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1

Castro, Marroquín Cesar Enrique, Rodriguez Juan Sebastian Guevara, Sajamin Jessenia Sonia Poicon, León Elizabeth Antuanette Rojas, and Azato Miyuki Jennifer Tengan. "HEALTH STREAM." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2021. http://hdl.handle.net/10757/656924.

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Este emprendimiento fue planteado por un grupo de estudiantes de la facultad de Negocios de la Universidad Peruana de Ciencias Aplicadas (UPC) que están próximo a obtener el grado de bachiller de Administración y Negocios Internacionales. Los conocimientos adquiridos durante estos años de la carrera nos han permitido plantear un modelo de negocio con una propuesta de valor de manera objetiva y directa. En primer lugar, se identificó el problema que es la tasa de crecimiento de enfermedades con trastornos psicológicos como es el estrés y ansiedad que están padeciendo las personas por el confinamiento social obligatorio a causa de la pandemia del COVID-19. Por estas razones, creamos la plataforma “Health Stream” que brinda diferentes cursos virtuales de deportes, para reducir el estrés que se da por la rutina del home office y clases. Asimismo, se ofrece talleres nutricionales y psicológicos para que el usuario pueda mejorar su estilo de vida. De esta forma, ponemos a disposición un servicio completo con tres planes de pago siendo Clásico, Gold y Premium. En conclusión, luego de haber realizado el lanzamiento de la página pudimos obtener diferentes críticas constructivas que nos ayudaron en el proceso del proyecto de negocio, por lo cual realizamos mejoras continuas para obtener la versión final.
This entrepreneurship was proposed by a group of students from the Business School of the Universidad Peruana de Ciencias Aplicadas (UPC) who are about to obtain their bachelor's degree in Administration and International Business. The knowledge acquired during these years of study has allowed us to propose a business model with a value proposition in an objective and direct manner. First, we identified the problem that is the growth rate of diseases with psychological disorders such as stress and anxiety that people are suffering from the mandatory social confinement due to the pandemic of COVID-19. For these reasons, we created the "Health Stream" platform that offers different virtual sports courses to reduce the stress caused by the home office routine and classes. We also offer nutritional and psychological workshops so that users can improve their lifestyles. In this way, we offer a complete service with three payment plans: Classic, Gold, and Premium. In conclusion, after the launching of the website we were able to obtain different constructive criticisms that helped us in the process of the business project, which is why we made continuous improvements to obtain the final version.
Trabajo de investigación
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2

Millington, Heidi Kathryn. "Spatial Analysis of the Impacts of Urbanisation on the Health of Ephemeral Streams in Southeast Queensland." Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367358.

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Aquatic ecosystems are vulnerable to threats from human activity. Numerous studies have shown that urban freshwater stream ecosystems are especially vulnerable to the intensity and complexity of stream health stressors associated with activities in the surrounding urban landscape. Scientists, government organisations and local volunteer groups are well aware of the deteriorating health of urban streams and are working towards understanding and managing the sources of stress on stream health. Improving the health of urban streams has the potential to provide local benefits such as biodiversity protection, enhanced ecosystem health, water purification, access to green space, scenic amenity and improved land values. While several important stressors have been identified in the Urban Stream Syndrome (elevated sediments, nutrients and contaminants, increased hydrologic flashiness and altered riparian and biotic assemblages) further research is required on the most important stressors and the mechanisms by which they impact stream health, especially in systems within dry climates where urban streams experience low flow conditions and flashy natural hydrology. Catchment-scale impervious surface has been identified in previous studies as a major driver of altered urban stream hydrology leading to degraded stream health. However, especially in drier climates, other aspects such as water quality and ecological processes associated with longitudinal and lateral connectivity have been identified as potentially more important stressors on urban stream health.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Griffith School of Environment
Science, Environment, Engineering and Technology
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3

Charron, Dominique F. "Livestock production and stream health in the Great Lakes Basin, an agroecosystem health approach." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq61971.pdf.

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4

Zhang, Jin. "Immunological modulation of antioxidants in side-stream cigarette smoke (SSCS) exposed mice." Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280048.

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Environmental tobacco smoke (ETS) is a complex mixture of chemicals generated during the burning of tobacco products. The principle contributor to ETS is side-stream cigarette smoke (SSCS), the material emitted from the smoldering tobacco product between puffs Our hypothesis is that reactive oxygen species from SSCS are playing an essential role in disease promotion and antioxidant supplementation (a single form of alpha-tocopherol or a mixture of multiple antioxidants) will potentially prevent SSCS associated tissue damage, pulmonary dysfunction. The specific aims of the present study are to determine if: (1) SSCS would induce tissue lipid peroxidation and proinflammatory responses; (2) SSCS would provoke pulmonary and cardiac function changes; (3) SSCS would cause oxidative stress, reduce nutrient concentrations and suppress immune function in murine retrovirus infections; (4) dietary alpha-tocopherol, specifically, can enhance resistance to oxidative damage by SSCS and improve lung function; (5) multiple antioxidant supplementation can modulate proinflammatory cytokine secretion and tissue lipid peroxidation induced by SSCS exposure in old healthy mice. SSCS exposure methodology in a murine model was developed to facilitate these goals. For the first time we established a SSCS model in murine retrovirus infection. Also we conduced a SSCS dose-response model for a cardiac function study. We found that SSCS exposure in mice consistently increased oxidation, depleted tissue vitamin E levels, and promoted inflammatory cytokines production. SSCS exposure at 120-min/day, 5 days/week for 12 weeks decreased heart contractile function and increased vascular resistance. SSCS induced increased oxidative stress, reduced nutrient concentrations and suppressed immune function, which could make mice with murine retrovirus more susceptible to opportunistic infections. Dietary alpha-tocopherol enhanced resistance against SSCS-induced oxidation and improved lung function, primarily through the antioxidant property of alpha-tocopherol and its modulation of local cytokine production. The multiple antioxidant with beta-carotene, bioflavanoids, Coenzyme Q10, d-alpha-tocopherol, L-ascorbic acid, L-carnitine, magnesium, N-acetylcysteine, retinol, selenium and zinc given as a dietary supplementation prevented oxidation and IL-6 production in healthy old mice during SSCS exposure. (Abstract shortened by UMI.)
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5

Lockard, Brendan Corbett. "Long Term Hydrologic Effects on Stream Health from Residential Development Patterns." Thesis, Virginia Tech, 2002. http://hdl.handle.net/10919/34013.

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In this study eight residential development scenarios are created for the mostly undeveloped Back Creek Watershed outside Roanoke, Virginia. The development scenarios include low, medium (cluster), medium (conventional), and high density development with and without development restrictions. These scenarios represent a large range of development as the land use imperviousness varies from 1% for the baseline condition to 34% for the most developed scenario. The hydrologic model HSPF is used to generate overland and channel flows from 43 years of rainfall.

Hydrologic output from HSPF of the various landuse patterns from the eight scenarios are evaluated using Post Processor, a Visual Basic program. The results show that increased development causes a reduction in Back Creek's baseflow and an increase in the occurrence of both high and low flow extreme events. Overall, these results indicate that increased development will increase the variability of flowrate in Back Creek.

Stream health impacts from flow variability were also analyzed with the Post Processor. First, hydrologic statistical variables with ecological relationships were used to gage the level of stream health impacts from flow variability. The averaged stream health index for the development scenarios was found to closely follow the amount of development, represented by the percent of impervious landuse. Second, the amount of velocity, depth, and both depth and velocity habitat available for three habitat guild representative species was evaluated for each scenario. The results indicated that increased development would lead to a substantial reduction in available riffle species habitat (represented by the fantail darter) and a moderate reduction in run and pool species habitat (represented by the central stoneroller and smallmouth bass, respectively).

Overall, increased development has been found to have a negative impact on stream health. This impact should be considered in any future expansion of the Roanoke suburbs into this watershed.


Master of Science
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6

Kennard, Mark. "A quantitative basis for the use of fish as indicators of river health in eastern Australia." Connect to this title online, 2005. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20051004.155737/.

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7

Gilfillan, Dennis, Timothy Andrew Joyner, and Phillip R. Scheuerman. "Maxent Estimation of Aquatic Escherichia Coli Stream Impairment." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5480.

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Background: The leading cause of surface water impairment in United States’ rivers and streams is pathogen contamination. Although use of fecal indicators has reduced human health risk, current approaches to identify and reduce exposure can be improved. One important knowledge gap within exposure assessment is characterization of complex fate and transport processes of fecal pollution. Novel modeling processes can inform watershed decision-making to improve exposure assessment. Methods: We used the ecological model, Maxent, and the fecal indicator bacterium Escherichia coli to identify environmental factors associated with surface water impairment. Samples were collected August, November, February, and May for 8 years on Sinking Creek in Northeast Tennessee and analyzed for 10 water quality parameters and E. coli concentrations. Univariate and multivariate models estimated probability of impairment given the water quality parameters. Model performance was assessed using area under the receiving operating characteristic (AUC) and prediction accuracy, defined as the model’s ability to predict both true positives (impairment) and true negatives (compliance). Univariate models generated action values, or environmental thresholds, to indicate potential E. coli impairment based on a single parameter. Multivariate models predicted probability of impairment given a suite of environmental variables, and jack-knife sensitivity analysis removed unresponsive variables to elicit a set of the most responsive parameters. Results: Water temperature univariate models performed best as indicated by AUC, but alkalinity models were the most accurate at correctly classifying impairment. Sensitivity analysis revealed that models were most sensitive to removal of specific conductance. Other sensitive variables included water temperature, dissolved oxygen, discharge, and NO3. The removal of dissolved oxygen improved model performance based on testing AUC, justifying development of two optimized multivariate models; a 5-variable model including all sensitive parameters, and a 4-variable model that excluded dissolved oxygen. Discussion: Results suggest that E. coli impairment in Sinking Creek is influenced by seasonality and agricultural run-off, stressing the need for multi-month sampling along a stream continuum. Although discharge was not predictive of E. coli impairment alone, its interactive effect stresses the importance of both flow dependent and independent processes associated with E. coli impairment. This research also highlights the interactions between nutrient and fecal pollution, a key consideration for watersheds with multiple synergistic impairments. Although one indicator cannot mimic the plethora of existing pathogens in water, incorporating modeling can fine tune an indicator’s utility, providing information concerning fate, transport, and source of fecal pollution while prioritizing resources and increasing confidence in decision making. Methods We used the ecological model, Maxent, and the fecal indicator bacterium Escherichia coli to identify environmental factors associated with surface water impairment. Samples were collected August, November, February, and May for 8 years on Sinking Creek in Northeast Tennessee and analyzed for 10 water quality parameters and E. coli concentrations. Univariate and multivariate models estimated probability of impairment given the water quality parameters. Model performance was assessed using area under the receiving operating characteristic (AUC) and prediction accuracy, defined as the model’s ability to predict both true positives (impairment) and true negatives (compliance). Univariate models generated action values, or environmental thresholds, to indicate potential E. coli impairment based on a single parameter. Multivariate models predicted probability of impairment given a suite of environmental variables, and jack-knife sensitivity analysis removed unresponsive variables to elicit a set of the most responsive parameters. Results Water temperature univariate models performed best as indicated by AUC, but alkalinity models were the most accurate at correctly classifying impairment. Sensitivity analysis revealed that models were most sensitive to removal of specific conductance. Other sensitive variables included water temperature, dissolved oxygen, discharge, and NO3. The removal of dissolved oxygen improved model performance based on testing AUC, justifying development of two optimized multivariate models; a 5-variable model including all sensitive parameters, and a 4-variable model that excluded dissolved oxygen. Discussion Results suggest that E. coli impairment in Sinking Creek is influenced by seasonality and agricultural run-off, stressing the need for multi-month sampling along a stream continuum. Although discharge was not predictive of E. coli impairment alone, its interactive effect stresses the importance of both flow dependent and independent processes associated with E. coli impairment. This research also highlights the interactions between nutrient and fecal pollution, a key consideration for watersheds with multiple synergistic impairments. Although one indicator cannot mimic theplethora of existing pathogens in water, incorporating modeling can fine tune an indicator’s utility, providing information concerning fate, transport, and source of fecal pollution while prioritizing resources and increasing confidence in decision making.
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8

