Yes / A large proportion of children are not able to perform age-appropriate fundamental movement skills (FMS). Thus, it is important to assess FMS so that children needing additional support can be identified in a timely fashion. There is great potential for universal screening of FMS in schools, but research has established that current assessment tools are not fit for purpose. To develop and validate the psychometric properties of a FMS assessment tool designed specifically to meet the demands of universal screening in schools. A working group consisting of academics from developmental psychology, public health and behavioural epidemiology developed an assessment tool (FUNMOVES) based on theory and prior evidence. Over three studies, 814 children aged 4 to 11 years were assessed in school using FUNMOVES. Rasch analysis was used to evaluate structural validity and modifications were then made to FUNMOVES activities after each study based on Rasch results and implementation fidelity. The initial Rasch analysis found numerous psychometric problems including multidimensionality, disordered thresholds, local dependency, and misfitting items. Study 2 showed a unidimensional measure, with acceptable internal consistency and no local dependency, but that did not fit the Rasch model. Performance on a jumping task was misfitting, and there were issues with disordered thresholds (for jumping, hopping and balance tasks). Study 3 revealed a unidimensional assessment tool with good fit to the Rasch model, and no further issues, once jumping and hopping scoring were modified. The finalised version of FUNMOVES (after three iterations) meets standards for accurate measurement, is free and able to assess a whole class in under an hour using resources available in schools. Thus FUNMOVES has the potential to allow schools to efficiently screen FMS to ensure that targeted support can be provided and disability barriers removed. / ESRC White Rose Doctoral Training Partnership Pathway Award (ES/P000745/ 1). ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing funded by the Medical Research Council (grant reference MR/S037527/). National Institute for Health Research Yorkshire and Humber ARC (reference: NIHR20016).

Doctor of Philosophy / Department of Biological & Agricultural Engineering / Stacy L. Hutchinson and Kyle R. Douglas-Mankin / Ecohydrology, a sub-discipline of hydrology, deals with the ecological impacts of and interactions with the hydrological cycle. Changes in hydrology of the Great Plains rivers, and their impacts on water quality, water resources, aquatic ecosystems, and fish species distributions have been documented. The major goal of this study was to develop and test methods to analyze watershed-level ecohydrological characteristics. The specific objectives were (a) to detect past temporal trends and spatial variability in hydrologic indices, (b) to evaluate the presence and/or extent of spatial and temporal relationships between climatic and ecohydrological variables and riverine historical data on fauna species density and distribution, and (c) to assess model calibration strategies for accurate ecohydrological indicator simulation. The Kansa River Basin (KRB), which has substantial land use, soil and climate variability, as well as variation in anthropogenic drivers (dams, diversions, reservoirs, etc.), was the focus of this study. Thirty eight hydrological indicators were generated using the indicators of hydrologic alterations software for 34 stations in the KRB using 50-year streamflow records and trend analysis using Mann-Kendall, Seasonal Kendall, and Sen’s slope estimator tests. Across the KRB a decreasing trend was evident for annual mean runoff, summer and autumn mean runoff, 30-day, 90-day minimum flows, and 1-day, 3-day, 7-day, 30-day and 90-day maximum flows. Most of the significant negative trends were observed in the High Plains ecoregion. Two hydrologic indicators, high-flow pulse count and mean summer streamflow, were significantly different in streams that lost two indicator fish species, indicating that changes in streamflow have altered the fish habitat of this region. The Soil and Water Assessment Tool (SWAT) biophysical model calibrated using a multi-objective framework (multi-site, multivariable and multi-criteria) was able to simulate most of the ecohydrological indicators at different hydrological conditions and scales. The SWAT model provided robust performance in simulating high-flow-rate ecohydrologic indicators. However ecohydrologic indicators performance was highly dependent on the level of calibration and parameterization. The effect of calibration and parameterization on ecohydrologic indicators performance varied between watersheds and among subwatersheds.

