The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). The study's research questions examined conditions of the neighborhood that impeded the weight status of young children. The theoretical framework included the environmental stress, socioeconomic, multiple exposures-multiple effects, and attachment theories. The twenty - six variables used in this secondary quantitative study included demographics on socioeconomic and education levels, home occupancy and vacancy rates, age of homes, and neighborhood accessibility features: access to parks; recreation facilities; grocery stores verses convenience stores; fast food restaurants; medical facilities; schools; day cares; and neighborhood incivilities such as numbers of reported crimes. The t - test were configured as Grouping Variables with the cut-point of 18.7% and with an Alpha of .05 and produced statistical significance on five of twenty - six variables. A mean rate of 19.3% yielded statistical significance on ten of twenty - six variables. The Levene's Test for Equality of Variances expressed assumptions on scores met for statistical significance on t-test at the Alpha = 0.05 level for twenty - four of the twenty - six variables. The results of this study would possibly increase the use of the innovative geographic information systems to inform policy decisions, environmental interventions and environmental design on obesogenic correlates between the understudied area of early childhood obesity and the built environment.

Skewness and kurtosis are measures used to describe shape characteristics of distributions. In this thesis, we examine the interval estimates about the skewness and kurtosis by using jackknife empirical likelihood (JEL), adjusted JEL, extended JEL, traditional bootstrap, percentile bootstrap, and BCa bootstrap methods. The limiting distribution of the JEL ratio is the standard chi-squared distribution. The simulation study of this thesis makes a comparison of different methods in terms of the coverage probabilities and interval lengths under the standard normal distribution and exponential distribution. The proposed adjusted JEL and extended JEL perform better than the other methods. Finally we illustrate the proposed JEL methods and different bootstrap methods with three real data sets.

Abstract Obesity in School Children from the Point of View of a Nurse Working in a GP's Surgery The thesis focuses on the problems of nursing care of children with overweight and obesity. This issue is very urgent nowadays, not only in the Czech Republic, but it is a global problem. Our country holds one of the leading positions in children obesity. Children suffering from overweight and obesity have not only health problems resulting from obesity complications, but also problems in the field of psyche and social relations, particularly among their peers. This is why the right insight into the issue and finding an acceptable solution for the future is so important. The theoretical part deals with the problems of children obesity, the specifics of nursing care of these children within a surgery of a general paediatrician. It also focuses on the needs of children with normal weight and on the needs of overweight children. Four aims were set within the research. The first aim was to map the situation in obesity among school and pre-school children in Benešov District. The second aim was to map services (possibilities of further assistance, treatment) that parents and practitioners may use in treatment of children with overweight and obesity in Benešov District. The third aim was to compare success rate of obesity treatment in children that have already undergone obesity treatment under specialist supervision and success rate of weight reduction in children trying themselves. The fourth aim was to map the problems of cooperation of a nurse with parents and school in treatment of a child with obesity. We used a qualitative research method in the research part of the thesis. The questioning method by means of semi structured interview was applied. Three research samples were prepared for the research purposes. The first research sample consisted of 10 nurses working in paediatrician practitioner surgeries in Benešov District. The second research sample consisted of 10 persons intentionally chosen from among parents of children with obesity that are trying to reduce the weight of their children themselves or under assistance of an obesity specialist. The children were of school and pre-school age. The third research sample consisted of 10 paediatrician practitioners practicing in Benešov District. Open-coding technique paper and pencil method was applied on interview processing. A document analysis was used for the mapping of the services in Benešov District and the whole Central Bohemia Region. Six research questions were set: 1. What are the possibilities of specialist help to obese children? 2. Are parents willing to help their obese children with overweight reduction? 3. Do parents of obese children also have problems with overweight? 4. What experience do nurses from paediatrician practitioner surgeries have with care about obese children? 5. What does cooperation between parents and a nurse from a paediatrician practitioner surgery looks like? 6. How does a nurse working in a paediatrician practitioner's surgery cooperates with the school? The thesis conclusion shows that the problem of children obesity is not just the matter of Benešov District, but it is a global problem, it is urgent and has an increasing trend.

