There is a growing need to understand and identify overarching organizational requirements for cybersecurity defense in large organizations. Applying proper cybersecurity defense will ensure that the right capabilities are fielded at the right locations to safeguard critical assets while minimizing duplication of effort and taking advantage of efficiencies. Exercising cybersecurity defense without an understanding of comprehensive foundational requirements instills an ad hoc and in many cases conservative approach to network security. Organizations must be synchronized across federal and civil agencies to achieve adequate cybersecurity defense. Understanding what constitutes comprehensive cybersecurity defense will ensure organizations are better protected and more efficient. This work, represented through design science research, developed a model to understand comprehensive cybersecurity defense, addressing the lack of standard requirements in large organizations. A systemic literature review and content analysis were conducted to form seven criteria statements for understanding comprehensive cybersecurity defense. The seven criteria statements were then validated by a panel of expert cyber defenders utilizing the Delphi consensus process. Based on the approved criteria, the team of cyber defenders facilitated the development of a Comprehensive Cybersecurity Defense Framework prototype for understanding cybersecurity defense. Through the Delphi process, the team of cyber defense experts ensured the framework matched the seven criteria statements. An additional and separate panel of stakeholders conducted the Delphi consensus process to ensure a non-biased evaluation of the framework. The comprehensive cybersecurity defense framework is developed through the data collected from two distinct and separate Delphi panels. The framework maps risk management, behavioral, and defense in depth frameworks with cyber defense roles to offer a comprehensive approach to cyber defense in large companies, agencies, or organizations. By defining the cyber defense tasks, what those tasks are trying to achieve and where best to accomplish those tasks on the network, a comprehensive approach is reached.

Background: Older patients are vulnerable to chemotherapy-related toxicity (CRT). Therefore we evaluated screening tools in their power to predict CRT. Methods: Patients with cancer aged ≥65 years completed three screening questionnaires (G8, optimised G8 and Cancer and Ageing Research Group (CARG). Additionally, Comprehensive geriatric assessment (CGA) for verification of supportive care needs was undertaken on patients with impaired G8 scores. During chemotherapy treatment patients were assessed, capturing grade 0–5 CRT as defined by NCI CTCAE 4. Results: 104 patients with non-haematological cancers were included at three study sites. Median age was 73 years (range 65–85). Onco-geriatric screening detected 74% as impaired using G8 and optimised G8 questionnaires and 86% using CARG screening. Grade 3–5 toxicity affected 64.4% of all patients. G8 (OR 0.3 95% CI [0.1;1.0]) and optimised G8 (OR 0.4 95% CI [0.1; 1.5]) did not reliably predict CRT, whereas screening with CARG demonstrated a strong prediction of severe CRT: OR 4.2, 95% CI [1.1, 15.9]. CGA was undertaken on 66 patients, revealing deficiencies in nutritional (83%) and functional-status (54%) and occurrence of relevant comorbidity (53%). Conclusion: The CARG tool could be useful for predicting CRT. CGA showed clinically relevant supportive care needs in patients with a positive G8 screening.:1. Einleitung ..................................................................................................................................... - 3 - 1.1 Epidemiologie der Krebserkrankungen bei älteren Patienten .................................................. - 4 - 1.2 Herausforderungen der geriatrischen Onkologie ..................................................................... - 5 - 1.3 Status Quo ................................................................................................................................. - 7 - 1.4 Geriatrisches Assessment (GA)................................................................................................ - 11 - 1.6 Geriatrisches Screening ........................................................................................................... - 13 - 1.5 Chemotherapie assoziierte Toxizität ....................................................................................... - 15 - 2 Ableitung der Studienrationale ...................................................................................................... - 17 - 3 Publikationsmanuskript .................................................................................................................. - 18 - 4 Zusammenfassung der Arbeit ........................................................................................................ - 26 - 5 Literaturverzeichnis der Einleitung ................................................................................................ - 29 - 6 Anlagen ........................................................................................................................................... - 35 - 7 Abkürzungsverzeichnis ................................................................................................................... - 52 - 8 Erklärung über die eigenständige Abfassung der Arbeit ................................................................ - 53 - 9 Lebenslauf – David Immanuel Kotzerke ......................................................................................... - 54 - 10 Spezifizierung des eigenen Beitrages ........................................................................................... - 56 - 11 Danksagungen .............................................................................................................................. - 58 -

