Tuberculosis (TB) is an important disease worldwide. Currently, one-third of the world’s population is infected with TB, and it is a leading cause of death among people living with HIV. Immediate but also accurate diagnosis is required for disease control, yet available diagnostics cannot do both simultaneously. Therefore, designing a technique that can diagnose the disease correctly in the shortest possible time is in great demand in order to stop its spread. Diffraction-based sensing is a novel technique for measuring of biomolecular interaction that has potential for disease diagnosis. In this study, diffraction-based sensing successfully demonstrated its usefulness for diagnostics of TB using recombinant TB antigen, or by detection of interferon-γ that is produced from white blood cells when the immune system activates. The feasibility of the technology was also evaluated in terms of providing real time observation, reducing diagnostic duration, and increasing sensitivity of detection.

Tuberculosis (TB) is an important disease worldwide. Currently, one-third of the world’s population is infected with TB, and it is a leading cause of death among people living with HIV. Immediate but also accurate diagnosis is required for disease control, yet available diagnostics cannot do both simultaneously. Therefore, designing a technique that can diagnose the disease correctly in the shortest possible time is in great demand in order to stop its spread. Diffraction-based sensing is a novel technique for measuring of biomolecular interaction that has potential for disease diagnosis. In this study, diffraction-based sensing successfully demonstrated its usefulness for diagnostics of TB using recombinant TB antigen, or by detection of interferon-γ that is produced from white blood cells when the immune system activates. The feasibility of the technology was also evaluated in terms of providing real time observation, reducing diagnostic duration, and increasing sensitivity of detection.

¡eAbstract¡f The difference of medical diagnosis and its related effect is important to medical quality consistency and medical care cost-effectiveness. At present, the specialists including radiologists, chest medicine doctors & family medicine doctors able to perform X-ray diagnosis of foreigners¡¦ physical examination would cause the difference of flow fluency & consistency of medical quality in foreigners¡¦ physical examination. Due to the shortage of studies in discussing the difference among doctors¡¦ diagnosis in our country, the study is an experimental cross-section design that focuses on the diagnosis difference of 3595 foreigners¡¦ chest X-ray among 3 different specialists. The result of research may be useful for making policy of public health and be referent to the quality control and management in the hospital. According to the result, the X-ray diagnosis of lung TB showed no difference between specialists & hospital levels in Chi-square analysis, but the diagnosis consistency of kappa between every 2 doctors was so fluctuant among 10 doctors, the kappa value ranged from ¡V0.005 to 1.0. Besides, the consistency of kappa among either 10 doctors, 4 chest medicine doctors, 3 radiologists or 3 family medicine doctors were poor, and the kappa value ranged from 0.035 to 0.2. The highest kappa was 0.18629 among 3 family medicine doctors, while the lowest kappa was 0.038197 among 4 chest medicine doctors. The other studying result also showed low consistency of kappa among 10 doctors in X-ray diagnosis of lung abnormality, the kappa value ranged from ¡V0.009 to 0.375. Besides, the low consistency of ICC was also noted among 10 doctors in X-ray diagnosis scores of lung abnormality. ICC value ranged from ¡V0.0159 to 0.5540. The exploration of doctors¡¦ difference in X-ray diagnosis of lung was under no interference of medical payment system. If the X-ray diagnosis followed the standard of CDC, only requiring the abnormal TB, 3 specialists would show no difference in X-ray TB diagnosis. Therefore, the first line family medicine doctors who see the foreigners directly would also fit to make the diagnosis of X-ray lung TB. Moreover, due to the family medicine doctors understand the foreigners¡¦ history than other specialists, if the family medicine doctors make the diagnosis of X-ray lung TB, the overall examination procedure would be fast and better. From the article review, the consistency was low among doctors in many medical diagnoses, such as chest X-ray, cytology, CT scan, breast sono, emergent chest X-ray, KUB and skeletal X-ray. Due to the low consistency, there were researchers making effort and doing study to suggest that the doctors could elevate the consistency and reliability by continual discussion and learning. However, our country is short of study in discussing the difference among doctors. From the study result, the variation of consistency is huge. Whether it would affect the medical behavior of doctors, such as overusing the related tests or medicine having influence on patients¡¦ health and safety, further studies will be needed.

