Thesis: Ph. D. in Atmospheric Chemistry, Massachusetts Institute of Technology, Department of Earth, Atmospheric, and Planetary Sciences, 2019 / Cataloged from PDF version of thesis. / Includes bibliographical references (pages 85-93). / Precursor emissions of air pollution can be reduced at emitting sources by end-of-pipe control policies or as co-benefits of climate policies that limit fossil fuel. Identifying cost-effective control strategies requires understanding policy costs, chemical non-linearities in pollution formation, and the value of health benefits. China suffers from severe air pollution, and is implementing both policies, but relevant studies are limited. This thesis incorporates three studies that examine the air quality co-benefits of China's recent climate policy for China and transboundary countries, and the potential changes in the sensitivities of inorganic PM₂.₅ to precursor emissions in China. The first study quantifies co-benefits of China's climate policy from reducing PM₂.₅ using a modeling framework that couples an energy-economic model with sub-national detail for China (C-REM) and an atmospheric chemical transport model GEOS-Chem. / The effects of an illustrative climate policy, a price on CO₂ emissions, are simulated under three stringencies. In a policy scenario consistent with China's recent pledge to peak CO2 emissions by 2030 (the 4% Policy scenario), national health co-benefits from improved PM₂.₅ pollution can partially or fully offset policy costs depending on chosen health valuation. This study also suggests co-benefits would rise with increasing policy stringency. Using the same model simulations, the second study further compares co-benefits from PM₂.₅ and ozone in China and three downwind countries (South Korea, Japan and the United States). This study suggests that under the 4% Policy scenario, avoided premature deaths from reducing ozone are about half of those from PM₂.₅ in China, and the total avoided deaths in transboundary countries are about 4% of those in China. / The third study examines the potential changes in the sensitivities of inorganic PM₂.₅ to precursor emissions in China in response to the current and projected national reductions in SO₂ and NO[subscript x] emissions. Under scenarios that reduce SO₂ and NO[subscript x], emissions, sensitivities to SO₂ and NO[subscript x] emissions would increase, but sensitivity to NH₃ emissions would decrease in January and July. The largest absolute changes in sensitivities are found in January for NO[subscript x] and NH₃. / "Funding from the Whiteman Fellowship, the Jack C. Tang (1949) Fellowship, the MIT Environmental Solutions Initiative, and the National Institutes of Health Superfund Research Program"--Page 5 / by Mingwei Li. / Ph. D. in Atmospheric Chemistry / Ph.D.inAtmosphericChemistry Massachusetts Institute of Technology, Department of Earth, Atmospheric, and Planetary Sciences

Continuous learning for health care workers in Tanzania - Design recommendations for an e-learning system within a health portal   This report describes a Master thesis conducted at the Human-Computer Interaction Department at KTH The Royal Institute of Technology. The project is based on a nine weeks field study in Tanzania during the spring and summer 2013. The field study was conducted as a Minor Field Study (MFS) financed through Swedish International Development Cooperation Agency, SIDA and ÅF. The aim has been to investigate the users interest, needs and expectations on an e-learning system. Specifically designed for the health care workers in Tanzania, to improve and developed their knowledge within their specific work area. The investigation of these questions resulted in design recommendations that can be used as a basis for future development. The users and their expectations and needs of the e-learning system were mapped down through observations, interviews and questionnaires. The user group was positive to an e-learning system and is interested in ICT, Information and communication technology. The most important result from the research is that to get a successful project, the involvement of the users is critical. Otherwise there is a risk that the user will not use the product. Another important result is that the user does not have his or hers own computer or Internet connection, they are dependent on the hospitals devices and connection. At the same time their schedule at the hospital is very tight and it will be a challenge to find time and a place were the health care workers can use the system. This project is a part of a project called the National Health Portal in Tanzania. It is a co-operation between Sweden and Tanzania about information and communication