King, Lisa A. "Using landscape variables to assess stream health in Ohio's Western Allegheny Plateau." Ohio : Ohio University, 2008. http://www.ohiolink.edu/etd/view.cgi?ohiou1206047003.

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9

Ahmed, Sara 1974. "The Stroke Rehabilitation Assessment of Movement (STREAM) : validity and responsiveness." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=20946.

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The main objectives of this prospective cohort study were to examine the construct and predictive validity of the STREAM, and estimating its responsiveness. Sixty three acute stroke patients were evaluated on the STREAM and other measures of impairment and disability during the first week post-stroke, four weeks later, and three months post-stroke. The results of the study showed that STREAM scores were associated with measures of impairment and disability, and could discriminate subjects based on Balance Scale and Barthel Index scores. Moreover, the STREAM during the first week post-stroke was found to be an independent predictor of discharge destination after the acute care hospital, and of gait speed and the Barthel Index at three months post stroke. In addition, the total and subscale STREAM scores were able to mirror changes in motor performance between each evaluation. The utility and measurement properties of STREAM warrant its use in clinical practice and research.
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10

Viamonte, Louis David. "Five Mile Creek bioassessment study baseline evaluation of stream health using fish communities /." Birmingham, Ala. : University of Alabama at Birmingham, 2007. http://www.mhsl.uab.edu/dt/2007m/viamonte.pdf.

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11

Hudgens, Faith Victoria. "AN ASSESSMENT OF STREAM QUALITY IN RELATION TO POPULATION HEALTH OF PLANTAGO CORDATA." OpenSIUC, 2021. https://opensiuc.lib.siu.edu/theses/2887.

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Understanding the health of rare and at-risk plant species is crucial for the conservation of biodiversity. Rare and at-risk species are often specialists with very specific requirements for growth and reproductive success. Some parameters associated with growth and reproductive success of rare aquatic species may include biotic and abiotic factors such as herbivory, competition, water depth, pH, and other factors associated with habitat quality. In this thesis, the population health of the rare and at-risk aquatic species Plantago cordata in Southern Illinois streams is assessed in relation to stream quality of sites containing Plantago cordata and sites without Plantago cordata.The objectives of this study were to (1) Determine if there is a relationship between population size structure and biotic habitat factors among populations and sites, and (2) Determine if there is a relationship between population size structure and abiotic habitat factors among populations and sites. Hypotheses were constructed using the hierarchy-of hypotheses method and most narrow alternative hypotheses are as follows: (1) There will be significant relationships between biotic and abiotic factors and Plantago cordata growth and reproductive success. (2) Levels of herbivory will have significant relationships with growth and reproductive success of Plantago cordata. (3) The abundance of co-occurring species individually and considered in functional groups (graminoid, herb, woody) will have significant relationships with growth and reproductive success of Plantago cordata. (4) Stream depth will have a unimodal relationship with growth and reproductive success of Plantago cordata, with maximum performance at an intermediate stream depth. (5) Stream pH will have a unimodal relationship with growth and reproductive success of Plantago cordata. (6) Stream quality (as outlined by the QHEI assessment) will have significant relationships with growth and reproductive success of Plantago cordata. General trends in herbivory suggest that Plantago cordata could be at greatest risk of herbivory during warmest average temperatures of the study season. There is evidence to suggest that flowering individuals could have a greater threat of herbivory than other growth stages based on Kendal correlation results. A Wilcox test determined that there were no statistical differences in species richness for plots with versus without Plantago cordata. There were relatively low values for percent cover of co-occurring species when considered in functional groups and there was overall relatively low species richness across all communities. Despite this, non-metric multidimensional scaling (NMDS) of community data provided evidence to suggest that there were statistical differences in the species composition of co-occurring individual riparian species among P. cordata populations. A significant negative correlation for water depth and flowering individuals and a significant positive correlation with water depth and pH occurred. A significant positive correlation for stream pH with the numbers of seedlings and dehiscing individuals was also found. One-way analyses of variance (ANOVAs) showed that some populations containing Plantago cordata were found to have stream pH values statistically different from nearby IEPA control streams without Plantago cordata. One population of Plantago cordata was found to be significantly different than two other populations in regards to stream pH using a linear mixed model. A principal components analysis (PCA) of stream Qualitative Habitat Evaluation Index (QHEI) assessments demonstrated distinct clustering of Plantago cordata streams and control IEPA streams without Plantago cordata. These findings provide partial evidence to suggest that growth and reproductive success of Plantago cordata could potentially be impacted by the abiotic and biotic parameters explored in this thesis.
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12

Arnold, Emily G. "Evaluation of Urban Riparian Buffers on Stream Health in the Tookany Watershed, PA." Master's thesis, Temple University Libraries, 2016. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/405730.

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Geology
M.S.
Stream channels and their corresponding riparian zones are composed of complex spatially and temporally dynamic systems. Changing land-use associated with urbanization has resulted in large shifts in riparian assemblages, stream hydraulics, and sediment dynamics leading to the degradation of the world’s waterways. To combat degradation, restoration and management of riparian zones is becoming increasingly common. However, the relationship between flora, especially the influence of invasive species, on sediment dynamics is poorly understood. This relationship must be studied further to ensure the success of management practices. Three methods were used to monitor erosion and turbidity within the Tookany Creek and its tributary Mill Run in the greater Philadelphia, PA region. To evaluate the influence of the invasive species Reynoutria japonica (Japanese knotweed) on erosion, reaches were chosen based on their riparian vegetation and degree of incision. Methods used to estimate sediment erosion included measuring changes in bank pins, repeated total station transects, and monitoring turbidity responses to storm events. While each method has been used in previous studies to monitor sediment flux, the combination of methods in this study allowed their applicability to be compared. Measurements taken with YSI turbidity loggers showed large fluctuations in turbidity based both on riparian conditions and geomorphic positioning, suggesting that future studies need to be careful with logger placement when using sediment calibration curves to estimate sediment yield within streams. There were pros and cons of using both total station and bank pins to estimate bank erosion. Total station has the potential to produce highly accurate measurements but a greater risk of loss of data if the control points used to establish the grid cannot be re-established from one measurement to the next. Bank pins are more likely to influence bank erosion and be affected by freeze-thaw conditions but provide a simple method of monitoring erosion at frequent intervals. Volume calculations based on total station transects along the main stem of the Tookany did not show a consistent relationship between riparian type and erosion rates. However, erosion calculations based on bank pins suggest greater erosion in reaches dominated by knotweed with 4.7x10-1 m3/m and 8.3x10-2 m3/m more erosion than those dominated by trees at Chelten Hills and Mill Run respectively. Turbidity responses to storm events were also higher (76.7 v 54.2 NTU) in reaches with knotweed, although this increase was found when the reach dominated by knotweed was also incised. Thus, this study linked knotweed to increased erosion using multiple methods.
Temple University--Theses
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13

Wu, Hong. "Protecting Stream Ecosystem Health in the Face of Rapid Urbanization and Climate Change." Thesis, University of Oregon, 2015. http://hdl.handle.net/1794/18747.

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The ability to anticipate and evaluate the combined impacts of urbanization and climate change on streamflow regimes is critical to developing proactive strategies that protect aquatic ecosystems. I developed an interdisciplinary modeling framework to compare and contrast the effectiveness of integrated stormwater management, or its absence, with two regional growth patterns for maintaining streamflow regimes in the context of climate change. In three adjacent urbanizing watersheds in Oregon's Willamette Valley, I conducted a three-step sequence to: 1) simulate land use change under four future development scenarios with the agent-based model Envision; 2) model resultant hydrological change under the recent past and two future climate regimes using the Soil and Water Assessment Tool; and 3) assess scenario impacts on streamflow regimes using 10 ecologically significant flow metrics. I evaluated each scenario in each basin using a flow metric typology based on the magnitude of change in each metric and the degree to which such changes could be mitigated, i.e., insensitive, sensitive and manageable, and sensitive and resistant. My results demonstrated distinct signatures of urbanization and climate change on flow regimes. Urbanization and climate change in isolation led to significant flow alterations in all three basins. Urbanization consistently led to increases in flow regime flashiness and severity of extreme flow events, whereas climate change primarily caused a drying trend. Climate change tended to exacerbate the impacts of urbanization but also mitigated urban impacts on several metrics. The combined impacts of urbanization and climate change caused substantial changes to metric sensitivities, which further differed by basin and climate regime, highlighting the uncertainties of streamflow regime responses to development and the value of spatially explicit modeling that can reveal complex interactions between natural and human systems. Scenario comparisons demonstrated the importance of integrated stormwater management and, secondarily, compact regional growth. My findings reveal the need for regional flow-ecology research that substantiates the ecological significance of each flow metric, develops specific targets for manageable ones, and explores potential remedies for resistant ones. The interdisciplinary modeling framework shows promise as a transferable tool for local watershed management. This dissertation includes previously unpublished co-authored material.
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Meyer, Christine J. "TESTING THE USEFULNESS OF GEOMORPHIC VARIABLES AS PREDICTORS OF STREAM HEALTH: WESTERN ALLEGHENY PLATEAU." Ohio : Ohio University, 2006. http://www.ohiolink.edu/etd/view.cgi?ohiou1150988062.

