Philosophiae Doctor - PhD / The nature of naval member’s job demands is that they experience high levels of stress. Stress is introduced in military training to familiarize sailors with real life stressors. This study is located in piloting and validity theory. It focuses explicitly on validating an existing tool, the Therapeutic Recreation Stress Leisure Appraisal Tool, to measure stress in the South African Navy. This study aimed to pilot and evaluate the validity and reliability of the developed tool in an African context in the South African Navy. A multi-stage procedure of instrument development using the instrument development model will be used, consisting of the following steps: 1) preliminary phase, 2) questionnaire development, 3) pilot testing, and 4) evaluation. The scope of this study, is only focused on stages three and four. The current study followed an explanatory sequential mixed-method design. In this study, the qualitative phase was done first, followed by the quantitative phase. The mixed-method design is used to build upon the same research questions. PHASE 1, the pilot-testing phase (qualitative, n=50), explored if the developed appraisal tool is interpreted correctly and contains the necessary applicable questions. This population and sample were purposefully selected from the navy. Data were collected in focus groups taking place at a naval base. Five focus groups of ten members each were completed using interview schedules. Recorded data was transcribed verbatim. Data were analysed using thematic analysis with data coding to extract themes. This study is an extension of from a masters study linked to the current study, which contributed towards the finalisation of the questionnaire. Iterative exploratory factor analyses were used at the item and scale levels to select and reassign the items and scales. PHASE 2, the evaluation phase (quantitative, n=1000), determined the validity and reliability of the refined, developed appraisal tool. The population (N=7000) and sample (n=1000) consisted of senior and junior ranks from the officer core, conveniently selected from a naval base. PHASE 1 informed PHASE 2, the evaluation phase.

Le développement d’un médicament est réalisé dans le but de répondre à des objectifs thérapeutiques tout en prévenant les risques pour les patients. L’observance, qui correspond au suivi rigoureux de la prescription du médecin, est une condition primordiale de la réussite du traitement. L'acceptabilité, qui peut être définie comme la capacité et la bonne volonté du patient à utiliser, et de son donneur de soins à administrer, le médicament tel que est prévu, joue un rôle crucial dans l’observance, notamment chez les individus les plus vulnérables. L’acceptabilité d'un médicament est déterminée par ses caractéristiques et celles des utilisateurs. De ce fait, le concepteur se doit de considérer les spécificités des utilisateurs cibles pour assurer l’adéquation d’un nouveau produit avec leurs besoins et leurs attentes. Intégrer l'évaluation de l’acceptabilité au développement pharmaceutique et clinique des médicaments apparaît alors d’une importance de premier ordre. A ce jour, il n’existe aucun outil validé et reconnu internationalement permettant d’évaluer ce concept multi-dimensionnel. Cette carence s’accompagne d’un manque de connaissances sur ce phénomène complexe. Ces travaux de thèse présente la conception d’un outil, le référentiel d’acceptabilité, qui permet, d’une part, d’évaluer de manière standardisée l’acceptabilité des médicaments, et d’autre part, d’extraire des connaissances utilisables dès les phases amonts du processus de conception de nouveaux produits. La démarche développée et appliquée dans le domaine des médicaments a été formalisée pour être utilisable dans d’autres univers d’étude. / Medicine development must satisfy efficiency and safety objectives. Patient compliance with physician’s prescription is an essential condition to achieve these objectives. Patient acceptability of a medicine improves patient compliance and thus ensures drug success, in particular in paediatric and geriatric populations. Acceptability could be defined as the overall ability and willingness of the patient to use, and its care giver to administer, the medicine as intended. Acceptability is driven by the users’ and the products’ characteristics. Thus, designers have to consider the specific features of the targeted users to develop a medicine with the most adapted characteristics to reach the best acceptability. Evaluation of the acceptability should be an integral part of pharmaceutical and clinical development. Today, knowledge on this complex phenomenon is still fragmented and there are no internationally agreed methods available to assess this multidimensional concept. This document sets out the development of a validated tool, the acceptability reference framework, providing standardized medicines acceptability evaluation and relevant knowledge usable by designers from the early stage of medicine development. As this research was carried out in a medical field, we propose a formalized methodology transferable to other domains.

