The thesis explores whether Swedish consumers value outerwear sold with an included repair service with the motive of supporting the transition towards a more sustainable fashion industry. In addition, to foster sustainable consumption and production patterns which align with the United Nations Sustainable Development Goals. This study is further associated with the EU Ecodesign for Sustainable Products Regulation and the upcoming EU regulation concerning the Extended Producer Responsibility. A mixed-method approach is used for the methodological framework. Qualitative semi-structured interviews are used as a pre-study to explore attributes and levels for the main quantitative Discrete Choice Experiment survey study. The Discrete Choice Experiment method integrates with the theoretical framework through the application of the Willingness to Pay estimates. A convenient sampling method, in combination with a snowball sampling method, is applied. The findings from the survey show implications for educated young urban women, a group with significant environmental impacts due to their clothing consumption. The 129 respondents showed a stated Willingness to Pay of an additional 35.6% or 562.30 SEK for outerwear with an included repair service. The calculations are based on the average price 1579.60 SEK the respondents in the survey pay for outerwear. The findings show that longer waiting times decrease the amount of money the respondents want to pay for the service. The stated Willingness to Pay decreases to 31.1% or 491.30 SEK with one week of waiting time. The creation of new jobs and a reduction of environmental impacts in production increase the stated Willingness to Pay. The findings show that outerwear sold with an included repair service could increase the frequency of repairs, extend the user phase of outerwear, and reduce the consumption of new outerwear.

No description available.

Background: Increased pressure, rising demand and cost constraints have driven a need for radical service re-design in the NHS. To deliver re-design objectives it is necessary to understand how they are perceived by service users and providers. Aim: To investigate the views of patients and health care professionals (HCP) on aspects of health policy and service re-design affecting primary care. Setting: Patients and HCPs from one geographical area in England. Method: Themes from phase one qualitative interviews were explored quantitatively using a questionnaire in phase two and a discrete choice experiment (DCE) in phase three. Factor analysis was used to explore HCP responses in phase two. In phase three the DCE was administered to explore patients‟ relative priorities of a range of attributes. Results: HCPs had concerns that the Quality Outcomes Framework (QOF) detracted from the patient‟s agenda and did not improve health outcomes. GPs felt continuity of care was important Monday through Friday but were not keen on its provision out of hours. Neither did they feel nurses could run chronic disease management clinics without a GP present. Patients felt continuity could be provided by different HCPs for different conditionsPatients stated continuity of care and consultation duration were the most important attributes in a primary care service. However, in the DCE they prioritised both being seen on the day and by a GP over longer appointments. Patient preference to be seen by a GP may reflect the low uptake of non-medical prescribing in the area. Conclusion: Continuity of care, while remarked as being important to both HCPs and patients, appears less important when weighted against other primary care service attributes. HCPs appear to want longer consultations whereas patients saw time as encompassing both the time to wait for an appointment and consultation length. For patients, the quality of the time with a HCP may be more important than its duration, additionally patients appear to want choice but not necessarily to choose.