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15

Dorji, Kinzang. "Utility of an existing biotic score method in assessing the stream health in Bhutan." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/97993/1/Kinzang_Dorji_Thesis.pdf.

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In many countries water quality is assessed by using indices derived from the presence of macroinvertebrate species. This study aimed to improve the application of one such index (Hindu-Kush Himalaya based index: HKHbios) to rivers and streams in Bhutan. Sampling in a number of different streams showed that there was a strong influence of the monsoon on stream macroinvertebrates, however the month to month and site to site HKHbios scores showed no consistent patterns. Dry season sampling and increased ecological information on a number of macroinvertebrate taxa were identified as areas where water quality assessment in Bhutanese streams could be improved.
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Daley, Katherine A. "The Stroke Rehabilitation Assessment of Movement (STREAM) : content validity and preliminary reliability." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=55439.

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The global objectives of this project were to refine and validate the content, and to obtain preliminary estimates of reliability for the STroke REhabilitation Assessment of Movement (STREAM). Two consensus panels, involving a total of twenty physical therapists, produced an intermediate test version of STREAM. Based on initial evaluations of internal consistency and reliability, items that were redundant, unrelated, and/or not reliably scored were eliminated. The final STREAM, with enhanced content validity, is made up of thirty items evaluating limb movements and basic mobility. Two reliability studies were conducted: (1) a direct observation of twenty stroke patients by pairs of raters in the clinical setting, and (2) two repeated ratings by twenty raters using videotaped assessments of four stroke patients. The STREAM demonstrated excellent internal consistency, inter- and intra-rater reliability, and is now ready for preliminary use in the clinical setting. The favorable results of this study indicate that further testing of the psychometric properties of the STREAM is warranted.
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Watson, Dale, and dale watson@ecosec com au. "The Regional Distribution and Significance of Stream Turbidity in Victoria." RMIT University. Mathematical and Geospatial Sciences, 2006. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20070206.150045.

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This thesis investigates the distribution and significance of stream turbidity in Victoria; specifically exploring the factors that may have influenced the pattern of regional variation in turbidity, and factors that give it significance in the regional, social, cultural and environmental context. The limits to water availability are set, not only by the quantity of water in storages or streams but, more fundamentally, by acceptable levels of water quality and catchment health. To make effective judgements of water availability managers of water resources need to know the significance of measured natural resource condition in the regional context. Stream turbidity can be considered by the agricultural community as a sign of soil erosion and a loss of agricultural potential, while from the ecological perspective it can be considered a sign of deteriorating river health. Fundamentally, levels of turbidity are closely bound with land use practice and, in the Australian context, turbidity can be considered a measure of the consequences of land management practices on soil erosion and run-off. Measured levels of turbidity in Victoria should be interpreted within the context of a unique history and geography. The spread of European colonisation and the introduction of massive land use change to the Victorian landscape have meant that over most of Victoria current levels of turbidity reflect the effects of over a hundred and fifty years of large scale intervention with its controlling factors. In Victoria current levels of turbidity are interpreted in a cultural context far different from that of early colonists or even of a few decades ago. The concept of Ecologically Sustainable Development which has dominated natural resource management in recent times brings new responsibilities to resource managers. Ecologically sustainable management means that resources must be considered in a more inclusive spatial and temporal context. In the early stage of Victoria's history sustainable management of water meant having enough water left from winter rains to supplement summer supply. However, in recent years, it has begun to have more complex associations; sustainable water use is now, almost universally considered to include maintenance of the environmental health of waterways, and by implication, the environmental health of the whole catchment. In this context, stream turbidity can be considered a useful indicator of catchment health, in particular, because levels of turbidity bear a direct physical relationship to catchment processes. New tools are needed to explore the relationship between land use and water quality at the regional scale. The results of this current research include a regional statistical model of stream turbidity, which is conceptually designed to offer useful predictions of stream turbidity and underpin sustainable resource management. The statistical model was used as input to the development of a unique map display using Geographic Information Systems (GIS). The GIS is used to display the distribution of model predictions over a large region of south-eastern Australia. The practical advantage of this modelling approach is that it provides managers with the ability to identify locations in Victoria where measured water quality differs significantly from modelled water quality and flag them for further investigation. The major project outputs are a map of Victorian Water Quality Monitoring Network (VWQMN) catchments showing catchments in Victoria where measured turbidity differs from model predictions and a raster representation of the state of Victoria in which cell values indicate predicted stream turbidity. Important to this project was the novel use of GIS technology to process large national and regional scale digital data sets using tools developed for catchment scale hydrological models.
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18

Gilfillan, Dennis, Timothy A. Joyner, and Phillip Scheuerman. "Maxent Estimation of Aquatic Escherichia Coli Stream Impairment." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5587.

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Background.The leading cause of surface water impairment in United States’ rivers and streams is pathogen contamination. Although use of fecal indicators has reduced human health risk, current approaches to identify and reduce exposure can be improved. One important knowledge gap within exposure assessment is characterization of complex fate and transport processes of fecal pollution. Novel modeling processes can inform watershed decision-making to improve exposure assessment.
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19

Andriamanamihaja, Rakoto Hasina Harivelo. "Erosion and stream sedimentation due to pipeline construction in laterite soils - Madagascar –." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=123247.

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Madagascar - Ambatovy region, AMBATOVY Project - Sherritt International. The Ambatovy Project, a mine for nickel and cobalt ore located in the centre of the country, required the construction of a slurry pipeline to transport the ore 220 km to be processed on the east coast. The pipeline and its maintenance road traverses primary forests, the sensitive Torotorofotsy Wetlands and include 172 stream crossings in sensitive laterite soils. The restoration and rehabilitation of the cut and fill geotechnical works and stream crossings is important technical works within the environmental portfolio and for project cost reductions.The surface water erosion of the soil and the associated stream sedimentation are studied. These processes are classified based on the characteristics of the vegetation/land use, the slopes and the type of laterite soil. Three representative sites are chosen for a detailed study using field observations and field measurements (TSS in streams). These results are compared to numerical modeling results using RUSLE (Revised Universal Soil Loss Equation model) for surface erosion within GeoWEPP (Geo-spatial interface for Water Erosion Prediction Project), a USGS (US Geological Survey) –LESAM (Landscape-based Environmental System Analysis & Modeling) model which conducts continuous and process-based simulations of small watersheds, for soil erosion and sedimentation.At the three selected sites, the use of GeoWEPP as a tool to explore possible mitigation measures using geotechnical engineering methods combined with revegetation is investigated and discussed. The results of these studies will be used to suggest measures to mitigate environmental impacts associated with the pipeline construction for the Ambatovy Project.
Madagascar – région d'Ambatovy, Projet AMBATOVY - Sherritt International. Le Projet Ambatovy, une mine de nickel et cobalt située au centre de l'ile, a requiert la construction d'un pipeline de pulpe pour pouvoir transporter le minerai sur 220kms, pour pouvoir être acheminé et transformé sur la côte Est. Le pipeline et son réseau routier de maintenance traverse des forêts primaires, la sensible région du marais de Torotorofotsy et incluant 172 cours d'eau sensibles reposant sur le sol latéritique. La restauration et la réhabilitation des tranchées de remblai et déblai grâce aux travaux géotechniques sont d'importants travaux techniques pour les cours d'eaux notamment au niveau de l'impact environnemental et jouant sur la réduction des couts du projet. Le phénomène de l'érosion de surface au niveau des cours d'eau et la sédimentation des rivières y associée ont été étudiés. Les processus sont classés sur base des caractéristiques de la végétation, de la pente et du type de sol latéritique. Trois sites représentatifs sont choisis aux fins d'une étude détaillée avec usage des données et observations de terrain (MES dans les rivières). Ces résultats sont par la suite comparés aux résultats avec usage des modèles numériques utilisant RUSLE (Revised Universal Soil Loss Equation model) pour l'érosion de surface dans GeoWEPP (Geo-spatial interface for Water Erosion Prediction Project), un modèle provenant de USGS (US Geological Survey) –LESAM (Landscape-based Environmental System Analysis & Modeling) qui conduit notamment des simulations en mode continu et sous base de processus pour les petits bassins versants, concernant l'érosion et la sédimentation.Au niveau de ces trois sites sélectionnés, l'utilisation de GeoWEPP comme utile de prédiction et de « design » des mesures de mitigation possibles par usage de solutions d'ingénierie géotechnique combinée à la re-végétalisation ont pu être étudiés et comparés. Les résultats de ces études pourront être utilisés en tant que suggestion de mesures de mitigation des impacts environnementaux relatifs à la construction du pipeline du Projet Ambatovy.
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Case, J., Phillip R. Scheuerman, C. Bishop, and A. Hougland. "An Evaluation of Microbial Enzyme Assays as an Indicator of Pollution in Stream Sediments." Digital Commons @ East Tennessee State University, 1997. https://dc.etsu.edu/etsu-works/2913.

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21

Johnston, M. Suzanne. "Effect of Internet-based health promotion on college preparatory stream adolescent girls' knowledge of depression." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0035/MQ65495.pdf.

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22

Gilfilan, Dennis, Phillip R. Scheuerman, and T. Andrew Joyner. "Seasonal and Spatial Variations in the Probability of Pathogenic Stream Impairment." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/2956.

