Il presente progetto di ricerca si è focalizzato sul processo di capitalizzazione, ovvero la condivisione di eventi positivi con il/la partner, da cui ci si aspetta una risposta attiva al fine di prolungare ed aumentare i benefici derivanti dall’evento stesso. L’articolazione in tre studi, di carattere quantitativo, ha permesso di approfondire la conoscenza dell’oggetto di ricerca utilizzando diverse metodologie. Il primo studio ha indagato, attraverso un disegno cross-sectional, la struttura della Perceived Responses to Capitalization Attempts scale (PRCA) e, attraverso un disegno longitudinale, i benefici intrapersonali ed interpersonali che derivano dagli stili di risposta di capitalizzazione nel tempo. Il secondo e il terzo studio, attraverso il diary method, hanno approfondito il processo di capitalizzazione attraverso l’introduzione di due aspetti innovativi nel processo: la differenziazione tra eventi positivi interni ed esterni alla relazione e la distinzione tra modalità di comunicazione più o meno esplicita dell’evento positivo. Nello specifico, il secondo studio si è focalizzato sui primi due elementi del processo di capitalizzazione (gli eventi positivi e i tentativi di capitalizzazione), mentre il terzo studio ha riguardato gli ultimi due elementi del processo (le risposte ai tentativi di capitalizzazione e la percezione di responsività da parte del/della partner). / The present research project focused on capitalization, that is the process through which people share good news with the partner, who in turn responds in an “active” way to maximize the benefits of the event. Three different studies approached this research object through different methodologies. The aims of the first study were to investigate, through a cross-sectional design, the structure of the Perceived Responses to Capitalization Attempts (PRCA) scale and to examine, through a longitudinal design, the intrapersonal and interpersonal benefits arising from the capitalization responses over time. The second and the third study, through diary methods, attempted to investigate two unexplored aspects of the capitalization process: the differentiation of the type of positive events (internal vs. external to the couple) and the distinction of the type of communication of the event (implicit vs. explicit). Specifically, the second study focused on the first two elements of the capitalization process (positive events and attempts to capitalization), while the third study concerned the last two elements of the process (responses to capitalization attempts and responsiveness).

BACKGROUND: Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. METHODS: Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. RESULTS: The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CONCLUSIONS: CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