Utilizou-se um modelo de escolha discreta (MED) para avaliar as preferências e disposição-a-pagar (DAP) dos pacientes por diferentes atributos de risco-benefício do tratamento insulínico, entre eles a via de administração da insulina. Através de uma revisão da literatura, consulta com especialistas, e do desenvolvimento de um estudo qualitativo utilizando as técnicas de entrevistas individuais e grupos focais, os atributos (e níveis) mais importantes do tratamento insulínico foram identificados, sob o ponto de vista dos pacientes. Os atributos incluídos no MED foram: controle da glicemia de jejum, número de episódios de hipoglicemia, ganho de peso, via de administração para as insulinas de ação longa e rápida, e custo do tratamento. Pares de opções de tratamentos insulínicos hipotéticos contendo diferentes níveis dos atributos foram apresentados aos pacientes com DM1 ou DM2, e lhes foi solicitado que, para cada cenário, eles escolhessem a alternativa de sua preferência. Dados demográficos, nível sócio-econômico (NSE) e informações relacionadas ao diabetes também foram coletados. Para a análise dos dados utilizou-se um modelo logit condicional de regressão e modelos segmentados foram posteriormente utilizados para a análise das sub-populações. Um total de 274 questionários foram incluídos na análise final dos dados. A idade média (± DP) dos participantes foi de 56.7 ± 12.98 anos, e 53% eram homens. Quarenta e nove por cento dos participantes eram usuários de insulina e 47 eram portadores de DM1. O tratamento insulínico ideal, sob o ponto de vista dos pacientes, resultaria em um melhor controle glicêmico, menos reações adversas, menor custo, e seria administrado por via oral. Houve uma forte preferência e uma DAP mais elevada por um melhor controle glicêmico, seguido pelos atributos de risco ganho de peso e episódios de hipoglicemia. Surpreendentemente, a via de administração da insulina foi o atributo menos valorizado. A estratificação social revelou que pacientes com alta renda anual familiar apresentaram uma DAP mais elevada por um melhor controle glicêmico e por menos reações adversas em relação aos grupos com rendas inferiores. Ainda, quanto mais alto o nível de renda, maior o desejo por uma insulina oral, enquanto a via inalada torna-se menos importante para os pacientes. A estratificação da amostra pelo uso de insulina e tipo de diabetes revelaram uma forte aversão pela via subcutânea pelos não-usuários de insulina e pacientes com DM2. Tais resultados sugerem a existência de uma importante barreira psicológica em se iniciar uso da insulina; no entanto, os resultados também revelam que os pacientes tendem a se acomodar com a via subcutânea uma vez iniciado o tratamento insulínico. Este estudo demonstra a importância que os pacientes com DM atribuem ao atributo controle glicêmico, e como suas preferências e DAP pelo tratamento insulínico variam entre as sub-populações. Especificamente, esforços devem ser realizados no sentido de vencer a barreira psicológica em se iniciar o uso da insulina, o que contribuirá para que se alcance um melhor controle glicêmico, através da melhor aderência do paciente ao tratamento, resultando em uma redução dos custos do DM e melhora na qualidade de vida dos pacientes. / We used a discrete choice experiment (DCE) to evaluate patients preferences for various attributes of insulin treatment, including route of insulin delivery. Through a review of the literature, expert consultation, and a qualitative descriptive study using individual interviews and focus group techniques, the attributes (and levels) of diabetes treatment most important to patients were identified. The attributes included in the DCE were: glucose control, frequency of hypoglycaemic events, weight gain, route of administration for the long-acting and the short-acting insulin, and out-of-pocket cost. Patients with type 1 or type 2 diabetes were presented with pairs of hypothetical insulin therapy profiles (i.e. choice sets) with different levels of the attributes and were asked to choose the treatment option they preferred. Sociodemographic data and diabetes medication were also collected. Data were analysed using conditional logit regression and segmented models were also developed for the analysis of subgroups. A Two hundred and seventy four questionnaires were completed. The mean age (±SD) of participants was 56.7 ± 12.98 years, and 53% were men. Forty-nine percent of participants were insulin users, and 47 had type 1 diabetes. Overall, patients ideal insulin treatment would provide better glucose control, result in fewer adverse reactions, have the lowest cost, and be administered orally. There was a strong preference and highest mean WTP for glucose control followed by the risk attributes weight gain and hypoglycaemic events. Surprisingly, route of insulin administration was the least valued attribute. Stratification of the sample revealed that patients with higher incomes had a significant higher WTP for better glucose control and less adverse reactions compared to lower income groups. Moreover, the highest the income, the stronger the preference for an oral insulin, while inhaled insulin becomes less important for patients. Segmented models by insulin use and type of diabetes indicated that insulin naïve and type 2 diabetics had a greater aversion to the subcutaneous route. These findings suggest that there may be an important mental barrier to initiating insulin therapy; however, patients tend to accommodate to subcutaneous administration once they initiate therapy. This study illustrates the importance that patients with diabetes place on glucose control and how preferences for insulin therapy vary between subgroups. Specifically, efforts need to be made to overcome the mental barrier to initiating insulin therapy, which may lead to improved control, through improved compliance and ultimately reduce the financial burden of the disease and improve patients quality of life.

