First responders are continuously moving at an incident site and this movement requires them to access Service-Oriented Architecture services, such as a Web Map Service, via mobile wireless networks. First responders from inside a building often have problems in communicating to devices outside that building due to propagation obstacles. Dynamic user geometry and the propagation conditions of communicating from inside buildings to transceivers on the outside are difficult to model reliably in network planning software. Thus, leading commercial network simulation software and open source network simulator software do not model wireless links between transceivers inside and outside of buildings; new modeling software is needed. The discrete simulation runs in this investigation were built on events in a scenario that is typical of first-responder activities at an incident site. This scenario defined the geometry and node characteristics that were used in a mobile wireless network simulation to calculate expected connectivity based on propagation modeling, transceiver characteristics, and the environment. The author implemented in software a propagation model from the United States National Institute of Standards and Technology (NIST) to simulate radio wave propagation path loss during the scenario. Modifications to the NIST model propagation path loss method were generated to improve consistency in results calculated with the same node separation distances and radio wave obstacle environments. The final set of modifications made the NIST model more generalized by using more building material characteristics than the original version. The modifications in this study to the path loss model from NIST engineers were grounded on ad hoc network connectivity data collected at the operational scenario site. After changes in the NIST model were validated, 1,265 operational simulation runs were conducted with different numbers of deployed nodes in an operational incident-response scenario. Data were reduced and analyzed to compare measures of mobile ad hoc network effectiveness. Findings in this investigation resulted in two specific contributions to the body of knowledge in mobile wireless network design. First, data analysis indicated that specific changes to a recent path loss model from NIST produced results that were more generalized than the original model with respect to accommodating different building materials and enhancing the consistency of simulation results. Second, the results from the modified path loss model revealed an operational impact in using relay nodes to support public safety. Specifically, placing relay nodes at the entrance to a building and on odd-numbered floors improved connectivity in terms of first responders' accessing Web Services via mobile network devices, when moving through a building in an incident scenario.

Doctor of Philosophy / Department of Kinesiology / Katie M. Heinrich / Tactical athletes (e.g., law enforcement, military, firefighters) require a proportionate fitness level, along with specific technical and tactical skills, to achieve short-term objectives and disable various threats. Although these professions have unique job duties and workplace exposures, tactical athletes share many commonalities. A tactical athlete’s occupation requires her to be physically prepared for the unknown to protect the public. So what happens when the tactical athlete becomes pregnant? Benefits of physical activity throughout pregnancy for athletes, non-athletes, and baby have been well-documented. However, certain common tactical occupational conditions may result in adverse birth outcomes. These include shift work, high job stress, and exposures such as lead handling or high ambient temperatures. Additionally, extreme physical exertion around the implantation period may harm the developing embryo. In an unpredictable, potentially extremely physically demanding and stressful job environment, the pregnant tactical athlete may have higher risk for adverse birth outcomes compared to other women. The purpose of this dissertation was to examine the reproductive health of physically active females with specific focus on tactical athletes. First, we wanted to determine any exercise limits for pregnant athletes. We were also interested whether reproductive health was an important concern for this population, and if their adverse birth outcomes were higher compared to the United States national average. Chapter one reviews the literature, examining the female athlete and tactical athlete, the physical and occupational demands of tactical professions, and the reproductive health concerns among law enforcement officers (LEOs) and firefighters. Chapter two is a comprehensive review on prenatal exercise. It highlights the lack of scientific rigor presented in earlier guidelines, and states the need for more research on the upper limits of exercise intensity for athletes. Female athletes can usually maintain regular exercise training during pregnancy. Chapter three uses grounded-theory to investigate reproductive health concerns among firefighters. Results indicate that reproductive health is unquestionably a large concern, with four resulting themes (i.e., decision-making, recruitment and retention, policy variation, and lack of research). Chapter four investigates adverse reproductive health outcomes in female LEOs. Miscarriage rates are compared with a large prospective linkage study, preterm birth rates are compared to a large systematic US review study, and links are explored between specific job exposures and pregnancy loss. Miscarriage rate for our population are 19.1%, and preterm birth rates are 16.4%, both significantly higher than US averages. Physical activity, including strenuous occupational demands during pregnancy, is not associated with pregnancy loss among female LEOs. Chapter five presents a findings summary and future research directions. Miscarriage and preterm birth appear to be higher than average for both female firefighters and LEOs. Exercise did not play a large role in the concerns of female firefighters, or findings from female LEOs. Future research should be conducted specifically on females working in tactical occupations, with an emphasis on reproductive health concerns. More education should be provided at the organization level on the potential occupational exposures that can cause increased risk of adverse birth outcomes in female tactical athletes.

