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Psykosociala faktorer kännetecknar allt som inte berör fysiska omständigheter på en arbetsplats. En god psykosocial arbetsmiljö ses bland annat när det råder goda relationer med arbetskamrater och när ansvars- och beslutstagande möjliggörs. Eftersom det i dagsläget råder otillräcklig information inom området är syftet med denna studie att ta fram och utforma en enkät med frågor som berör tandhygienistens psykosociala arbetsmiljö. Frågorna i enkäten kommer att konstrueras utifrån de redan etablerade frågorna i Copenhagen Psychosocial Questionnaire, COPSOQ. Enkäten ska sedan prövas i en pilotstudie. Efter utförd pilotstudie redovisas respondenternas kommentarer på enkätens innehåll och disposition. Resultatet visar att frågorna i COPSOQ innehåller en del svagheter vad avser formulering och innebörd. För enkäten som helhet har både fördelar och nackdelar påträffats. Slutsatsen blir därför att enkäten inför eventuellt framtida ändamål bör bearbetas och förtydligas innan den realiseras. / Psychosocial factors characterize everything that does not concern physical circumstances at a workplace. A good psychosocial work environment is exemplified by good relations with colleagues and the possibility of taking responsibility and making decisions. The information regarding the dental hygienist psychosocial work environment is insufficient. The aim of this study is therefore to develop and design a questionnaire within the given subject. The questionnaire will be based on established questions in the Copenhagen Psychosocial Questionnaire, COPSOQ. The questionnaire will then be tested in a pilot study. The pilot study will present the respondents comments on the questionnaire, in terms of its content and presentation. Results show that the questions in COPSOQ contain some weaknesses regarding formulation and meaning. For the survey as a whole, both advantages and disadvantages were encountered. It is therefore concluded that the questionnaire for any future purpose should be reworked and refined before application.

<p><strong>Background and objectives</strong>: Physiotherapists provide conservative treatment for neck pain utilizing manual therapies (MT), including spinal manipulation. Adverse events (AE) have been associated with manipulation provided mainly by other professions. Physiotherapy specific data are lacking. Definitions of AEs following MT require clear standardized criteria informed by both practitioners and patients. The objectives of this thesis were to: a) establish practice patterns of spinal manipulation in Canadian manipulative physiotherapists (CMPTs), b) establish patients’ perceptions of an AE related to MT and c) pilot the collection of AE data reported by practitioners and patients. <strong>Methods</strong>: For the first objective, multiple linear regression of survey data determined the association between experience and frequency of use of manipulation amongst CMPTs. For the second objective, Poisson regression identified predictors of patients more likely to report the occurrence of an AE. The final objective utilized descriptive statistics of patient and practitioner reported AE to assess feasibility for a future large-scale study. <strong>Results</strong>: For the first, increased experience was associated with increased use of upper cervical manipulation in males (14% more often for every 10 years after certification; beta 1.37, (95% confidence interval) (0.89,1.85) pConclusion: Manipulation by CMPTs remains a valued option as experience increases. Adverse events reported by patients are influenced by expectations. A large cohort study attempting to accurately define and measure AE rates following manipulation will be challenging to perform in private practice settings.</p> / Doctor of Philosophy (PhD)

This study evaluated effects of driving torques on screw direct withdrawal resistance (SDWR) from wood-based composites. The results on the screw seating torques indicated that the face-grain orientation of each material type had the highest mean load. The face-grain orientation of OSB had the highest mean load of 11.1 lb.in., and the MDF had the lowest mean load of 7lb.in.. For the screw stripping torques, the result showed the face-grain orientation of each material type had the highest mean load. The face-grain orientation of OSB had the highest load of 55.9 lb.in. Effects of torque levels on SDWR, the results indicated that the SDWR was lower at the torque level closer to the seating and stripping torque levels in OSB, whereas the SDWR was only lower in the torque level closer to the stripping torque within MDF and PB. Face-grain orientations of the each wood material had the highest SDWR.

