Access to affordable high-quality health care solutions is a global challenge, especially in emerging markets where health care systems are the most resource constrained. The socio-economic benefits of investing in health care are considerable, especially in terms of improvement of life quality and economic development. This creates a strong demand for efficient health care delivery models with good health outcomes. In particular, health programs targeting children in their formative years can have a longlasting effect on the children’s and their families’ lives. In India, which has one of the highest burdens of disease in the world, many states lack adequate school health programs. To address this need, the NICE Foundation has developed a school health program that provides free health care to over 200,000 children. The NICE Foundation has experienced a great interest in their school health model and thus aims to expand their operations. This study analyses the characteristics of the school health program in order to identify future opportunities and to provide strategic advice for the expansion of the NICE Foundation School Health Program. / Tillgång till prisvärd och högkvalitativ sjukvård är en global utmaning, i synnerhet i tillväxtländer där sjukvårdssystemen  är mycket  resursbegränsade.  De socio-ekonomiska  fördelarna  av att investera  i sjukvård  är avsevärda,  med förbättrad  livskvalitet  och ekonomisk  utveckling  som följd.  Det  finns  därför  en  stor  efterfrågan  på  effektiva  hälsomodeller  som  renderar  goda hälsoresultat.   Särskilt  hälsoprogram   som  är  inriktade  på  barn  i  deras  formativa  år  har dokumenterats ge långtgående positiva effekter för individerna och samhället. I Indien, som har en  av  de  högsta  nivåerna   av  sjukdomsbörda   i  världen,   saknar  många  av  delstaterna skolhälsoprogram.   För   att   addressera   detta   behov   har   NICE   Foundation   utvecklat   ett skolhälsoprogram   som  i  nuläget  erbjuder  gratis  sjukvård  för  över  200  000  barn.  NICE Foundation  skolhälsomodell  har  fått  mycket  positiv  respons  och  organisationen  ämnar  att expandera  programmet.  Denna  studie  analyserar  NICE  Foundation  skolhälsomodell  för  att identifiera framtida möjligheter samt för att tillhandahålla strategiska råd för expansion.

The evaluation of discrete processes are performed for industrial and healthcare processes. Count data may be used to measure the number of defective items in industrial applications or the incidence of a certain disease at a health facility. Another classification of a discrete random variable is for binary data, where information on an item can be classified as conforming or nonconforming in a manufacturing context, or a patient's status of having a disease in health-related applications. The first phase of this research uses discrete count data modeled from the Poisson and negative binomial distributions in a healthcare setting. Syndromic counts are currently monitored by the BioSense program within the Centers for Disease Control and Prevention (CDC) to provide real-time biosurveillance. The Early Aberration Reporting System (EARS) uses recent baseline information comparatively with a current day's syndromic count to determine if outbreaks may be present. An adaptive threshold method is proposed based on fitting baseline data to a parametric distribution, then calculating an upper-tailed p-value. These statistics are then converted to an approximately standard normal random variable. Monitoring is examined for independent and identically distributed data as well as data following several seasonal patterns. An exponentially weighted moving average (EWMA) chart is also used for these methods. The effectiveness of these methods in detecting simulated outbreaks in several sensitivity analyses is evaluated. The second phase of research explored in this dissertation considers information that can be classified as a binary event. In industry, it is desirable to have the probability of a nonconforming item, p, be extremely small. Traditional Shewhart charts such as the p-chart, are not reliable for monitoring this type of process. A comprehensive literature review of control chart procedures for this type of process is given. The equivalence between two cumulative sum (CUSUM) charts, based on geometric and Bernoulli random variables is explored. An evaluation of the unit and group--runs (UGR) chart is performed, where it is shown that the in--control behavior of this chart is quite misleading and should not be recommended for practitioners. / Ph. D.

