Konsumtionsbeteende är idag en viktig undersökningspunkt för att med säkerhet kunna genomföra implementeringar av nya policys inom konsumentpolitiken. Både klassiska nationalekonomiska teorier och beteendeekonomiska teorier används för att beskriva och förutsäga dessa beteenden, men det saknas undersökningar på deras faktiska kopplingar till olika typer av prissättning. Denna uppsats har gjort ett försök till att undersöka vilken påverkan en förändring i pris genom en förändring i paketstorlek har på efterfrågan. Den har även försökt ge en analys till om de förändringar som noteras är kopplade till beteendeekonomi eller klassisk nationalekonomisk teori. Med hjälp av en vanlig tidstrendsanalys tillsammans med en interrupted-time-series-analysis har försäljningstrenderna för försäljning i KG för två substituerande produkter skapats och jämförts. Dessa fastställer att förändringens påverkan framförallt stämmer överens med teorier gällande beteendeekonomi men att sambandet mellan en förändring i försäljningsnivå och en förändring i paketstorlek inte är säkerställt. Analyserna gjorda i denna studie blir därför inte fastställda och möjligtvis otillräckliga för att besvara den fråga som ställts. Jag som författare vill därför uppmana till att flera utvecklande studier inom ämnet bör utföras för att säkerställa möjliga resultat. / Consumer behaviour is today an important aspect of making quality decisions regarding policies on the consumer market. Both classical economical models and behavioural economical models are used to describe and predict these kinds of behaviours. Although todays studies on their connections to different methods of pricing are lacking. This paper tries to investigate what kind of impact a change in price by changing the size of the good has on demand. It also tries to produce an analysis on if this impact is connected with bevioural or classical economic theories. Based on a classical time-trend analysis together with an interrupted-time-series-analysis different trends for sales in KG regarding two substitutional products have been created. These determine that the effects on demand are most likely connected to behavioural economics but that the effects aren’t statistically significant. The analysis done in this paper therefore cannot be statistically determined and indicates that further studies on the subject need to be done to answer these questions with more certainty.

Processos de torneamento, muitas vezes na condição de corte interrompido, estão presentes em diversas operações na manufatura de componentes mecânicos, seja quando uma geometria específica é necessária como função deste componente ou quando ela é resultante de uma etapa anterior no processo produtivo, como no caso de peças forjadas. Este trabalho apresenta uma metodologia para avaliação da severidade de perfis irregulares durante o processo de torneamento. Esta avaliação é realizada principalmente sob o enfoque de esforços de corte e vibração, utilizando para tanto um dinamômetro e um acelerômetro. São estudados dois casos de torneamento apresentando geometria irregular: barras de seção transversal quadrada e barras cilíndricas contendo rasgos de chaveta. O material utilizado em ambos os casos foi o aço SAE 52100. Os sinais de forças e vibração foram obtidos em diferentes etapas do torneamento, sendo cada etapa representada por uma taxa de contato diferente. As velocidades de corte utilizadas foram de 60 m/min e 120 m/min, com avanço constante e igual a 0,2 mm/volta e profundidade de corte de 1 mm. Para a medição dos esforços foi instrumentado um porta-ferramentas equipado com extensômetros. Neste porta-ferramentas foi fixada a pastilha de metal duro (TPUN 160304) utilizada nos ensaios, buscando-se assim a condição de corte ortogonal. Como análises secundárias foram realizadas medições de rugosidade nas peças e medição dos cavacos obtidos durante o processo, assim como fotografias das ferramentas utilizando microscopia óptica. Os resultados obtidos mostraram relações entre a taxa de contato e as forças médias e máximas, além de diferenças significativas nos valores de rugosidade em função da geometria da peça, permitindo assim validar a metodologia empregada para análise de torneamento em condições de corte interrompido. Portanto, é possível relacionar forças e vibrações à geometria do material por meio do aparato experimental desenvolvido. / Interrupted cutting conditions often occur in the manufacturing of many mechanical components during turning processes. For instance, if a specific geometry feature is required or even if the geometry of the work piece is a result of a previous process, like in forged parts. This work presents a method to evaluate the severity during the turning process of irregular shape work pieces. This evaluation was carried out mainly analyzing the cutting forces and vibration signals by using a dynamometer and an accelerometer, respectively. Two different irregular geometries were studied during turning: square section bar and cylindrical bar with longitudinal key beds. The samples were made of the SAE 52100 steel for both geometries. Forces and vibration signals were recorded during different turning steps; each turning step was indicated by a different contact ratio. The cutting speeds used in the tests were 60 m/min and 120 m/min, with 0.2 mm/turn of feed rate and 1 mm of cut depth. A strain gage instrumented tool-holder was used to measure the cutting forces. The cemented carbide tool (TPUN 160304) used in the tests was fixed in the tool-holder device and the turning tests were carried out near the orthogonal cutting conditions. Complementary analysis of surface quality, chips size and shape and optical microscopy photos of the tools after the tests were also conducted. The results showed a relationship between the contact ratio and the cutting forces (average and maximum), and significant differences in the surface quality (roughness) as a function of work piece geometry. These results allow validating the proposed methodology to evaluate interrupted cutting conditions in turning operations. Therefore, it is possible to relate the forces and vibrations signals to the geometry of the material by the use of the experimental apparatus developed.