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23

Purvis, Jeffrey. "Effectiveness of Antimicrobial Coated Catheters for Prevention of Blood Stream Infection in a Trauma Patient Population." Thesis, University of Maryland, Baltimore, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3563364.

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Background: Clinical leaders are faced with making the decision to utilize products with varied designs without enough evidence to make an informed decision. An example of this problem is the decision regarding whether to change from uncoated to antimicrobial or antibiotic catheters to prevent Central Line Associated Blood Stream Infection (CLABSI).

Purpose: This study compares the effectiveness of three types of central venous catheters (CVC): (1) non-coated (2) antimicrobial (silver) and (3) antibiotic coated. The four CLABSI outcome measures were: (1) CLABSI rate per 1,000 catheter days, (2) gram positive organism cultures per total admissions (3) gram negative organism cultures per total admissions, (4) yeast organism cultures per total admissions.

Methods: This retrospective study assessed the comparative effectiveness of CVCs in a trauma hospital population (n = 10,680) admitted between July 01, 2006 and June 30th, 2011. Monthly data were obtained for the time periods when each catheter type was purchased. Linear mixed models (LMMs), with data nested within units, were used to examine differences among the three periods in BSI rates and frequency of organism type.

Results: Antibiotic coated catheters reduced BSI rates (beta=4.054, p <0.001) and gram negative organisms (beta=6.608, p <0.001). Silver impregnated catheters reduced gram negative organisms (beta= 3.194, p=0.009) compared with uncoated catheters.

Conclusion: Further improvement in CVC technology is required to be effective for broad spectrum of organisms. Large prospective randomized clinical trials are needed to determine the effectiveness of devices to inform purchasing decisions.

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Rossano, Eriko Morishita. "Definition and measurement of stream health in Japan based on index of biological integrity (IBI) concepts /." Thesis, Connect to this title online; UW restricted, 2002. http://hdl.handle.net/1773/5401.

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25

Sjöberg, Axel, and Stjernberg Johan Olsson. "In-house glove recycling : Eliminating a waste stream with a circular approach." Thesis, Blekinge Tekniska Högskola, Institutionen för maskinteknik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-19660.

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Background. Between 2012 and 2017 the plastic supply in Sweden increased by almost 400000 metric tons. In 2017, the hospitals in Sweden contributed to 4550 metric tons of plastic waste, disposable gloves counted for 2100 metric tons, which is 358 million disposable gloves. The majority made in other countries than Sweden, which is not only contributing to a considerable waste stream but also vulnerability when the system is dependent on continuous material supplies. Aim and Purpose. The research aim has been to understand the challenges and opportunities of needs relating to plastic waste flows from the health care sector. From the needs, choose an area to develop an innovative solution that changes the current waste flow into value for the health care sector in Sweden. Method. For this thesis, the researcher has used the Design Research Methodology and the MSPI innovation process. Design Research Methodology has been used to find and validate crucial information about the problem, by the usage of literature research and Unstructured interviews within the research area. MSPI was iteratively used with DRM to design the intended support as well as building the actual support. Results. The final prototype proves that circularity for plastic materials in hospitals is reachable. The Needfinding highlights the need for circularity, regarding both an effective use of the material and the health care’s readiness levels where access to Personal Protection Equipment (PPE) is crucial, especially in times of crisis. Conclusions. During the time of crisis, the COVID-19 pandemic, it has been clear that changes regarding preparedness and access to PPE needs improvement. Circularity is one way of achieving greater control of the material flow, which affects the hospital's level of independence. The development has proven one way of making the flow of disposable gloves circular by developing an inhouse recycling machine. This thesis work is just one angle of approach towards circularity and more efficient usage of material. To prove the concept in a hospital environment, future development is required.
Bakgrund. Mellan åren 2012 och 2017 har plastförsörjningen i Sverige ökat med nästan 400 000 ton. Under 2017 bidrog sjukhusen i Sverige till 4550 ton plastavfall varav engångshandskar bidrog med 2100 ton, vilket motsvarar 358 miljoner engångshandskar. Majoriteten är tillverkade i andra länder än Sverige, vilket inte bara bidrar till en stor avfallsström, utan också sårbarhet när systemet är beroende av kontinuerlig materialförsörjning. Syfte och Mål. Forskningens syfte har varit att förstå utmaningarna och möjligheterna med plastavfallsflöden från vårdsektorn. Från behoven väljs ett område för att utveckla en innovativ lösning som stöder cirkularitet inom hälso-sjukvården i Sverige. Metod. Denna avhandling har genomförts med hjälp av DRM- och MSPI-innovationsprocess. DRM, Design Research Methodology, har använts för att hitta och validera avgörande information kring problemet och har också gett akademisk trovärdighet. Detta har gjorts med litteraturforskning och ostrukturerade intervjuer inom forskningsområdet. MSPI har använts tillsammans med DRM på iterativt sätt för att utforma det avsedda stödet och bygga det faktiska stödet. Resultat. Projektets prototyp bevisar att cirkularitet för plastmaterial på sjukhus kan nås. Behovsundersökningen visar på behovet av cirkularitet, både när det gäller materiell effektivitet och beredskapsnivåer på sjukhus där tillgången till personlig skyddsutrustning är avgörande. Speciellt i kristider. Slutsatser. Under kristiden, covid-19-pandemin, har det varit tydligt att förändringar avseende beredskap och tillgång till personlig skyddsutrustning måste göras. Cirkularitet är ett sätt att uppnå större kontroll över materialflödet som påverkar sjukhusens självständighetsnivå. Projektet har visat ett sätt att göra flödet av engångshandskar cirkulärt genom att utveckla ett system för remanufacturing. Detta är bara en inställningsvinkel mot cirkularitet och en mer effektiv användning av material. För att bevisa konceptet i en riktig sjukhusmiljö krävs vidareutveckling.
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Barker, Linda Suzann. "Quantification of the effectiveness of Agricultural Riparian Buffers to protect stream health in Maryland's Coastal Plain and Piedmont regions." College Park, Md. : University of Maryland, 2004. http://hdl.handle.net/1903/203.

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Thesis (Ph. D.) -- University of Maryland, College Park, 2004.
Thesis research directed by: Biological Resources Engineering. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
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Evanshen, Brian G., Kurt J. Maier, and Phillip R. Scheuerman. "A Comparison Study of Microbial Enzyme Activities and Coliforms in the Sediments of a Fecally-Contaminated Tennessee Stream Relative to Season and Land Use." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/2941.

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Enzymes react quickly to environmental stress and can serve as sensitive indicators of environmental change. Microbial enzyme activities (MEA’s) can be a useful tool to evaluate the health of an aquatic ecosystem. In this study we compared the trends of MEA’s (µg/g) to total and fecal coliform concentrations (CFU/g) in sediments from a stream in Northeast Tennessee that had an approved fecal coliform Total Maximum Daily Load (TMDL). The comparisons were based on season and land use through which the stream flowed. Triplicate grab samples of stream sediments were collected monthly for 29 months at 14 sites located in agricultural, urban, and forest regions. Dehydrogenase, acid phosphatase, alkaline phosphatase, galactosidase and glucosidase activities were determined using specific colorimetric analyses. Total coliforms and fecal coliforms were determined using the membrane filtration method. There was significant positive correlation (p<0.05 Pearson) between the total coliform concentrations and all five enzyme activities in the winter (January, February and March). A positive correlation was also seen with alkaline phosphatase in the summer. Fecal coliform concentration was positively correlated with dehydrogenase activity in the winter and spring (April, May and June), and with galactosidase activity in the winter, spring and summer (July, August and September). Fecal coliforms were also positively correlated with acid phosphatase in the summer. Only those sediments located in the urban region showed a positive correlation between total coliforms and dehydrogenase, acid phosphatase, alkaline phosphatase and glucosidase. DHA also showed a positive correlation between total coliforms and the forest region. The only correlation between fecal coliforms and region was with acid phosphatase in the urban region. A strong inverse relationship existed with the ratio of each specific MEA over the fecal coliform concentration versus both the seasons and regions. These correlations show that elevated activities of these five microbial enzymes can serve as another indicator of stream impairment.
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Tukey, Melissa Hoffman. "Identification and prevention of complications associated with bedside medical procedures." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21266.

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(Thesis: M.S.P.H.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
INTRODUCTION: Although serious complications of invasive bedside procedures are rare they can be life threatening. Interest in identifying and preventing complications of bedside procedures has been heightened recently in light of such complications increasingly being linked to hospital reimbursement. In part I of this thesis we present the validation of ICD-9-CM codes for identification of the two most common complications associated with central venous catheterization. In part II we determine the impact of the development of a medical procedure service (MPS) on patient safety surrounding bedside procedures and resident education. METHODS: Part I: Cases of iatrogenic pneumothorax and central line associated blood stream infections (CLABSI) identified by ICD-9-CM codes in discharge data provided by Boston University Medical Center to the University HealthSystem Consortium were compared with those revealed by medical record abstraction of central venous catheters placed between 7/10-12/11. Part II: Retrospective cohort analysis of consecutive adults admitted to the internal medicine service who underwent a bedside medical procedure between 7/10-12/11 comparing characteristics and outcomes of procedures performed by the MPS versus primary services. RESULTS: Part I: The ICD-9-CM code for iatrogenic pneumothorax (512.1) had a sensitivity of 66.7%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.5%. The ICD-9-CM codes for CLABSI (999.31 and 999.32) had a sensitivity of 41.7%, specificity of 98.0%, positive predictive value of 20.0% and negative predictive value of 99.3%. Part II: We evaluated 1707 bedside procedures (548 by MPS, 1159 by primary services). While the MPS was more likely to successfully complete procedures (95.8% vs. 92.8%, p=0.02) and to use best practice safety process measures (95.4% vs. 51.0%, p<0.0001), the composite rate of major complications was similar (1.6% vs. 1.9%, p=0.71). CONCLUSIONS: Complications associated with invasive beside procedures are rare. The low sensitivity and variable positive predictive value of ICD-9-CM codes for detection of complications of central venous catheterization limits their use for internal quality improvement purposes. While use of a medical procedure service was associated with increased use of evidence based process measures, it did not significant affect the rate of major complications associated with bedside procedures.
2031-01-01
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29

Semlow, Andrea R. "The Power of Place: A Qualitative Evaluation of Stream Monitoring Data Usage by Decision-Makers in Dane County, Wisconsin." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1505147/.

