Aim: To test the interactive effects of the constructs of Modified Social Learning Theory (MSLT) in relation to predicting health behaviour in Type 2 Diabetes. Methods: The study is mixed methods and employs an exploratory sequential design. Qualitative Phase: (N=12) Semi-structured interviews with adults with insulin-treated type 2 diabetes, explored how beliefs and values influence self-management behaviour. Interim Phase: Thematic analysis allowed development of an adapted Health Value Measure. Quantitative phase: (N=107) Valid questionnaires measured Health Value, Health Locus of Control (HLC) and Self-efficacy (SE). Health Value was measured pre and post diagnosis in order to compare any changes with time. Anxiety and depression was controlled for using the Hospital Anxiety and Depression(HAD) scale. Five subscales measured diabetes outcome behaviour: general diet, specific diet, exercise, blood sugar and foot care. Hierarchical Multiple Regression(HMR) analyses consisted of four blocks, including three two-way interaction terms and one three-way interaction term to test the interactive effects of the three-predictor variables on outcome behaviours. ANOVA’s were conducted in an effort to add support to HMR results. Results: The interviews suggest that people may hold terminal (beliefs about desired end states)/instrumental health values (beliefs about desired modes of action) pre-diagnosis but these are mainly instrumental post-diagnosis in order to meet their new needs and maintain quality of life. The qualitative data also drew attention to the way in which LOC and SE beliefs impact on behaviour. Additionally, differing dimensions of various emergent themes highlight the demands Type 2 diabetes places on a person and how this influences beliefs and values. Interim phase results resulted in the new items being removed from the adapted health value measure prior to the quantitative data analysis, as item 5 was deemed problematic. Sensitivity analysis was carried out to increase the robustness of the quantitative findings due to removing 29 cases with missing data from Dataset 1. Dataset 1 includes 78 complete cases and Dataset 2 contains 107 cases, 29 of which had missing values and were replaced using regression imputation. HMR analyses produced significant results that support MSLT when the three-way interaction variable was added to block 4. ANOVA results produced minimum support for MSLT. Conclusion: Support for MSLT has been found and can be used to inform interventions to change self-management behaviours of patients with poor diabetes control. Change in health value orientation post-diagnosis purports further investigation, as it is supported by qualitative results but not quantitative.

Master of Agribusiness / Department of Agricultural Economics / Ted C. Schroeder / The beef cattle industry is one of the last industries in production agriculture that is not heavily integrated. Therefore each segment of the industry is constantly looking for opportunities to increase the value of their cattle. In recent years, one of those opportunities available to cow-calf producers was verification of certain production practices (i.e. Age and Source, Natural, and Non-Hormone Treated). The value flows from the consumer to the cow-calf producer. The packers need these verified cattle to fill export contracts therefore they are willing to pay a premium for these types of cattle. The objective of the thesis was to determine the value of a Health Verified Program (HPV) to feedlot operators. HPV is not required to export beef like other verified programs, but it does verify the procedures that a group of calves has received from the previous owner. Since the feedlot is a deciding factor of value for HPV, feedlot managers were asked from across the United States not only what value they place on HPV but other questions that could be beneficial to others involved in the beef cattle industry. Regression models were used along with a correlation analysis to determine value. There is value to a health verified program along with other procedures that are available to cow-calf producers. Individual producers need to determine which verifications and procedures are economical and efficient for their individual operations with all factors considered.