technologies (ICT) in the health care in Tanzania, in order to facilitate the work. Keywords: ICT, user centered design, e-learning, health care, Minor Field Study, Tanzania / Fortbildning för sjukvårdspersonal i Tanzania - Designrekommendationer för ett e-lärandesystem i en hälsoportal Rapporten beskriver ett examensarbete utfört på Institutionen för Människa-datorinteraktion på Kungliga Tekniska Högskolan (KTH). Projektet baseras på en nio veckors fältstudie i Tanzania under våren och sommaren 2013. Fältstudien är en Minor Field Study (MFS) och finansierades av Styrelsen för internationellt utvecklingssamarbete, SIDA och ÅF AB. Syftet har varit att undersöka användarnas intresse samt behov och förväntningar på ett e-lärandesystem, speciellt designat för sjukvårdspersonalen i Tanzania, för att förbättra och utveckla deras kunskaper inom sitt yrkesområde. Utredningen av dessa frågor har resulterat i designrekommendationer som kan användas som bas i det fortsatta utvecklandet av systemet.  Användarna samt deras behov och förväntningar på e-lärandesystemet kartlades genom observationer, intervjuer och enkäter. Resultatet av denna rapport visar på vikten av att användarna är inblandade i projekt för att det ska bli lyckat. Användarna bör vara inblandade i och intresserade av projektet. I annat fall är risken stor att användarna inte vill bidra med sin expertis som just användare och att projekt därmed inte slutförs. Ett annat viktigt resultat är att användaren inte har någon dator eller internetuppkoppling hemma utan använder sig av den som finns på jobbet. Dock är det ett väldigt pressat schema på jobbet och det kommer att bli en utmaning att hitta tid och plats då sjukvårdspersonalen kan använda systemet. Examensarbetet är en del av ett projekt som är ett samarbete mellan Sverige och Tanzania vid namn National Health Portal in Tanzania. National Health Portal in Tanzania är ett projekt som handlar om hur man kan använda sig av informations- och kommunikationsteknologier (IKT) i sjukvården i Tanzania för att underlätta arbetet.   Nyckelord: IKT, användarcentrerad design, e-lärande, sjukvård, Minor Field Study, Tanzania

Background Migrants in many European countries including Germany tend to utilize preventive measures less frequently than the majority population. Little is known about the dental health of migrants as well as about their oral health behaviour, particularly in the adult population. The aim of this study was to examine differences in the uptake of annual dental check-ups in adult migrants and non-migrants in Germany. Methods We used data from the cross-sectional survey ‘German Health Update 2010’ conducted by the Robert Koch Institute (n = 22,050). Data from 21,741 German-speaking respondents with information on the use of dental check-ups was available, of which 3404 (15.7%) were migrants. Multiple logistic regression models were applied to adjust for demographic and socioeconomic confounders, including the place of residence as well as type of health insurance. Results Migrants were generally younger, had a lower socioeconomic status and showed a lower utilization of dental check-ups. The unadjusted odds ratio (OR) for utilization was 0.67 (95%-CI = 0.61–0.73). After adjusting for demographic and socioeconomic confounders the chance only increased slightly (adjusted OR = 0.71; 95%-CI = 0.65–0.77). Conclusions The analysis shows that migration status is associated with a reduced chance of attending dental check-ups, independently of demographic and socioeconomic factors. The influence of other factors, such as type of health insurance and place of residence had also no influence on the association. Migrants are exposed to different barriers in the health care system, comprising the patient, provider and system level. Further studies need to examine the relevant barriers for the uptake of preventive dental services in order to devise appropriate migrant- sensitive measures of dental prevention.

La tesi è una raccolta di tre saggi sul processo di invecchiamento, salute e disabilità in Italia. Il primo capitolo esplora la relazione tra gli indicatori di salute. Il secondo guarda all'associazione tra condizioni di cattiva salute e la qualità del lavoro in un'ottica multidimensionale e di genere. Infine il terzo studia la disabilità in Italia con l'ausilio del capability approach. / The thesis is a collection of three essays on ageing, health and disability for Italy. The first chapter explores the complex structure of un-health among older people in Italy. The second investigates the connection of un-health and quality of work by adopting a multidimensional view and a gender perspective. The third explores disability by adopting the capability approach.