Plastic was initially designed to enhance human well-being, but now it has become a threat to us and the planet. The plastic industry faces significant scrutiny due to the sustainability challenges associated with plastic products. The purpose of this study is to understand how organisations in the plastic industry manage its legitimacy and ensure the industry's survival. We employ organisational legitimacy as a lens and the three pillars of institutions - regulative, normative, and cultural-cognitive - as an analytic framework, to understand the roles of legitimacy in shaping an organisation's sustainability practices. Site Zero, Europe's largest plastic packaging waste sorting facility in Motala, Sweden has caught our attention. Utilising a qualitative research strategy and a case study research design, this paper explores how the multifaceted nature of legitimacy impacts Site Zero on its sustainability practices. Besides the site visit, we have conducted seven semi-structured interviews with five key members of Swedish Plastic Recycling and two material experts from a public agency and a producer responsibility organisation. Through this case study, we conclude that there is a gap between legitimacy and sustainability. Pursuing legitimacy increases the chance of organisations' survival in the plastic industry, however, it may also hinder them from achieving sustainability. Additionally, while high-quality recycling plays a crucial role in handling plastic packaging waste, it has its limitations in making plastic sustainable with the current profit-driven market and an overconsumption lifestyle.

Wikipedia umschreibt die Topologieoptimierung als ein computerbasiertes Berechnungsverfahren, durch welches eine günstige Grundgestalt (Topologie) für Bauteile unter mechanischer Belastung ermittelt werden kann. Durch die Verwendung von 3D-Druck-Verfahren wird die Gestaltung der Komponenten revolutioniert, weil diese nicht mehr abhängig vom Fertigungsverfahren sind. Dabei werden auch optimale Gitterstrukturen innerhalb der Komponenten immer wichtiger. Diese neuen Herausforderungen können im Creo Umfeld mit ProTopCI (Hersteller CAESS, PTC Partner Advantage, Silver) elegant gelöst werden. Im Vortrag (mit Live-Demonstration) werden die neuen Möglichkeiten dieser innovativen Lösung beleuchtet: Modellerzeugung in Creo Simulate (FEM-Mode): - Verschiedene Lastfälle, - Kontakte, - Schraubenverbindungen, - CAD-Geometrie, - zu optimierende Bereiche, ... Technologische Randbedingungen zur Berücksichtigung des Fertigungsverfahren Innovatives Erzeugen/Optimieren der Gitterstrukturen Glätten, Exportieren der optimierten Geometrie

Syftet med studien är att få en förståelse för vad kvalitet är i förskolan. Barnkonventionen säger att allt som rör barnet ska se till barnets bästa. Vi runt omkring barnet har olika erfarenheter och kunskaper, vilket gör att vi kan bidra med det bästa till barnet. Att kunna samarbeta med barnets vårdnadshavare, för att barnet ska kunna utvecklas rikt och mångsidigt, är viktigt för att vi ska kunna ge barnet rätt start i livet med de bästa förutsättningarna. Studien genomfördes genom en kvalitativ undersökning där empirin samlades in genom brevdata. Pedagoger, förskolechefer och vårdnadshavare fick svara på två öppna frågor om deras syn på vad kvalitet i förskolan är. Slutsatsen blev att kvalitet i förskolan är ett begrepp som inte går att slutgiltigt definiera. Kvalitet måste sättas i förhållande till något när man ska beskriva det, det måste ses från flera olika dimensioner. Det som definierar kvalitet beror på flera olika faktorer, däribland kulturella skillnader, normer och värden, kunskap om ämnet, vilken filosofi förskolan har, personalens kompetens och ekonomiska förutsättningar. / The purpose of the study is to get an understanding of what quality is in kindergarten. The Convention says that everything related to the child to see the child. We are around the child have different experiences and knowledge, which allows us to provide the best for the child. Being able to work with the child's guardian for the child to develop rich and diverse is important for us to give the child the right start in life with the best conditions. The study was conducted through a qualitative survey of the empirical data was gathered through letters data. Educators, preschool managers and guardians were asked to answer two open questions about what they considered to be quality in preschool. The conclusion was that quality in preschool is concepts that cannot be conclusively define. Quality must be in relation to something when describing it, then it must be viewed from several different dimensions. What defines quality depends on several factors, including cultural differences, norms and values, knowledge of the subject, the philosophy of pre-school, staff skills and economic conditions. / <p>Godkännandedatum: 2016-06-05</p>