Knee osteoarthritis (OA) is the commonest form of lower limb OA with a lifetime risk of over 40%. It is a disease characterised by symptoms such as pain and loss of function. In addition there are typical structural features on both radiographs and MRI. Knee OA represents a spectrum of disease, ranging from early preclinical cartilage change to established full thickness disease. Anteromedial knee OA is a particular phenotype of knee OA where disease is confined to the medial compartment. Whilst end stage arthritis is treated reliably with joint arthroplasty, those with early stage disease are treated with a variety of non- surgical interventions with varying success. This thesis is concerned with understanding the disease of patients that have early radiographic changes but symptoms not controlled by conservative measures. Up to 150 of these patients a year present to the Nuffield Orthopaedic Centre, Oxford. They have been described as being in the “Treatment Gap”. A series of validation studies were performed to determine the optimal method for diagnosing cartilage defects within the knee. The three commonest diagnostic methods were examined for their validity. Arthroscopic assessments of cartilage lesions demonstrated a moderate level of intra and inter observer reliability. In contrast, radiographs and MRI demonstrated high levels of reliability. When using MRI as a criterion standard, both radiographs and arthroscopic assessment were found to have poor accuracy. Based on the work in this thesis a formal definition of the cartilage changes exhibited in early knee OA was proposed. A cross sectional cohort of 100 patients with the symptoms and radiological features of early knee OA were identified. Their pain and function profile was compared to two comparison groups of patients at the end stage of knee OA (defined by the need for partial or total arthroplasty). In up to 78% of individual cases those with early OA had pain and function profiles as bad as those with end stage disease. The cross sectional symptoms of early knee OA demonstrate a marked discordance with their mild radiographic changes. The same cohort was extended to 125 patients. They were followed over one year with monthly PROM assessments to determine how symptoms change over time. 43% of patients experience a clinical improvement over 12 months, 31% experience a clinical deterioration and 26% remain unchanged. The range in OKS variation over 12 months was on average 12 points, with clinically relevant variation occurring on 45% of monthly measurements. Patients with early knee OA can expect to experience considerable variation in their symptoms over 12 months and this must be considered when planning interventions. A number of patients with early knee OA were noticed to demonstrate medial meniscal extrusion. Using data from the Osteo Arthritis Initiative (OAI) a nested case control study was designed to determine how the presence of meniscal extrusion in an otherwise normal knee affects the risk of developing knee OA over the next 48 months. This demonstrated an Odds Ratio of 3.5, suggesting that meniscal extrusion is a considerable risk factor for the development of OA. The presence of a knee injury or operative intervention to the index meniscus was shown to increase this risk. Many phenotypes of OA are known to demonstrate familial aggregation. In an attempt to determine where the earliest structural changes occur in medial compartment knee OA, a cohort of patients selected only for their family history of the disease were developed. This cohort was compared to spouse controls for the presence of knee OA, as well as meniscal extrusion and long leg alignment. In addition, a functional analysis of their cartilage was performed. This cohort was not shown to be at increased risk of disease compared to controls. Discussion of the possible reasons for this finding is presented. Early knee osteoarthritis is a considerable clinical problem. This thesis has aided the understanding of the condition by firstly defining the radiological description of these patients. Secondly, their cross sectional and longitudinal symptom profile have been described for the first time. In addition, the presence of an extruded meniscus has been demonstrated as a substantial risk factor for the disease. Finally, family history has not been demonstrated as a risk factor for the disease within the limits of the study described here. Future work has been proposed.

Background; It is important from a public health perspective to gain a greater understanding of young people's daily lives, their living conditions and lifestyles to promote for a healthy future.  Today is online gaming a large part of young people's daily lives, however, online games especially MMORPGs (Massively multiplayer online role-playing game) are more prominent in the case of a problematic gaming. Previous research has shown negative health consequences and implications such as truancy and poorer school performance among some of the players. Aim; The study aimed to investigate gaming among young people and the relationship between gaming, well-being in the school, truancy and health.  Method; The study has a deductive quantitative approach with a cross-sectional design and populationbased data from the Liv och hälsa ung 2012 was used.  Results and Conclusion; The study showed that the majority of young people never to rarely play, however when it comes to boys it is more common as 1149 out of a total of 2080 played two to seven days per week. Further investigations revealed links between truancy and gaming, among those who truant has increased odds to play in comparison than those who do not truant. No significant correlation was found regarding health and games where the game was the dependent variable in the logistic regression / Bakgrund; Det är viktigt ur ett folkhälsoperspektiv att få en ökad förståelse kring ungdomars vardag, deras livsvillkor och levnadsvanor för att främja för en hälsosam framtid.  Idag är dataspelandet online en stor del av ungdomars vardag, dock är online spel framförallt datarollspel såsom Massively multiplayer online role-playing game (MMORPG) mer framträdande när det gäller ett problematiskt spelande. Tidigare forskning har påvisat negativa hälsokonsekvenser och följder så som skolk och sämre skolprestation hos vissa av spelarna. Syfte; Studien syftade till att undersöka spelande bland ungdomar i Västmanland och sambandet mellan spelande, trivsel i skolan, skolk samt hälsa.  Metod; Studien har en deduktiv kvantitativ ansats med en tvärsnittsdesign och populationsbaserad data från Liv och hälsa ung studien 2012 användes.  Resultat och Slutsats; Studien påvisade att majoriteten av ungdomarna aldrig till sällan spelar, dock är killarna mer utmärkande då det kommer till spelande och 1149 av totalt 2080 uppger att de spelar cirka två till sju dagar per vecka. Vidare framkom samband mellan skolk och spel, då de som skolkar har ökade odds för att spela i jämförelse än de som inte skolkar. Inga signifikanta samband framkom gällande hälsa och spel där spel utgjorde den beroende variabeln i logistisk regression.