The purpose of the present thesis is to explore and to demonstrate how the combination of two methodological approaches, text mining plus the systemic vision of TRIZ empowered by semantics, can bring a larger and more comprehensive analysis of the evolution of a technology. Both approaches had been not combined before the first of the four papers constituents of the present thesis based in a compendium of publications. However, this combination applied to the evolution of technologies is increasingly being published in the scientific literature. Such combination shows a second benefit in the form of an improvement in accessing and connecting knowledge from disparate scientific literatures in a systematic manner. The common element in all these papers is the use of the technology mining approach, 'techmining', the application of text mining techniques based on technology management knowledge, combined with the use of semantic TRIZ, the advantage of syntactic applied to the systemic vision of TRIZ. These papers show that a better analysis of evolving technologies, e.g. by profiling technologies from a systemic point of view or, a better access to knowledge, e.g. by semantically connecting concepts with meaning, can be achieved. The research on applying the combination of these approaches to scientific and technological information analysis explores the advantages and new possibilities for technology trends assessment as well as the semantic connection of concepts which represents a change in the way information research can be done. The different applications of the aforementioned combination are explored by means of the here presented articles. The structure followed in this research is the collection of three papers published in international academic journals indexed in the most prestigious databases and one chapter in a proceedings book of an international congress. The attached articles show the research undertaken to demonstrate the aforementioned benefits of the proposed combination. Despite it can be found many methods and approaches about the assessment of the evolution of technologies, distributed across the literature, there is still a need to better understand which technologies may emerge, which may evolve faster and at what pace can they reach the market. The combination of the techmining approach and the semantic TRIZ approaches allows understanding the trends enriched with a systemic vision of the links, functions, and influences of constituent and enabling elements of a technology. Such systemic link of elements with its components and ecosystem also allows for a multi-dimensional view of a technology and further reduces the uncertainty to preview the progress of a technology. The papers presented in this dissertation are based on the combination of the TRIZ methodology, the techmining approach and the semantic TRIZ approach, applied to different technologies in different domains, to proof the advantages and implications of the combination. The articles try the different interactions of the combined approaches, applied to the assessment of different technologies, such as lithium batteries for the electric car, a medical case linked to a disease known as Meniére's Disease, the prognosis of prostate cancer, and the usage of probiotics as substitutes of antibiotics in the animal health. The wide range of technologies was selected to show the clear benefits of either combining the two approaches or applying predominantly one of them in the case of the Meniére's disease article. That difference in the nature of technologies also helped to better understand the systemic point of view of the technology, exploring new applications based on the general system theory from Bertalanffy as well as other related approaches about technologies. / El propósito de la presente tesis es la exploración y la demostración de la combinación de dos enfoques metodológicos, la minería de textos y la visión sistémica de TRIZ reforzada con la semántica, pueden aportar un mayor y mas exhaustivo análisis de la evolución de una tecnología. Ambos enfoques no habían sido combinados antes del primero de los cuatro artículos que representan esta tesis por compendio de publicaciones, aunque dicha combinación ha sido crecientemente publicada en la literatura científica, para multiples propósitos desde entonces. Un segundo aporte proporcionado por esta combinación es la mejora de la capacidad de acceso al conocimiento y cómo ello supone un avance para el descubrimiento a través de literaturas no relacionadas "disparate literature discovery" de una forma metódica y científica. El elemento común en los artículos aquí presentados es el aprovechamiento de techmining, esto es, la minería de textos con base en la gestión tecnológica, por ejemplo mediante el perfilado de tecnologías, junto al enfoque de la metodología TRIZ potenciada por el análisis sintáctico y semántico, esto es, mediante la conexión semántica de conceptos, para un análisis más completo de la evolución tecnológica, proporcionando al mismo tiempo un acceso más racional al conocimiento. La investigación sobre la aplicación de la citada combinación al análisis de información científica y tecnológica explora las ventajas y nuevas posibilidades en la evaluación del avance de la tecnología, así como la conexión semántica de conceptos que representa nuevas posibilidades en la forma en que la investigación textual puede hacerse. La estructura de la investigación aquí presentada