The quest towards sustainable development, both nationally and globally, puts the construction industry in the foreground as the main consumer of natural resources. The industry has profound economic, social and environmental impacts. Sustainable construction is one of the most important challenges faced by the construction industry today. In the UK, sustainability is being driven and enforced by the government through stringent fiscal policies and regulations, voluntary initiatives combined with naming and shaming strategies. Stakeholders are becoming more aware of the global challenges and are using their power to exert pressure on companies. Increasingly, construction clients are demanding that their business partners submit: their corporate sustainability policies with tender packages to demonstrate their performance in dealing with opportunities and risks stemming from economic, environmental and social aspect of sustainability. However, the lack of understanding of the concept and its practical application has been a recurrent problem. The conceptual confusion; its vagueness and ambiguity, the complexity of the myriad of challenges and fluidity of the sustainability concept, compounded with the myopic attitude of the industry, lack of clear-cut and practical framework are causing frustration in the construction industry. Consequently, a number of sustainability management frameworks have been proposed. There are probably more than one hundred frameworks for sustainable business strategy. However, the majority of these are either complicated to implement or lack sound theoretical base, effective change management and completeness. These, therefore, do not make the situation any easier. Many are still baffled as to what they should do and how they should go about affecting change. Corporate sustainability in the construction industry is a challenge to many companies. The industry is still under-performing in each of the key themes of sustainable construction and this has lead to a 'blame culture' where each sector of the industry allocates responsibility for its current failings to others (CIRIA C563, 2001). Such a situation poses a need for a comprehensive, practical and easy to use tool that would aid the implementation and management of sustainability at the core of business process. The tool will complement the existing frameworks, which breaks down the strategic and management issues into manageable components. This will enable companies to focus on individual areas and identify actions needed to facilitate change. The problem is that such a tool is virtually non-existent. The main focal point of this research is the development of a tool to facilitate the implementation, management and integration of sustainability issues at the strategic level and promote wider uptake of the concept in the construction industry. This requires a thorough understanding of the concepts of sustainable development, sustainable construction and related issues as well as drivers, benefits, barriers and enablers for achieving corporate sustainability. It also demands an examination of existing management frameworks and collation of case studies from the early adopters to establish critical factors for strategic and management issues involved in achieving corporate sustainability. Through, diverse research epistemologies (quantitative, qualitative and triangulation methods), the research established four main critical factors and thirty-six sub-critical factors for achieving corporate sustainability. These factors underpinned the development of a web-based prototype software (ConPass). This thesis presents the development and evaluation ConPass Model and the prototype software.

<p>There is no debate over the importance of IT security. Equally important is the research on security assessment; methods for evaluating the security of IT systems. The Swedish Defense Research Agency has for the last couple of years been conducting research on the area of security assessment. To verify the correctness of these methods, tools are implemented.</p><p>This thesis presents the design and implementation of an environment to support and aid future implementations and evaluations of security assessment methods. The aim of this environment, known as the New Tool Environment, NTE, is to assist the developer by facilitating the more time consuming parts of the implementation. A large part of this thesis is devoted to the development of a database solution, which results in an object/relational data access layer.</p>

Anaerobic digester (AD) technology is a form of renewable energy that’s economic feasibility assessment is required site by site. This thesis presents a freely available workbook to determine the financial feasibility of a farm-based AD and to demonstrate its use for the Ontario livestock sector. To assess the profitability of ADs for farmers in Ontario with uncertainty included the theory of real options is used. Investment in an AD is financially feasible only for the largest dairy farms in Ontario under current electricity prices, which are approximately six times greater than the wholesale price. Shifting to a duel fuel continuous system would improve returns, as would the availability of additional substrate material in the form of solid grease waste. The real options approach shows that even higher net returns are necessary, than indicated by more traditional approaches, in order for AD investments to be feasible for Ontario livestock farmers.

An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations theory. Patients were additionally screened for 5 potential risk factors of delirium from the multifactorial model of delirium to determine if delirium could be identified in the local population admitted to a single hospital. With a high quality education intervention, the staff nurses on the medical unit successfully implemented the CAM into their nursing practice and accurately identified delirium. Nurses identified delirium and subsyndromal delirium in 25% of the 208 patients in the study population. Consistent with the literature, patients who had a urinary catheter and experienced an iatrogenic event were predictors of delirium. An additional predictor of delirium, not included in the multifactorial model of delirium, included patients receiving benzodiazepines. This quality improvement project suggests that quality delirium education combined with the use of an accurate delirium detection tool could predict delirium accurately in the medical floor population. This has the potential to reduce the impact of delirium on patients, hospital staff, and reduce hospital expenditures.

No description available.

No description available.

