As the green movement begins to sweep through the construction industry, decision-makers are beginning to include a sustainable aspect to their purchase decisions. Selecting a product solely based on its sustainability, however, is not enough to drive product selection in the construction industry. Cost still dominates the selection of building products. The level of sustainability of a product and its cost are not interconnected as market prices do not reflect the cost of environmental impacts, such as the cost of global warming or fossil fuel depletion. Having two distinct aspects to consider adds complexity in the product selection process. Typically, it constrains decision-makers to perform a trade-off analysis that does not necessarily guarantee the most environmentally preferable purchase decision. This study proposes a life-cycle management (LCM) system that reinforces the choices made by decision-makers by providing a scientific justification for those decisions. The proposed system analyses the environmental and economic performance of building product through life-cycle analysis and purchase price analysis. It operates on tools publicly available in the market and state-of-the-art analysis, assessment, and interpretation methods. The LCM system combines two distinct product attributes into a single performance score that can be easily interpreted. It allows decision-makers to compare product scores and ultimately make the most environmentally responsible and financially viable selection. A comprehensive approach is used to refine and test the LCM system using case studies comprised of an environmental and economic performance evaluation of flooring products. The contribution of this research includes the consideration of a holistic approach to product selection based on environmental and cost performance. Pre-construction estimators and construction managers could improve their estimating and product selection practices using the proposed system. Material suppliers can also benefit from this approach, as they can use it to enhance their pricing strategies, marketing plans, and overall product competitiveness.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This dissertation aims to build a set of tools based on mathematical models to assist a rural electrification cooperative in taking strategic decisions on investing in electrical generation in face of erratic and non-periodic future scenarios. Time series analysis using the Box-Jenkins methods for forecasting was employed to construct the models to predict future energy consumption. Qualitative analysis of future scenarios using Kohler method, that is suited to regional applications, was used. An heuristic approach with hierarchical levels was employed to define the parameters of a mathematical model for the application of integer linear programming at a lower level. This mathematical program was used to optimize the location of photovoltaic solar power plants within a transformer substation area and its branches to minimize disbursements in assets investments, and operations and maintenance costs. The model was tested in a cooperative with six substations, 572 branches, 7,574 cooperative members and a 2,737 km length network. In results obtained was SARIMA models (1,1,1) x (0,1,1) 12. In total, obtained an increase of 1.292 kW for the six substations in the next five years, representing a disbursement R$ 17,170,000.00 if the cooperative to chooses to build a photovoltaic solar power plant to meet this increase of consumption. / A presente dissertação tem por objetivo o desenvolvimento de um modelo de previsão pautando-se em um conjunto de ferramentas com base em modelos matemáticos que auxilie uma cooperativa de eletrificação rural na tomada de decisões estratégicas de investimentos em geração frente a cenários aperiódicos futuros. Como metodologia foi utilizada a análise de séries temporais com métodos de Box-Jenkins para a construção de modelos que foram utilizados na previsão de consumo energético. Análise qualitativa de cenários futuros utilizando a metodologia de Kohler adequada a aplicações regionalizadas. Utilizou-se uma abordagem heurística e em níveis hierárquicos para definição dos parâmetros de um modelo matemático, para aplicação de programação linear inteira. A programação matemática foi usada num nível hierárquico inferior para otimizar a localização de usinas geradoras de energia elétrica por painéis fotovoltaicos em áreas de subestações e ramais visando minimizar desembolsos em geração, manutenção distribuição e operação. O modelo foi testado numa cooperativa com seis subestações, 572 ramais, cerca de 7.574 cooperados e com uma extensão em redes de 2.737 km. Como resultados foram obtidos modelos SARIMA (1,1,1) x (0,1,1) 12. No total foram previstos um aumento de 1.292 kW para as seis subestações nos próximos cinco anos, o que representa um desembolso R$ 17.170.000,00 caso a cooperativa opte na construção de uma usina solar fotovoltaica para suprir este aumento de consumo.

How is research and science being used in political debate? An idea analysis of the debate about försäkringsmedicinskt beslutsstöd (decision tool in healthcare security) This is a case study on different types of research use (utilization) The aim of this paper is to examine how the politicians make use of expertise and research in the parliamentary debate surrounding the decision tool in healthcare security (försäkringsmedicinskt beslutsstöd). The aim is also to find out to what extent different types of research use are present in this debate. In this case study the qualitative method of idea analysis is being used on the empirical material. The tool of analysis is based upon the theories of research use by Amara et al. (building on Beyer) and Carol Weiss. My conclusion is that the most common type of research use in this debate is the symbolic, followed by the conceptual type. The instrumental type of research use is the least frequent one in this debate.