Au cours de ces dernières années, les chercheurs ont démontré l’importance de l’accordabilité dans les systèmes de télécommunications fonctionnant pour des multiples bandes de fréquences, afin de réduire leur complexité et leur coût. Ce travail se focalise sur des filtres innovants accordables optiquement et propose ainsi une solution alternative aux méthodes plus classiques comme les MEMS ou les diodes. Cette thèse retrace la conception de trois résonateurs pouvant être de bons candidats à intégrer dans le système accordable optiquement développé au travers du manuscrit. Ces éléments sont conçus par le biais de différentes technologies comme : la technologie « Substrate Integrated Waveguide » combinée avec un effet dit métamatériau et la méthode de cavité chargée par un plot capacitif. Tous ces résonateurs ont été créés dans le but d’avoir des performances intéressantes pour trois critères : le facteur de qualité à vide (Q0), la plage d’accord (TR) et la taille. La dernière partie, quant à elle, se consacre au système d’accordabilité basé sur l’utilisation de capacité CMS et de switches RF contrôlés optiquement et fabriqués à l’aide de la technologie silicium CMOS. Plusieurs méthodes ont été utilisées afin d’améliorer les pertes d’insertion des switches RF et par conséquent les performances du système global, démontrant la faisabilité de ce concept innovant accordable optiquement. / Researchers have demonstrated over the last decade the importance of tunability to reduce the complexity and the cost of telecommunication systems operating at multiple frequency bands and standards. This work focuses on novel optically tunable filters for microwave applications and therefore proposes alternative solution to commonly used tuning methods such as MEMS or diodes. The thesis has investigated different resonators for having good candidates for the novel optically tunable system developed throughout this manuscript. Different technologies are used to design such components, namely: Substrate Integrated Waveguide (SIW) technology combined with metamaterial effect and cavity loading. All manufactured resonators are designed to be balanced between three features: the unloaded quality factor (Q0), the tuning range (TR) and the size. The last part deals with the tuning system based on SMT capacitance and optically controlled RF switches based on Si CMOS technology. Several methods have been used to improve the insertion loss of manufactured switches and therefore the performance of the whole system, demonstrating the feasibility of this novel optically based tunable concept.

El presente trabajo de investigación analiza los aspectos más importantes de las madres actuales respecto al cuidado de sus hijos en edades pequeñas. Principalmente, por el cuidado y protección que los niños necesitan en su ropa. Diferentes estudios demuestran que padres con hijos entre las edades de 0 a 5 años invierten mucho dinero en la vestimenta, es ahí donde se encontró una necesidad insatisfecha y nuestra propuesta es ofrecerles un producto innovador y de más alta calidad sin dejar de lado la protección a los niños antes las caídas y suciedades que están expuestos. Al mismo tiempo que contribuimos con la economía familiar y el cuidado del medio ambiente. Se han realizado estudios de mercado y entrevistas a los clientes con la finalidad de conocer los factores determinantes que influyen en la decisión de compra de ropa para niños. Así mismo, se analizó el mercado y determinó con claridad el nicho al cual queremos llegar. Finalmente se realizó un estudio del plan de marketing que permitirá constituir la empresa, además de diseñar el plan de operaciones, estrategias y financiamiento del proyecto. / This research work analyzes the most important aspects of current mothers regarding the care of their children at young ages. Mainly, for the care and protection that children need in their clothes. Different studies show that parents with children between the ages of 0 to 5 years invest a lot of money in clothing, this is where an unmet need was found and our proposal is to offer them an innovative and higher quality product without neglecting the protection children before the falls and dirt that are exposed. At the same time we contribute to the family economy and the care of the environment. Market studies and interviews with clients have been conducted in order to know the determining factors that influence the decision to purchase children's clothing. Likewise, the market was analyzed and clearly determined the niche we want to reach. Finally, a marketing plan study was carried out that will allow the company to be established, as well as designing the project's operations, strategies and financing plan. / Trabajo de investigación