se muestra a través de los artículos publicados en revistas internacionales de alto impacto y el capítulo de los 'proceedings' de un congreso internacional. Dichos artículos muestran la investigación llevada a cabo para demostrar los beneficios mencionados de la combinación propuesta. A pesar de la gran actividad de investigación y de la existencia de varios enfoques para la prospectiva y la previsión tecnológica presentes en la literatura científica, existe aún la necesidad de entender qué tecnologías pueden emerger, pueden evolucionar más rápido y a qué velocidad pueden llegar al mercado. La combinación de los enfoques de minería tecnológica o techmining y TRIZ semántico permite entender las tendencias de una tecnología dada, enriquecida con una visión de su sistémica, y teniendo en cuenta las conexiones de sus elementos y las influencias de sus elementos constituyentes. Tal conexión entre los components y su entorno permite una vision multidimensional de la tecnología reduciendo más aún la incertidumbre en la previsión de la evolución de una tecnología. Los artículos presentados en esta tesis son aplicaciones y exploraciones de la combinación de mencionada, a diferentes tecnologías de diversos ámbitos muy dispares entre sí, con el fin de demostrar sus ventajas e implicaciones. Los artículos tratan las diferentes interacciones entre ambos enfoques de trabajo, aplicados a tecnologías como baterías de litio para los vehículos eléctricos, un caso médico ligado a una dolencia como el síndrome de Méniere, a la prognosis del cáncer de próstata y al uso de probióticos en la alimentación animal como sustitución de los antibióticos. Este amplio rango de tecnologías han sido seleccionados para mostrar las ventajas, de forma más objetiva, de la combinación de ambos enfoques o con predominancia de alguno en particular, como es el caso del artículo explorando el síndrome de Méniere. Estas exploraciones permiten también entender mejor el punto de vista sistémico de una tecnología, descubriendo nuevas aplicaciones basadas en la teoría general de sistemas de Bertalanffy así como en otros enfoques relacionados. / El propòsit de la present tesi és l'exploració i la demostració de la combinació de dos enfocaments metodològics, la minería de textes i la visió sistémica de TRIZ, reforçada amb la sintáctica i la semántica, mostrant que poden oferir un abast més gran i més holístic en l'enteniment de l'evolució d'una tecnología. Tots dos enfocaments no habían estat combinats abans del primer article dels quatre que composen aquesta tesi, però creixentment combinat dins la literatura científica per a múltiples propostes des de la primera publicació. Una segona aportació proporcionada per aquesta combinació és la millora de la capacitat d'accés al coneixement, i de com això suposa un avanç en l'àrea de recerca a traves de literatures no relacionades "disparate literature discovery" d'una forma metòdica i científica. L'element comú en els articles presentats en aquesta tesi és l'aprofitament de la mineria de textos amb base en la gestió tecnològica, 'techmining', per exemple mitjançant el perfilat de tecnologies, al costat de l'enfocament de la metodologia TRIZ potenciada per l'anàlisi sintàctica i semàntica, mitjançant la conexión semántica de conceptes, per assolir un anàlisi més complet de l'evolució tecnològica, així com per a garantir un accés més racional al coneixement. La investigació de l'aplicació de la combinació dels dos enfocaments a l'anàlisi d'informació científica i tecnològica realizat, exploren els avantatges i noves possibilitats en l'avaluació de l'avanç de tecnologies, així com la conexión de conceptes uqe representa noves possibilitats en la forma en què la investigació textual pot fer-se. L'estructura de la investigació ací presentada es mostra a través dels articles publicats i el capítol dels 'proceedings' d'un congrés internacional. Aquests articles mostren la investigació duta a terme per demostrar els beneficis esmentats. Tot i la gran activitat de recerca i enfocaments per a la prospectiva i la previsió tecnològica existents a la literatura científica, existeix encara la necessitat d'entendre quines tecnologies poden emergir, poden evolucionar més ràpid i a quina velocitat poden arribar al mercat. La combinació dels enfocaments de mineria tecnològica o 'techmining' i TRIZ semàntic permet entendre les tendències d'una tecnologia donada, amb una visió del seu sistema, les connexions dels seus elements i les influències dels elements constituents. Els articles presentats en aquesta tesi són aplicacions i exploracions de la combinació de la metodologia TRIZ, la seva potenciació mitjançant la semàntica i el techmining a diferents tecnologies de diversos àmbits, alguns molt dispars entre si, per tal de demostrar les seves avantatges i implicacions. Els articles tracten les diferents interaccions entre els dos enfocaments de treball, aplicats a tecnologies com bateries de liti per als vehicles elèctrics, un cas mèdic lligat a una malaltia com la síndrome de Ménière, a la prognosi del càncer de pròstata i en alimentació, a l'ús de probiòtics en l'alimentació animal com a substitució dels antibiòtics. Aquest ampli rang de tecnologies han estat seleccionats per mostrar els avantatges de forma més objectiva, de la combinació de tots dos enfocaments o amb predominança d'algun en particular, com és el cas de l'article explorant la síndrome de Ménière. Aquestes exploracions permeten també entendre millor el punt de vista sistèmic d'una tecnologia, descobrint noves aplicacions amb base en la teoria general de sistemes de Bertalanffy així com altres treballs relacionats. / Vicente Gomila, JM. (2017). The combination of the disciplines of Techmining and semantic TRIZ for better and faster analyzing technology evolution [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/89088 / TESIS