ABSTRACT Background: The Rwandan government has set family planning (FP) as one of the goals and strategies to improve the health of the population. However, unmet needs for modern contraceptive methods are still a problem, as is the variance of modern contraceptive use among the five regions of Rwanda.   Aim: This study aimed at assessing key factors that contribute to the variance of modern contraceptive use between five regions of Rwanda. Methods: This study was a secondary analysis of the Rwanda Demographic health survey, 2010. A total of 492 clusters (urban/rural), composed by 12,792 households were selected in the survey; 13,790 women of reproductive age were systematically selected from selected households and interviewed about maternal and reproductive health issues. 6834 married women or living with their partners at the time of the survey were selected for this study. Results: Socio-economic and demographic characteristics of women, access to family planning (FP) information and women’s empowerment were associated with the variance of modern contraceptive use between the regions. Women’s empowerment was positively associated with modern contraceptive use in all regions. Access to information was associated with modern contraceptive use in all regions except in the North region (AOR: 1.24, 95%CI: O.8- 1.92). Conclusion: This study highlights that the variance of modern contraceptive use was associated to the way in which FP factors are associated with modern contraceptive use vary between regions and how different FP factors occur among regions. Further researches are needed to investigate potential factors on supply side that influence such variance.

Stroke is a common and multifaceted disease that often involves motor deficits in the upper limb. This thesis investigated reliability and validity of existing clinical assessments of upper limb function in persons with post-stroke symptoms and in non-disabled controls. Study I was conducted in a clinical setting where the Motor Evaluation Scale of Upper Extremity in Stroke patients (MESUPES) was assessed in persons post-stroke by two physiotherapists selected from a group of four.  Study II-IV took place in a motion analysis laboratory with an optoelectronic system. Kinematic measures and clinical measures were used to investigate the validity of the Arm Posture Score (APS), the Finger-to-Nose test (FNT), and the Standardised Nine Hole Peg test (S-NHPT) in persons post-stroke and non-disabled controls.   The results showed that the MESUPES had a high inter-rater reliability while the concurrent validity was not fully confirmed. MESUPES has a maximum score of 58 and the minimal detectable change ranged from 5 to 8 for a confidence level of 80% and 95%. The Arm Posture Scores, which include either four or six arm movement variables, were able to distinguish between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls. The total movement time of the FNT, which is a coordination test, was able to distinguish persons post-stroke from controls, at least at a group level. Movement smoothness, accuracy and compensation, obtained from kinematic analysis, were the most discriminative variables for the FNT. Smoothness was most strongly correlated with the timed FNT and had the greatest association with the variance of the timed FNT. For the S-NHPT, which is a dexterity test involving grasping and reaching, the movement times, smoothness and compensation discriminated between the stroke group and the control group. Persons post-stroke spent considerably more time in the grasp-related parts of the task compared to controls. Smoothness and upper limb impairments had the strongest correlation with the S-NHPT.   In conclusion, the clinical measures used within stroke rehabilitation seem valid and reliable, although some limitations are highlighted by the kinematic assessment. MESUPES was shown to be a reliable assessment of upper limb movement quality after stroke. The kinematic analysis revealed that the timed FNT does not have sufficient discriminative validity at an individual level. The timed FNT reflected speed-related aspects of pointing movements such as smoothness and length of the deceleration phase, but should not be used as an overall measure of upper limb coordination after stroke. The timed S-NHPT demonstrated sufficient discriminative validity and reflected smoothness and upper limb impairments. For both the FNT and S-NHPT, kinematic analysis showed that the clinical outcomes of those tests (time of performance) did not adequately detect qualitative aspects of the upper limb movements after stroke such as possible compensatory movements. Therefore, clinical assessments that capture qualitative aspects of upper limb movements would improve the assessment of upper limb coordination and dexterity after stroke. In addition, 3D movement analysis provided unique information about upper limb function after stroke, not least in persons with mild post-stroke impairments. The APS, for instance, which quantifies how much the arm swing during gait deviates from normal, discriminated between persons with stroke and non-disabled persons. Such subtle deviations are not possible to quantify with the human eye.

