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Diabetic foot ulcers (DFUs) impart a large burden on patients and the healthcare system in Canada. Health utility estimates are an integral part of determining the cost-effectiveness of treatments for DFUs. The objective of this thesis was to identify health utility estimates for patients with non-healing DFUs. A systematic review of studies reporting health utility estimates for non-healing DFUs was conducted and included nine studies. The quality of the studies, as it related to the health utility estimates for non-healing DFUs, was difficult to determine due to a lack of reporting of study and patient characteristics. The health utility estimates ranged from 0.44 to 0.89. None of the studies investigated for factors associated with the health utility of patients with non-healing DFUs. In addition, an exploratory regression analysis of data from a randomized controlled trial (RCT) of hyperbaric oxygen therapy (HBOT) in patients with chronic, non-healing DFUs was conducted. No factors were identified that were associated with health utility; however, the sample size was small and the analysis exploratory. Further research is required to identify such factors. Finally, a descriptive regression model, including several baseline factors, was created which provided a heath utility estimate of 0.647 for Canadian patients with non-healing DFUs; however, the results should be interpreted with caution, especially as some subgroups had very small numbers of patients (e.g., Wagner Grade of 4; patients with 4 or more wounds). In summary, guidance is lacking on the best methodology to conduct and analyze studies that provide estimates of the health utility of patients with non-healing DFUs, or any other health state, that are to be used to inform economic evaluations. Additionally, a tool is needed to aid analysts in critically appraising studies so that they can select the best estimate of health utility value to include in economic evaluations. / Thesis / Master of Health Sciences (MSc) / Diabetic foot ulcers (DFUs) impart a large burden on patients and the healthcare system in Canada. The objective of this thesis was to identify health utility estimates for patients with non-healing DFUs. A systematic review was conducted and included nine studies, for which health utility estimates ranged from 0.44 to 0.89. An exploratory regression analysis of data from an Ontario-based study in patients with non-healing DFUs was conducted. No factors associated with health utility were identified but further research is required. A descriptive regression model, adjusting for several baseline factors, provides a health utility of 0.647 for Canadian patients, but should be interpreted with caution. Guidance is needed on the best methodology to conduct studies to estimate the health utilities for use in economic evaluations and for a tool to critically appraise studies to help select the best estimate of health utility for inclusion in economic evaluations.

With the importance of versatility in freelance work in the world of trombone performance, along with increased competition for that work, the need for players to play alto, tenor, and bass trombones to a high level of proficiency has become more and more crucial. This, coupled with the growing number of orchestras looking to hire musicians who are highly competent on all three instruments means that university professors need to be able to teach all three instruments. This evolution of the job market is driving a need for pedagogical material that is specifically designed to address the unique challenges of practicing and performing at a professional level on the main three instruments in the trombone family. As of the time of writing, this material simply does not exist. This project aims to fill that instructional gap. It gives students and teachers a resource that outlines an approach for a four-year undergraduate course of study that allows for the development of the playing of each of the trombones individually and collectively, utilizing the strengths of one instrument to develop the other two. It will also allow for the exploration of the technical challenges that arise when playing and changing between instruments. This four-year course of study combined with a clear explanation of numerous routines can be used from early in a student's development. It can be tailored to their specific needs and will give any teacher and student a comprehensive and holistic method for the acquisition of the skills needed to become a successful utility trombonist.

While perhaps the most recognizable hallmark of David Hume's moral philosophy is his commitment to an anti-rationalist theory of ethics, I argue that Hume came to reject this position found the Treatise of Human Nature (1739) in his later Enquiry Concerning the Principles of Morals (1751). In the Treatise, Hume endorses the view that reason is wholly inactive and cannot be the source of our sense of morals. According to the Treatise, our human reasoning does not give rise to the feelings of pleasure that we associate with an action being right. Instead, the determination we make that an action is right arises from feelings of approval that are rooted solely in natural sympathy and fellow-feeling, and these feelings never arise from reason. Yet, I argue that in the Second Enquiry, Hume abandons these anti-rationalist commitments and allows rational judgments of utility to give rise to the sentiments that ultimately approve our actions. In this paper, I argue for two claims about the role of reason in Hume's moral philosophy. First, I argue that in the Treatise, Hume is committed to a strong form of anti-rationalism where reason has no role in the process in which we approve/disapprove actions that are right or wrong. Second, I argue Hume moves away from these strong anti-rationalist commitments in the Treatise to a version of his moral theory where reason plays a role in making determinations of morality by allowing rational judgments of utility to give rise to the sentiments that approve actions. Finally, I argue that Hume makes these changes in the Second Enquiry to rule out an egoistic interpretation of his theory, and by accepting a rationalistic sentimentalism, Hume can defend his moral theory from an egoistic interpretation and prevent his system from collapsing into egoism. / Master of Arts / In the Treatise of Human Nature (1739) and the Enquiry Concerning the Principles of Morals (1751), the Scottish philosopher David Hume argued for a moral theory where the rightness or wrongness of any action could be determined by our feelings of pleasure or pain that we feel when we have an idea of that action. While contemporary historians of philosophy agree that in the earlier Treatise version of his theory Hume did not allow these feelings associated with moral rightness to arise from reason, I argue that Hume fundamentally changed his theory in the later Second Enquiry to do just that. In particular, I argue that in the Treatise, Hume did not believe that our feelings about rightness or wrongness could arise from rational judgments. Nevertheless, in the Second Enquiry, Hume changed is theory to allow rational judgments about what is useful to give rise to those moral feelings. I then conclude that Hume made these changes to his theory to prevent his moral philosophy from reducing to a theory where only those actions that are in my self-interest could be considered morally right.