Thesis: Ph. D., Harvard-MIT Program in Health Sciences and Technology, 2015. / Cataloged from PDF version of thesis. / Includes bibliographical references. / Cancer is a Darwinian evolutionary process in which rounds of mutation and selection lead to increasingly fit clones. Understanding how cancers evolve and in particular how they form lethal metastases is critical to informing the design of new therapies. In the first part of this thesis, we performed whole-exome sequencing of paired endometrial cancer primaries and metastases to explore how tumors sample the genetic landscape. We find that mutations of PTEN, and TP53 occur early in the evolution of endometrial cancers, whereas BAF complex alterations occur late. We identified novel recurrent alterations in primary tumors, including mutations in the estrogen receptor cofactor NRIPJ in 12% of patients. Phylogenetic analyses in cases with multiple metastases indicated these metastases typically arose from one lineage of the primary tumor. We observed subclones within the sequenced part of the primary tumor that seeded metastases. We document extensive heterogeneity and genomic disruption across the various clinical stages in endometrial cancers. In the second part of this thesis we explore how the widespread genomic disruption observed in tumors can generate therapeutic opportunities. We use data from genome-scale shRNA screens to perform an unbiased analysis of all copynumber: gene dependency interactions. We identify a class of interactions called CYCLOPS interactions in which genomic loss of essential genes sensitizes cancer cells to their further suppression. We explore the properties of CYCLOPS genes and show that the splicing factor SF3B1 is one of them. Biochemical analyses showed that cancer cells harboring hemizygous loss of SF3BI lack a buffer of SF3BI present in cells whose SF3BI locus is intact. These data provide evidence for the utility of developing nononcogene targeted therapies as a means of advancing cancer therapeutics. / by William J. Gibson. / Ph. D.

Thesis (Ph. D. in Electrical and Medical Engineering)--Harvard-MIT Program in Health Sciences and Technology, 2013. / Cataloged from PDF version of thesis. / Includes bibliographical references (p. 124-135). / When viewed under the microscope, biological tissues reveal an exquisite microarchitecture. These complex patterns arise during development, as cells interact with a multitude of chemical and mechanical cues in the surrounding extracellular matrix. Tissue engineers have sought for decades to repair or replace damaged tissue, often relying on porous scaffolds as an artificial extracellular matrix to support cell development. However, these grafts are unable to recapitulate the complexity of the in vivo environment, limiting our ability to regenerate functional tissue. Biomedical engineers have developed several methods for printing two- and three-dimensional patterns of proteins for studying and directing cell development. Of these methods, laser microprinting of proteins has shown the most promise for printing sub-cellular resolution gradients of cues, but the photochemistry remains too slow to enable large-scale applications for screening and therapeutics In this work, we demonstrate a novel high-speed photochemistry based on multi-photon photobleaching of fluorescein, and we build the fastest 2-D and 3-D laser microprinter for proteins to date. First, we show that multiphoton photobleaching of a deoxygenated solution of biotin-4-fluorescein onto a PEG monolayer with acrylate end-group can enable print speeds of almost 20 million pixels per second at 600 nanometer resolution. We discovered that the mechanism of fluorescein photobleaching evolves from a 2-photon to 3- and 4-photon regime at higher laser intensities, unlocking faster printing kinetics. Using this 2-D printing system, we develop a novel triangle-ratchet method for directing the polarization of single hippocampal neurons. This ability to determine which neurite becomes an axon, and which neuritis become dendrites is an essential step for developing defined in vitro neural networks. Next, we modify our multiphoton photobleaching system to print in three dimensions. For the first time, we demonstrate 3-D printing of full length proteins in collagen, fibrin and gelatin methacrylate scaffolds, as well as printing in agarose and agarose methacrylate scaffolds. We also present a novel method for 3-D printing collagen scaffolds at unprecedented speeds, up to 14 layers per second, generating complex shapes in seconds with sub-micron resolution. Finally, we demonstrate that 3-D printing of scaffold architecture and protein cues inside the scaffold can be combined, for the first time enabling structures with complex sub-micron architectures and chemical cues for directing development. We believe that the ultra-rapid printing technology presented in this thesis will be a key enabler in the development of complex, artificially engineered tissues and organs. / by Mark Andrew Scott. / Ph.D.in Electrical and Medical Engineering