Background. Long-term sick leave is one of the main risk factors for permanent exit out of the labour market. The longer the duration of sickness absence, the less likely sick leave conclusion. Objectives and Methods. The aims were to analyse possible determinants of sick leave conclusion and their relative impacts, to analyse the properties of two models for the assessment of sick leave conclusion, to study the impact of a multidisciplinary vocational intervention for sick leave conclusion in a high-risk group for long-term sick leave compared to a matched-control group, and to compare the patients’ own assessment on chance to sick leave conclusion within 6 months with the assessment of a team of rehabilitation professionals. A prospective cohort study of 943 patients aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden during 8 months in 2004, and follow-up for three years. Results. Significant determinants increasing time to sick leave conclusion were number of sick leave days the year before baseline, age and a psychiatric diagnosis (F in ICD-10). Concordance between actual sick leave conclusion and that predicted by a computer-based model was 73-76% during the first 28-180 days in a manual model, and approximately 10% units higher in a computer based model. Three nomograms provided detailed information on the probability on sick leave conclusion. Before intervention started, the rehabilitation group had a 73% higher sick leave conclusion rate than the control group but during the rehabilitation programme period, a 51% lower conclusion rate, and after there were no significant differences between the groups. The patients’ and the rehabilitation teams’ assessment scores were highly correlated (r=0.49).   Conclusions. Previous sick leave was the most influential variable associated with sick leave conclusion. A computer- based assessment model gave more detailed information on sick leave conclusion than a manual model. A multidisciplinary intervention declined sick leave in a high-risk group for long-term sick leave but after intervention there was no difference between groups. Patients’ own view on sick leave conclusion was highly correlated to the assessment of professionals’.

Det övergripande syftet var att beskriva och jämföra sjuksköterskors och underskö­terskors bedömningar av patienters smärta, näringstillstånd och hudkostym samt de­ras uppfattningar om att använda bedömningsinstrument. Vidare att beskriva sjuk­sköterskors och undersköterskors uppfattningar om hur de bedömer patienters smärta, näringstillstånd och hudkostym. Metod: Etthundrasjuttio pati­entjournaler granskades. Intervjuer med sjuksköterskor (n=9) och undersköterskor (n=9) genomfördes. Resultatet av sjuksköterskors (n=34) och undersköterskors (n=43) bedömningar jämfördes. Interbedömarreliabilitet undersöktes när sjuk­sköterskor (n=50) och undersköterskor (n=61) använde bedömningsinstrument.  Resultat: Sextio pro­cent av patientjournalerna vid inskrivningen och 78 % vid utskrivningen innehöll do­kumentation om patientens hudstatus. Det fanns dokumentation om trycksår i 15 % respektive 20 % av patientjournalerna. Patienter som var i risk för trycksårutveckling enligt Modifierad Nortonskala (MNS) erhöll i medeltal 4,6 omvårdnadsåtgärder och patienter som ej var i risk erhöll i medeltal 3,8. Det var inte några tydliga grän­ser för hur sjuksköterskor och undersköterskor genomförde bedömningar, vem som gjorde vad och på vilket sätt det gjordes. Det var inga skillnader mellan sjukskö­terskors och undersköterskors bedömningar av risk för undernäring och trycksår när det gäller poäng för initial bedömning och totalpoäng. Det var dock skillnader i deras bedömningar av enskilda delskalor och smärta. Sjuksköterskors och undersköterskors uppfattning om hur det var att använda bedömningsinstrument varierade. Inter­bedömarreliabiliteten avseende MNS, Short- Form Mini Nutritional Assessment och trycksårkortet varierade mellan och inom sjuksköterskegruppen och undersköterskegruppen. Konklusioner: Sjuksköterskor dokumenterar inte alltid bedömning av patienters hudkostym och risk för trycksårutveckling. Det är såväl likheter som skillnader mellan sjuksköterskor och undersköterskor när det gäller hur de genomför bedömningar och resultatet av deras bedömningar. Interbedömarreliabilite­ten mellan och inom sjuksköterske- och undersköterskegruppen varierar vid deras bedömning med olika bedömningsinstrument och trycksårkort. Ett viktigt led i arbetet med att säkerställa patientsäkerhet och hög vårdkvalitet är att vara steget före och fortlö­pande bedöma patienters smärta, näringstillstånd och