Improved analytical methods using novel cleanup techniques and inexpensive instrumentation for the determination of residue estrogens in municipal wastewater and swine lagoon wastewater have been developed. Presented approaches are less expensive, less time consuming, yet produce comparable detection limits and extraction efficiencies to existing methods. Chapter I provides an overview on environmental estrogens. Chapter II describes a novel method to quantify five estrogens including estriol, estrone, 17alpha-estradiol, 17beta-estradiol, and 17alpha-ethynylestradiol in influent and effluent municipal wastewater. The method includes sample preparation using solid-phase extraction followed by a “QuEChERS” cleanup, dansylation and LC/MS/MS detection. Hydrophilic-lipophilic balance solid phase extraction (SPE) was used for sample preconcentration and the extract was cleaned up using a dispersive SPE method using MgSO4, PSA and C-18. The resulting extract was then derivatized with dansyl chloride. Separation was achieved on a C-18 column and quantification was accomplished in the positive ion mode using multiple reaction monitoring. The method is capable of detecting below 1 ng/L. Chapter III describes improved approaches to quantify five estrogens and two conjugates, Estrone 3-glucuronide and beta-Estradiol 3-sulfate, in swine lagoon wastewater and storm water runoff. A considerable residue was collected when lagoon wastewater samples were centrifuged therefore both resulting residues and aqueous portions were analyzed separately. Analysis of the aqueous portions was carried out using a similar approach to the method described in Chapter II. However, a simple test-tube liquid-liquid extraction was used as an additional sample clean-up step. A modified QuEChERS method was utilized to efficiently extract the target analytes in the residue. Methods have 0.9 – 2 ng/L detection limits. Chapter IV describes an approach to quantify residue estrogens in municipal wastewater using a comprehensive two-dimensional gas chromatograph (GCxGC). This method requires no further cleanups after SPE and has detection limits ranging from 1.4 – 22.2 ng/L. All presented methods use relatively small initial sample volumes and produce negligible matrix interferences. The developed methods were validated by performing mini surveys on the estrogen levels in environmental aqueous matrices in north Mississippi.

This study examines the regional Comprehensive Economic Development Strategy (CEDS) framework as a tool for cooperative practice among Connecticut's municipal practitioners. The creation of a CEDS document is a prerequisite for municipalities wishing to access planning and public works funds of the Economic Development Administration (EDA). It is the primary means by which the EDA uniformly measures regional commitment to economic planning. With ever decreasing real funding levels and ever increasing demand, the EDA relies on its regional CEDS framework to evaluate the planning and implementation capacities of economic development organizations that cross political boundaries. This study examines the regional CEDS process and document from the municipal perspective, the claims that a CEDS developed through an inclusive process, driven by diverse stakeholders, results in lasting implementation strategies that are in greater adherence to regional goals; and that a well constructed CEDS document fosters greater cooperation among municipal officials in regional economies. The findings are based on primary data collection, including interviews and the surveying of two Connecticut CEDS regions and one control region that has not been involved in the creation of a CEDS. I use interviews and survey results from municipal stakeholders to assess the benefits and limitations of the CEDS process to economic development practice in Connecticut. This study finds participation in a regional CEDS is, by itself, insufficient to increase development of regional solutions. However, strong administrative leadership by various regional organizations participation in a CEDS increases inter-municipal communication and engagement in comprehensive economic development planning.

The problem of this study is whether between-channel redundancy in an instructional audio-visual message enhances immediate recall of information more than within—channel redundancy. A secondary purpose was to compare three forms of between—channel redundancy! audio—video, audio—video—caption, and audio-caption with one form of within-channel redundancy: video-caption. These comparisons were designed to demonstrate which form of redundancy had a higher association with recall of information. The subjects were administered the Kentucky Comprehensive Listening Inventory to measure listening skills, and the Receiver Apprehension Inventory to identify subjects who experienced significantly high apprehension as receivers of information. Then the subjects were randomly divided into four treatment groups and shown an eight minute newscast. All four groups were presented the same instructional message, but the mode of presentation differed depending upon the treatment group. After viewing the instructional program each member of each group was given a forty item multiple-choice retention inventory based on the information presented in the newscast. The data were presented in terms of correct responses on the Kentucky Comprehensive Listening Inventory and the forty item retention inventory. Discriminate analysis was used to determine which items from the multiple-choice retention inventory accounted for the most variance. Thirteen items were found to account for the greatest amount of variance. Reliability estimates were calculated for all four story categories and for the forty items collectively. All reliability estimates were acceptable.

Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age Hana Vaňková, MD Abstract Background: Given the population ageing in Europe and in the Czech Republic, strategies aiming to prevent functional decline in older age are of great importance. Depression in old age increases functional decline and is also associated with increased morbidity, mortality and deterioration of quality of life (Anstey et al., 2007; Karakaya et al., 2009). Therefore, there is a need for a comprehensive intervention addressing both functional status and depressive symptoms. Methods: Using comprehensive geriatric assessment, the relationship between functional status and depressive symptoms was examined in 308 residents of long-term care facilities (RCFs) in the Czech Republic. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. An additional randomized control trial (RCT) evaluated the effect of a dance-based therapy on depressive symptoms in 162 institutionalized older adults with average age over 80 years. Results: A multiple regression analyses adjusted for sociodemographic factors and for taking antidepressants found that cognitive function and functional limitation by pain were most strongly associated with depressive symptoms. The ability to...

The purpose of this diploma thesis was to find out what type of therapies exist for pupils with combined disabilities within the Rehabilitation Club at the Special Primary School, what the course of these therapies looks like and what could be potentially improved. As part of the thesis, four research questions are answered. The theoretical part contains of the description of the comprehensive rehabilitation care which is further divided into medical, social, educational (pedagogical) and work rehabilitation. Furthermore, the theoretical part describes the individual therapies falling under the medical and the educational (pedagogical) rehabilitation. Part of the thesis is an introduction and comparison of three various organizations: educational institutions, social services and non-profit organizations. In the practical part, four research questions are defined and answered by using three methods: method of observation, interview and an analysis of pupils' documentation. It is researched what kind of therapies are being used within the Rehabilitation Club, how they are being executed, their frequency and the type of children undergoing them. The research concludes with a comparison of three different facilities whose clients suffer from severe disabilities. From the results of the research are...

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Purpose: Coordinated school health programs (CSHPs), a type of health promoting school (HPS) program adopted by Canada and the USA, were developed to provide a comprehensive approach to school health in the USA. Community partnerships are central to CSHP and HPS efforts, yet the quality of collaboration efforts is rarely assessed. The purpose of this paper is to use Himmelman’s strategies for working together to assess the types of partnerships that are being formed by CSHPs and to explore the methodological usefulness of this framework. The Himmelman methodology describes four degrees of partnering interaction: networking, coordinating, cooperating, and collaborating, with each degree of interaction signifying a different level of partnership between organizations. Design/methodology/approach: Data were collected as part of the 2008-2009 and 2009-2010 CSHP annual Requests for Proposal from all 131 public school systems in Tennessee. Thematic analysis methods were used to assess partnerships in school systems. Descriptive analyses were completed to calculate individual collaboration scores for each of the eight CSHP components (comprehensive health education, physical education/activity, nutrition services, health services, mental health services, student, family, and community involvement, healthy school environment, and health promotion of staff) during the two data collection periods. The level of collaboration was assessed based on Himmelman’s methodology, with higher scores indicating a greater degree of collaboration. Scores were averaged to obtain a mean score and individual component scores were then averaged to obtain statewide collaboration index scores (CISs) for each CSHP component. Findings: The majority of CSHPs partnering activities can be described as coordination, level two in partnering interaction. The physical activity component had the highest CISs and scored in between coordinating and cooperating (2.42), while healthy school environment had the lowest score, scoring between networking and coordinating (1.93), CISs increased from Year 1 to Year 2 for all of the CSHP components. Applying the theoretical framework of Himmelman’s methodology provided a novel way to quantify levels of collaboration among school partners. This approach offered an opportunity to use qualitative and quantitative methods to explore levels of collaboration, determine current levels of collaboration, and assess changes in levels of collaboration over the study period. Research limitations/implications: This study provides a framework for using the Himmelman methodology to quantify partnerships in a HPS program in the USA. However, the case study nature of the enquiry means that changes may have been influenced by a range of contextual factors, and quantitative analyses are solely descriptive and therefore do not provide an opportunity for statistical comparisons. Practical implications: Quantifying collaboration efforts is useful for HPS programs. Community activities that link back to the classroom are important to the success of any HPS program. Himmelman’s methodology may be useful when applied to HPSs to assess the quality of existing partnerships and guide program implementation efforts. Originality/value: This research is the first of its kind and uses a theoretical framework to quantify partnership levels in school health programs. In the future, using this methodology could provide an opportunity to develop more effective partnerships in school health programs, health education, and public health.