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Has years of citizen-based nutrient sampling and baseline water quality monitoring efforts only had a "trivial" impact on natural resource management decisions? This thesis will explore this and other findings from a qualitative evaluation of the Rock River Coalition (RRC) citizen-based stream monitoring project in Dane County, Wisconsin, USA. These findings are the culmination of 47 semi-structured interviews with decision-makers from seven client-identified categories and participant observations of board meetings and other watershed groups. Interview questions focused on current strategies of data design and dissemination with the goal of constructing a clearer picture of existing data usage by Dane County decision-makers. In the wider picture of citizen science and community-based research, this case study aims to highlight barriers to data use and potential solutions. The results of this case study were understood through four key frames: (1) Bourdieu's concept of symbolic capital, (2) Barzilai‐Nahon's theory of network gatekeeping, (3) Newman et al.'s framework for leveraging the power of place, and (4) a Foucauldian approach to the production of scientific knowledge. The findings of this study highlight the presence of gatekeeping mechanisms within the scientific field as well as government institutions, problematize the practice of placemaking, assert there is untapped symbolic capital to be wielded by citizen scientists, and trace the "innovation" of volunteer water monitoring data in Dane County.
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30

Semlow, Andrea R. "The Power of Place: A Qualitative Evaluation of Stream Monitoring Data Usage by Decision-Makers in Dane County, WI." Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc1505147/.

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Has years of citizen-based nutrient sampling and baseline water quality monitoring efforts only had a "trivial" impact on natural resource management decisions? This thesis will explore this and other findings from a qualitative evaluation of the Rock River Coalition (RRC) citizen-based stream monitoring project in Dane County, Wisconsin, USA. These findings are the culmination of 47 semi-structured interviews with decision-makers from seven client-identified categories and participant observations of board meetings and other watershed groups. Interview questions focused on current strategies of data design and dissemination with the goal of constructing a clearer picture of existing data usage by Dane County decision-makers. In the wider picture of citizen science and community-based research, this case study aims to highlight barriers to data use and potential solutions. The results of this case study were understood through four key frames: (1) Bourdieu's concept of symbolic capital, (2) Barzilai‐Nahon's theory of network gatekeeping, (3) Newman et al.'s framework for leveraging the power of place, and (4) a Foucauldian approach to the production of scientific knowledge. The findings of this study highlight the presence of gatekeeping mechanisms within the scientific field as well as government institutions, problematize the practice of placemaking, assert there is untapped symbolic capital to be wielded by citizen scientists, and trace the "innovation" of volunteer water monitoring data in Dane County.
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31

Bankey, Laura Anne. "Responses of Cytochrome P450IA in Freshwater Fish Exposed to Pulp Mill Effluents in Experimental Stream Channels." W&M ScholarWorks, 1993. https://scholarworks.wm.edu/etd/1539617660.

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32

Alharthi, Adel Aifan. "An integration of Lean Six Sigma and health and safety management system in Saudi Broadcasting Corporation." Thesis, Brunel University, 2015. http://bura.brunel.ac.uk/handle/2438/13781.

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Lean Six Sigma is a method used to improve the quality and efficiency of processes by reducing variation and eliminating wastes (non-value added activities) in an organisation. The concept of combining the principles and tools of Lean Enterprise and Six Sigma has been discussed in the literature. The majority of Lean Six Sigma applications in private industry have focused primarily on manufacturing applications. The literature has not provided a framework for implementing Lean Six Sigma programmes in non-manufacturing or transactional processes like those in the Entertainment Media industry. The Saudi Broadcasting Corporation (SBC), like many other industries in Saudi Arabia, has high occupational safety risks, such as electric, fire and fall hazards which often occur in the media workplace. These risks are considered very costly and affect productivity and employee morale in general. The main objective of this research is to provide a synergistic approach to integrating occupational health and safety programmes and Lean Six Sigma tools using the DMAIC (Define-Measure-Analyse-Improve-Control) problem-solving method to strengthen and assure the success of safety programmes in the Saudi Broadcasting Corporation (SBC). This research identifies the roadmap (i.e. activities, principles, tools, and important component factors) for applying Lean Six Sigma tools in the media industry. A case study addressing the safety issues that affect employees’ performance within the Saudi Broadcasting Corporation (SBC) TV studio is used to validate work outlined in this research. Furthermore, the Bayesian Belief Networks (BBN) method is used to understand the probability occurrence of safety hazards. The application of the Taguchi Experimental Design method and other Lean Six Sigma tools, such as Cause and Effect diagrams, Pareto principles, 5S, Value Stream map, and Poka-Yoke have been incorporated in to this research. The application of Lean Six Sigma DMAIC problem-solving tools resulted in significant improvement in safety within SBC. The average electrical hazard incident decreased from 2.08 to 0.33, the average fire hazard incident decreased from 1.25 to 0.08, and the average fall hazard incident decreased from 3.42 to 0.17. The research has important implications for the company and its employees, with positive outcomes and feedback reported by top management, the senior technicians, and experts. The research improved the safety by reducing electrical, fire and fall risks. The Safety training sessions are one of the most significant factors that improve their safety awareness. It is observed that Lean Six Sigma problem-solving tools and methods are effective in the Saudi Broadcasting Corporation (SBC).
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Padgett-Vasquez, Steve. "Tracking landscape changes in the Upper Cahaba River watershed and its tributaries (1974-2007) using Landsat and ASTER multipsectral image." Birmingham, Ala. : University of Alabama at Birmingham, 2010. https://www.mhsl.uab.edu/dt/2010m/padgett-vasquez.pdf.

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34

Evanshen, Brian G., Kurt J. Maier, and Phillip R. Scheuerman. "Comparison Study of Sediment Microbial Enzyme Activities to Biochemical Oxygen Demand, Nitrate Concentration, Phosphate Concentration in the Sediments of a Fecally-Contaminated Stream in Northeast Tennessee Relative to Season and Land Use." Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/2942.

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Microbial metabolism reacts quickly to environmental conditions. These reactions are dependent on the need for nutrients and respiration and can be measured using an assay of individual microbial enzyme activities (MEA’s). In this study, we measured MEA’s in the sediments of a stream in northeast Tennessee that had an approved fecal coliform Total Maximum Daily Load (TMDL). These values were compared to biochemical oxygen demand (BOD), phosphate concentration and nitrate concentration in the water column of this stream. Comparisons were grouped by season and land use. Stream sediments and water were collected monthly for one year and then quarterly for an additional two years at 14 sites located in agricultural, urban and forest regions. Dehydrogenase (DHA), a measure of microbial respiration, along with acid phosphatase (AcidPA), alkaline phosphatase (AlkPA), galactosidase (GalA) and glucosidase (GluA) activities were measured using colorimetric assays. BOD was determined using the standard 5-day BOD test (BOD5). Nitrate and phosphate concentrations were measured using colorimetric procedures. There were significant positive and negative correlations (p5, DHA vs. nitrate concentration, and DHA vs. phosphate concentration. Also in the fall months there were significant negative correlations between GalA and GluA vs. BOD5, and concentrations of nitrate and phosphate. There was also a negative correlation between AcidPA and BOD5. In the warmer months of spring and summer, there were positive correlations between AcidPA, AlkPA, GalA and GluA vs. the BOD5 ’s, and the concentrations of nitrate and phosphate. The only negative correlation in a warmer season was in the summer between AlkPA vs. BOD5 and phosphate concentration. No significant correlations were found by land use type. Results indicate that significant relationships may exist between MEA’s and other water quality measures (e.g. BOD5, nitrate concentration, and phosphate concentration) that could make it possible to use MEA’s as another tool for water quality assessment.
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Soh, Kim Lam. "Improving health outcomes by preventing intensive care related infection in Malaysia Intensive Care Unit (INVEST study)." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/996.