Objectives Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. Methods Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data. Results Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements. Conclusion Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.

Stigma about mental illness is often identified as one of the most prominent obstacles to seeking mental health services. This seems to be particularly true among first responders. Unfortunately, the research regarding stigma in first responders is lacking. This may be due, in part, to the absence of appropriate measurement tools to allow such research. Stuart’s Police Officer Stigma Scale (POSS) has recently been developed to address this issue, but its psychometric properties have gone largely untested. Therefore, this study sought to identify the underlying factor structure and internal consistency of the POSS. This paper used a sample of one hundred and thirty-five first responders. This paper used a sample of one hundred and thirty-five first responders. Sixty participants were police officers, forty-eight were firefighters/EMTs, three were dispatchers, and twenty-four did not complete some portion of the scale/training and were omitted. Using factor analysis with an orthogonal rotation on Stuart’s eleven-item POSS, the participant’s results revealed two main components. Component one is “maltreatment of colleagues with a mental disorder,” and component two is “fear of disclosing a mental disorder.” Findings from this research are similar to the results of previous studies with components such as unwillingness to disclose a mental health condition, fear of how the public will treat an individual with a mental disorder, and anger towards those who decide to seek treatment or get diagnosed with a mental illness. These findings imply that Stuart’s POSS is reliable but needs to include two components rather than one. With the two main components, further research can now be conducted to understand why and ultimately mitigate maltreatment or stigma against first responders with a mental health condition.

C. albicans est une levure pathogène opportuniste. Elle est un agent causal fréquent des infections muco-cutanées. C. albicans peut alterner entre la forme blastospore et mycélium. Cette dernière forme est impliquée dans la formation des biofilms. Le dimorphisme de C. albicans est contrôlé en partie par le phénomène de perception du quorum (quorum sensing) qui en autre, est associé à la molécule farnésol, produit par cette levure. La présence de cette molécule, inhibe la formation d’hyphe par C. albicans et par conséquent limite la formation de biofilms. Certaines souches ne répondent pas au farnésol et nous avons vérifié les hypothèses que : 1) la proportion des Non-Répondeurs (NR) au farnésol est similaire entre les souches de provenance orale et vaginale; 2) la capacité de formation de biofilm varie d’une souche à une autre mais les Non-Répondeurs en produisent en plus grande quantité; 3) la technique RAPD-PCR permettra de regrouper les souches de cette levure suivant leur provenance, leur capacité de formation de biofilm et leur aptitude à répondre au farnésol. La découverte d’une souche vaginale Non-Répondeur nous permet de croire que la proportion de ces souches est similaire entre les deux types de provenance. Les souches caractérisées Non-Répondeurs produisent 30 % plus de biofilm que les Répondeurs en absence de farnésol exogène dans le milieu. En présence de farnésol exogène, les Non-Répondeurs produisent 70 % plus de biomasse que les Répondeurs. De plus, la technique RAPD ne nous a pas permis de classer nos souches d’après les caractéristiques proposées. En conclusion, les souches orales de C. albicans semblent produire en moyenne plus de biomasse que les souches vaginales. Aussi, les NR semblent moins affectés par la présence du farnésol, ce qui pourrait causer la présence de biofilms tenaces. Les amorces utilisées pour la technique RAPD n’ont pas été efficace à la classification des souches dépendamment de leur provenance, de leur capacité à former un biofilm et à répondre au farnésol. Mots clés : Candida albicans, biofilm, perception du quorum (quorum sensing), farnésol, Non-Répondeur / The opportunistic dimorphic yeast Candida albicans is frequently associated with mucosal infections in humans. It can colonize both oral and vaginal mucous membranes. One of its virulence factors is the capacity to form or participate in biofilms formation. Biofilms are a community of bacteria embedded in a matrix of exopolysaccharide and provide protection against environmental stress and antibiotics. The dimorphic characteristic of this yeast is involved in biofilm formation and is controlled in part by the quorum sensing system. Recently, it has been shown that farnesol, a quorum sensing molecule, can control the formation of biofilms through the inhibition formation of hyphae. However, we have shown that some oral and vaginal strains can still form biofilms under the influence of exogenous farnesol and these strains were named Non-Responders (NR). We hypothesized that: 1) The proportion of Non-Responders is similar between oral and vaginal strains; 2) biofilm formation differs between strains but Non-Responders produce more of it; 3) The technique of RAPD-PCR will allow us to group strains according to their origin, biofilm formation and response to farnesol. The discovery of a NR vaginal strain leads us to believe that the proportion of NR is similar between oral and vaginal strains. The NR strains seem to produce 30 % more biofilm than Responders in media without exogenous farnesol. This percentage increased to 70 % when exogenous farnesol was added to the media. The RAPD technique did not allow us to group strains according to their proposed characteristic. In conclusion, oral strains seem to produce more biofilm than vaginal strains. The NR’s are less affected by farnesol and may cause persistent biofilms. The primers used for RAPD technique were not effective to discriminate C. albicans strains according to origin, capacity to form biofilms and farnesol responding. Key words: Candida albicans, biofilm, quorum sensing, farnesol, Non-Responders