The purpose of this research is to study the effect of the thermal treatment on the devices. We dissolved polymer light emitting materials in different solvents to discuss the influence on polymer thin film and device efficiency at different thermal conditions. We confirmed that the best thermal condition was changed as that of solvent changes. In this study, we dissolved polymer blue light material¡ÐBP105 in Toluene and o-xylene. The glass transition temperature (Tg) of BP105 is 120.7¢J, and the boiling point of Toluene and o-xylene were 110 and 145¢J. That is namely the boiling point of Toluene and o-xylene are lower and higher, respectively, than the Tg of BP105. This makes us to compares the thermal treatment conditions on different influence from different boiling point of solvents. The interrelations between the thermal treatment temperature, the boiling point of solvents and the glass transition temperature of polymer is an interesting topic to study, because it does affect the surface morphology of polymer thin films and the characteristic of devices. The device structure is as follows: ITO/ PEDOT:PSS/ BP105/ LiF/ Ca/ Al. Known from the experimental results that the spectra and the morphologies of polymer thin films will change in the different thermal treatment condition, and the choice of different solvent will also affect the best thermal treatment condition for device processing. We observed the surface roughness of polymer thin film is one of the important factors to affect the device efficiency in this study. We found that if the boiling point of used solvent was higher than the thermal treatment temperature, which was higher than the Tg of polymer, the surface roughness of polymer thin film is more smooth resulting in higher current injecting and higher stability of the device. The best thermal treatment temperature is 130¢J by using o-xylene as solvent. The surface roughness of polymer thin film is 0.393 nm, and the maximum brightness of the device is 8593 cd/m2 at 12.5 V as a configuration of ITO(1500Å)/PEDOT:PSS(800Å)/BP105(650Å)/LiF(10Å)/ Ca(100Å)/ Al(2000Å). The luminous and the power efficiencies are 3.98 cd/A, and 1.43 lm/W, respectively, at the current density 100 mA/cm2.

Background and purpose: Tuberculosis (TB) is one kind of chronic infectious disease which caused by the mycobacterium tuberculosis, and still widely exists in the world. In Taiwan, there are approximately 15,000 new tuberculosis patients and 1,300 died annually. The incidence and mortality rate rank the number one among the legal reported disease in Taiwan. Therefore, how to prevent and control the tuberculosis becomes a crucial policy for Centers for Disease Control (CDC) in Taiwan. Directly Observed Treatment, Short-course (DOTS) is a TB control program implemented in many countries aggressively by the World Health Organization (WHO) since 1993. The implementation method is that patients are supervised by well-trained health care staff while medication is administered, to assure the clients taking each dose of medicine. This policy is intended to cure the patient in time, cutting off the infectious sources, prevent the efficacy of anti-tuberculosis drugs and cease the emerging of multidrug resistant tuberculosis (MDRTB) . For the long-term planning and the target of ¡§Halve the TB over the next ten years,¡¨ the CDC of Taiwan has been enforced the DOTS program since April 1st, 2006. The rate implementing DOTS in smear- positive case has been exceeded 90%. The purpose of this study is to examine the effect of DOTS policy on the outcomes of Tuberculosis before and after the DOTS policy implementation. Methods: The secondary databases from the study hospital were retrieved. The data included 24 months before and after the DOTS implementing (April 1st, 2006). We investigated if there¡¦s significant improvement in treating tuberculosis after the DOTS. Both descriptive and Chi-square tests were used to depict the study sample and to examine the correlation between treatment outcome and DOTS, respectively. Results: There is no difference on treatment outcome between male and female. Male had higher cavity formation on the chest x-ray. There¡¦s more easy treatment completion when the clients were younger than 65 years old. No cavity on the chest x-ray was statistically associated with negative acid fast stain. The chest x-ray showed cavity was related to higher completion rate of treatment. There¡¦s no correlation between the acid fast stain and treatment completion. There¡¦s no significant difference on treatment outcome after the DOTS implementing. Conclusions: There¡¦s no difference in treatment result between the ¡§DOTS¡¨ and ¡§without DOTS¡¨ group after April 2006. The reason we deliberate that may be the study hospital is located at the urban area, which is high prevalence area in tuberculosis and thus have been under control for years. The completion rate in tuberculosis treatment is already high enough. No wonder there¡¦s no such difference. Anyway, we can not ignore the policy of the DOTS, we must keep cooperation with this policy, make great efforts on tuberculosis prevention and control in Taiwan.