Objective: To determine the extent to which aspects of the Sport Concussion Assessment Tool 3 (SCAT3) or Child SCAT3 (C-SCAT3), and the King-Devick Test (KDT) predict Three-Dimensional Multiple Object Tracking (3D-MOT) speed. Participants: A sample of 304 healthy, non-concussed participants with a sporting history (101 females, 203 males) ranging in age from 7-29 years (mean age = 16.05 +/- 4.36) were included in the analysis. Methods: Participants completed the SCAT3, KDT and 3D-MOT in a single visit. Data Analysis: A regression analysis was performed to determine the extent to which aspects of the SCAT3 (immediate memory (IM), coordination (COOR), delayed recall (DR)), and the KDT predicted 3D-MOT speed. Results: Using the stepwise method, it was found that KDT, DR and COOR explain a significant amount of the variance in the speed of the 3D-MOT (F(3, 256)) = 11.82, p < .000 with an R2 = .12. The analysis shows that KDT (Beta = -0.01, p < .000), DR (Beta = 0.07, p < .02), and COOR (Beta = .23, p < .03), were significant predictors of 3D-MOT speed. Conclusions: This study suggests that the KDT, DR, and COOR significantly account for 12% of the 3D-MOT scores, however, there is a large portion of variability unaccounted for by the SCAT3 or C-SCAT3 and KDT. This shows that 3D-MOT likely accounts for central cognitive functions above and beyond the SCAT3 or C-SCAT3 and KDT. Future studies should examine this relationship at baseline, post-injury, and through concussion recovery. This could provide valuable information to better inform clinicians responsible for making return to play determinations. Keywords: Concussion, Mild Traumatic Brain Injury, 3D-MOT, King-Devick Test, Sport Concussion Assessment Tool 3, Child Sport Concussion Assessment Tool 3. / Graduate / 0769 / 0633 / 0566 / oslundk@uvic.ca

Vombsjön är en av de viktigaste dricksvattentäkterna i södra Skåne som förser bland annat Malmö och delar av Lund med dricksvatten. Sjön lider av övergödning och återkommande algblomningar som komplicerar dricksvattenproduktionen. Fosfor från sjöns bottensediment (intern belastning) och fosfor från det jordbruksdominerade avrinningsområdet (extern belastning) behöver kartläggas för att råda bukt på övergödningsproblematiken i sjön och trygga produktionen av ett säkert dricksvatten. Inom ramen för detta examensarbete har den externa fosforbelastningen kartlagts genom modellering av Vombsjöns avrinningsområde med den hydrologiska modellen Soil and Water Assessment Tool (SWAT+). Resultaten från modelleringen visar att det nära 45 000 ha stora avrinningsområdet i genomsnitt tillför 25 ton totalfosfor per år via de tre huvudvattendragen som mynnar ut i Vombsjön. Medelvärdet är beräknat på simuleringar gjorda för åren 2011 – 2022 och belastningen varierar mellan 14–37 ton totalfosfor för de undersökta åren. 79 % av totalfosforn tillförs sjön via det största vattendraget Björkaån, 11 % via Torpsbäcken och 10 % via Borstbäcken. Den månatliga vattenföringen har manuellt kalibrerats och validerats mot en mätpunkt i avrinningsområdet. Miljöövervakning från ett jordbruksdominerat typområde i samma läckageregion som Vombsjöns avrinningsområde till största del ligger inom användes för att jämföra storleksordningen på den arealspecifika fosfortransporten. De arealspecifika månads- och årstransporterna låg inom samma storleksordning men variationerna mellan de två områdena var stora somliga år och månader. Den hydrologiska modellen behöver vidareutvecklas för att bättre simulera vattenföringen under höst och vinter, när vattenföringen generellt är som störst. Vidare behöver modellen kalibreras och valideras mot fler vattenföringsstationer och uppmätta fosforhalter i avrinningsområdet för att avgöra hur väl modellen simulerar fosfortransporten. / Vombsjön is one of the most important drinking water sources in southern Skåne, supplying drinking water to Malmö and parts of Lund. The lake suffers from eutrophication and reoccurring algal blooms which are complicating the drinking water production. Phosphorus leaching from the bottom sediment of the lake (internal load) and phosphorus coming from the agriculture- dominated catchment (external load) needs to be investigated to address the eutrophication issues and ensure a safe drinking water production. As part of this thesis, the external phosphorus load has been investigated through hydrological modeling of the catchment area, using Soil and Water Assessment Tool (SWAT+). The modeling results show that the approximately 45 000 hektar big catchment area contributes to an average of 25 tons of total phosphorus per year via the three main watercourses that flows into Vombsjön. The average load is based on simulations between 2011 and 2022, and the load varies between 14–37 tons of total phosphorus for the examined years. 79 % of the total phosphorus load is supplied to the lake via the largest watercourse, Björkaån, 11 % via Torpsbäcken and 10 % via Borstbäcken. The monthly water flow has been manually calibrated and validated against flow measurements at one point in the catchment area. Environmental monitoring data from an agriculture- dominated catchment area, located in the same leakage region as most of the Vombsjöns catchment area, was used to compare the magnitude of the area-specific phosphorus transport. The area-specific monthly and annual transports of total phosphorus were within the same order of magnitude, but there were significant variations between some years and months. The hydrological model needs further development to better simulate water flow during autumn and winter, when the flow is generally highest. Furthermore, the model needs to be calibrated and validated against more flow stations and measured phosphorus concentrations within the catchment area to determine how well the model simulates phosphorus transport.