Thesis advisor: David Scanlon / Changes in policy and practice that originated with the 2004 Reauthorization of the Individuals with Disabilities Education Act ([IDEA], US Department of Education) created systems that exposed students to earlier and more consistent research-based intervention (Fuchs & Vaughn, 2012) thereby reducing the rate and increasing the mean age of students diagnosed with learning disabilities. Despite these documented positive outcomes, research has identified 2 -5 % of students who continue to demonstrate an “inadequate response” to evidence-based instruction that has been largely effective for their peers (Greulich et al., 2014). Little research has traced the educational histories of “inadequate responders,” and no known case studies have included children’s perspectives together with those of their parents and teachers. There is also a dearth of special education literature that is situated in private, faith-based schools where students function without all of the protections and structures of IDEA (Russo et. al., 2011; Scanlan, 2009a). This dissertation was an exploratory, comparative case study (Yin, 2014) of three third grade boys who were identified by their Catholic school staff as having demonstrated an inadequate response to intervention in reading. Each student was observed in a combination of his general education classroom and reading intervention periods, and interviews were conducted with the students and their parents and teachers. The learners’ Individualized Education Programs (IEPs), test reports, and cumulative records were also analyzed. Findings indicated that the students’ identification as inadequate responders did not accurately reflect their early reading experiences in which their instruction did not align with evidenced-based practices for students with learning disabilities (Ehri, Nunes, Stahl, & Willows, 2001). The students shared the deep emotional impact of past school-related events, and demonstrated patterns of sadness, anxiety, and avoidance during reading instruction. Parents and educators expressed their dedication to the students’ achievement as well as their frustration with the lack of comprehensive on-site academic systems of support within the boys’ schools. Implications for creating evidenced-based systems of intervention that honor and take into account the strengths and emotional-needs of students struggling to read are discussed. / Thesis (PhD) — Boston College, 2018. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

This thesis sought to understand reasons for noncompliant respondents and ineffective leadership in the National Incident Management System (NIMS) by Texas public safety training officers. Research has been conducted on the policies and their implications for NIMS, organizational culture and its impact on NIMS, and the hierarchy network of the Incident Command System (ICS). However, research evaluating the attitudes and perceptions regarding the effectiveness of NIMS is scarce. Training officers from rural fire departments, emergency medical services, and law enforcement agencies were the population for this study (n=33). The results of this study have implications for combined fire department, emergency medical services, and law enforcement training (interoperability), simplification of the management structure, and a mentoring program. This study should be explored further in an urban setting, based on this model. This study showed that respondents agreed that rural emergency responders tend to be noncompliant with NIMS. Respondents mentioned that rural emergency responders disagree with the effectiveness of NIMS. This study showed that a correlation occurred between the effectiveness of NIMS and the number of times a respondent was involved in a formal NIMS incident command. The following recommendations were made based on the findings and conclusions of this study. Researchers should continue to look at what public safety training officers believe affects the adaptability of NIMS. Training officers should consider contributing to the future NIMS curriculum. Training officers should focus on interoperability issues through increased field exercises. Research should be conducted to determine what improvements to curriculum effect future NIMS compliance. Further research should be conducted on the effectiveness of individual compliance, and achievement.