Obesity has become a global problem. Its prevalence has been increasing not only in the world but also in the Czech Republic. There exist two main causes of its development - imbalance between energy reception and energy expenditure. This imbalance can be explained as an excessive food supply containing improper constitution and lack of movement. However, there can also occur genetic predispositions. Moreover, obesity is connected with various kinds of health complications. It cannot cause only physical problems but also psychological, social and economic ones. Reducing of weight is based on way of living including diet and movement. Long-term preservation of this regime is difficult. Is is much better to prevent occurrence of this negative phenomenon. Prevention activities should be done even at very early age. The aim of the thesis is to map out prevalence of obesity among pupils attending second stage of basic schools in Prachatice. The graduation thesis presents a quantitative research in which a questionnaire is used as the main research method. The targeted group comprises pupils attending second stage of basic schools in Prachatice. Prevalence of obesity is found out by using Body Mass Index and all obtained data are compared with percentile graphs. The research has shown that 4,8 % of them are obese and 11 % overweighted. Higher prevalence of obesity and overweight was detected with boys. The other aims of the graduation thesis are to find out other factors which can influence obesity. The influences contributing to the development of obesity can be eating in fast foods or being influenced by advertisements presenting food products. Monitored children admitted drinking of different sweet lemonades. The thesis introduces three hypothesis. First, chidren are unaware of health risks connected with obesity. The hypothesis is confirmed. Second, obese children prefer high-energy foods. This hypothesis is not confirmed. Third, obese children lack movement. The final hypothesis is confirmed. The thesis will be provided as an information source for public, mostly for parents and teachers. All obtained information is hoped to be used for increasing interest in prevention of childhood obesity.

Außerhalb ihrer ursprünglichen Heimat in Südamerika steigt die Anzahl der Alpakas stetig an. Die Tiere erfreuen sich auch in Deutschland einer großen Beliebtheit. Aktuellen Schätzungen zufolge leben in Deutschland circa 10.000 Alpakas. Siewerden zur Wollgewinnung, sowie als Begleit- und Therapietiere in kleinen Hobbyhaltungen oder in Beständen mit einer Herdengröße von bis zu 150 Tieren gehalten. Damit verbunden werden auch zunehmende Ansprüche an die Qualität der tierärztlichen Betreuung dieser Neuweltkameliden gestellt. Die Beurteilung des Wachstums und der Entwicklung junger Alpakas bildet dabei, genauso wie im Rahmen der Zucht, eine wichtige Grundlage. Derzeit existieren nur unzureichende Informationen über den Wachstumsverlauf beim Alpaka. Bisher dienten proportional angepasste Daten vom Lama zur Orientierung. Das Ziel dieser Arbeit ist die auf morphometrischen Daten basierende Beschreibung der physiologischen Entwicklung des Skelettes und des Körpergewichtes beim Alpaka in den ersten 36 Lebensmonaten. Weiterhin soll untersucht werden, welche Faktoren Einfluss auf das Wachstum junger Alpakas haben. Die Bestimmung einer Gleichung zur Berechnung des Körpergewichtes stellt einen weiteren Schwerpunkt der Arbeit dar. Über einen Zeitraum von 12 Monaten wurden 162 Alpakas im Alter von wenigen Tagen bis zu 36 Monaten vermessen. In einem zweiwöchentlichen Rhythmus wurden 9 verschiedene Parameter bei jedem Tier erfasst: Gewicht, Widerristhöhe, Hüfthöhe, Rückenlänge, Rumpflänge, Tuberculum majus-Olecranon-Distanz (TOD), Basis patellae-Tuber ischiadicum-Distanz (BTD), Thoraxumfang und Body Condition Score. Mit Hilfe von speziell angefertigten Messschiebern, einer digitalen Waage und einem flexiblen Maßband erfolgte die Datenerhebung am stehenden Tier. Das Wachstum beeinflussende Faktoren wurden mittels Allgemeiner Untersuchung der Tiere, stichprobenartigen Kotprobenuntersuchungen, Futtermittelanalysen und vom Halter ausgefüllten Fragebögen erfasst. Die erhobenen Messwerte wurden unter Verwendung der nichtparametrischen Regression LOESS (locally weighted scatterplot smoothing) zur Erstellung von Wachstumskurven genutzt, die den durchschnittlichen Wachstumsverlauf des Körpergewichtes, sowie verschiedener Körpermaße von bis zu 36 Monate alten Alpakas darstellen. Sie ermöglichen die Beurteilung der körperlichen Entwicklung eines Alpakas. Unter Anwendung der LMS-Methode (Schiefe der Verteilung der Messwerte λ [L], Mittelwert M, Standardabweichung S) wurden Perzentilkurven von vier Parametern erstellt, die als Referenzkurven und Richtlinien zur Beurteilung der tierartspezifischen Größe und des Gewichtes