Les Technologies de l’Information en Santé (TIS) sont de plus en plus utilisées pour améliorer la qualité des soins et la sécurité du patient. Cependant, certains problèmes d’utilisabilité peuvent amenuiser leur impact et peuvent même induire de nouveaux problèmes dont la mise en danger du patient. Pour éviter ces effets négatifs, il est notamment nécessaire d’améliorer l’utilisabilité des TIS ce qui requiert l’application de connaissances d’utilisabilité éprouvées. Les connaissances en utilisabilité appliquée aux TIS sont rares, éparpillées à travers diverses supports et peu utilisables. Par ailleurs, leur couverture en termes de problèmes d’utilisabilité est peu connue. Ce travail a deux objectifs: (i) participer à l’amélioration de l’accumulation de la connaissance en utilisabilité pour les TIS, (ii) fournir une connaissance structurée sur l’utilisabilité des TIS et dont la couverture est établie. Le domaine d’application est celui des systèmes d’alerte médicamenteux.Méthode. Deux analyses indépendantes de la littérature ont été menées : d’un côté, identifier et organiser les problèmes d’utilisabilité des systèmes d’alerte médicamenteux ainsi que leurs conséquences ; de l’autre, identifier et synthétiser les principes d’utilisabilité spécifiques à ces systèmes. Les résultats de ces analyses ont été croisés afin de connaitre la couverture desdits principes en termes de problèmes d’utilisabilité.Résultats. La revue systématique a identifié 13 types de problèmes d’utilisabilité dans les systèmes d’alerte médicamenteux. Les conséquences de ces problèmes sur le clinicien et son système de travail sont variées et ont un grand pouvoir de nuisance (e.g., fatigue, erreur d’interprétation). Au total, 63 principes d’utilisabilité permettent de rendre compte de tous les problèmes d’utilisabilité identifiés. Ils sont organisés en 6 thèmes : améliorer le ratio signal-bruit, être en adéquation avec l’activité des cliniciens, supporter le travail collaboratif, afficher les informations pertinentes, rendre le système transparent et fournir des outils utiles. Le croisement des deux ensembles de données révèle une bonne correspondance entre les principes d’utilisabilité énoncés et les problèmes d’utilisabilité réellement observés.Discussion. Une liste structurée des principes d’utilisabilité illustrés par des exemples réels de leur violation a été développée à partir de ce travail. Cette liste peut aider les concepteurs et les experts en Facteurs Humains à comprendre et à appliquer les principes d’utilisabilité durant la conception et l’évaluation de systèmes d’alerte médicamenteux. L’utilisabilité appliquée aux TIS est une discipline relativement récente qui souffre d’un déficit de structuration et de capitalisation de ses connaissances. Ce travail montre qu’il est possible d’accumuler et de structurer les données d’utilisabilité des TIS. Ce travail pourrait être poursuivi en développant une base de connaissance en utilisabilité appliquée aux TIS afin de tendre vers une « utilisabilité fondée sur les preuves ». / Health Information Technology (HIT) is increasingly implemented to improve healthcare quality and patient safety. However, some usability issues may reduce their impact and even induce new problems (including patient safety issues). To avoid those negative outcomes, amongst other actions, HIT usability must be improved. This action requires applying validated usability knowledge. However, usability knowledge applied to HIT is scattered across several sources, is not structured and is hardly usable. Moreover, its coverage regarding related usability flaws is not known. This work has two aims: (i) to participate in improving the accumulation of usability knowledge for HIT and (ii) to provide synthetic structured easy-to-use HIT usability knowledge with a clear coverage. Those aims are applied to medication alerting systems.Method.Two independent analyses of the literature have been performed. On the one hand, usability flaws and their consequences for the clinicians and the work system have been searched and organized; on the other hand, existing usability design principles specific to medication alerting systems have been synthesized. Results of both analyses have been matched together. Results.A systematic review identified 13 types of usability flaws in medication alerting systems. Consequences on the clinicians and the work system are varied: they greatly impede the clinicians and negatively impact the work system (e.g., alert fatigue, alert misinterpretation). Sixty-three usability design principles dedicated to medication alerting systems are identified. They represent six themes: improve the signal-to-noise ratio, fit clinicians’ workflow, support collaborative work, display relevant information, make the system transparent and provide useful tools. The matching between usability flaws and principles is quite good.Discussion.As a result of this work, a list of usability design principles illustrated by actual instances of their violation has been developed. It may help designers and Human Factors experts understand and apply usability design principles when designing and evaluating medication alerting systems. Usability applied to HIT is a recent research field that suffers from a deficit of structured knowledge. This work shows that it is possible to accumulate and structure usability knowledge. It could be carried on by developing a usability knowledge base dedicated to HIT in order to strive towards “evidence-based usability”.