hudkostym. / The overall aim was to describe and compare registered nurses’ (RNs’) and enrolled nurses’ (ENs’) assessments of pain, nutrition and skin and their perceptions of using assessment tools. Further to describe RNs’ and ENs’ perceptions of how they assess patients’ pain, nutrition and skin. Methods: One hundred and seventy patient records were reviewed for patients with hip fracture. Interviews were conducted with RNs (n=9) and ENs (n=9). Results of the RNs’ (n=34) and ENs’ (n=43) assessments of patients with hip fracture were compared. Interrater reliability was examined between and among RNs (n=50) and ENs (n=61) using assessment tools for assessments (n=228) of patients with hip fracture and stroke. Results: Sixty percent of patient records on admission and 78% at discharge had documentation of the patient’s skin status. Pressure ulcers were documented in 15% and 20% of patient records respectively. Patients at risk for developing pressure ulcers according to the Modified Norton Scale (MNS) received a mean of 4.6 nursing interventions, while those not at risk received a mean of 3.8. There were no established boundaries between RNs’ and ENs’ assessment who performed it and in what way it was done. There were no differences between RNs’ and ENs’ as­sessments of risk for malnutrition and pressure ulcer regarding screening or total scores. However, there were differences regarding their assessments on the subscales and patients’ pain.  RNs’ and ENs’ perceptions of using assessment tools varied. Interrater reliability regarding MNS total score was very good among RNs, good among ENs and between RNs and ENs. For Short- Form Mini Nutritional Assessment screening score, interrater reliability was good between RNs and ENs and among RNs, while it was moderate among ENs. Interrater reliability between and among RNs and ENs varied for Pressure Ulcer Card. Conclusions: RNs do not always document assessment of patients’ skin and risk for pressure ulcer. Patients at risk for pressure ulcers receive more nursing interventions than patients not at risk. There are both similarities and differences between RNs and ENs regarding how they perform their assessments and what the results of their assessments are. Interrater reliability between and among RNs and ENs varies regarding the different assessment tools. An important part of the work in establishing patient safety and high quality of care is to be one step ahead and continuously assess the patients’ pain, nutrition and skin.

Master of Science / Department of Biological and Agricultural Engineering / Kyle R. Douglas-Mankin / Aleksey Y. Sheshukov / According the U.S. Environmental Protection Agency’s (EPA) website, our planet is at risk of global warming due to greenhouse gas emissions. The earth’s average temperature has been reported to have risen by 1.4°F over the last century. This seemingly small increase in average planetary temperature has been linked to devastating floods, severe heat waves, and dangerous and unpredictable shifts in our climate (US EPA, 2013a). In the 2012 report, the Intergovernmental Panel on Climate Change states that bioenergy has the potential to significantly mitigate greenhouse gases as long as this is produced in a sustainable manner (Chum, et al., 2011). In light of these facts, research into the sustainable production of bioenergy sources in the United States is currently underway. To ensure that the correct biofuel crop is selected for a given region and to investigate any secondary effects of changing our nation’s agricultural practices to include biofuels, computer models can be very useful. The Soil Water Assessment Tool (SWAT) is a robust, continuous time step model that was developed by the USDA Agricultural Resource Service that can simulate changes in land use and land management and the effect this has on erosion, water quality, and other important factors. This paper describes the preliminary work to create a model of the Kanopolis Lake Watershed that is part of the Kansas River Basin using SWAT 2009. Data pertaining to weather, topography, land use, management, stream flow, and reservoirs was gathered and incorporated into the SWAT model. This was then simulated to obtain the uncalibrated data. SWAT produced unacceptable statistics for both crop yields and for stream flow using the Nash-Sutcliffe Efficiency equation and using percent bias. This suggests that the model must be calibrated to be of use in understanding both the current and future land use scenarios. Once the model is calibrated and validated, it can be used to simulate different biofuel cropping scenarios.