genutzt werden können. Wachstumsprognosen und Rückschlüsse auf das Alter eines Alpakas sind mit Hilfe der Perzentilkurven möglich. Sowohl die Wachstumskurven als auch die Perzentilkurven lassen erkennen, dass Alpakas mit 36 Monaten noch nicht ausgewachsen sind. Die Kurven wurden anhand von Messwerten von Alpakas erarbeitet, die unter Bedingungen gehalten wurden, die keinen beziehungsweise einen minimalen Einfluss auf das Wachstum haben. Dies ist anhand der Ergebnisse der parasitologischen Untersuchungen und der Futtermittelanalysen erkennbar. Weitere Auswertungen der Messdaten zeigen, dass keine signifikanten Entwicklungsunterschiede zwischen Hengsten und Stuten beziehungsweise zwischen der Rasse Huacaya und der Rasse Suri bestehen. Ähnlich wie bei anderen Tierarten auch, eignet sich der Thoraxumfang zur zuverlässigen Berechnung des Körpergewichtes besonders gut. Eine große Korrelation besteht auch zwischen der Rumpf- beziehungsweise der Rückenlänge und dem Körpergewicht. Praktische Bedeutung haben die Erkenntnisse dieser Arbeit vor allem für Alpakazüchter und –halter, sowie für Veterinärmediziner. Die Ergebnisse bilden eine wichtige Grundlage für das Fütterungs- und Reproduktionsmanagement beim Alpaka. / The number of alpacas bred outside their natural habitat in South America increases continuously. Alpacas become more and more popular in Germany. According to recent estimates about 10.000 alpacas live in Germany. They are used for wool production, as companion animal and for therapeutic treatments. The alpacas are kept as pets in smaller groups or as livestock in herds of up to 150 animals. Due to the rising number of these camelids in Germany and more intense use, higher demands on the quality of veterinary care of alpacas occur. Knowledge and data on growth and development in young alpacas are essential for an objective health evaluation as well as for breeding management. Currently very limited information is available on growth of alpacas and the data published have been adapted by calculation using measurements performed on llamas. The primary objective of this study was to determine the physiological development of the skeleton and the body weight of alpacas from birth until 36 months of age based on morphometric data. An additional aim was to analyze factors that influence the growth of young alpacas. A third focus of this study was to generate a mathematical formula to calculate the body weight. The measurements were performed on 162 alpacas with an age ranging from the first day of life up to 36 months. For each alpaca nine different parameters were determined every two weeks: body weight, height at withers, height in the hip, thoracic circumference, length of the back, length of the trunk, Greater tubercle-Olecranon-distance (TOD), Base of the patella-Ischial tuber-distance (BTD) and body condition score. All measurements were carried out on standing animals. Three custom designed caliper gauges, a digital balance and a flexible measuring tape were used to obtain the nine parameters. Factors that influence growth were captured by clinical examination, randomized fecal samples, analysis of forage and a questionnaire completed by the breeder. Based on the data collected growth curves were developed using the nonparametric regression LOESS (locally weighted scatterplot smoothing). These curves represent the average growth pattern of body weight and various body measurements of up to 36 months old alpacas. Using theses curves the physical development of this species can be assessed. By applying the LMS-Method (skewness of the measurement distribution λ [L], mean M, coefficient of variation S) percentile curves of four different parameters have been generated. They can serve as reference curves and as guidelines for objective evaluation of species specific size and weight. Using the percentile curves a reliable prediction of growth or conclusions regarding the age of an alpaca are possible. The growth curves as well as the percentile curves show that alpacas are not mature at the age of 36 months. The curves are based upon data from alpacas who were raised under environmental conditions which have no or minimized influence on growth. This is evident in the results of the parasitological examinations and the feed analysis. Further analyses indicate that no significant differences in growth exist between males and females respectively between the two breeds Huacaya and Suri. Like in other species the thoracic circumference is particularly suitable for estimating the body weight. A strong correlation exists between body weight and the length of the trunk as well as the length of the back. The results of this study are of practical significance for alpaca owners, breeders and veterinarians. They provide a sound basis for recommendations in feeding and management of reproduction.