A pediatric intensivist in the University of Iowa Hospitals and Clinic's (UIHC) Pediatric Intensive Care Unit (PICU) was concerned about antimicrobial use in the unit. However, no one had quantified antimicrobial use in the UIHC's PICU or described the patterns of antimicrobial use in this unit. To address the intensivist's concern, the principal investigator (PI) conducted a retrospective study to determine the percentage of patients who received antimicrobial treatments, to determine the indications for antimicrobial use, and to identify antimicrobial agents used most frequently in the unit. On basis of our data, we hypothesized that empiric antimicrobial use, particularly the duration of therapy, could be decreased. We implemented a six-month intervention during which we asked the pediatric intensivists to complete an antimicrobial assessment form (AA) to document their rationale for starting antimicrobial treatments. We postulated that this documentation process might remind physicians to review antimicrobial therapies, especially empiric therapies, when the microbiologic data became available. In addition, we utilized the AA form to identify factors pediatric intensivists considered when deciding to prescribe empiric antimicrobial treatments. Data from the AA forms suggested that pediatric intensivists in the UIHC's PICU often considered elevated C-reactive protein, elevated white blood cell counts, and elevated temperatures when deciding to start empiric antimicrobial therapy. Data from the three nested periods showed that the median duration of empiric and targeted treatments decreased during the intervention and remained stable during the post-intervention period. The PI estimated that 193 days of empiric antimicrobial therapy and 59 days of targeted antimicrobial therapy, respectively, may have been saved by the decreased durations of therapy. Time series analysis assessing the trend in use of piperacillin-tazobactam, cefepime, and ceftriaxone (measured in mg/wk) did not reveal a significant change over time. On the basis of our results, an intervention strategy using an AA form alone may not be an effective strategy for antimicrobial stewardship in PICUs. Additional measures such as automatic stop orders and computer decision support may be useful for reducing the duration of empiric therapy in PICUs.

PROBLEM INVESTIGATED: Methodological issues and policy implications arising from the application of interrupted time series (ITS) analyses to assess the impact of Pharmaceutical Benefit Scheme (PBS) subsidisation policies on drug utilisation in Australia. PROCEDURES FOLLOWED: A critical review of methodological issues relating to the application and analysis of ITS designs was undertaken. This included an examination of drug utilisation data sources in Australia. The PBS policies examined were: (i) the introduction of copayments in 1990; (ii) the introduction of re-supply limits in 1994 and (iii) the introduction of a form of reference pricing in 1998. Monthly aggregate drug utilisation data was obtained from the Australian Department of Health and Ageing. Segmented regression analyses incorporating autocorrelated errors were implemented and statistical diagnostics applied to ensure correct ITS model specification. Alternative seasonal modelling approaches were compared. RESULTS OBTAINED: The copayment ITS evaluation found that while these copayments produced a reduction in the utilisation of essential and discretionary medications, this effect was stronger for discretionary drugs. An unintended policy effect was a large anticipatory increase in drug utilisation during the month prior to the copayments. Repatriation PBS data was also utilised due to the limited number of pre-intervention data points in the Community series. The re-supply limit ITS evaluation found that the 20-day rule markedly reduced the size of the seasonal increase during the month of December. However, logistic regression analyses showed that the size of this reduction attenuated over time, highlighting the need to consider alternative analysis strategies when applying a ITS approach. The reference pricing ITS evaluation found that this policy had achieved its drug utilisation objectives for H2RAs and ACE Inhibitors. However with regard to CCBs, no increase in the utilisation of benchmark priced drug was apparent, which probably reflected clinical concerns at the time about the safety of these drugs. MAJOR CONCLUSIONS: Well implemented ITS analyses provide a valuable tool for evaluating the impact of PBS subsidisation policy change on drug utilisation in Australia. As with any methodology, however, different design and data integrity issues will affect the quality of information provided.