Nurse-client relationships are inherently valued in descriptions of the nature of public health practice and require consideration as intentional work that demands knowledge, skill, and personal engagement. They are also matters of place. In public health, they are largely taken-for-granted, particularly in the area of infectious diseases and the tuberculosis (TB) program specifically. TB nursing is structured within an explicit population focus, which challenges such relationship ideals as client-centered care, autonomy, and empowerment in everyday practice. This interpretive phenomenological study (Benner, 1994) of the relational work of TB nurses was undertaken to understand the nature of nurses’ relational work, wherever it happened, and how it was understood within the mix of assigned program tasks. Carried out in one of Canada’s largest TB programs, this study involved observing nine nurses and 24 clients in their respective visits over time, and interviewing 16 participants. Visits happened in homes and cars, and other assorted locations, highlighting how place shows up in these relationships and how nurses help clients to make sense of TB and broader life concerns shaping the experience of it. How they involve themselves interpersonally in these situations is the stuff that relational work is made of. Through the use of thematic analysis (Benner, 1994; Chesla, 1994), notes and transcripts were analyzed. The resulting interpretation of the nature of relational work is that of ‘welcome intrusions’, a notion that along with three key thematic dimensions: ‘getting through the door’, ‘doing TB but more than that’, and ‘beyond a professional’, addresses the central control-care tone of relational work. Together these themes identify key areas of knowledge and skill. That is, honesty and respect for privacy, ‘expertise’ in TB, dismantling the effects of stigma and displacement, and socializing-with-purpose. This emphasizes the value of articulating the everyday practices of nurses in population-focused programs that can contribute to successful treatment, and client healing and well-being. This relational work of TB nurses may be supported and enhanced when framed as the skill of involvement (Benner et al, 1996; Benner et al, 1999) and critically examined as part of providing comfort and enacting surveillance.

Sverige har under många decennier sett en minskning av tuberkulos (TBC), men infektionen har kontinuerligt ökat från 2003. Majoriteten av TBC-fallen är personer som är födda utanför Sverige. Hälsotillståndet har förbättrats i Sverige men det finns fortfarande problem. Kommunikationen mellan flyktingar och sjukvårdsspecialister är bristande idag, vilket resulterar att endast ett fåtal genomgår hälsokontroller. Detta kan leda till en ökning av infektioner och sjukdomar i Sverige. Denna studie undersöker hur hälsokommunikationen idag fungerar mellan den svenska sjukvården, nyanlända immigranter, asylsökande och flyktingar, samt vilken typ av vård som finns tillgänglig för flyktingar med hög risk för att utveckla TBC. Specifikt syftar studien till att förstå på vilket sätt kommunikation brister på samt analysera vilka sätt det finns för att en reducering av TBC i Sverige ska kunna ske och hur kommunikationen kan förbättras. Studien har genomförts med hjälp av både primära källor i form av intervjuer och sekundära källor. Baserat på de intervjuer och sekundära källor som genomförts i studien dras slutsatsen att trots att den svenska sjukvården utvecklas positivt så finns det en hel del brister - hälsokommunikation är bristande idag mellan nyanlända flyktingar, sjukvårdspersonal och myndigheter. En av huvudorsakerna som informanterna i studien nämnt är språket, mycket av det som skrivs och sägs är på svenska. Det är viktigt att en mer välfungerad hälsokommunikation utvecklas mellan de nyanlända flyktingarna, sjukvårdspersonal och myndigheterna för att det ska kunna underlättas för flyktingar att söka vård och samarbeta med sjukvårdspersonal med deras arbete för att kunna förhindra spridning av TBC och andra sjukdomar och infektioner i Sverige. / Sweden has for many decades witnessed a decrease of the spread of tuberculosis (TB), but between the years of 2003-2012 a new pattern has emerged with refugees carrying TB entering the country and contributing to a situation where the infection has slowly begun to spread again. The communication between the refugees and the health professionals has been inefficient, which inevitably results in fewer refugees undergoing health examinations. This in turn can lead to an increase of infections and diseases. The purpose of this study is to examine the current health communication between Swedish health professionals and immigrants, asylum seekers and refugees, and to give an overview of what type of health care currently exist for refugees with a high risk of TB. This is done to understand what is missing in the communication process, what has been done in order to improve the situation, and how it can be further improved in order to prevent TB. In order to fulfill the purpose of this study, a qualitative method has been used combining text analysis of interviews and secondary sources. This study has shown based on the interviews and secondary sources that the Swedish prevention work regarding TB is developing positively in general, but the communication between newly arrived refugees, health professionals and authorities in Sweden is lacking due to the fact that most of what is written and said in this communication process is in Swedish. This makes it difficult for the refugees to understand what is communicated and is stated as one of the main reasons why many refugees do not undergo health examinations, combined with the lack of awareness. Therefore a better functioning health communication between refugees, authorities and health professionals is required to support refugees seeking health care, as well as co-operating with health professionals to prevent the spread of not only TB but other infections and diseases in Sweden.