Utilizou-se um modelo de escolha discreta (MED) para avaliar as preferências e disposição-a-pagar (DAP) dos pacientes por diferentes atributos de risco-benefício do tratamento insulínico, entre eles a via de administração da insulina. Através de uma revisão da literatura, consulta com especialistas, e do desenvolvimento de um estudo qualitativo utilizando as técnicas de entrevistas individuais e grupos focais, os atributos (e níveis) mais importantes do tratamento insulínico foram identificados, sob o ponto de vista dos pacientes. Os atributos incluídos no MED foram: controle da glicemia de jejum, número de episódios de hipoglicemia, ganho de peso, via de administração para as insulinas de ação longa e rápida, e custo do tratamento. Pares de opções de tratamentos insulínicos hipotéticos contendo diferentes níveis dos atributos foram apresentados aos pacientes com DM1 ou DM2, e lhes foi solicitado que, para cada cenário, eles escolhessem a alternativa de sua preferência. Dados demográficos, nível sócio-econômico (NSE) e informações relacionadas ao diabetes também foram coletados. Para a análise dos dados utilizou-se um modelo logit condicional de regressão e modelos segmentados foram posteriormente utilizados para a análise das sub-populações. Um total de 274 questionários foram incluídos na análise final dos dados. A idade média (± DP) dos participantes foi de 56.7 ± 12.98 anos, e 53% eram homens. Quarenta e nove por cento dos participantes eram usuários de insulina e 47 eram portadores de DM1. O tratamento insulínico ideal, sob o ponto de vista dos pacientes, resultaria em um melhor controle glicêmico, menos reações adversas, menor custo, e seria administrado por via oral. Houve uma forte preferência e uma DAP mais elevada por um melhor controle glicêmico, seguido pelos atributos de risco ganho de peso e episódios de hipoglicemia. Surpreendentemente, a via de administração da insulina foi o atributo menos valorizado. A estratificação social revelou que pacientes com alta renda anual familiar apresentaram uma DAP mais elevada por um melhor controle glicêmico e por menos reações adversas em relação aos grupos com rendas inferiores. Ainda, quanto mais alto o nível de renda, maior o desejo por uma insulina oral, enquanto a via inalada torna-se menos importante para os pacientes. A estratificação da amostra pelo uso de insulina e tipo de diabetes revelaram uma forte aversão pela via subcutânea pelos não-usuários de insulina e pacientes com DM2. Tais resultados sugerem a existência de uma importante barreira psicológica em se iniciar uso da insulina; no entanto, os resultados também revelam que os pacientes tendem a se acomodar com a via subcutânea uma vez iniciado o tratamento insulínico. Este estudo demonstra a importância que os pacientes com DM atribuem ao atributo controle glicêmico, e como suas preferências e DAP pelo tratamento insulínico variam entre as sub-populações. Especificamente, esforços devem ser realizados no sentido de vencer a barreira psicológica em se iniciar o uso da insulina, o que contribuirá para que se alcance um melhor controle glicêmico, através da melhor aderência do paciente ao tratamento, resultando em uma redução dos custos do DM e melhora na qualidade de vida dos pacientes. / We used a discrete choice experiment (DCE) to evaluate patients preferences for various attributes of insulin treatment, including route of insulin delivery. Through a review of the literature, expert consultation, and a qualitative descriptive study using individual interviews and focus group techniques, the attributes (and levels) of diabetes treatment most important to patients were identified. The attributes included in the DCE were: glucose control, frequency of hypoglycaemic events, weight gain, route of administration for the long-acting and the short-acting insulin, and out-of-pocket cost. Patients with type 1 or type 2 diabetes were presented with pairs of hypothetical insulin therapy profiles (i.e. choice sets) with different levels of the attributes and were asked to choose the treatment option they preferred. Sociodemographic data and diabetes medication were also collected. Data were analysed using conditional