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Ventilator-associated pneumonia (VAP), catheter-related blood stream infection (CRBSI) and pressure ulcers (PU) are well recognized complications in intensive care units (ICUs). Many of these are preventable but can also complicate patient recovery, prolong length of stay, increase costs, morbidity and mortality. In Malaysia, the majority of studies investigating VAP and CRBSI in Malaysia have focussed on identifying risk factors, diagnostic criteria and treatment of ICU-related complications. Further, in spite of the burden of PU there are limited studies undertaken in Malaysia and few of these have been nurse-led. Importantly, to date there has been limited investigation of the efficacy and effectiveness of quality improvement initiatives and the contextual issues impacting on clinical practice improvement in Malaysia.In spite of the increasing emphasis on quality assurance in Malaysian ICUs there has been a limited focus on nurse-specific interventions and the majority of projects have been initiated by physicians. This study has evaluated the utility of a nurse-led action research project to drive clinical practice improvement in the ICU and is significant in demonstrating the capacity of nurses to critique and control their practice. The project conducted for this thesis was called the Improving health outcomes by preveNting intensiVe care related infEction in Malaysia intenSive care uniT - INVEST study. The INVEST Study as reported in this thesis has been undertaken using an action research approach to improve the uptake of evidence-based strategies to prevent infection in the ICU in the Malaysian cultural context.The aims of this thesis were to identify best practices, evaluate the current nursing practice in prevention of VAP, CRBSI and PU in ICU patients in a single Malaysian ICU, and evaluate the impact of the evidence-based interventions to improve patient outcomes. The specific and research objectives of this study were to:1. Identify best practice interventions for preventing VAP, CRBSI and PU in the ICU. 2. Document the current rates of VAP, CRBSI and PU in an ICU in Malaysia. 3. Implement an action research intervention to collaboratively develop and implement strategies for improvement 4. Assess the impact of the intervention on clinical outcomes, staff dynamics, work place culture and sustainability of practice change An action research approach was used in this study to involve and empower nurses and drive practice change. A literature review identified that many action research studies conducted in the ICU were mainly most focused on process measures and not outcomes. In this study the data were collected in three phases following the action research cycles which comprised of a period of planning, acting, observation, reflecting and re-planningIn Phase I of the thesis current best practice interventions for the prevention of VAP, CRBSI and PU in ICU are described. A literature search was conducted to identify evidence-based practices (EBP) that were recommended by bodies to improve the prevention of VAP, CRBSI and PU. A core set of nursing activities was identified in preventing the complications of VAP, CRBSI and PU. These were hand washing, hygiene care, positioning of patient, elevation of the head of bed and providing adequate nutrition.Pre- intervention data collection consisted of an environmental scan, including interview with the key stakeholders, patient profiling and a nurse survey. Twenty-one cases of ICU complications were identified in 18 of the 91 patients (19.8%) admitted in December 2009. Of the patients, three developed two complications - PU and VAP (two patients) or CRBSI (one patient). The findings indicated that this ICU had a high case load due to the high ICU bed demand. Patients needing ICU care were being nursed in general wards due to the unavailability of ICU beds.Nurses reported a good knowledge of prevention strategies with a mean score of 124.84 ±SD14.66 and reported a high level of positive regard for their professional practice environment based on the results of Revised Professional Practice Environment (RPPE). Three components had mean scores of ≥3 and five <3 within the eight components. Three components of RPPE subscales with highest mean scores were Internal Work Motivation (M 3.24; SD 0.3), Relationship With Physician (M 3.22; SD 0.53) and Cultural Sensitivity (M 3.04; SD 0.24). The two lowest mean scores were for Handling Disagreement and Teamwork with 2.77 (SD 0.16) and 2.45 (SD 0.47), respectively. Nurses also showed positive attitudes toward the sustainability of the change process. The Sustainability Indices ranged from 13.4 to 100 with a mean of 75.21 (SD 21.71).In Phase 2 the intervention was conducted over six months from February to July 2010. The Center of Disease Control and Prevention (CDC) criteria for diagnosis of VAP and CRBSI, and the Waterlow Pressure Ulcer Risk Assessment Scale were promoted in the unit. Nurses were exposed and encouraged to implement evidence-based nursing interventions as identified in care criteria. All nurses were invited to the unit nursing education to increase their knowledge and awareness about evidence-based practice in prevention of the ICU complications. Nurses were encouraged to gain control of their practice. Evidence-based practice articles were also provided to increase their knowledge level and posters were distributed and placed in the unit to increase nurses awareness of the quality improvement initiativesFocus group discussions were conducted in Phase 2 and found that nurses in the unit were unaware of the importance of standardized assessment in their daily practice. They had a lack of understanding regarding the importance of standardised risk assessments. Despite the reluctance of many nurses to embrace the EBP, due to a perception of their workload, the focus groups also revealed nurses were optimistic that change will get easier and could be eventually achieved. Participants were positive about the change that could take place in the future. The hierarchical relationships with medical doctors were also identified as a factor limiting nurses from adopting the guidelines.Phase 3 of the project, the post-intervention phase was conducted from March to May 2011. The data collection process was repeated as Phase 1 and Phase 2. There were 11 cases of ICU complications identified during the post-intervention phase in 10 (8.7%) of the 115 patients admitted during March 2011. One patient developed both VAP and PU, while four developed VAP and another five PU. In the post-intervention group, no cases of CRBSI were detected. The total mean score of nurses’ knowledge was 121.45±SD16.85. An independent-samples t-test was conducted to compare nurses’ knowledge pre and post intervention, and found no significant differences, t (150) =1.32, P 0.189. The Sustainability Indices ranged from 41.3 to 100 percent with a mean of 76.81±SD21.45.Approximately 84% of the nurses in pre-intervention and 70% in post-intervention scored >55%. The nurses reported a positive regard for their practice environment in the pre- and post-intervention groups. The mean scores for each component were comparable for both the pre- and post-intervention groups except for Internal Work Motivation, Control Over Practice and Staff Relationship With Physician. The highest mean scores within the eight components for the post-intervention group were for Internal Work Motivation (M 3.13; SD 0.27), Relationship With Physician (M 3.04; SD 0.33) and Cultural Sensitivity (M 3.01; SD 0.23). The three lowest were for Handling Disagreement and Conflict (2.80; SD 0.20), Control Over Practice (2.71; SD 0.34) and Teamwork (2.48; SD 0.31).There was a reduction in overall complications from 19.8% to 8.7%. Few nurses in the focus group were optimistic that at least some changes had taken place, and positively improving their knowledge on assessment of patients and some of their common practices in the ICU. The challenge, which they were presently facing was the implementation of hospital information system because most of them were not knowledgeable in information technology.The main outcome of this study was that there was a reduction in number of patients with PU from 16 to 6 in pre and post intervention groups. This reduction of PU was statistically significant (χ[superscript]2=8.14, df=1, p=0.04).In conclusion whether there was a real improvement in patient care provided due to the interventions given was not able to be determined due to methodological considerations and inability to control for confounders. These data underscore the importance of considering cultural factors, both organisational and societal in quality improvement initiatives and empowering nurses for practice change. A risk management system which acknowledges competing demands in dynamic, real world environments is important to consider in future quality improvement studies. The series of studies presented in this thesis have contributed to understanding of factors influencing implementation and sustainability of quality improvement initiatives in a Malaysia ICU. Information acquired from the thesis will be useful information for further improvement targeting education, services, research, policy and future quality improvement project plans in Malaysia.
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Kusi, Joseph. "Potential Toxicity of Silver Nanoparticles to Microbial Communities and Macroinvertebrates." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3780.

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Silver nanoparticles (AgNPs) are the most common nanomaterials incorporated in commercial products due to their antimicrobial activity. Recently, AgNPs were detected in surface waters suggesting the potential for bioavailability in the aquatic receptor organisms. This dissertation research attempts to understand the potential toxicity of AgNPs on water quality indicators, focusing on the microbial community and amphipods. This study evaluated whether: (1) the antimicrobial properties of AgNPs pose potential risks to microbial communities in pathogen impaired streams; (2) AgNPs can cause a shift in functional diversity and metabolic fingerprinting of microbial communities; (3) survival and growth of Hyalella azteca (amphipods) could be affected by AgNPs; and (4) surface coating agents influence AgNP toxicity in H. azteca. Microbial community responses to AgNPs were assessed using standard plate count, microbial enzyme assays, and carbon substrate utilization with Biolog EcoPlates™. Ten-day and 28-d toxicity tests were conducted in a static system to assess AgNP effects on H. azteca. AgNPs caused a 69% decrease in microbial concentration and a 77% decrease in β-glucosidase activity at 0.32 mg Ag kg-1 dry sediment. The substrate utilization pattern of the microbial community was altered by AgNPs at 0.33 mg Ag kg-1 dry sediment. Ten-day LC50s for the survival of H. azteca were 3.3, 9.2, and 230.0 µg Ag L-1 for AgNO3, citrate-AgNP, and PVP-AgNP, respectively, whereas the 28-d LC50s were 3.0, 3.5, and 66.0 µg Ag L-1 for AgNO3, citrate-AgNP, and PVP-AgNP, respectively. The EC20s for growth (calculated as biomass) for the 10-d test were 1.6, 4.7, and 188.1 µg Ag L-1 for AgNO3, citrate-AgNP, and PVP-AgNPs; while the 28-d EC20s for AgNO3, citrate-AgNP and PVP-AgNP were 3.2, 0.5, and < 50 µg Ag L-1. The NOECS for dry weight were 4 and 1, and 100 µg Ag L-1, while those for biomass were 2, 0.5, and < 50 µg Ag L-1 for AgNO3, citrate-AgNP, and PVP-AgNP, respectively. The overall toxicity followed the trend: AgNO3 > citrate-AgNP > PVP-AgNP. The studies suggest that AgNPs pose potential risks to microbial communities and epibenthic macroinvertebrates used as bioindicators of water quality to protect public health and ecosystem health.
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Villines, Jonathan A. "USING GIS TO DELINEATE HEADWATER STREAM ORIGINS IN THE APPALACHIAN COAL-BELT REGION OF KENTUCKY." UKnowledge, 2013. http://uknowledge.uky.edu/bae_etds/15.

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Human activity such as surface mining can have substantial impacts on the natural environment. Performing a Cumulative Hydrologic Impact Assessment (CHIA) of such impacts on surface water systems requires knowing the location and extent of these impacted streams. The Jurisdictional Determination (JD) of a stream’s protected status under the Clean Water Act (CWA) involves locating and classifying streams according to their flow regime: ephemeral, intermittent, or perennial. Due to their often remote locations and small size, taking a field inventory of headwater streams for surface mining permit applications or permit reviews is challenging. A means of estimating headwater stream location and extent, according to flow regime using publicly available spatial data, would assist in performing CHIAs and JDs. Using headwater point-of-origin data collected from Robinson Forest in eastern Kentucky along with data from three JDs obtained via a Freedom of Information Act (FOIA) request to the U.S. Army Corps of Engineers (USACE), headwater streams in the Appalachian Coal Belt were characterized according to a set of spatial parameters. These characteristics were extrapolated using GIS to delineate headwater streams over a larger area, and the results were compared to the National Hydrography Dataset (NHD).
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Hayes, Johan Barnard. "Assessment of fish as bio-indicators of river health in rivers of the southwestern Cape." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52704.