Doctor of Philosophy / Department of Family Studies and Human Services / Bronwyn S. Fees / Positive child outcomes are related to high quality child care environments as evidenced through longitudinal studies (Campbell, Ramey, Pungello, Sparling, & Miller-Johnson, 2002; The National Institute of Child Health and Human Development [NICHD] Early Child Care Research Network, 2005; Schweinhart, Montie, Xiang, Barnett, Belfield, & Nores, 2005). These findings are important particularly for young children from low-income families. As these children are commonly the recipients of child care by a relative, high quality relative care is essential (U. S. Census Bureau, 2005; Brown-Lyons, Robertson, & Layzer, 2001; Collins & Carlson, 1998; Ehrle, Adams, & Tout, 2001). Prior research on the quality of care provided by relatives has been limited, inconsistent, and inconclusive due to differing methodological approaches. Previous studies have often grouped relative child care providers along with other home-based care settings; however, they are not the same. Previous studies have also employed a variety of measurement tools to assess quality. This study examined the overall quality of care in relative child care settings using a tool specifically designed for relative child care, comparing the quality of care and motivations for care between subsidized and non-subsidized settings. Overall, findings were consistent with results of previous studies on kith and kin or relative child care providers in that 1) a wide range of quality of care was observed among both subsidized and non-subsidized settings; 2) no differences were observed between quality in subsidized and non-subsidized; 3) no differences were observed between quality of care based on motivation for providing care. The majority of providers will provide care for family regardless of availability of payment; however, subsidized providers were more family-oriented in their motivation compared to non-subsidized who more child-oriented. While all levels of care were observed in both infant/toddler and preschool settings, infant/toddler settings scored higher on all adult-child interaction variables. These settings were also observed to be safer than preschool settings. Also subsidy status alone does not necessarily increase or affect quality of the care as payment is not the primary motivation for care. Policymakers should, therefore, explore other means by which to enhance quality such as equitable subsidy rates across home-based settings and support programs for this population.

Les éco-quartiers contribuent, depuis la fin du XXe siècle, à l'essor d'un modèle de ville durable à travers le monde. Cependant, si les grands principes théoriques du développement durable font relativement consensus à l'échelle internationale, les modalités de leur application au niveau local sont multiples et diverses. Suite à ce constat, de nombreux acteurs déploient dès la fin des années 2000 des référentiels de suivi et d'évaluation des éco-quartiers. Ces derniers permettent d'orienter la conception et la construction des quartiers durables tout en justifiant les choix retenus, et ce grâce à la mesure de leur performance selon plusieurs critères consensuels et mesurables dans le temps. Ces référentiels, conçus à l'échelle locale et souvent standardisés, sont en outre susceptibles d'être exportés à l'international, indépendamment du milieu naturel et culturel dans lequel ils s'appliquent. Ceci représente un paradoxe vis à vis du concept de développement durable qui promeut l'intégration des projets à un territoire spécifique. Aussi, le travail de thèse interroge l'impact des référentiels d'évaluation sur l'intégration territoriale des éco-quartiers au travers de l'analyse de trois études de cas en France, aux Etats-Unis et au Brésil: Clichy Batignolles localisé à Paris et labellisé EcoQuartier, Melrose Commons développé à New York et certifié LEED-ND, et llha Pura construit à Rio de Janeiro à la fois certifié LEED-ND et AQUA -HQE-A. Notre étude examine également succinctement un quatrième cas, le quartier de Vinhomes Riverside ayant reçu le prix de l'architecture ve1te du Vietnam et construit à Hanoï, dont l'étude n'a pu être complètement aboutie faute d'accès à des données essentielles à notre analyse. Nous énonçons le postulat qu'il existe des divergences entre les objectifs de performance fixés par le référentiel, ceux exigés par les acteurs du projet menant à une évaluation donnée, et enfin la réalité de l'éco-quartier une fois construit au sein d'un territoire plus large. Ces divergences sont particulièrement fortes en cas d'export du référentiel. Elles sont en outre mesurables et témoignent de différences de niveau d'intégration. Aussi, notre recherche s'appuie sur la comparaison des cas selon trois phases à savoir: 