinin O-glucosides and ribosides towards maturity, suggesting differences in cytokinin signalling, which could lead to regulation of chlorophyll levels via activation of the SGR promoter by transcription factors. It is likely that the chlorophyll degradation pathway and cytokinin metabolism are linked. The differential expression of cytokinin response regulators could lead to differential regulation of cytokinin levels in the fruit of the two species, and possibly differential regulation of the chlorophyll degradation pathway. Progress towards elucidation of the control of chlorophyll levels provides knowledge of this key process in kiwifruit and potentially gene-based markers for breeding new kiwifruit cultivars.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 110-126).

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Background: High nursing turnover and early nursing career exit rates evidenced by the current global nursing shortage is the impetus for effective strategies aimed at retaining nurses in their current positions. Nurses’ behavioral intentions to leave or stay are not well understood. Aim: This thesis aims to increase understanding of why clinical nurses choose to remain in their current positions and to assess the influence that nursing leaders have on staff nurses’ intent to stay. Methods: Two systematic literature reviews were conducted; one to synthesize current research on clinical nurses’ intentions to stay and the influence of leadership practices on those intentions; the other to determine the appropriateness of conceptualizing intentions to stay and leave as opposite ends of a continuum. Building on two published conceptual models (Boyle et al. 1999; Tourangeau & Cranley (2006), a new theoretical model of nurses’ intent to stay was developed and tested as a structural equation model using LISREL 8.8 and a subset of the QWEST study data provided by 415 nurses working in nine hospitals in one Canadian province. Results: The systematic reviews identified positive relationships between relational leadership practices and nurses’ intentions to stay, supporting the assertion that managers influence the behavioral intentions of nurses and their intentions to stay and leave. Intentions to stay and leave were found to be separate but correlated concepts. Model testing results, χ2=169.9, df=148 and p=0.105, indicated a fitting model that explained 63% of the variance in intentions to stay. Concepts with the strongest direct effects on intent to stay were empowerment, organizational commitment, and desire to stay. Leadership had strong total effects and indirectly influenced intent to stay through empowerment. Conclusions: Findings suggested that intent to stay or leave should be investigated as separate but correlated concepts. Relational leadership that focuses on individual nurses and supports empowering work environments will likely affect nurses choosing to remain in their current positions.

A burn injury is a disastrous trauma and can have very wide ranging impacts, including individual, family, and social. Burns patients generally have a long period of hospital stay whose accurate prediction can not only facilitate allocations of scarce medical resources but also help clinicians to counsel patients and relatives at an early stage of care. Besides prediction accuracy, prediction timing of length of hospital stay (LOS) for burn patients is also critical. Early prediction has profound effects on more efficient and effective medical resource allocations and better patient care and management. Hence, the objective of this study is to apply a backpropagation neural network (BPNN) for predicting length of hospital stay (LOS) for burn patients at early stages of care. Specifically, we defined two early-prediction timing, including admission and initial treatment stages. Prediction timing at the admission stage is to predict a burn patient¡¦s LOS when the patient is admitted into the Burns Unit. Prediction at the initial treatment stage refers to the timing right after the first surgery for burn wound excision and skin graft is performed (typically within 72 hours of injury if the patient¡¦s condition allows). Experimentally, we evaluated the prediction accuracy of these two stages, using that achieved at the post-treatment stage (referring to the timing when all surgeries for burn wound excision and skin graft are performed) as benchmarks. The evaluation results showed that prediction LOS at the admission and the initial treatment stages could attain an accuracy of 50.37% and 57.22%, respectively. Compared to the accuracy of 62.13% achieved by the post-treatment stage, the performance reached by the initial treatment stage would consider satisfactory.