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Thesis (MSc)--University of Stellenbosch, 2002.
ENGLISH ABSTRACT: In this study, the Fish Assemblage Integrity Index (FAll) was applied on three rivers within the southwestern Cape. This index uses fish as indicators of biological aquatic integrity and is based on indigenous species expected to be present in biological fish habitats. Fish integrity classes were calculated for each of the sites in the three rivers studied. Sites 2 and 4 within the Lourens River were rated as Class C, whereas sites 1 and 3 were rated as Class F and Class D respectively. Sites 1, 2 and 4 within the Palmiet River were rated Class F, whereas sites 3 and 5 were rated as Class E and Class D respectively. Site 1 within the Hout Bay River was rated as a Class F site, in addition to sites 2 and 3 been rated as Class A. It is however, suggested that the FAll needs to be adjusted to accommodate the general low species richness experienced in the southwestern Cape. In addition to the FAll been applied, the effects of long-term exposure to subtle water quality changes associated with human activities, specifically potential estrogenic compounds in fish from the Lourens River were also investigated. The production of the yolk precursor lipoprotein complex, vitellogenin (Vtg) produced in the liver under estrogen control was employed as biomarker for environmental estrogen exposure. Male fish from the Lourens River were studied using SDS-PAGE gel electrophoresis. Results indicated that 60% of male fish showed the presence of Vtg in their plasma. Abnormal gonad morphology in male and female fish were also assessed using standard histological procedures. Results from this study indicated no observed abnormalities in either male or female gonads. The immediate presence of endocrine disrupters with estrogen activity was investigated by screening water samples from the Lourens, Palmiet and Hout Bay Rivers for estrogen activity. Results indicated that none of the samples appeared to be cytotoxic. In addition, estrogen activity of water samples was also investigated by in vitro culturing of water samples with frog, Xenopus laevis, liver slices. Results indicated that none of the water samples from the three rivers studied indicated estrogenic activity. Although cytotoxicity and estrogen activity results were negative, the production of Vtg in male fish suggests further research regarding the presence of estrogenic substances in these rivers.
AFRIKAANSE OPSOMMING: In die huidige studie is die 'Fish Assemblage Integrity Index' (FAIl) toegepas op drie rivere in die suidwes Kaap. Hierdie indeks gebruik visse as bioindikatore van biologies akwatiese integriteit en is gebasseer op die inheemse visspesies wat verwag word in biologiese vishabitatte. Integriteitsklasse is bepaal vir elke studieterrein in die drie rivere wat ondersoek is. 'n Klas C is bepaal vir studieterreine 2 en 4 in die Lourensrivier. Klas F en Klas D is bepaal vir studieterreine 1 en 3 in die rivier onderskeidelik. 'n Klas F is bepaal vir studieterreine 1, 2 en 4 en Klas E en Klas D bepaal vir studieterreine 3 en 5 in die Palmietrivier onderskeidelik. 'n Klas F is bepaal vir studieterrein 1 in die Houtbaairivier waar 'n Klas A bepaal is vir studieterreine 2 en 3. Dit word egter voorgestel dat die FAII aangepas moet word om die algemene lae spesierykheid wat ervaar word in die suidwes Kaap te akkomodeer. Die reaksie van visse, afkomstig van die Lourensrivier, op die langtermyn blootstelling aan estrogeniese stowwe is ook bestudeer. Spesifieke reaksies van endokriene versteuring, soos vitellogeen (Vtg) produksie in manlike visse is ondersoek deur middel van SDS-PAGE gel elektroforese. Resultate toon dat in 60% van die manlike visse Vtg in die plasma teenwoordig was. 'n Ondersoek na abnormale gonade morfologie in manlike en vroulike visse van die Lourensrivier is deur standard histologiese prosedures gedoen. Resultate hiervan dui op geen sigbare abnormaliteite in die gonades nie. Die onmiddelike teenwoordigheid van endokriene versteurders is bestudeer deur die sitotoksisiteit van watermonsters afkomstig van die Lourens, Palmiet en Houtbaai riviere te bepaal. Resultate dui aan dat geen monsters sitotoksies was nie. Die estrogeenaktiwiteit van die watermonsters is ook ondersoek deur van in vitro kulture van watermonsters saam met padda, Xenopus leavis, lewersnitte gebruik te maak. Geen estrogeniese aktiwiteit is in die watermonsters gevind nie. Al is die sitotoksisiteit en estrogeenaktiwiteit resultate negatief, dui die produksie van Vtg in manlike visse op die noodsaaklikheid van verdere navorsing ten opsigte van die teenwoordigheid van estrogeniese stowwe in drie riviere.
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Miranda, Luisa Helena Silva de. "ANÁLISE DOS METAIS PESADOS E SUA RELAÇÃO COM O MEIO AMBIENTE E A SAÚDE NA BACIA DO RIBEIRÃO ANICUNS." Pontifícia Universidade Católica de Goiás, 2007. http://localhost:8080/tede/handle/tede/3068.

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Made available in DSpace on 2016-08-10T10:55:21Z (GMT). No. of bitstreams: 1 LUISA HELENA SILVA DE MIRANDA.pdf: 8463578 bytes, checksum: f26750d9173140d19c6086b7fe993c1a (MD5) Previous issue date: 2007-02-27
The aim of this study was to analyze the alterations in the heavy metals concentration levels in water and sediment samples, in the Anicuns watershed, in Goiânia GO. A survey of the most important anthropogenic contamination sources in this environment was accomplished. For the best development of field activities and analyses results the study was divided into three steps: 1- The situation diagnosis of Anicuns watershed and the sampling field mapping; 2- Water and sediment sample collecting for the analyses of the chemical elements; 3 Geochemistry analyzes and the discussion of the multielements associations of sediment phase 1, phase 2 and water. The methodology used in order to determine the multielements concentration was ICP-OES. From these results the data went through a statistical treatment, and them the matrices correlations and the geochemical maps. Considering the sediments, the results have showed chemical elements alterations in the following sampling points: 1) Phase 1; in the drainage of Cpaim Puba (CF-S-067) and Botafo (CF-S-068) streams, the elements Cu, Zn, Cd, Tl, Sr, Ca, K, Hg, Cs, were found in Vaca Brava (CF-S-061) and Cascavel (CF-S-062) streams, the Cs; 2) Phase 2, in the points at São José farm (LMS-004), the elements Nb, V, Fe, B, Ti, Te, Co, Zn and La; at Anicuns stream/bridge at Anhaguera Avenue (LMS-013), Nb, V, Fe and B; at the Anicuns stream bridge/ Criméia Oeste (LMS-018), Ti, Te, Co, Sn and Sr, and in Capim Puba stream drainage (LMS-022, LMS-023, LMS-024), the elements Sr, Fe, B, Cu, Pb, Zn, Ni, Ba; 3) About the water, in the drainages of Meia Ponte river (LMS-020), in Capim Puba stream and at the bridge in Criméia Oeste, the elements Si, Ca, Mg and Bi were found. Considering the field observations, the sampling points which are located furthest from the spring show a bigger urban agglomeration what, consequenthy, increase the environmental impacts caused by human action.
O presente trabalho tem como objetivo realizar uma análise das alterações dos níveis de concentração de elementos químicos, em amostras de água e sedimentos de corrente, na bacia do ribeirão Anicuns, em Goiânia-GO. Foi realizado levantamento geoquímico das principais fontes de contaminações antrópicas nesse ambiente. Para o melhor desenvolvimento das atividades de campo e analises dos resultados o trabalho foi dividido em três etapas: 1a. o diagnóstico da situação da bacia do ribeirão Anicuns e mapeamento da área de amostragem; 2a. coleta das amostras de água e sedimento de corrente para análise dos elementos químicos; 3a. análise geoquímica e discussão das associações dos multielementos de sedimento de corrente Fase 1, Fase 2 e Água. A metodologia utilizada para determinar as concentrações dos multielementos foi ICP-OES. A partir desses resultados os dados passaram por um tratamento estatístico e, em seguida, foram confeccionadas matrizes de correlações e mapas geoquímicos. Considerando os sedimentos de corrente, os resultados mostraram alterações nas concentrações dos elementos químicos nos seguintes pontos de amostragens: 1) - Fase 1, nas drenagens dos córregos Capim Puba (CF-S-067) e Botafogo (CF-S-068) para os elementos Cu, Zn, Cd, Tl, Sr, Ca, K, Hg, Cs, e nos córregos Vaca Brava (CF-S- 061) e Cascavel (CF-S-062) para Cs.; 2) - Fase 2, nos pontos da fazenda São José (LMS-004), Nb, V, Fe, B, Ti, Te, Co, Zn e La; no ribeirão Anicuns/ponte Av. Anhanguera (LMS-013), Nb, V, Fe e B; na ponte do ribeirão Anicuns/Criméia Oeste (LMS-018), Ti, Te, Co, Sn e Sr e na drenagem do córrego Capim Puba (LMS-022, LMS-023, LMS-024), os elementos Sr, Fe, B, Cu, Pb, Zn, Ni, Ba; 3) Água, nas drenagens do rio Meia Ponte (LMS-020), córrego Capim Puba e Ponte Criméia Oeste, os elementos Si, Ca, Mg, e Bi. Conforme observações de campo, os pontos de amostragem mais distantes da nascente apresentam uma maior aglomeração urbana e com isso aumentam os impactos ambientais causados pela ação humana.
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40

Pressley, Jana. "Program evaluation exploratory investigation of the problem of client attrition at Outreach Community Center /." Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.

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41

Gordon, A. K. (Andrew K). "Assessing the effect of a laundry detergent ingredient (LAS) on organisms of a rural South African river." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1006201.

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Powdered laundry detergents are consumed in high volumes worldwide. Post use, they are directed toward water resources via wastewater treatment works or, as is the situation in many rural areas of South Africa, they enter the environment directly as a result of laundry washing activity undertaken alongside surface waters. Within wastewater treatment works, the main ingredient in powdered laundry detergents, the narcotic toxin linear alkylbenzene sulfonate (LAS), is mostly removed, rendering the waste stream a negligible risk to the aquatic biota of receiving waters. In contrast, the biological and ecological impacts of direct LAS input to the aquatic environment, as a consequence of near-stream laundry washing, are yet to be fully realised. Consequently, this thesis posed two research questions: 1) 'What are the LAS concentrations in a small rural South African river'? and 2) 'Is the in-stream biological community negatively affected at these concentrations?' The chosen study area, the community of Balfour in the Eastern Cape Province, is like many rural areas of South Africa where inadequate provision of piped water to homesteads necessitates laundry washing alongside the nearby Balfour River. The first research question was addressed in two ways: by predicting LAS concentrations in Balfour River water by assessing detergent consumption and laundry washing behaviour of residents living alongside the river; and measuring actual in- stream LAS concentrations on different days of the week and during different seasons. Results indicated that LAS concentrations were highly variable temporally and spatially. High peak concentrations of LAS occurred infrequently and were limited to the immediate vicinity of near-stream laundry washing activity with the highest measured concentration being 342 μg.L ⁻¹ and the average 21 μg.L ⁻¹ over the sampling period. The second research question was addressed by integrating the chemical evidence, determined from the first research question, with the biological evidence of stress responses measured in macroinvertebrates collected downstream of near-stream laundry washing activity on the Balfour River. Predicted and measured LAS exposure concentrations from the Balfour River were compared to a water quality guideline for LAS (304 μg.L ⁻¹), specifically derived in this thesis. Biological stress responses were measured at different levels of organisation: two sub-cellular responses (lipid peroxidation and cholinesterase activity); three measures of macroinvertebrate tolerance to water quality impairment; five measures of community composition; three measures of community richness; and a surrogate measure of ecosystem function (functional feeding groups). Weight-of-evidence methodology was utilised to assess, integrate and interpret the chemical and biological evidence, and at its conclusion, determined no effect on the in-stream biological community of the Balfour River downstream of laundry washing activity.
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42

Leku, Faton, and Louis Perikala. "Hälsoekonomisk utvärdering av ett nytt arbetssätt för behandling av knäskador : En studie gjord på ortopedkliniken på Länssjukhuset i Kalmar." Thesis, Linnéuniversitetet, Institutionen för ekonomistyrning och logistik (ELO), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-65821.