The breakthrough in mobile technology and the development of smartphones, supplied with sensing devices such as Inertial Measurement Units (IMUs), has made it possible to obtain accurate and reliable data on the angular velocity for different objects. The available technical sensors for wrist movements, such as electrogoniometers, are costly, time-consuming, and need a particular computer program to be analyzed. Therefore, there is a need to develop user-friendly risk assessment methods for wrist angular velocity measurements. This master thesis aimed to validate the accuracy of a newly developed iPhone application (App), "ErgoHandMeter," for wrist velocity in actual work tasks, by comparing the “ErgoHandMeter” to standard electrogoniometers. The project study was performed with four participants, two females and two males, from three jobs performing actual work tasks. The total angular velocity obtained by the mobile application was compared with the angular velocity data from the standard electrogoniometer. The total angular velocities obtained from the smartphone and the goniometer were computed at the 10th, 50th and 90th percentile for the four subjects. The 50th percentile of goniometer-flexion velocity (G-flex) was 7.4 ± 5.4°/s, for the goniometer-total (G-tot) 8.7 ± 6.5)°/s and for App 7.2 ± 4.9°/s. The correlation coefficient for the 50th percentile of goniometer-flexion (G-flex) parameter and smartphone application was 0.994. For the goniometer-total (G-tot) and the application, it was 0.993. In a Bland-Altman plot the mean difference between G-flex and App for the 50th percentile was -0.18 °/s and for G-tot and App was -1.54 °/s, i.e. the App was lower in average. The limit of the agreement between G-Flex and App, and G-tot and App stayed within two standard deviations. For G-Flex and App (mean+1.96SD) was 1.34 °/s, (mean-1.96SD) was -1.71 °/s, while for G-tot and App (mean+1.96SD) was 1.89 °/s, (mean-1.96SD) was -4.96 °/s, indicating an adequate agreement between the two methods. A limitation was that the included occupations were all relatively low velocity. However, in conclusion, the results indicate that the two methods agree adequately and can be used interchangeably. / Genombrottet inom mobiltekniken och utvecklingen av smarttelefoner med sensorer som t.ex. tröghetsmätningsenheter (IMU) har gjort det möjligt att få exakta och tillförlitliga uppgifter om vinkelhastigheten för olika objekt. De tillgängliga tekniska sensorerna för handledsrörelser, t.ex. elektrogoniometrar, är dyra, tidskrävande och de samplade signalerna kräver ett särskilt datorprogram för att analyseras. Det finns därför ett behov av att utveckla användarvänliga riskbedömningsmetoder för mätningar av handledens vinkelhastighet. Syftet med detta examensarbete var att validera noggrannheten hos en nyutvecklad iPhone-applikation (App), "ErgoHandMeter", för handledshastighet i verkliga arbetsuppgifter, genom att jämföra "ErgoHandMeter" med vanliga elektrogoniometrar. Projektstudien genomfördes med fyra deltagare, två kvinnor och två män, från tre yrken som utförde verkliga arbetsuppgifter. Den totala vinkelhastigheten som erhölls av mobilapplikationen jämfördes med vinkelhastighetsdata från standardelektrogoniometern. De totala vinkelhastigheterna som erhållits från smarttelefonen och goniometern beräknades vid den 10:e, 50:e och 90:e percentilen för de fyra försökspersonerna. Den 50:e percentilen för goniometer-flexionshastigheten (G-flex) var i genomsnitt 7,4°/s och för goniometertotalen (G-tot) 8,7°/s. Korrelationskoefficienten (r) för den 50:e percentilen för goniometer-flexionsparametern (G-flex) och smartphone-applikationen var 0,994. För goniometer-total (G-tot) och applikationen var r 0,993. I en Bland-Altman-plot var den genomsnittliga skillnaden mellan G-flex och appen för den 50:e percentilen -0,18°/s och för G-tot och appen -1,54°/s (App var lägre än Gon). Medelvärdet för differensen mellan G-Flex och App och G-tot och App ligger inom två standardavvikelser. För G-Flex och App (medelvärde+1,96SD) var 1,34 °/s, (medelvärde-1,96SD) var -1,71 °/s, medan för G-tot och App (medelvärde+1,96SD) var 1,89 °/s, (medelvärde-1,96SD) var -4,96 °/s. Vilket tyder på en tillräcklig överensstämmelse mellan de två metoderna. En begränsning var att de inkluderade yrkena alla hade relativt låg hastighet. Sammanfattningsvis visar dock resultaten att de två metoderna stämmer väl överens och kan användas på ett utbytbart sätt.