1) le choix du référentiel 2) l'évaluation du projet d'éco-quartier par le référentiel dont il estime la performance, et enfin 3) le résultat opérationnel, c'est à dire l'éco­quartier construit. La méthodologie de recherche est multidisciplinaire et déploie des outils associés aux statistiques, à l'ingénierie du territoire, à la géographie, mais aussi à l'analyse architecturale, urbaine et paysagère. Nous observons que les référentiels s'appuient sur diverses stratégies relatives à la sélection et à la mesure d'indicateurs permettant de planifier l'intégration du quartier au sein d'un territoire donné. Cette intégration est néanmoins extrêmement variable non seulement en fonction des critères et des échelles d'analyse choisis, mais aussi des jeux d'acteurs qui adaptent leur démarche aux spécificités d'un site. Les référentiels d'évaluation occultent alors la complexité, et sous-estiment la richesse de la diversité des éco-quartiers contemporains. / Since the end of the 20th century, eco-neighborhoods have contributed to the international development of a sustainable city paradigm. However, while the concept of sustainable development is today the result of an international consensus, its urban applications at the local level are multiple and diverse. Following this observation, many stakeholders have designed neighborhood sustainability assessment tools (NSAT) in the past ten years. The latter contribute to the design and construction of sustainable neighborhoods while justifying stakeholders choices. Those tools also measure the eco-neighborhood performance, using several consensual and measurable criteria over time. Moreover, NSA T which are locally designed and often standardized, are likely to be exported internationally. However, internationally exporting a NSAT designed locally is paradoxical, in relation to sustainable development principles. Our research examines the impact of NSAT on eco-neighborhoods' territorial integration. It analyses three case studies located in France, the United States and Brazil. Clichy Batignolles was developed in Paris and received the EcoQuartier label. Melrose Commons was built in New York and is LEED-ND certified. Ilha Pura is located in Rio de Janeiro, and is both LEED-ND and AQUA-HQE-A certified. Our study also briefly examines a fow1h case. Vinhomes Riverside was built in Hanoi, and received the Vietnam Green Architecture Award. However, our analysis could not be completed due to the Jack of access to essential data. From the data we do have, we extrapolate that there are discrepancies between the objectives set by the NSA T, those requested by the project's stakeholders leading to a given assessment, and finally the reality of the built eco­neighborhood. These discrepancies are more important when the NSA T has been exported. They are also measurable, and enlighten different levels of projects' territorial integration. Our research is based on the comparison of the cases. This comparison is following three steps: 1) analyzing the chosen NSA T 2) studying the eco-neighborhood performance score and 3) analyzing the built project. Our methodology is multidisciplinary and uses tools related to statistics, territorial engineering, geography, and architectural, urban and landscape analysis. We conclude that NSAT use various strategies related to the selection and measurement of indicators to integrate a neighborhood within a given territory. However, this integration is extremely variable. This is not only due to criteria and scale selection, but also to stakeholders who adapt their strategies to their territory. Finally, NSAT conceals urban complexities, and underestimates the diversity of contemporary eco-neighborhoods.

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to implement the necessary cultural change for effective deployment of PERT and MIAHTAPS. MIAHTAPS, with PERT as an integral component, was used by the primary nurse on admission and during every care shift to assess patients' potential for violence. Pre- and post- intervention assessments were completed to determine the effectiveness of the intervention. Quantitative and open-ended question responses from 200 nurse participants, who completed the 2 online surveys, were analyzed using descriptive and frequency distributions. Findings from the project showed that nurses could identify patient potential for violence and recognize how to diffuse situations effectively 34% of the time, compared to 14% before PERT. A post-implementation survey showed that 75% of the nurses found the MIAHTAPS and PERT system useful and easy to use. Having an easy-to-use tool that helps to identify potential for violence will help hospital and other workplace staff to develop and implement preventive interventions and as a result promote positive social change.