Experimental measurements are conducted on uninterrupted and interrupted aluminum microchannel heat sinks of 300, 500, 600 and 900 &mu / m channel widths. Two different versions of interrupted channels are tested / with single interruption and with 7 interruptions. Distilled water is used as the working fluid and tests are conducted at volumetric flow rates in a range of 0.5-1.1 lpm. Thermoelectric foils are used to supply uniformly distributed heat load to the heat sinks such that for all the tests the heat removed by water is kept constant at 40 W. Pressure drop and temperature increase are measured along the channels of different configurations for a number of different flow rates. For the interrupted channels thermal boundary layers re-initialize at the leading edge of each interrupted fin, which decreases the overall boundary layer thickness. Also the flow has been kept as developing, which results in better heat transfer performance. Due to the separation of the flow into branches, secondary flows appear which improves the mixing of the stream. Advanced mixing of the flow also enhances the thermal performance. In the experiments, it is observed that interruption of channels improved the thermal performance over the uninterrupted counterparts up to 20% in average Nusselt number, for 600 micron-wide channels. The improvement of average Nusselt number between the single interrupted and multi interrupted channels reached a maximum value of 56% for 500 micron-wide channels. This improvement did not cause a high pressure drop deviation between the uninterrupted and interrupted microchannels even for the maximum volumetric flow rate of 1.1 lpm. Highest pressure drop through the channels was measured as 0.07 bar, which did not require to change the pump. In the tests, maximum temperature difference between the inlet of the fluid and the base of the channel is observed as 32.8&deg / C, which is an acceptable value for electronic cooling applications.

Background: This thesis is composed of three studies testing the effect of the Colon Cancer Check (CCC) program, the organized screening program for colorectal cancer in Ontario, on screening participation. In the first paper, we described the trends of participation to Fecal Occult Blood Test (FOBT) and endoscopy, and the trend of ‘up-to-date’ consistent with guidelines, overall and stratified by demographic characteristics between 2005 and 2011. In the second paper, we tested the effect of physician’s recommendation on FOBT participation and disparities in participation. In the third paper, we measured the effect of the CCC program on FOBT participation using an interrupted time series. Methods: We identified six annual cohorts of individuals eligible for CRC screening in Ontario between 2005 and 2011 by linking the Registered Persons Database to Ontario Health Insurance Plan and 2006 Census from Statistics Canada. We used descriptive statistics to describe the trends of participation. The effect of physician’s recommendation on screening participation was tested using multiple logistic regression analysis. The effect of the CCC program on FOBT participation was tested using segmented regression analysis. Results: An increasing trend in FOBT participation and ‘up-to-date’ status was observed across all demographic characteristics. The disparity gaps persisted over time by gender, income, recent registrant and age. The rural/urban gap was removed. Physician’s recommendation tripled the likelihood of FOBT participation (prevalence rate ratio=3.23, CI= 3.22-3.24) and mitigated disparities. The CCC led to a temporary increase in level (8.2‰ person-month) in FOBT participation followed by a decline in trend and then a plateau. The increase in level was significant across all population sub-groups. Conclusions: We found that CRC screening has increased in Ontario across all subgroups of the population but remained suboptimal. Disparities in screening participation were identified. Proposed strategies to improve performance include interventions to increase the rate of physician’s recommendation at the practice level, tailored interventions to motivate under-users and public media campaigns.