Tidigare studier har visat att det finns en övervägande nytta för samhället som helhet vid införandet och användandet av förstainsatsaktörer. I Sverige har nyttjandet av förstainsatsperson, FIP, inom räddningstjänsten visat på en kortare responstid än övrig styrka vid en olycka. Vid en byggnadsbrand är det enligt räddningstjänstens lagföreskrift ett rökdykarpar som utför livräddningen med resterande styrka (släckbil) verkande i bakgrunden. Den här studien utvärderar på nationell nivå tidsbesparingen (den kortare responstiden för två FIP-enheter jämfört med nästkommande enhet) samt den nytta som införandet och användandet av två FIP-enheter resulterar i för samhället som helhet vid en byggnadsbrand. Metoden för att analysera den minskning i skadevärde som en tidigare påbörjad insats medför genom nyttjandet av två FIP-enheter är en kostnadsnyttometod, även kallad CBA (Cost- benefit analysis). Kostnadsnyttoanalysen ställer den merkostnad som investeringen i FIP- enheter medför i kontrast till den nytta som FIP-enheter bidrar med, har nyttan ett större värde än kostnaden så är projektet samhällsekonomiskt lönsamt. Efter sortering av analysunderlaget genomförts återstod 210 stycken fall med fatal utkomst vid brand i byggnad mellan åren 2010 – 2014. Datamaterialet är från räddningstjänstens insats- samt dödsrapporter som ifyllts vid en olyckshändelse som räddningstjänsten larmats till. Resultatet från analysen visar att den genomsnittliga årliga nyttan av FIP-enheterna är beroende på hur stor andel av den avsedda populationen som återfinns inom stationsområde (benämns som täckningsgrad i studien) samt om stationen väljer att investera i en FIP-enhet eller två FIP-enheter. Täckningsgraden för att det ska vara lönsamt att investera i en FIP-enhet är 5311 stycken individer, för att det ska vara samhällsekonomiskt lönsamt att investera i två FIP-enheter måste stationen täcka 10 621 stycken individer. Investeringsalternativen är till följd av att utgångsläget för räddningstjänstens stationer är av olika art, d.v.s. en del stationer har redan en verksam FIP-enhet. För att stationen i fråga ska kunna ta del av den tänkta åtgärden med tidsbesparingen av två stycken FIP-enheter presenteras därav ett case scenario med investeringsalternativet om en FIP-enhet. Slutsatsen som dras är att det är samhällsekonomiskt lönsamt att implementera och nyttja två FIP-enheter för Sveriges räddningstjänster beroende på hur stor andel av Sveriges befolkning som den aktuella stationen täcker och vilket investeringsalternativ som är av intresse. / Previous studies have shown that there is an overwhelming benefit to society as a whole for the introduction and use of first responders. In Sweden, the use of first responders, FIP, for the civil protection demonstrated a shorter response time than the other rescue force when an accident occurred. When there is a fire in a building, according to rescue services regulations a smoke-diving couple performs the lifesaving operation with the residual rescue force (fire engine) acting in the background. This study evaluates if the national time savings; the shorter response time for two FIP units compared with the next unit arriving at the scene of an accident. If the introduction and use of two FIP units and the time saved results in a benefit to the society as a whole when there is a fire in a building. The method for analyzing the reduction in the damaged value as a previously initiated effort involving the use of two FIP units is a cost-benefit approach, also called CBA. Cost-benefit analysis makes the extra cost an investment in FIP units brings in contrast to the benefits that FIP units contributes, is the benefit of greater value than the cost the project is said to be economically viable. After sorting the analytical framework remained 210 cases, with fatal outcomes, for the variable fire in building between the years 2010 - 2014. The data material obtained is from the emergency input and death reports completed after an accident occurred that the rescue services were alerted to. The results of the analysis show that the average annual benefit of FIP units is dependent on the proportion of the intended population found in the station area (referred to as coverage in the study) and if the station chooses to invest in one FIP unit or two FIP units. Adequacy for it to be profitable to invest in one FIP unit requires that the station covers 5311 individuals, for it to be economically profitable to invest in two FIP units the station must cover 10 621 individuals. The investment options are due to the starting position for the rescue stations are of different kinds, i.e. some stations already have an effective FIP unit. For the station in question to take part of the division and time savings with two FIP units therefore a case scenario is presented with the investment option of one FIP unit. The conclusion is that it is economically viable to implement and use two FIP units for Sweden's emergency services depending on the proportion of the population of Sweden that the current station covers and what investment options that are of interest.