Blood sampling causes significant blood loss in intensive care unit (ICU) patients (up to 41 mL per day). Only 10% of the blood collected is used for testing suggesting that volumes can be reduced without compromising patient care or laboratory processes. Blood loss contributes to anemia which is highly prevalent in the ICU (>90% after 3 days) and is associated with major adverse cardiovascular outcomes and death. Diagnostic blood loss increases the likelihood of red blood cell (RBC) transfusion which is administered to about 40% of ICU patients (half are given in absence of hemorrhage) and has significant health risks. Small-volume blood collection tubes, which collect about 50% less blood, are available, but rarely used in adults. They have the same cost as standard-volume tubes and are compatible with laboratory equipment. The rationale for the continued use of standard-volume tubes is a theoretical concern about inadequate volume for testing, and the absence of data showing the benefit of small-volume tube use on an important clinical outcome. A study is needed to show that small-volume tubes reduce blood loss, anemia and RBC transfusion without harms or negative consequences on patient care and hospital procedures compared to standard-volume tubes. If this could be shown, it may lead to practice change regarding blood collection for laboratory testing. A stepped-wedge cluster randomized trial is the ideal study design for this low-risk intervention. By incorporating the small-volume tubes into routine clinical practice and using administrative and hospital electronic medical record data, this study would be a pragmatic, cost-effective way to evaluate effectiveness and implementation. However, prior to conducting a full-scale trial powered on clinical outcomes, a pilot study is needed to determine whether a larger study will be feasible. The goals of this thesis are to (i) summarize the existing evidence regarding small-volume tubes; (ii) discuss cluster randomized trial methodology;(iii) discuss the use of health care administrative data for research; (iv) discuss the role of pilot studies; and (v) present the design of a pilot stepped wedge randomized trial of small-volume versus standard-volume blood collection tubes to evaluate the feasibility of a full-scale trial. / Thesis / Master of Science (MSc) / Blood testing is a preventable cause of blood loss. Patients in the intensive care unit (ICU) have about 41 mL of blood taken per day for testing (like donating 1 unit of blood every 8 days). This contributes to anemia (low red blood cells) and transfusion, which are harmful. About 40% of ICU patients get at least one red blood cell transfusion which is a limited resource with health risks. Most of the blood sent to the laboratory is discarded (up to 90%) suggesting that volumes can be reduced without compromising care. The goals of this thesis are to (i) summarize the evidence for reducing blood loss for laboratory testing; (ii) discuss cluster randomized trials; (iii) discuss use of health care administrative data for research; (iv) discuss the role of pilot studies; and (v) present a pilot stepped wedge cluster randomized trial of small-volume versus standard-volume blood collection tubes in ICU patients.

Aging and age-related frailty are important public health problems. There is a need to develop rehabilitation interventions to reduce the prevalence and disabling effects of frailty. This thesis reports the rationale and design of two studies and findings of three studies aimed to optimize health outcomes of frail older adults and their caregivers. The second chapter describes the protocol of the first network meta-analysis to determine the comparative effect of interventions targeting the prevention or treatment of frailty. In the third chapter, the results of frailty network meta-analysis were presented and 89 RCTs were included. The review shows that physical activity and medication management are the most effective frailty interventions. The fourth chapter describes a protocol of pilot randomized controlled trial (RCT) to examine a preoperative multi-modal frailty intervention in pre-frail/frail older adults undergoing elective joint replacements. The fifth chapter describes the results of a subgroup analysis of a RCT examining the effect of complex primary care intervention to support caregivers of frail older adults. There were no differences between caregivers of frail older adults and non-caregivers in quality of life, social support, hospitalization, and emergency department visits. The sixth chapter examines the construct validity and discriminative properties of the fracture rating scale (FRS) (a tool designed for fracture risk assessment in long term care (LTC)). The FRS is a valid tool for identifying LTC residents at different risk levels for hip fracture in three Canadian provinces. The work presented in this thesis is proposing and examining the comparative effect of frailty interventions, a preoperative frailty intervention/ model, a primary care intervention to identify and support caregivers, and a predictive tool to optimize care planning of LTC residents. These findings will support the rehabilitation and care program for older adults and their caregivers and improve their health outcomes. / Thesis / Doctor of Philosophy (PhD) / There is a need to develop rehabilitation interventions to reduce the prevalence and disabling effects of frailty. This thesis reports the rationale and design of two studies and findings of three studies aimed to improve health outcomes of frail older adults and their caregivers. The second and third chapters of this thesis describe the protocol and results of a review aims to identify the effect of interventions targeting frailty, the review found that physical activity and medication management are the most effective frailty interventions. The fourth chapter describes a study examining the possibility of comparing a complex intervention to usual care in frail older adults undergoing joint replacements. The fifth chapter showed that a primary care intervention did not improve the caregivers’ health outcome. The sixth chapter presents the fracture rating scale, a valid tool for identifying Long-term care residents at risk of hip fracture in three Canadian provinces. These findings aim to improve the care for older adults and their caregivers.

Mythic is an animated family series that will collide the worlds of the beloved Disney style musical feature, with everyday children’s programming. Based on 8 public domain works by Hans Christian Andersen, the series will follow Princess Viv, Farmhand Penelope, Pit-Pocket Leina, and a hopelessly romantic Prince Agner, as they travel through magical kingdoms in hopes of retrieving 8 mythical relics. Together, the four will learn about the meaning of love, the danger of greed, and the joy of being selfless as they fight to keep Leina from becoming a true villain.

After a nightmare where her best friend is killed by a terrifying creature, a teenager girl, wakes up to find that not only is he missing in real life, but no one in the perfect town of Fallmore seems to remember he ever existed...