Background: This thesis is composed of three studies testing the effect of the Colon Cancer Check (CCC) program, the organized screening program for colorectal cancer in Ontario, on screening participation. In the first paper, we described the trends of participation to Fecal Occult Blood Test (FOBT) and endoscopy, and the trend of ‘up-to-date’ consistent with guidelines, overall and stratified by demographic characteristics between 2005 and 2011. In the second paper, we tested the effect of physician’s recommendation on FOBT participation and disparities in participation. In the third paper, we measured the effect of the CCC program on FOBT participation using an interrupted time series. Methods: We identified six annual cohorts of individuals eligible for CRC screening in Ontario between 2005 and 2011 by linking the Registered Persons Database to Ontario Health Insurance Plan and 2006 Census from Statistics Canada. We used descriptive statistics to describe the trends of participation. The effect of physician’s recommendation on screening participation was tested using multiple logistic regression analysis. The effect of the CCC program on FOBT participation was tested using segmented regression analysis. Results: An increasing trend in FOBT participation and ‘up-to-date’ status was observed across all demographic characteristics. The disparity gaps persisted over time by gender, income, recent registrant and age. The rural/urban gap was removed. Physician’s recommendation tripled the likelihood of FOBT participation (prevalence rate ratio=3.23, CI= 3.22-3.24) and mitigated disparities. The CCC led to a temporary increase in level (8.2‰ person-month) in FOBT participation followed by a decline in trend and then a plateau. The increase in level was significant across all population sub-groups. Conclusions: We found that CRC screening has increased in Ontario across all subgroups of the population but remained suboptimal. Disparities in screening participation were identified. Proposed strategies to improve performance include interventions to increase the rate of physician’s recommendation at the practice level, tailored interventions to motivate under-users and public media campaigns.

Processos de torneamento, muitas vezes na condição de corte interrompido, estão presentes em diversas operações na manufatura de componentes mecânicos, seja quando uma geometria específica é necessária como função deste componente ou quando ela é resultante de uma etapa anterior no processo produtivo, como no caso de peças forjadas. Este trabalho apresenta uma metodologia para avaliação da severidade de perfis irregulares durante o processo de torneamento. Esta avaliação é realizada principalmente sob o enfoque de esforços de corte e vibração, utilizando para tanto um dinamômetro e um acelerômetro. São estudados dois casos de torneamento apresentando geometria irregular: barras de seção transversal quadrada e barras cilíndricas contendo rasgos de chaveta. O material utilizado em ambos os casos foi o aço SAE 52100. Os sinais de forças e vibração foram obtidos em diferentes etapas do torneamento, sendo cada etapa representada por uma taxa de contato diferente. As velocidades de corte utilizadas foram de 60 m/min e 120 m/min, com avanço constante e igual a 0,2 mm/volta e profundidade de corte de 1 mm. Para a medição dos esforços foi instrumentado um porta-ferramentas equipado com extensômetros. Neste porta-ferramentas foi fixada a pastilha de metal duro (TPUN 160304) utilizada nos ensaios, buscando-se assim a condição de corte ortogonal. Como análises secundárias foram realizadas medições de rugosidade nas peças e medição dos cavacos obtidos durante o processo, assim como fotografias das ferramentas utilizando microscopia óptica. Os resultados obtidos mostraram relações entre a taxa de contato e as forças médias e máximas, além de diferenças significativas nos valores de rugosidade em função da geometria da peça, permitindo assim validar a metodologia empregada para análise de torneamento em condições de corte interrompido. Portanto, é possível relacionar forças e vibrações à geometria do material por meio do aparato experimental desenvolvido. / Interrupted cutting conditions often occur in the manufacturing of many mechanical components during turning processes. For instance, if a specific geometry feature is required or even if the geometry of the work piece is a result of a previous process, like in forged parts. This work presents a method to evaluate the severity during the turning process of irregular shape work pieces. This evaluation was carried out mainly analyzing the cutting forces and vibration signals by using a dynamometer and an accelerometer, respectively. Two different irregular geometries were studied during turning: square section bar and cylindrical bar with longitudinal key beds. The samples were made of the SAE 52100 steel for both geometries. Forces and vibration signals were recorded during different turning steps; each turning step was indicated by a different contact ratio. The cutting speeds used in the tests were 60 m/min and 120 m/min, with 0.2 mm/turn of feed rate and 1 mm of cut depth. A strain gage instrumented tool-holder was used to measure the cutting forces. The cemented carbide tool (TPUN 160304) used in the tests was fixed in the tool-holder device and the turning tests were carried out near the orthogonal cutting conditions. Complementary analysis of surface quality, chips size and shape and optical microscopy photos of the tools after the tests were also conducted. The results showed a relationship between the contact ratio and the cutting forces (average and maximum), and significant differences in the surface quality (roughness) as a function of work piece geometry. These results allow validating the proposed methodology to evaluate interrupted cutting conditions in turning operations. Therefore, it is possible to relate the forces and vibrations signals to the geometry of the material by the use of the experimental apparatus developed.