Nel contesto della nuova rivoluzione industriale, alti livelli di turbolenza, dinamismo, volatilità, globalizzazione, competizione e un diverso ruolo del consumatore riconfigurano il panorama delle supply chain e delle innovazioni. Nonostante il valore co-creato e le ultime innovazioni in ottica customer driven siano ormai elementi imprescindibili, poche ricerche si sono focalizzate sulle caratteristiche di una supply chain guidata dal consumatore e sull’impatto o implementazione della stampa 3D. Pertanto, questa tesi mira ad esplorare gli aspetti principali della customer driven supply chain e della direct digital manufacturing technology. Il Paper I presenta una revisione sistematica della letteratura e fornisce un quadro concettuale utile per organizzare i contributi più recenti sull'argomento, implementando la teoria e suggerendo linee guida per i manager. Il Paper II e Paper III propongono ricerche qualitative mediante singoli casi studio che rispettivamente analizzano come la stampa 3D è in grado di facilitare la supply chain customer centricity attraverso la co-creazione di valore nel settore aerospaziale e come un technology provider può implementare un’innovazione customer centric nel settore della gioielleria italiana. Gli studi suggeriscono modelli concettuali e proposizioni che incrementano la letteratura esistente e guidano i manager. Questa tesi contribuisce all'esplorazione dei recenti progressi in merito all’'orientamento della supply chain e della direct digital manufacturing technology fornendo analisi critiche approfondite relative a diverse metodologie. / In the new industrial revolution, high levels of turbulence, dynamism, volatility, globalization, competition and modified customer’s role reconfigure supply chains and innovations landscape. Even if value co-creation and last technologies towards customer driven orientation are unavoidable elements, few contributions have focused on customer driven supply chain characteristics and on 3D printing impact on supply chain or elements of its implementation. For this reason, the thesis aims to explore the main features of customer driven supply chains and direct digital manufacturing technology. Paper I presents a systematic literature review that shows a conceptual framework able to organize the most recent contributions on the topic, implementing the knowledge on the theme and suggesting guidelines to managers. Paper II and Paper III provide qualitative constructive single case study research respectively focused on how 3D printing can enable supply chain customer centricity by value co-creation in the aerospace sector and how 3D printing can be implemented by a technology provider in the Italian jewellery sector. The studies suggest conceptual framework and propositions for improving existing knowledge and addressing managers. This thesis contributes to the exploration of recent advancements in supply chain orientation and direct digital manufacturing technology by providing deep critical analysis related to diverse methodologies.

Background Migrants in many European countries including Germany tend to utilize preventive measures less frequently than the majority population. Little is known about the dental health of migrants as well as about their oral health behaviour, particularly in the adult population. The aim of this study was to examine differences in the uptake of annual dental check-ups in adult migrants and non-migrants in Germany. Methods We used data from the cross-sectional survey ‘German Health Update 2010’ conducted by the Robert Koch Institute (n = 22,050). Data from 21,741 German-speaking respondents with information on the use of dental check-ups was available, of which 3404 (15.7%) were migrants. Multiple logistic regression models were applied to adjust for demographic and socioeconomic confounders, including the place of residence as well as type of health insurance. Results Migrants were generally younger, had a lower socioeconomic status and showed a lower utilization of dental check-ups. The unadjusted odds ratio (OR) for utilization was 0.67 (95%-CI = 0.61–0.73). After adjusting for demographic and socioeconomic confounders the chance only increased slightly (adjusted OR = 0.71; 95%-CI = 0.65–0.77). Conclusions The analysis shows that migration status is associated with a reduced chance of attending dental check-ups, independently of demographic and socioeconomic factors. The influence of other factors, such as type of health insurance and place of residence had also no influence on the association. Migrants are exposed to different barriers in the health care system, comprising the patient, provider and system level. Further studies need to examine the relevant barriers for the uptake of preventive dental services in order to devise appropriate migrant- sensitive measures of dental prevention.