Management Summary Die Orthopädie- und Rehatechnik Dresden GmbH ist ein innovatives Unternehmen der Orthopädietechnik in Dresden und der kompetente Partner für Gesundheit, Wohlbefinden und Mobilität. Ein Schwerpunkt liegt bei der Fertigung orthopädischer Hilfsmittel. Dabei wird die gesamte Bandbreite möglicher Versorgungen abgedeckt. Diese sind: — Bein- und Armprothesen, — Bein- und Armorthesen, — Korsetts zur Behandlung von Wirbelsäulendeformationen, — Sitzschalen für Rollstühle, — Orthopädische Maßschuhe. Mit hoher handwerklicher Präzision werden die Hilfsmittel in der eigenen Werkstatt individuell für jeden Kunden gefertigt. Die Wertschöpfungskette besteht abhängig von der Versorgungsart aus unterschiedlichen Bestandteilen. Allgemeingültig für alle Versorgungen sind: — Maßnahme beim Kunden, — Modellierung und Erstellung von Positivmodellen, — Herstellung der Hilfsmittel bis zur Anprobe, — Anprobe und Anpassung der Hilfsmittel, — Endmontage und Fertigstellung der Hilfsmittel, — Einweisung in den Gebrauch sowie Auslieferung. Sinkende Vergütungen durch die Krankenkassen, stark zunehmende Versorgungszahlen und die immer schwieriger werdende Gewinnung von Fachpersonal erfordern eine Straffung der Wertschöpfungskette. Erreichbar ist diese Straffung nur über eine Umgestaltung der zugrundeliegenden Produktionsprozesse. Die Geschäftsführung entschied, innerhalbeines Projektes zu prüfen, ob der Einsatz digitaler Datenerfassungs- und Bearbeitungstechniken einen wirtschaftlichen Vorteil für die künftige Unternehmensentwicklung darstellt. Dabei sollen künftig die betroffenen Körperbereiche der Kunden individuell durch geeignete 3D-Digitalisiertechnik erfasst, aufbereitet, modifiziert und archiviert und schließlich als Modellvorlagen in einem CAD/CAM-Verfahren durch CNC-Fräsen hergestellt werden. Für die Orthopädie- und Rehatechnik Dresden GmbH als stark handwerklich geprägtes KMU ist dieses Projekt ein Meilenstein für die weitere Entwicklung, sowohl hinsichtlich des Investitionsbedarfes als auch der Projektorganisation und der Kommunikation der Änderungen im Unternehmen. Bedingt durch die Art der angebotenen Produkte und Dienstleistungen finden sich im Unternehmen Mitarbeiter, die über hochspezialisiertes Wissens und individuelle Fähigkeiten verfügen. Die hohe Mitarbeiterzahl im den Bereichen Orthopädie-technik und Orthopädieschuhtechnik erlaubt eine Spezialisierung von Mitarbeitern auf einzelne Produktgruppen. Diese ist der entscheidende Wettbewerbsvorteil in einem von starkem Wettbewerbsdruck geprägten Markt. Sie ist sowohl notwendig für den wirtschaftlichen Erfolg als auch für die erfolgreiche Umsetzung der Veränderungsprozesse. Eine Umgestaltung der Produktion wie Sie im Rahmen dieses Projektes angestrebt wird bedeutet eine tiefgreifende Veränderung des bisherigen Arbeitsumfeldes. Es entstehen neue, spezialisierte Aufgaben, Verschiebungen von Arbeitsinhalten sowie die Notwendigkeit, vermehrt Aufgaben zu delegieren.

Background: Home health is the fastest-growing healthcare setting in the country. Through Home Health Value-Based Purchasing (HHVBP), the Center for Medicare and Medicaid Services (CMS) provides incentives or penalties to HHAs based on outcomes. Hospitalization and emergency department use are weighted heaviest as poor outcomes. HHVBP requires HHAs to report on whether they are engaging in advance care planning (ACP) conversations. For this study, ACP was defined as a conversation held in advance of a medical crisis with a loved one and/or a health care provider about goals; values; preferences for future medical treatments; and choice of a surrogate decision-maker. Purpose: to determine whether the proportion of Black patients was correlated with robustness of HHAs’ ACP protocols and levels of acute care services use. Methods: A cross-sectional, quasi-interventional design was used. The sample size was n = 89. Electronic surveys about ACP protocols were distributed to HHAs. Existing data about demographics and acute care services use were accessed via CMS websites. Spearman’s correlation coefficient was used. Results: No relationship was found between robustness of ACP protocols and the proportion of Black population per agency. No relationship was found between overall acute care services use rates proportion of Black patients. However, a trend was found: The greater proportion of Black patients, the greater the tendency for an agency to have a higher hospitalization rate. Discussion: Results are compared to current literature and to a CMS-commissioned study’s discussion about the potential for value-based purchasing programs to exacerbate health disparities in vulnerable populations.

This diploma thesis deals with the health of the individual, the health values in his life and the problems of drug abuse. It is dividend into two parts: the theoretical and the practical ones. The theoretical part is further divided into three main sections. The first of them deals with health and different views on it; the second one is devoted to values, particularly the perception of health as a value; finally the third section concerns the issue of drug abuse in general. The practical part of the thesis presents the result of a survey research made among the pupils of the 8th and 9th classes at two elementary schools in Veselí nad Lužnicí. The aim of this research effort was to determine the awareness of pupils about the aspects of drugs use and related potential risks; and whether they recognize the health as a value, which they are responsible of.