This study conducted baseline research to determine home range, movements and habitat selection of Manitoban elk (Cervus elaphus manitobensis) in the Duck Mountain (DM) of west-central Manitoba. Cow elk (n =22) were captured by helicopter net-gun and GPS radio-collared in 2005/06. Data was analyzed with ArcView 3.3 for Windows (ESRI). DM elk show selection for deciduous forest and avoidance of roads. Mean 100% MCP home ranges were 127.85 km2 with 95% and 50% adaptive kernel home range sizes of 58.24 km2 and 7.29 km2, respectively. Home range overlap occurs at all times of the year with many elk using farmland. Elk moved the least in late winter. Movements increased in the spring, declined in June with a gradual increase from July to October. Elk had generalized movement in southerly directions. No cow elk dispersed from the study area. Mean estimated calving date was June 3rd and mean estimated breeding date was September 27th. DM elk were found in mature deciduous/mixed-wood forest and shrub/grassland/prairie savannah ecosites but not found within 200 m of a road or water feature more often than expected by random. Elk were found in areas with <10% and >81% crown closure, on middle slopes and variable aspects. Elk displaced from forestry cut-blocks. Only 149 of 79,284 elk locations were within 100 m of a winter cattle operation. Recommendations to mitigate forestry and BTB impacts focus on riparian areas, road management, farming practices and hunting.

Tuberculosis (TB) is called a disease of poverty and is the main cause of death from infectious diseases among adults. In 1993 the World Health Organisation (WHO) declared TB to be a global emergency; however there were still approximately 1.4 million deaths due to TB in 2011. This thesis contains a detailed study of the existing literature regarding the global risk factors of TB. The risk factors identified from the literature review search which were also available from the NFHS-3 survey were then analysed to determine how well we could identify respondents who are at high risk of TB. We looked at the stigma and misconceptions people have regarding TB and include detailed reports from the existing literature of how a persons wealth, health, education, nutrition, and HIV status affect how likely the person is to have TB. The difference in the risk factor distribution for the TB and non-TB populations were examined and classification trees, nearest neighbours, and logistic regression models were trialled to determine if it was possible for respondents who were at high risk of TB to be identified. Finally gender-specific statistically likely directed acyclic graphs were created to visualise the most likely associations between the variables.

This study conducted baseline research to determine home range, movements and habitat selection of Manitoban elk (Cervus elaphus manitobensis) in the Duck Mountain (DM) of west-central Manitoba. Cow elk (n =22) were captured by helicopter net-gun and GPS radio-collared in 2005/06. Data was analyzed with ArcView 3.3 for Windows (ESRI). DM elk show selection for deciduous forest and avoidance of roads. Mean 100% MCP home ranges were 127.85 km2 with 95% and 50% adaptive kernel home range sizes of 58.24 km2 and 7.29 km2, respectively. Home range overlap occurs at all times of the year with many elk using farmland. Elk moved the least in late winter. Movements increased in the spring, declined in June with a gradual increase from July to October. Elk had generalized movement in southerly directions. No cow elk dispersed from the study area. Mean estimated calving date was June 3rd and mean estimated breeding date was September 27th. DM elk were found in mature deciduous/mixed-wood forest and shrub/grassland/prairie savannah ecosites but not found within 200 m of a road or water feature more often than expected by random. Elk were found in areas with <10% and >81% crown closure, on middle slopes and variable aspects. Elk displaced from forestry cut-blocks. Only 149 of 79,284 elk locations were within 100 m of a winter cattle operation. Recommendations to mitigate forestry and BTB impacts focus on riparian areas, road management, farming practices and hunting.