C. albicans est une levure pathogène opportuniste. Elle est un agent causal fréquent des infections muco-cutanées. C. albicans peut alterner entre la forme blastospore et mycélium. Cette dernière forme est impliquée dans la formation des biofilms. Le dimorphisme de C. albicans est contrôlé en partie par le phénomène de perception du quorum (quorum sensing) qui en autre, est associé à la molécule farnésol, produit par cette levure. La présence de cette molécule, inhibe la formation d’hyphe par C. albicans et par conséquent limite la formation de biofilms. Certaines souches ne répondent pas au farnésol et nous avons vérifié les hypothèses que : 1) la proportion des Non-Répondeurs (NR) au farnésol est similaire entre les souches de provenance orale et vaginale; 2) la capacité de formation de biofilm varie d’une souche à une autre mais les Non-Répondeurs en produisent en plus grande quantité; 3) la technique RAPD-PCR permettra de regrouper les souches de cette levure suivant leur provenance, leur capacité de formation de biofilm et leur aptitude à répondre au farnésol. La découverte d’une souche vaginale Non-Répondeur nous permet de croire que la proportion de ces souches est similaire entre les deux types de provenance. Les souches caractérisées Non-Répondeurs produisent 30 % plus de biofilm que les Répondeurs en absence de farnésol exogène dans le milieu. En présence de farnésol exogène, les Non-Répondeurs produisent 70 % plus de biomasse que les Répondeurs. De plus, la technique RAPD ne nous a pas permis de classer nos souches d’après les caractéristiques proposées. En conclusion, les souches orales de C. albicans semblent produire en moyenne plus de biomasse que les souches vaginales. Aussi, les NR semblent moins affectés par la présence du farnésol, ce qui pourrait causer la présence de biofilms tenaces. Les amorces utilisées pour la technique RAPD n’ont pas été efficace à la classification des souches dépendamment de leur provenance, de leur capacité à former un biofilm et à répondre au farnésol. Mots clés : Candida albicans, biofilm, perception du quorum (quorum sensing), farnésol, Non-Répondeur / The opportunistic dimorphic yeast Candida albicans is frequently associated with mucosal infections in humans. It can colonize both oral and vaginal mucous membranes. One of its virulence factors is the capacity to form or participate in biofilms formation. Biofilms are a community of bacteria embedded in a matrix of exopolysaccharide and provide protection against environmental stress and antibiotics. The dimorphic characteristic of this yeast is involved in biofilm formation and is controlled in part by the quorum sensing system. Recently, it has been shown that farnesol, a quorum sensing molecule, can control the formation of biofilms through the inhibition formation of hyphae. However, we have shown that some oral and vaginal strains can still form biofilms under the influence of exogenous farnesol and these strains were named Non-Responders (NR). We hypothesized that: 1) The proportion of Non-Responders is similar between oral and vaginal strains; 2) biofilm formation differs between strains but Non-Responders produce more of it; 3) The technique of RAPD-PCR will allow us to group strains according to their origin, biofilm formation and response to farnesol. The discovery of a NR vaginal strain leads us to believe that the proportion of NR is similar between oral and vaginal strains. The NR strains seem to produce 30 % more biofilm than Responders in media without exogenous farnesol. This percentage increased to 70 % when exogenous farnesol was added to the media. The RAPD technique did not allow us to group strains according to their proposed characteristic. In conclusion, oral strains seem to produce more biofilm than vaginal strains. The NR’s are less affected by farnesol and may cause persistent biofilms. The primers used for RAPD technique were not effective to discriminate C. albicans strains according to origin, capacity to form biofilms and farnesol responding. Key words: Candida albicans, biofilm, quorum sensing, farnesol, Non-Responders

Thesis (M.A.)--Naval Postgraduate School, 2008. / Description based on title page of source document ( viewed on April 23, 2008). Includes bibliographical references (p. 135-139).