Les microrésonateurs à mode de galerie passifs à base de cristal ou de verre fabriqués par la méthode de fusion possèdent un facteur de qualité limité à quelques 10E8. Ceci est généralement dû à la contamination de la surface du résonateur lors de sa fusion. Dans ces travaux, nous proposons de contourner cette limitation en utilisant des microrésonateurs actifs pour compenser les pertes. Afin de caractériser les microrésonateurs actifs de très haut facteur de qualité ainsi obtenu, nous nous appuyons sur la méthode CRDM (Cavity Ring Down Measurement). Cette méthode interférométrique est d'une part bien adaptée à la caractérisation de résonateurs de très haut facteur de qualité et d'autre part elle permet de remonter de manière univoque aux facteurs de qualité intrinsèque Qo et extrinsèque Qe du résonateur. Dans un régime de compensation de pertes, nous avons pu atteindre tous les régimes de couplage et obtenus des facteurs de qualité intrinsèques excédant les 10E10. En régime d'amplification sélective, nous avons démontré expérimentalement que l'on pouvait obtenir des gains élevés allant jusqu'à 33 dB et des retards de groupe excédant 2,3 µs dans ces microrésonateurs actifs. Ces microrésonateurs de très haut facteur de qualité et de très haute finesse peuvent présenter un couplage modal se manifestant par un doublet de résonances. Une confrontation théorie/expérience avec la méthode CRDM permet de mesurer un écart très faible entre les doublets. Par ailleurs, ces microrésonateurs présentant un fort confinement spatial et une forte surtension, sont propices à l'observation d'effets non-linéaires. Une modélisation intégrant l'effet thermique et l'effet Kerr a été réalisée. Une confrontation théorie/expérience nous a permis d'estimer la puissance réellement injectée dans le mode ainsi qu'à estimer le volume du mode. / Glass-based whispering gallery mode (WGM) microresonators are easy to produce by melting techniques. However, they suffer from surface contamination which limits their long term quality factor to only about 10E8. In this thesis, we show that an optical gain provided by erbium ions can compensate for residual losses. The optical characterization method is based on frequency-swept “Cavity-Ring-Down-Measurement”. This method can fully describe the linear properties of microcavities such as coupling regime and group delay. In compensation loss regime we demonstrate that it is possible to control the coupling regime of an ultrahigh Q-factor microresonator from undercoupling to spectral selective amplification. Under the selective amplification regime, we obtain an internal Q-factor exceding 10E10. In selective amplification, we experimentally show that it is possible to obtain high amplification up to 33 dB and a high group delay. The microresonators with high Q-factor and high finesse could give rise to a modal coupling which exhibits a splitting of the resonance in the transmission. A characterization of this phenomenon with the cavity ring down method was realized. Moreover, these microresonators, are conducive to the non-linear effect observation. A model incorporating the thermal effect and the Kerr effect has been achieved. Confrontation between theory and experiment allowed us to estimate the real optical power injected into the mode as well as estimating the mode volume.