Accuracy and efficiency are extremely critical factors for large real-time control applications. A small oversight can cause catastrophic failure of a real-time system. Thus, these applications have to be tested meticulously to prevent any catastrophe that might occur. But, testing these applications exhaustively is not tractable, mainly due to the inherent complexity of the applications and also the huge amount of inputs and outputs that these applications involve. In order to save valuable amounts of time and resources, automated testing is imperative. Also, quantitative metrics have to be provided that assess the existing quality of the system and help increase the confidence in the user towards the software. However, to improve the overall quality of the software, additional focused testing needs to be done. The work in this thesis involves providing specific test suggestions that help the user conduct thorough and precise domain tests based on the knowledge of the various parameters used in previous test runs. The information about the defective portions of the input domain is provided by dividing the input range into percentiles, which is referred to here as bucketing. The goal is to expose the exact inputs causing the defects and the range of inputs that have been lightly tested or left untested during previous tests. A Reliability Analysis Test Tool (RATT) was developed to implement these test suggestions.

Cardiac troponins are crucial for the diagnosis of acute myocardial infarction. Despite known differences in their diagnostic implication, there are no recommendations for only one of the two troponins, cardiac troponin I (cTnI) and troponin T (cTnT) so far. In an everyday routine diagnostic, cTnT (Roche) as well as cTnI (Abbott) were measured in 5667 samples from 3264 patient cases. We investigated the number of identical or discrepant troponin findings. Regarding cTnI, we considered both, sex-dependent and unisex cutoffs. In particular, the number of cTnT positive and cTnI negative results was strikingly high in 14.0% of cTnT positive samples and increases to 23.8% by using sex-specific cTnI cutoffs. This group was considerably greater than the group of cTnI positive and cTnT negative results, also after elimination of patients with an eGFR < 60 mL/min/1.73 m2. Comparing the troponin cases with a dynamic increase or decrease between two measurements, we saw a balanced number of discrepant cases (between cTnT+/cTnI− and cTnT−/cTnI+), which was, however, still present. Using ROC analysis, sex-dependent cutoffs improved sensitivity and specificity of cTnI. This study shows in a large cohort that comparing the two cardiac troponins does not amount to identical analytical results. Consideration of sex-dependent cutoffs may improve sensitivity and specificity.