Approximately 20% of congestive heart failure (CHF) patients are readmitted within 30 days of hospital discharge, a rate which may be affected by in-hospital and post-discharge care. Reducing this rate is important to hospitals, both to improve outcomes and to avoid reductions in Medicare reimbursement. Assessing outcomes within a short post-discharge window best measures the impact of the care, planning, and followup of that admission; but most research on the effects of changes in CHF care has measured outcomes over periods longer than 30 days, adding the unpredictable long-term course of CHF to the factors affecting the outcome. As well, almost no studies to date have included the appreciable effects of CHF comorbidities in their analyses. This study addresses these needs by measuring rates of 30-day all-cause readmission, and by adjusting for comorbidities and demographic factors in our analysis. We hypothesize that an improved CHF care protocol including both in-hospital and post-discharge components will reduce the risk of readmission, and may alter the rate of change of that risk. We have analyzed as an interrupted time series data on 2764 discharges of CHF patients from a hospital that implemented such a change to assess the effect of the new protocol on the readmission risk and on the trend in that risk, comparing outcomes in the 22 months preceding introduction of the new protocol to those in the first 31 months of full implementation. Using multiple logistic regression, we have tested for an association between the new protocol and both the unadjusted risk of readmission, and that risk in a model including comorbidities and demographic factors as covariates. Neither model found a statistically significant association between introduction of the protocol and log-odds of readmission (unadjusted p = 0.847, adjusted p = 0.755) or between introduction of the protocol and change in risk of readmission over time (unadjusted p = 0.437, adjusted p = 0.313). These results, in comparison with other published results, can clarify what changes to care protocols have been shown to be effective. Further, post hoc power analysis of this study can inform study design for further research.

Background: A previous experiment with 70 interrupted monosyllabic words demonstrated that recognition performance was influenced by the location of an interruption pattern (Wilson, 2014). The interruption paradigm (10 interruptions/sec, 50% duty cycle periodic interruption) was referenced to word onset. The words were interrupted such that alternate 50-msec segments were parsed to separate files. In the 0-msec condition the first on-segment coincided with the word onset, whereas in the 50-msec condition the first on-segment occurred 50 msec after word onset. The 0- and 50-msec conditions were complementary halves. Recognition performance by young listeners was 19% better on the 0-msec condition (86%) than on the 50-msec condition (68%); there were a minority number of words on which the results were just the opposite. A second study using the same interruption paradigm but 300 different words reported similar relations, with 63% correct recognition on the 0-msec condition and 48% on the 50-msec condition (Wilson and Irish, 2015). Both studies suggest the importance that the first 50 msec of the target word has on intelligibility. Purpose: To define in detail the effects that interruption patterns have on word recognition as the interruption pattern was incremented with reference to word onset from 0 to 90 msec in 10-msec steps. Research Design: A repeated-measures design with ten interruption patterns (onset conditions). Study Sample: Twenty-four young listeners (19-29 yr) with normal hearing for pure tones participated in this study. Data Collection and Analyses: Seventy consonant-nucleus-consonant words formed the corpus of materials with 25 additional words used for practice. For each participant, the 700 stimuli (70 words by ten onset conditions) were interrupted (10 interruptions/sec; 50% duty cycle), randomized, and recorded on compact disc in 28, 25-word tracks. Results: The overall mean recognition performance was 80.4% with mean performances for the ten conditions ranging from 73.0% (50-msec condition) to 87.7% (90-msec condition). The mean recognition performances changed systematically, decreasing from the 0-msec condition to the 50-msec condition and then increasing to the 90-msec condition, which formed a U-shaped function of the means. Of the 45 mean paired comparisons (post hoc t-tests with Bonferroni corrections), there were 17 significant differences at the p ≤ 0.001 level, increasing to 31 significant differences when the significance level was increased to the p ≤ 0.01 level. Visual inspection of the 70-word performance functions revealed that 32 words had flat functions, 34 words had U-shaped functions, two functions were rising, one was an inverted V-shape, and one was irregular. Conclusions: First, some words (utterances of those words) were immune to any differential effects of the ten interruption patterns. These words with flat performance functions constituted 46% of the word corpus. Second, 49% of the words exhibited U-shaped performance functions that were always systematic, going from maximum to minimum and back to maximum. These words were thought to be more dependent on the initial consonant to attain maximum performance. The conclusion is that some words are not affected by the location of the interruption pattern (those with flat functions) whereas other words are substantially affected (those with U-shaped functions).