This paper compares two technologies, Public Key Infrastructure (PKI) and Virtual Private Network (VPN). PKI and VPN are two approaches currently in use to resolve the problem of securing data in computer networks. Making this comparison difficult is the lack of available data. Additionally, an organization will make their decision based on circumstances unique to their information security needs. Therefore, this paper will illustrate a method using a utility function and the Analytic Hierarchy Process (AHP) to determine which technology is better under a hypothetical set of circumstances. This paper will explain each technology, establish parameters for a hypothetical comparison, and discuss the capabilities and limitations of both technologies. / Master of Arts

ELABORATIONS ON MULTIATTRIBUTE UTILITY THEORY DOMINANCE By David L. Vairo A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2019. Major Director: Dissertation director’s name, Dr. Jason Merrick, Supply Chain Management and Analytics Multiattribute Utility Theory (MAUT) is used to structure decisions with more than one factor (attribute) in play. These decisions become complex when the attributes are dependent on one another. Where linear modeling is concerned with how factors are directly related or correlated with each other, MAUT is concerned with how a decision maker feels about the attributes. This means that direct elicitation of value or utility functions is required. This dissertation focuses on expanding the types of dominance forms used within MAUT. These forms reduce the direct elicitation needed to help structure decisions. Out of this work comes support for current criticisms of gain/loss separability that is assumed as part of Prospect Theory. As such, an alternative to Prospect Theory is presented, derived from within MAUT, by modeling the probability an event occurs as an attribute.

Abstract Given that most utilities are located beneath public right of ways, it is difficult to perform repairs to the utility without significantly disturbing the existing roadway. Currently there are several standard orders of procedure that deal with small-scale repairs on asphaltic surfaces. This study investigates the use of Grade D Aggregate as a backfill during a utility repair versus the condition of the repair. Five East Tennessee utilities provided a total of 60 utility repair locations over three years of age; 30 of which incorporated Grade D Aggregate and 30 incorporated #57 Stone. The Tennessee Department of Transportation specifies a smoothness criterion of the roadway to regulate any deviation of the surface of the roadway greater than ¼ inch over a 12-foot span. The parameters measured during this study include smoothness, condition of the asphalt topcoat, adjacent stress cracking, depth of repair and disturbed surface area. Multiple linear regression and analysis of variance tests were used to analyze the results. Results suggest that there is no difference between using and not using Grade D Aggregate except with failures of one inch or greater. The results also suggest that there is little to no relationship between roadway characteristics and the performance of the repair except with failures one inch or greater. There is a correlation between slope and failures that had a deviation of one inch or greater. The results suggest that Grade D Aggregate performs better when significant failures occur. Recommendations include implementation of a cutback area, development and implementation of installation guidelines within the municipality, and implementation of a maintenance program that will address the repair cut failures in a timely manner.

博士（経営） / 85 p. / 一橋大学

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Homeownership is both an individual and society objective, because of the positive neighborhood effects associated with areas of higher homeownership. To help realize these positive effects, the Mexican government has several programs directed to increasing homeownership. Many factors, however, may influence homeownership including shocks experienced by households. Shocks such as death in family, illness or accidents, unemployment, and business, crop, or livestock loss affect homeownership if households are unable to cushion the impact of the shock. Government income support programs, however, may help cushion the effect of a shock. The main objective is to determine how shocks that households’ experience and government income support programs influence homeownership in Mexico. A secondary objective is to determine how socio-demographic variables influence homeownership in Mexico. Based on the Random Utility Model, logit models of homeownership are estimated using data are from the 2002 Mexican National Survey on Living Levels of Households. Two models are estimated; with and without income. Income is excluded because of a large number of households that did not report income. Generally, inferences from the two models are similar. Homeownership appears to not be affected by shocks experienced by households. It appears households are able to cushion the impact of shocks. The two income support programs, the Program of Direct Rural Support of Mexico (PROGRESA) and the Program of Direct Rural Support of Mexico (PROCAMPO), appear to be increasing homeownership. These social welfare programs provide cash transfers to households. For whatever reason, PROGRESA has a larger effect on homeownership than PROCAMPO. Households with older heads have a larger probability of being a homeowner than households with younger heads. No statistically significance relationship exists between education and homeownership. Regional differences are seen in homeownership, with households located in the northwest region having a higher probability of homeownership than other regions. Differences in the significance of variable representing the household head’s gender, marital status, and occupation on homeownership exist between logit models that include and do not include current income. The most likely reason for these differences is interactions between the variables and a wealth effect.