logit regression and segmented models were also developed for the analysis of subgroups. A Two hundred and seventy four questionnaires were completed. The mean age (±SD) of participants was 56.7 ± 12.98 years, and 53% were men. Forty-nine percent of participants were insulin users, and 47 had type 1 diabetes. Overall, patients ideal insulin treatment would provide better glucose control, result in fewer adverse reactions, have the lowest cost, and be administered orally. There was a strong preference and highest mean WTP for glucose control followed by the risk attributes weight gain and hypoglycaemic events. Surprisingly, route of insulin administration was the least valued attribute. Stratification of the sample revealed that patients with higher incomes had a significant higher WTP for better glucose control and less adverse reactions compared to lower income groups. Moreover, the highest the income, the stronger the preference for an oral insulin, while inhaled insulin becomes less important for patients. Segmented models by insulin use and type of diabetes indicated that insulin naïve and type 2 diabetics had a greater aversion to the subcutaneous route. These findings suggest that there may be an important mental barrier to initiating insulin therapy; however, patients tend to accommodate to subcutaneous administration once they initiate therapy. This study illustrates the importance that patients with diabetes place on glucose control and how preferences for insulin therapy vary between subgroups. Specifically, efforts need to be made to overcome the mental barrier to initiating insulin therapy, which may lead to improved control, through improved compliance and ultimately reduce the financial burden of the disease and improve patients quality of life.

No description available.

Le dépistage du cancer de la prostate est largement controversé de par l’équilibre de la balance bénéfices-risques de cette procédure. L’enjeu de santé publique est alors d’accompagner au mieux les hommes susceptibles de se faire dépister pour qu’ils puissent être informés et participer au choix. L’objectif de ce doctorat est de contribuer à comprendre pourquoi les hommes participent au dépistage du cancer de la prostate, pour pouvoir améliorer dans un second temps leur accompagnement. Nous avons tout d’abord interrogé des hommes sur leurs connaissances, leurs sources d’informations et leur rôle dans le choix de participer au dépistage du cancer de la prostate. Ces entretiens ont abouti à la nécessité de concevoir un nouvel outil d’information pour améliorer les connaissances des hommes, en particulier sur les risques de la procédure de dépistage. Enfin, nous avons estimé comment les bénéfices et les risques étaient intégrés dans le choix des individus selon si ces derniers avaient eu accès à notre outil d’information. Les résultats de ce travail montrent que les hommes semblent moins favorables à une proposition de dépistage après avoir eu accès à notre outil d’information. Cependant, cela ne modifie pas leur appréciation des bénéfices et des risques du dépistage. Il est nécessaire de poursuivre les efforts pour permettre aux hommes de faire un choix éclairé. / Prostate cancer screening is highly controversial because of the benefit risk ratio. An issue is to support men susceptible to perform this screening towards informed choice and shared decision-making. The aim of this doctorate is to understand why men adhere to prostate cancer screening, and in a second time to improve their support. We interviewed men about their knowledge, their information seeking behaviour, and their implication in prostate cancer screening decision. This highlighted the necessity to create a new information tool to improve men’s knowledge, in particular regarding risks of the screening procedure. Finally, we investigate benefit risk trade-off with and without our information tool access. Results of this work shows that men are less favourable to a screening option after taking into account our information tool. However, benefit and risk of this screening appreciation was not changed. We need to continue efforts to allow men to make an informed choice.