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The common drivers for hotel accommodation are tourism and business travel and hotel demand seem to outstrip supply in many places. More than 50 % of visitors to Sweden stay at a traditional hotel but is there room for alternate accommodation like serviced apartments besides the traditional hotel for people visiting? These are usually referred to as extended stay or long-stay accommodation. The aim of this thesis project is to explore whether there are growth opportunities for serviced apartments in Sweden. A secondary aim of the thesis project is to identify challenges (if any) to this segment and also to identify the major operators of serviced apartments in Sweden. The research has been conducted through literature review, survey and interviews. The findings are that there seem to be growth opportunities particularly in the Stockholm area, even though there are issues that need to be addressed by the industry such as its fragmented nature and to keep up with company traveler programs and policies. The research also found that the major operators in Sweden are small, independent and national. Efterfrågan på hotellrum drivs framförallt av turist och affärsresenärer och på manga ställen verkar efterfrågan vara större än efterfrågan. Mer än hälften av turisterna som kommer till Sverige bor på ett traditionellt hotell när de kommer på besök och övernattar men finns det utrymme för alternativt boende som lägenheter med självhushållning? Syftet med detta examensarbete är att undersöka huruvida det finns tillväxtmöjligheter för segmentet självhushållda lägenheter (s.k. long-stay) tillhandahållna av operatörer. Syftet är också (om än sekundärt) att identifiera utmaningar för denna bransch samt vilka de största operatörerna är? Information har samlats in via genomgång av befintlig litteratur på ämnet, via enkätundersökning och intervjuer. Slutsatsen är att det verkar finnas tillväxtmöjligheter, framförallt i Stockholm även om branschen står inför flera utmaningar såsom tydlighet med produkten. Operatörerna i Sverige är identifierade som små, fristående och nationella.

Tourism industry plays an important role in developing countries like Thailand. An acccommodation is a key expense of almost every trip, therefore accommodation development need to be taken into account in order to attract target tourists from other countries. The long-stay tourism is important since the longer the tourists’ stay means the more receipts spent. Subsequently, many studies have been focused both on the tourism and real estate sides about long-stay accommodation in various types. Long-stay tourism in Thailand is an outstanding tourism alternative. Tourists from high cost of living, cold countries and aging population are the target market as we can see from the Americans, Europeans and Japanese tourists. Accordingly, future demographic structure is expected to increase so that cause emerging niche market called retirement home as a sub-set of the long-stay tourism. This thesis analyzes the attributes of the long-stay tourism in Thailand. The Scandinavian tourists are selected case studies according to their qualification and potential to be prospective customers. The opinions from the demand side, Scandinavian tourist-investors, were collected. Currently many projects of the Scandinavian are in the markets and will continue more as a consequence of predictions following tourism trend. In contrast, the study shows that there are some obstacles, which decelerate the growth of this market. Government policy is key to drive tourism and real estate sector to get along together. Until now, there is no exact solution but some alternatives from relevant market in sample countries were exemplified in order to develop tourism accommodation with the long-stay tourism in Thailand later on.

Doctor of Philosophy / Department of Family Studies and Human Services / Sandra M. Stith / Male-to-female intimate partner violence (IPV) remains a significant social problem as research into its prevalence, incidence, severity, and resulting health consequences has documented. Just as we are beginning to understand some of the pieces of this problem in the United States, researchers and domestic violence advocates have called for expanding that understanding by exploring the range of risks involved in leaving a relationship with a violent man or in seeking help. In addition to the risk of personal physical harm, women in relationships with violent men may also consider the risk of harm to others, and the financial, social and legal risks to leaving (Hamby, 2008). Others have called for a better understanding of IPV through the examination of experiences of IPV within specific groups or subpopulations, such as with immigrant women (Menjívar & Salcido, 2002). This study uses Hamby’s (2008) holistic risk assessment, Choice and Lamke’s (1997) 2-part decision-making model, and a comparison between immigrant and non-immigrant women, to expand our understanding of the decisions women make about leaving their relationship and to seek help. With a sample of 1,307 women in the United Stated, similarities and differences between immigrant and non-immigrant women in the predictors to leaving and help seeking were determined through logistic regression analysis. Results indicate support for a holistic risk assessment such as Hamby’s (2008), and demonstrate significant differences between immigrant and non-immigrant women in their risks and barriers to leaving and help seeking. Nevertheless, examinations of the predictors to leaving and help seeking demonstrate many areas of similarity between immigrant and non-immigrant women in the ways they make decisions about leaving a relationship with a violent man or seeking help. Domestic violence advocates and therapists who work with women in relationships with violent men are encouraged to explore more fully the impact of the risks of harm to others, and the financial, social and legal risks to leaving or staying, and are further encouraged to expand their ideas of what women need once they leave, given the barriers that may make leaving more difficult for them.