Submitted in fulfillment of Masters in Radiography, Durban University of Technology, Durban, 2007. / Aim/research questions The aim of the study was to evaluate CT-based treatment planning versus digitised image planning (standard planning technique) for carcinoma of the breast, using the four-field breast technique, in terms of the depth of supraclavicular and axillary nodes, the variability of the breast tissue and the dose inhomogeneity at the matchline. The variability of the depth of supraclavicular and axillary nodes has not been documented in any local or national studies. When simulating patients for treatment, it is evident that the anatomical variability of patient chest wall thickness, shape and size is a contributing factor towards the final treatment plan and dose distribution achieved. Therefore knowing the correct depth of the nodes and being able to clearly demarcate the breast tissue should result in a favourable dose administration. The following questions were addressed:  What is the dose to the supraclavicular nodes from both plans?  What is the dose to the axillary nodes from both plans?  How do the plans differ in terms of dose coverage to the supraclavicular and axillary nodes?  What is the relationship between the depth of the supraclavicular nodes and the patient separation? ii  What is the relationship between the depth of the axillary nodes and the patient separation?  Does the target volume receive adequate dose coverage from the plans?  How is dose to the heart volume affected by target coverage on both plans?  How is dose to the lung volume affected by target coverage on both plans?  What is the dose variability along the matchline?  Are the plans over dosing?  Are the plans under dosing? / M

In recent years, an increasing amount of research has been conducted on the topic of personal spiritual practices, such as prayer. Fewer studies have been conducted on reasons for changes in the frequency of such practices within the church. Those that have addressed church behavior have most often measured attendance and membership. It is the goal of this study to conceptualize potential causes for changes in personal prayer practice at one church. A yearlong marketing campaign was used to help increase church attenders’ frequency of the personal spiritual practice of prayer. Two cross-sectional studies were conducted one-year apart and revealed a significant increase in prayer. Possible reasons for this change, limitations and suggestions for further research will be discussed.