La contamination des eaux marines par les apports terrigènes induit de nombreuses perturbations biogéochimiques. La conséquence la plus marquante de ces apports est très certainement le phénomène d'eutrophisation des masses d'eau côtières résultant de l'apport excessif de nutriments et accentuant les efflorescences algales. Néanmoins, la contribution des bassins versants ainsi que l'origine des polluants incriminés restent généralement difficiles à évaluer finement à partir des mesures intermittentes ponctuelles issues des réseaux de surveillance, particulièrement dans le cas d'émissions diffuses. Dans ce cadre, le recours à la modélisation des bassins versants apparaît comme une solution complémentaire pertinente en termes de gestion, notamment de par les possibilités de scénarisation qu'elle offre. En s'appuyant sur un site d'étude localisé en Bretagne Sud, constituant le principal hydrosystème à alimenter le Golfe du Morbihan, le modèle Soil and Water Assessment Tool a été mis en oeuvre sur une période de six ans. Dans une optique opérationnelle, des protocoles de paramétrage ont été établis à partir de référentiels de données courants et différents utilitaires ont été développés afin de favoriser l'exploitation autonome de cet outil par les gestionnaires en charge du suivi et de la gestion des eaux littorales. Cette implémentation a notamment permis de quantifier de manière continue les apports nutritifs terrigènes et d'en déterminer les principales origines. Ainsi, l'identification des bassins versants élémentaires les plus contributeurs, peut constituer un appui pour la désignation de secteurs d'intervention prioritaires pour les actions de reconquête de la qualité des masses d'eau de l'hydrosystème alréen.

The present project is a first step towards a new Swedish assessment tool to examine phonological ability in preschool-aged children. The work consisted of developing a word list with words that was considered to reveal a child’s phonological ability and to try out the word list on pre-school children. The reason was to make sure that the words existed in the vocabulary of the children in the chosen ages. A word list consisting of 109 words, which convey relevant phonological information, was created. Every phoneme in the Swedish language is represented at least twice in initial, medial and final word position. The majority of the consonant clusters, which are allowed in the Swedish language, are included. Also words consisting of three or more syllables, words consisting of an initial unstressed syllable and both of the tonal word accents used in the Swedish language, are included in the wordlist. The 85 children who participated in the present study was 3;0-5;11 years old and their task was to name the pictures of the material. The children were divided into six half-yearly intervals. The result showed that the children’s ability to name the pictures was improved with increased age. The children in the youngest interval (3;0-3;5) named a mean of 92 pictures correctly, while children in the oldest interval (5;6-5;11) named a mean of 107 picture. The authors decided that words which were produced by at least 80% of the children in an interval were judged to be appropriate for the current age. Consequently, 79 of the 109 words were judged to be appropriate for children in interval 1. Among these 79 words, there are words which represent the majority of the phonological aspects that a phonological assessment tool should comprise. / Föreliggande uppsatsarbete utgör ett första steg i utformandet av ett nytt svenskt bedömningsmaterial för fonologisk förmåga hos barn i förskoleåldern. Arbetet bestod av att välja ut ord som kan anses ringa in ett barns fonologiska förmåga samt att testa dessa på barn i förskoleåldern, för att säkerställa att orden finns i det aktiva ordförrådet hos barn i aktuella åldrar. En ordlista bestående av 109 ord, som bär på relevant fonologisk information, skapades. Samtliga svenska fonem finns representerade minst två gånger i initial, medial och final ordposition. Dessutom ingår majoriteten av konsonantförbindelser, som är tillåtna enligt svensk fonotax, i de utvalda orden. Även ord med tre eller fler stavelser, ord innehållande pretonisk stavelse samt svenska språkets båda tonaccenter är representerade. Orden illustrerades med bilder från Boardmaker. De 85 barnen som deltog i studien var 3;0-5;11år och fick benämna samtliga bilder i materialet. Barnen delades in i sex halvårsintervall. Resultaten visade att barnens förmåga att benämna bilderna förbättrades med stigande ålder. Medelvärdet för antalet korrekt benämnda bilder för barnen i det yngsta åldersintervallet (3;0-3;5 år) var 92, medan motsvarade siffra för de äldsta barnen (5;6-5;11år) var 107. Författarna beslutade att ord som minst 80% av barnen i ett åldersintervall producerade, kunde anses som användbara i ett test för barn i den aktuella åldern. Därmed ansågs 79 av de 109 orden som användbara från och med åldersintervall 1. Bland de 79 orden finns ord som representerar majoriteten av de fonologiska aspekter som ett fonologiskt bedömningsmaterial bör förmedla.