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Bakgrund: Kostnadsökningen inom hälso- och sjukvården har varit ett stort problem sedan 1980-talet och kommer att fortsätta vara ett problem i framtiden. Det har lett till en mer ansträngd ekonomisk situation som hälso- och sjukvården fått förhålla sig till. Därför är det av stor vikt att de disponibla medel som finns inom hälso- och sjukvården allokeras till de områden där de skapar som mest nytta. Syfte: Syftet med studien är att göra en hälsoekonomisk utvärdering av ett nytt arbetssätt för behandling av knäskador på ortopedkliniken på Länssjukhuset i Kalmar. Metodval: Studien är utformad som en utvärderingsstudie med en abduktiv utgångspunkt. Datainsamlingen har skett utifrån semistrukturerade intervjuer på LSK med personal som är involverad i projektet. Utöver de semistrukturerade intervjuerna har även numeriska data utgjort en del av studiens empiri. Slutsats: Efter genomförd studie kan vi konstatera att fler hälsoekonomiska utvärderingar behövs på icke-nationella nivåer för att stödja verksamheter inom hälso- och sjukvården. Det är viktigt att det aktivt arbetas med effektiviseringsarbeten inom offentliga verksamheter som främst finansieras av skattemedel. Vi kan även konstatera att det nya arbetssättet är mer lönsamt än det gamla både monetärt och icke-monetärt där förändringen bidragit med flera vinningar som exempelvis kortare ledtider, bättre samarbete och utökad kompetens.
Background: The cost increase in healthcare has been a major problem since the 1980s and will continue to be a problem in the future. This has led to a more strained economic situation for the healthcare sector. Therefore, it is of the utmost importance that the available funds in the healthcare sector are allocated to the areas where they are most beneficial.  Purpose: The purpose of this study is to make a health-economic evaluation of a new work procedure for the treatment of knee injuries at the orthopedic clinic at Kalmar’s County Hospital. Method: The study is designed as an evaluation study with an abductive outset. The data collection has been based on semi-structured interviews at LSK with the staff that was involved in the project. In addition to the semi-structured interviews, numerical data has also been part of the study for the empirical data collection. Conclusion: After completion of the study, we can state that more health-economic evaluations are needed at non-national levels to support healthcare organisations. It is important to actively work with efficiency initiatives in public organisations that are primarily funded by tax assets. We can also state that the new work procedure is more profitable than the old one, both monetary and non-monetary, where the change of work procedure has resulted in several non-monetary gains, such as shorter lead times, better cooperation and increased competence.
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43

Eddins, Jennifer Marie. "The Impact of Lemongrass, Oregano, and Thyme Essential Oils on Candida albicans' Virulence Factors." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5182.

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Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and combined, kill rates of fluconazole, caspofungin, and the kill rates when the antifungals were each combined with the 3 essential oils were compared using 117 isolates recovered from bloodstream infections between January 2009 through August 1, 2017. The data collected were analyzed using 2-way repeated ANOVAS. According to study results, there were statistically significant increases in kill rates when the isolates were exposed to any of the combinations of essential oils tested. Using binomial and multinomial regression to analyze age, gender, race, and comorbidities resulted in the age group 25-34, kidney failure, and solid organ tumor cancer all being statistically significantly associated with an increased risk for Candida albicans bloodstream infections, and multiple organ failure negatively associated with the risk. Health care practitioners can use the results of this study to reduce the number of patients becoming infected with life-threatening yeast infections, which could reduce the costs associated with infections.
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Widner, David E. "BRIDGING THE GAP BETWEEN TRADITIONAL CULTURE AND MAINSTREAM SOCIETY: DEVELOPING AN ENVIRONMENTAL EDUCATION AND STREAM HEALTH MONITORING PLAN TO PROMOTE THE IMPROVEMENT OF THE SUGAR CREEK WATERSHED AND THE PRESERVATION OF SWARTZENTRUBER AMISH CULTURE." Kent State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=kent1416446669.

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45

Banning, James L. "Assessing the Effectiveness of the Roaring Branch BMP Retrofit Using Macroinvertebrate Bioassessment." Scholar Commons, 2010. https://scholarcommons.usf.edu/etd/1567.

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Using benthic macroinvertebrates to measure stream health has been widely used and accepted around the world. Macroinvertebrates are resident monitors of chronic impairment in a stream since they are relatively sessile and most commonly respond to disturbance by drift but can recolonize a restored stream reach very quickly. This study tested the effectiveness of macroinvertebrate metrics developed through the Rapid Bioassessment Protocol (RBP) to detect changes in stream integrity as the result of placement of a best management practice (BMP), installed on a tributary of Roaring Branch, located in Columbus, Georgia. The BMP was designed to attenuate flow to reduce sediment suspension and downstream deposition. A sampling protocol derived from the Georgia Ecoregions Project was implemented to evaluate the macroinvertebrate community, located downstream of the BMP, and downstream of the confluence with Roaring Branch, both before and after the BMP installation. The resulting metrics were compared to a reference condition described for subecoregion 65c, sandhills-lower piedmont. A dramatic improvement or increase of macroinvertebrate populations suggests an improvement in water quality (via reduction in fine sediment deposition) due to improved physical habitat conditions for indicators (Trichoptera) of healthier streams. The results of this study suggests further restoration activities should continue and that re-evaluation of the sampling protocol should take into account a larger subsample size of benthic macroinvertebrates than currently recommended by the RBP.
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46

Williams, Julia. "Street homelessness : people's experiences of health and health care provision." Thesis, King's College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426214.

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47

Miller, Travis John. "Evaluating riparian health assessment methods for perennial streams in Montana." Thesis, Montana State University, 2005. http://etd.lib.montana.edu/etd/2005/miller/MillerT0805.pdf.

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48

Cook, Nicholas Alexander. "Surface Water Quality and Aquatic Ecological Health in Central Appalachian Streams." Diss., Virginia Tech, 2015. http://hdl.handle.net/10919/56603.

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The Central Appalachian region is home to several resource-extraction industries, a host of globally unique aquatic wildlife species, and region-wide poverty. These overlapping circumstances make solving environmental issues in the region challenging. Of particular focus is the coal mining industry, both because of its prevalence and because of controversial methods of practice such as mountain top mining. One of the primary concerns in the region is the extirpation of sensitive aquatic macroinvertebrate species. Several studies have suggested the primary driver of this loss of biodiversity is due to increased conductivity in streams impacted by these mining practices. The reality is that several pollutant sources coexist in these Central Appalachian watersheds. Because of geographic isolation, many headwater communities lack proper sewerage and discharge directly into nearby waterways, compounding potential effects of upstream mining activities. Additionally, several legacy sites exist throughout the Appalachian region, both underground and surface mining in nature. To best mitigate ecological impacts of all of these pollutant types, relative contributions of each must be understood, as well as the nature of the pollution contributed by each. As a contribution towards this region-wide need for better information on pollution, the studies comprising this dissertation seek to better understand the composition of these different pollutant sources and their in-stream contributions to conductivity. The first paper found that these sources are indeed distinct in their inorganic ion make-up: surface coal mining was found to contribute primarily Ca, K, Ni, Se, and SO₄⁻², while untreated household waste (UHW) was primarily associated with P. HCO₃⁻ Mn, and Si were found to be associated with a legacy underground discharge. The second and third scientific studies included here analyzed conductivity's effect on Virginia Stream Condition Index (VSCI) versus other water quality and habitat parameters as well as the effect of specific ion suites on VSCI score. Findings indicated that excellent habitat extends species resilience against elevated conductivity, with passing VSCI scores found at conductivity in the 600-800 µs/cm range in cases of excellent habitat metric scores. Meanwhile, VSCI score suppression was highly related to surface mining-related inorganic ions (Ca, K, Mg, Ni, and SO₄⁻²), but also negatively correlated with ions related to UHW (P and Na). These results indicate the need for quantification of biological responses to specific ions in order to initiate targeted mitigate of pollutants in Central Appalachian watersheds.
Ph. D.
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McGibbon, Elizabeth Anne. "The mental health experiences of female street youth." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0012/MQ49398.pdf.

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50

Holland, Mark Ashley. "Street drugs, alcohol and mental health : what helps?" Thesis, University of Salford, 2009. http://usir.salford.ac.uk/18988/.

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The use of street drugs and/or alcohol combined with mental health problems is referred to as dual diagnosis within mental health and substance misuse services. The aim of this research study was two-fold. Firstly, to discover what people considered helpful in terms of support or intervention that could then be developed into information materials. And secondly, to develop an explanatory theory that added to the subjects’ wider understanding. A grounded theory methodology was employed to elicit the personal experiences of participants which in turn would ensure that the production of information materials and the development of theory remain rooted in the data. Twenty-six unstructured conversational interviews and 9 focus groups were conducted. Two carers, 6 practitioners and 18 service users were interviewed. The focus group participants were all service users, just under half of whom participated in interviews also, the remainder were new to the study; all took place in mental health and substance misuse treatment settings. In total 41 people, 34 of whom were service users, participated. Including repeat participants, 51 separate voices or contributions were made. Data incidents and happenings (n = 977) were analysed using open, axial and selective coding procedures overlaid by constant comparison. Twelve categories sharing properties and dimensions relating to helpful advice, intervention or behaviour emerged. The theme of helpfulness was a key concept and emerged as the major category subsequently entitled Help. The theory related to help developed. It challenged dual diagnosis convention by identifying people with a dual diagnosis as positively seeking, for themselves or others, recovery or alleviation of substance or mental health related problems. They did this from within a harm reduction or damage limitation paradigm. The examples of help related incidents (from which the help theory emerged) were collated and formed the content of dual diagnosis information materials.
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