The overall goal of this study was to analyse the welfare effect of improved wastewater treatment with the view of making policy recommendations for sustainable urban and peri-urban irrigation agriculture in Kenya. This goal was achieved by investigating three specific objectives. The first objective was to assess the farmers’ awareness of health risks in urban and peri-urban wastewater irrigation. Second objective was to analyse the factors that affect the choice of low-risk adaptations in reuse of untreated wastewater for irrigation. The third objective was to estimate the value that urban and peri-urban farmers who practice wastewater irrigation impute to improvements in specific characteristics of the wastewater input in agriculture. In order to achieve the first objective, an ordered probit model was used to identify the factors that influence farmers’ awareness of health risks in untreated wastewater irrigation. The model was fitted to data collected from a cross-sectional survey of 317 urban farm households in the Kibera informal settlement of Kenya. Results of this study show that gender of household head, household size, education level of household head, farm size, ownership of the farm, membership to farmers’ group, and market access for the fresh produce significantly affect awareness of farmers about health risks in wastewater irrigation. Therefore, there is need for awareness programs to promote public education through regular training and local workshops on wastewater reuse in order to improve the human capital of the urban and peri-urban farmers. To achieve the second objective, the study used a multinomial logit model to analyse the farmers’ choice of low-risk adaptations in untreated wastewater irrigation. A survey of 317 urban and peri-urban farmers was conducted and measures for risk-reduction in wastewater reuse were analysed. The urban and peri-urban farmers were found to have adopted low-risk wastewater irrigation techniques such as cessation of irrigation before harvesting, crop restriction and safer application methods. Results of the study show that adoption of risk-reduction measures is significantly influenced by the following factors: household size, age of the household head, education of household head, access to extension, access to media, access to credit, farmers’ group membership, and risk awareness. Also, marginal analysis of the coefficients confirmed the socio-economic characteristics are key determinants in adoption of low-risk measures in wastewater reuse. The study recommends that policies in support of low-risk urban and peri-urban irrigation agriculture should disaggregate farmers according to their socio-economic and institutional characteristics in order to achieve their intended objectives. To achieve the third objective, the study employed the discrete choice experiment approach to estimate the benefits farmers impute to improvements in attributes of the wastewater irrigation input, whose aim is to reduce the health risks associated with untreated wastewater irrigation. Urban and peri-urban farmers who practice wastewater irrigation drawn from Motoine-Ngong River in Nairobi were randomly selected for the study. A total of 241 farmers completed the presented choice cards for the choice model estimation. A random parameter logit model was used to estimate the individual level willingness to pay for wastewater treatment. The results show that urban and peri-urban farmers are willing to pay significant monthly municipality taxes for treatment of wastewater. Conclusion of this study was that, quality of treated wastewater, quantity of treated wastewater and the riverine ecosystem restoration are significant factors of preference over policy alternative designs in wastewater treatment and reuse. / Thesis (PhD)--University of Pretoria, 2013. / gm2014 / Agricultural Economics, Extension and Rural Development / unrestricted

No description available.

The aim of this study is to examine the public preferences for urban riparian corridors in arid ‎regions, by testing to what extent people are willing to trade-off unmaintained ecological ‎landscape for aesthetics offered by specific micro and ‎macro environmental factors. Landscape ‎design reflects ecological and aesthetic values, and trade-offs are often made ‎between the two in ‎‎practice. In arid regions, water scarcity means riparian corridors are the ‎richest landscape ‎typology and the only ‎blue-green links for hundreds of miles. Pressure from ‎urbanization and ‎lack of eco-literacy contribute to negative ‎feedback loops which present dire ‎challenges for ‎migrating avifauna and regional wildlife. Regarding natural ‎resources and ‎biodiversity, where ‎multiple deliverable ‎ecosystem services rely on the quality and health of that ‎‎ecosystem, riparian ‎systems with high biomass