Individuals with type 2 diabetes mellitus (T2DM) are at risk for developing life-threatening comorbidities such as cardiovascular disease (CVD). As a consequence, T2DM is associated with increased morbidity and mortality and decreased quality of life, thus highlighting the importance of prevention of T2DM. Further, the prevalence of T2DM is substantially greater in rural populations compared to urban populations, making rural individuals particularly appropriate targets for T2DM prevention. T2DM is a largely preventable disease that is associated with modifiable risk factors such as poor diet, sedentary lifestyle, and obesity. Lifestyle interventions to improve these modifiable risk factors have been used to decrease the risk of developing T2DM. There is little evidence that supports lifestyle interventions as a means to decrease T2DM risk in rural populations with prediabetes, the precursor of T2DM. The purpose of this dissertation was to determine whether rural-living individuals with prediabetes would improve modifiable risk factors, specifically diet quality by following a lifestyle intervention; thereby, decreasing their risk of developing T2DM. Specific aims for this dissertation were to, 1) examine and synthesize data from dietary interventions used to reduce risk of T2DM in rural populations on order to identify gaps and guide future research, 2) critically evaluate validity and reliability of indices used to determine diet quality in research, and 3) determine the effect of a risk reduction program on improving diet quality and glucose control (as a measure of T2DM risk) in rural adults with prediabetes and CVD risk factors. Specific aim one was achieved by a review and synthesis of literature focused on lifestyle and dietary interventions used in rural populations to decrease the risk of developing T2DM. Common goals in these studies were a decrease in weight, decrease in dietary fat and calories, and an increase in physical activity. Decreased weight and increased physical activity were demonstrated in all eight studies, and a decrease in T2DM incidence was also demonstrated in one of the studies. However, diet quality was not adequately assessed in the majority of the studies. Furthermore, none of the studies were randomized controlled trials and only half used a control group. It was concluded that research using a more robust design is needed to determine the effect of lifestyle changes, specifically diet, on T2DM risk in rural populations. Specific aim two was addressed by a critical analysis of six common indices of dietary quality. Validity and reliability of the Healthy Eating Index, the Alternative Healthy Eating Index, the DASH diet score, the Diet Quality Index-Revised, the Healthy Diet Indicator, and the Diet Quality Score were examined. Five of the six indices are valid and reliable tools for measure diet quality but all five rely on an extensive food frequency questionnaire that may be burdensome for participants. The Diet Quality Score does not provide adequate evidence to support its use in research. It was concluded that a short, reliable, and validated diet screener may be useful in research. Specific aim three was addressed by a secondary data analysis of a longitudinal, randomized controlled study of rural residents with CVD risk factors and prediabetes. Diet quality, measured by the Mediterranean Diet Adherence Screener (MEDAS), and glucose control, measured by hemoglobin A1c, were analyzed in a subpopulation of 62 participants with prediabetes. Neither diet quality nor glucose control improved between baseline, four month, and 12 month post intervention. The reliability and validity of the MEDAS in this population is not known and may have been a factor in the lack of intervention effect related to diet quality. Participants were also not informed of their prediabetes status, thus it is not known if this knowledge would have made an impact on the outcomes of the study. In addition, the small sample size limits the statistical power to determine changes between the intervention and control groups. It was concluded that further research is needed to determine if a high quality diet will reduce T2DM risk in this rural population Considering the disproportionate prevalence of T2DM in rural populations compared to their urban counterparts, the results of this dissertation demonstrate a continued need for interventions that decrease modifiable risk factors associated with this disease. Interventions that target obesity, poor diet quality, and sedentary lifestyles in at-risk rural populations that are culturally tailored are needed to decrease risk of developing T2DM and the comorbidities associated with this preventable disease.

Many early childhood learners enter kindergarten not academically and social-emotionally prepared. This qualitative study explored teachers' perceptions of what constitutes high-quality learning concerning kindergarten readiness and parents' understanding and support of kindergarten readiness. The conceptual framework is based on recent studies by early childhood researchers on how and what early learners should experience during their pre-k years. The research questions focused on teachers' understanding of structural quality and process quality, kindergarten readiness, and age- appropriate curriculum. In addition, parents' understanding of kindergarten readiness and what types of learning opportunities they offer their children were examined. Through purposeful sampling, 16 teachers and 17 parents were interviewed from an early childhood site. Interview data were analyzed using a thematic analysis. The data were analyzed by coding and observing for recurrent categories and themes. Key findings indicated that teachers demonstrated a lack of understanding of structural quality and process quality and believed that the current curriculum is outdated and should be replaced to significantly impact student learning. Parents perceived that academics were far more important than social-emotional development and that affording their children learning opportunities outside of school was important. As a result of this study, a professional development program was developed for teachers intended to enhance their instructional practices in preparing early learners towards kindergarten success. Parents will also receive training from teachers to support social-emotional learning opportunities. The training could enable both teachers and parents to better support the cognitive and social-emotional growth of children.