Background: Participation in physical activity (PA) is influenced by a multitude of factors. Traditionally, research has focused on several theoretical frameworks focusing on the individual ; however, they do not necessarily take into consideration other influencing factors such as the social environment or the physical or built environment. As such, a comprehensive socio-ecological model considering a multiplicity of factors is useful in explaining behaviour. Aims: To 1) assess the prevalence of the individual level correlates and their association with PA and walking; 2) assess the prevalence of environmental determinants and neighbourhood characteristics and the association between these and PA and walking behaviours; 3) explore within a comprehensive and socio-ecological approach, the contribution of the individual, social, and environmental factors in predicting PA and walking. Methods: The studies used in this thesis are national, random-digit dialling telephone-based surveys of a representative population sample within Canada. All research questions and procedures underwent ethics review at York University. The studies incorporated a two-stage probability selection process to select a survey respondent, and included a number of standard self-report measures across the data collection cycles. PA and all-domain walking were measured using the telephone-administered, short International Physical Activity Questionnaire, the neighbourhood environment was measured using an abbreviated version of the Neighbourhood Environment Walkability Scale (NEWS), and individual factors such as knowledge about amount of PA required for guidelines, beliefs about the benefits of PA, self-efficacy, intention, and initial behaviour changes. Walking for transport was measured through the Physical Activity Monitor and walking for recreation were measured through an adapted version of the Minnesota Leisure-Time PA questionnaire (for the 2007 collection only). Complex sampling methods were required to take into account stratification by province or territory within Canada. Complex samples cross-tabulation procedures were used to calculate the prevalence estimates of Canadians meeting the PA and walking guidelines and 95% confidence intervals. The relationship between factors predicting sufficient activity and sufficient walking were examined using complex samples logistic regression procedures that were reflect the sample design. This thesis explored associations and the relative strength of the factors as the independent measures predicting sufficient PA and sufficient walking as the dependent measures, using age, sex, and education as covariates for each of these models. Chapter Six expands this model by including walking for recreation and transportation, and examining sub-population groups. Results: Individual factors (e.g., self-efficacy, intention, and some trial behaviours) and social factors were associated with sufficient PA and certain types of walking. Relatively few environmental factors were associated with sufficient walking (all domain and domain-specific) or sufficient PA. The relationship between high density neighbourhoods and higher rates of walking (generally and specific), and the availability of supportive walking facilities with various modes of walking were evident. Proximity of many shops and the presence of sidewalks were associated with the highest quartile of walking for transport. A greater number of the individual factors predicted walking and PA compared to the environmental/neighbourhood factors, within the context of a full socio-ecological model. Findings differed when stratified by age and sex of respondents. Conclusions: The results suggest that individual factors may be more relevant for predicting activity and walking than environmental factors, or at least should be considered in their inter-relationship with environmental factors when developing environment-based interventions. Although the inter-relationship between individual factors, social factors and the built environment are important, understanding individual factors are critical for determining strategies and interventions to promote PA among certain populations with traditionally lower levels of activity. Findings suggest that within countries like Canada, with a relative abundance of supportive environments, more specific and detailed measures of the perceived and objective physical environment may be required in order to achieve sufficient variation.

En studie gjord av den internationella mäklarfirman Knight Frank placerar den svenska bostadsmarknaden på en fjärde plats i rankingen över världens hetaste bostadsmarknader. Många kommuner i Sverige har upplevt en kraftig prisutveckling på bostäder de senaste åren och det är därför viktigt att studera den svenska bostadsmarknaden och dess priser. Syftet med denna studie är således att undersöka vilka faktorer det är som påverkar prisutvecklingen på småhus i Sveriges kommuner. Studien är en tvärsnittsstudie över 288 kommuner där förändringen i bostadspriserna studeras under åren 1996 till 2015. Studien har utförts med hjälp av en statistisk metod i form av en regressionsanalys som har delats upp i två perioder: 1996 till 2005 och 2006 till 2015. Den beroende variabeln är prisutvecklingen på bostäder och de förklarande variablerna är utbudet av bostäder, förvärvsinkomst, arbetslöshet, befolkning och kommunalskatt. Regressionsanalysen visar att befolkningsökningen är den variabel som är signifikant med prisutvecklingen under den första perioden och alla förklarande variabler utom kommunalskatten ärsignifikanta under den andra perioden. Genom den deskriptiva statistiken kan vi även se ett samband mellan utbud av bostäder per invånare och prisutvecklingen på bostäder. / According to a study by the international real estate firm Knight Frank, the Swedish housing market is in a fourth place in the rankings of the world's hottest housing markets. Many municipalities in Sweden have experienced a strong price trend in housing during recent years. Therefore, it is important to study the Swedish housing market and its prices. The purpose of the study is to examine which factors affect the increase in house prices in Sweden's municipalities. We have made a cross-sectional study of 288 municipalities and studying the change in housing prices from year 1996 to 2015. The study was conducted using a statistical method in form of a regression analysis that has been divided into two time periods: 1996 to 2005 and 2006 to 2015. The dependent variable is the change in housing prices and the explanatory variables are the supply of housing, professional income, unemployment rate, population rate and municipal taxes. The regression analysis show that population growth is the variable that is significant to the price trend during the first period. All the explanatory variables except municipal taxes is significant during the second period. Through the descriptive statistics, we can also see a connection between supply of housing per capita and increases in house prices.