L'objectif de cette thèse est de développer et d'évaluer des paramètres quantitatifs de l'IRM de la prostate en discriminant les cancers de score de Gleason (GS) ≥7. Nous supposons que les paramètres quantitatifs de l'IRM pourraient aider à standardiser le diagnostic, et à diminuer la variation inter-lecteur et/ou inter-institution du diagnostic du cancer de la prostate. Cette thèse est divisée en trois chapitres. Le premier chapitre, intitulé « IRM T2 quantitatif de la prostate », est une étude rétrospective sur une base de données des patients avant prostatectomie radicale. Le deuxième chapitre, intitulé « IRM multiparamétrique quantitative de la prostate », est aussi une étude rétrospective avant prostatectomie radicale. Le troisième chapitre, intitulé « Élastographie IRM de la prostate par voie trans-périnéale» est une étude expérimentale. Notre première étude montre que le T2 est robuste sur les machines de constructeurs différents. Le T2 est un prédicteur significatif, mais de faible performance, d'agressivité du cancer de la prostate à 3T. Notre deuxième étude montre que la combinaison du 10ème centile de l'ADC avec le Time-topeak (TTP) améliore la performance du diagnostic, et ce modèle est lui aussi robuste entre des machines de constructeurs différents. Notre troisième étude montre les résultats préliminaires sur l'élasticité de la prostate. Ces résultats montrent que l'élastographie IRM de la prostate en haute fréquence d'excitation (>100 Hz) par voie trans-périnéale est faisable. L'élastographie pourrait à l'avenir être intégrée à l'IRM multiparamétrique quantitative pour améliorer la performance de diagnostic / The purpose of this thesis is to develop and evaluate the quantitative methods of multiparametric MRI of prostate in discriminating Gleason score (GS) ≥7 cancers. We suppose that the quantitative parameter of MRI could help standardizer the diagnostic, reduce the inter-lecture and/ or inter-institution variation in diagnostic of prostate cancer. This thesis is divided into three chapters. The firs chapter, entilted « Quantitative T2 MRI of prostate » is a retrospective study on a database of prostate cancer patients before radical prostatectomy. The second chapter, entilted « Multi-parametric Quantitative MRI of prostate » is also a retrospective study before radical prostatectomy. The third chapter, entitled « MR elastography of prostate by transperineal approach », is an experimental study. Our first study shows that T2 value is robust between machines of different constructors. T2 value is significant predictor, but of weak performance, of aggressively cancer of prostate at 3T. Our second study shows that the combination of ADC_10th percentile with Time-to-peak (TTP) improved the diagnosis performance, and this model is also robust between two machines of different constructors. Our third study shows the initial results on elasticity of the prostate. These results show that MRI elastography of prostate at high excitation frequency (>100 Hz) by trans-perineale approach was feasible. The elastography may, in the future, be integrated in quantitative multi-parametric MRI to improve the diagnosis performance

An ergonomically designed work environment may decrease work related musculoskeletal disorders, lead to less sick leaves and increase production time for operators and companies all around the world. Volvo Construction Equipment wants to deepen the knowledge and investigate more carefully how operators are actually sitting whilst operating the machines, how this affects placement of controls and furthermore optimize controls placements accordingly. The purpose is to enhance their product development process by suggesting guidelines for control placement with improved ergonomics based on operators’ sitting postures. The goal is to deliver a process which identifies and transfers sitting postures to RAMSIS and uses them for control placement recommendations in the cab and operator environments. Delimitations concerns: physical ergonomics, 80% usability of the resulted process on the machine types, and the level of detail for controls and their placements. Research, analysis, interviews, test driving of machines, video recordings of operators and the ergonomic software RAMSIS has served as base for analysis. The analysis led to (i) the conclusion that sitting postures affect optimal ergonomic placement of controls, though not ISO-standards, (ii) the conclusion that RAMSIS heavy truck postures does not seem to correspond to Volvo CE’s operators’ sitting postures and (iii) and to an advanced engineering project process suitable for all machine types and applicable in the product development process. The result can also be used for other machines than construction equipment. The resulted process consists of three independent sub-processes with step by step explanations and recommendations of; (i) what information that needs to be gathered, (ii) how to identify and transfer sitting postures into RAMSIS, (iii) how to use RAMSIS to create e design aid for recommended control placement. The thesis also contains additional enhancements to Volvo CE’s product development process with focus on ergonomics. A conclusion is that the use of motion capture could not be verified to work for Volvo Construction Equipment, though it was verified that if motion capture works, the process works. Another conclusion is that the suggested body landmarks not could be verified that they are all needed for this purpose except for those needed for control placement. Though they are based on previous sitting posture identification in vehicles and only those that also occur in RAMSIS are recommended, and therefore they can be used. This thesis also questions the most important parameters for interior vehicle design (hip- and eye locations) and suggests that shoulder locations are just as important. The thesis concluded five parameters for control categorization, and added seven categories in addition to those mentioned in the ISO-standards. Other contradictions and loopholes in the ISO-standards were identified, highlighted and discussed. Suggestions for improving the ergonomic analyses in RAMSIS can also be found in this report. More future research mentioned is more details on control placement as well as research regarding sitting postures are suggested. If the resulted process is delimited to concern upper body postures, other methods for posture identification may be used.