are more desirable. Although this can be ‎achieved with low or no ‎‎maintenance riparian buffers, these unmaintained ecological landscapes ‎play an intrinsic role in ‎sustaining the ‎global ecosystem services and are important for the survival of the inhabitants ‎‎(avifauna). Ecological ‎landscapes are often subjected to trade-offs with aesthetic ‎landscapes that ‎include micro and ‎macro environmental factors such as manicured landscapes. It is accepted that ‎‎there is a ‎preference for aesthetics in landscape design; however, it is unclear how laypeople ‎prioritize ‎aesthetics ‎over different ecological factors in landscape scenes. This study uses a ‎Discrete Choice ‎Experiment (DCE) to elicit the ‎preferences of current or pretendant residents of ‎Jeddah City, Saudi Arabia for multiple landscape scenes. The method ‎combines ecological ‎landscape characteristics adopted from ‎the QBR index that are found in the study area in Jeddah ‎and aesthetic ‎characteristics, such as micro and macro environmental factors that are commonly ‎suggested in landscape design projects adapted from relevant visual preference studies (Alsaiari, ‎‎2018; Kenwick et al., 2009; Kuper‎ ‎,‎2017; Zhao et al., 2017). ‎DCE is a widely used method to ‎reveal preferences by analyzing the trade-offs people make ‎between ‎alternatives. Participants in ‎this study were exposed to a set of designs, which included ‎various configurations of ‎aesthetic ‎and ecological elements. Participants' choices revealed the influence of their ecological and ‎‎aesthetic values. Results show that minimal design interventions would prevent trading off the ‎ecological unmaintained landscape and that there are four subgroups with distinct homogeneous ‎preferences for the attributes affecting the appeal for the urban riparian corridor in Jeddah City. ‎Finally, results show that even though there are significant differences between subgroups based ‎on preferences, the demographic information is proportionally distributed in a way the means ‎differences diminish between the subgroups. ‎Findings in this study will equip ‎decision-makers ‎with operational definitions relating to riparian ‎landscape design and a method ‎that they can use ‎to minimize losses in ecological value over aesthetic value. This study will help‎ ‎researchers and ‎landscape architects advance visual preference research further into the domain ‎of empirical ‎‎studies.‎ ‎ / Doctor of Philosophy / Landscape architecture is a profession that entails planning and design outdoor spaces, ‎‎landmarks, and ‎structures to improve the built environment and increasing the quality of ‎‎people's lives by achieving ‎environmental, social, economic, and aesthetic outcomes‎. The ‎profession often reflects ecological and ‎aesthetic values, and trade-offs are often made ‎between ‎the two in ‎practice. These ecological values ‎represent environmental characteristics that are ‎important for the survival of wildlife (protected path ‎and safe habitat) and the overall ecosystem ‎‎(every being has a role that sustain the health of the ‎environment). Culturally, human is ‎accustomed to a slick-and-clean (tamped) looking plant within urban ‎developments (i.e., ‎neighborhoods). An example of the trade-off that often happen in practice between ‎the ‎ecological and aesthetic values is replacing an ecologically unmaintained plants that play ‎important ‎ecological role (i.e., wildlife habitat) with clean tamped plants to increase the value of ‎a real estate. Due ‎to the uncertainty surrounding people's acceptance of the features of these ‎ecological unmaintained ‎plants, especially when it entails introducing ecological riparian ‎landscape attributes within ‎neighborhoods for the first time, this dissertation focuses on both ‎assessing ecological elements ‎preferences within an urban arid region in Jeddah, Saudi Arabia ‎and assessing the extent to which ‎advanced analytical methods are capable of providing a better ‎understanding of ecological riparian ‎landscape attributes preference differences among a ‎seemingly homogenous sample of participants. ‎The increasing usage of manipulated images in ‎choice tasks inspired this dissertation. The results of the ‎study demonstrate that among the ‎relatively homogenous sample of participants that was recruited, ‎four significant preference ‎patterns have emerged, which could be used to describe and predict ‎preference for ecological ‎riparian landscape attributes and choice with great accuracy. The dissertation ‎also investigates ‎policy implications that might be beneficial in creating a ‎physical environment that ‎match public ‎preferences. ‎It also offers research implications and recommendations for landscape ‎architects ‎and urban designers on how to employ visual choice experiments, which have been well-‎‎developed in other research field