La douleur, fréquemment rencontrée lors d’atteintes musculosquelettiques, est un phénomène complexe influencé par une combinaison multifactorielle de déterminants biopsychosociaux. Elle présente un important taux de chronicité avec près de huit millions de personnes au Canada atteintes de douleur chronique (douleur qui perdure plus de trois mois), c’est-à-dire un Canadien sur cinq. Les troubles musculosquelettiques incluent le syndrome de conflit sous-acromial (SCSA), une atteinte fréquente à l’épaule, qui a une forte tendance à se chroniciser. Un an après le début des symptômes, environ la moitié des personnes avec ce syndrome présentent de la douleur et une limitation de la fonction persistantes. Des facteurs psychosociaux seraient prédictifs de la chronicité pour le SCSA. Toutefois, dans les guides de pratique qui orientent la prise en charge de cette atteinte, les interventions ciblant ces facteurs sont limitées et parfois même manquantes. En physiothérapie, une discipline fréquemment impliquée dans la réadaptation de cette atteinte, des approches englobant les facteurs biopsychosociaux seraient à privilégier. L’enseignement au patient, une modalité faisant partie intégrante de la physiothérapie, mais pour laquelle les recommandations sont limitées pour en guider la réalisation, serait une avenue pertinente. Cette thèse vise à développer des recommandations qui soutiennent l'enseignement structuré auprès des patients ciblant l’autonomisation (implication active pour la prise de décision et la gestion de la condition) de la personne dans le suivi du SCSA en physiothérapie. Elles intègrent les données scientifiques, expérientielles et contextuelles et les composantes de la Classification internationale du fonctionnement, du handicap et de la santé. La première phase de cette thèse contient une revue systématique de la portée qui visait à répertorier l’étendue de la littérature sur les interventions d’enseignement au patient lors de la prise charge du SCSA. Cette revue a permis d’identifier des cibles initiales d’enseignement au patient issues de la littérature, utilisées pour orienter la phase suivante du projet. La deuxième phase a utilisé une consultation d’experts par des groupes de discussion focalisée intégrant des professionnels de la réadaptation et des patients-partenaires pour explorer les cibles et décrire les stratégies d’enseignement (plan pour atteindre un objectif d’enseignement visé). Cette consultation a été analysée de manière qualitative en vue de faire ressortir les thématiques principales d’enseignement au patient émergeant des discussions. Cette étape a mené au développement de recommandations préliminaires. La troisième phase visait à obtenir un consensus sur la pertinence et la formulation de recommandations détaillées encadrant les interventions d’enseignement au patient en physiothérapie pour le SCSA à l’aide d’une consultation par approche Delphi. À la suite de ces trois phases, sept recommandations générales encadrant les stratégies d’enseignement au patient et six recommandations touchant des cibles d’interventions spécifiques d’enseignement ont été développées. Un outil d’aide à la décision guidant l’utilisation de ces recommandations d’enseignement structuré lors du suivi des personnes atteintes d’un SCSA a aussi été élaboré. Ces recommandations sont les premières existantes pouvant soutenir l’enseignement structuré au patient lors du suivi du SCSA. Celles-ci sont pertinentes pour guider l’enseignement prodigué basé sur la littérature et un consensus d’experts. Les cibles d’autogestion et d’engagement actif de la personne sont pertinentes pour intervenir sur les facteurs psychosociaux et ainsi potentiellement réduire la chronicité de cette atteinte. / Pain, frequently encountered in musculoskeletal injuries, is a complex phenomenon influenced by a multifactorial combination of biopsychosocial determinants. It has a high rate of chronicity with nearly eight million people in Canada suffering from chronic pain (pain lasting more than three months), i.e., one in five Canadians. Among musculoskeletal disorders, subacromial pain syndrome (SAPS), a frequently encoutered shoulder disorder, has a high propensity to become chronic. One year after the onset of symptoms, about half of individuals with SAPS have persistent pain and functional limitations. Psychosocial factors are predictive of SAPS chronicity, however, in the clinical practice guidelines that guide the management of this condition, interventions targeting these factors are limited and sometimes absent. Approaches that target biopsychosocial factors should be favoured, among others, in physiotherapy, a discipline frequently involved in the rehabilitation of this condition. Patient education, a modality that is an integral part of physiotherapy, but for which there is limited evidence and recommendations to guide its implementation, would be a relevant avenue. Therefore, this thesis aims to develop recommendations that support structured patient education. These recommendations focus on the person's empowerment and self-management during the follow-up of SAPS in physical therapy. They are based on scientific, experiential and contextual data as well as components of the International Classification of Functioning, Disability and Health. The first phase of this thesis contains a systematic scoping review that aimed to map the extent of the literature on patient education interventions in the management of SAPS. This review identified the initial patient education targets from the literature that were used to guide the next phase. The second phase used expert consultation through focus groups involving rehabilitation professionals and patient-partners to explore targets and outline strategies for structured patient education interventions in physical therapy for the follow-up of individuals with SAPS. The development of the interview guide and the analysis of these discussions were based on the initial educational targets and strategies (plan to conduct the educational intervention) extracted from the previous phase. This consultation was qualitatively analyzed to identify the main patient education themes resulting from the discussions. The main themes led to the development of preliminary recommendations. The third phase aimed to reach consensus on the relevance and formulation of detailed recommendations framing patient education interventions in physical therapy for the follow-up of individuals with SAPS using a Delphi consultation approach. As a result of these three phases, seven general recommendations framing patient teaching strategies and six recommendations for specific teaching interventions targets were developed. A decision support tool guiding the use of these structured patient education recommendations in the follow-up of people with SAPS has also been developed. These recommendations are the first that can comprehensively support structured patient education intervention during the follow-up of individuals with SAPS. They are relevant to guide patient education interventions that are based on the literature and expert consensus. The goals of self-management and active engagement of the person are relevant to intervene on psychosocial factors and thus potentially reduce the chronicity of this condition.