Earlier studies of culmination tend to put operations first and logistics second, as an underlying factor to the culminating point. This case study aims to revert this relationship and focuses solely on the causes for logistical culmination. Utilizing Kress theory of responsiveness, factors directly linked to a culmination within thelogistical organisation are studied to improve the understanding of logistical culmination. The cases studied are operation Desert Shield/Desert Storm and operation Iraqi Freedom. These cases are interesting due to the fact that one case closes the logistical gap and manages to provide a responsive logistical chain, while the other in spite of completed preparations, reaches logistical culmination. The study finds that an under-responsive chain can more strongly be linked to logistical culmination. Factors such as insufficient resources, miscommunication, decision-making and infrastructure play a vital role in forming as well as avoiding a logistical culmination.

During the last decades, the world has become increasingly globalized, leading to an increased interdependence between nations. This development has given rise to an increased vulnerability to turbulence created by external events and made it even harder to find the right strategic fit while managing the trade-offs between global integration and local responsiveness. The purpose of this thesis is, therefore, to understand how external events, namely Trade wars, Brexit and Pandemic affect an MNC's international strategy and how an MNC can adapt its strategy and structure to respond to the turbulent environment. Consequently, this thesis follows a case study-based design which helps to provide an in-depth company view and a strong foundation for the analysis of the strategic considerations made by the case company. The findings show that external events affect the company's capacity to produce, reduces trade opportunities, and prevents the continuous supply. Further, a direct response to the turbulent environment is to adapt the strategy and structure towards an adjusted Regional Strategy, with a focus on interdependence within geographical market clusters. This will create more opportunities to find the integral trade-off between global integration and local responsiveness and consequently respond to the arising regional complexities.

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京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第21456号 / 社医博第90号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 滝田 順子, 教授 小杉 眞司, 教授 三森 経世 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

This descriptive study used a mixed methods design and sought to examine students' perceptions on workforce education and development (WED) curriculum responsiveness to culturally and internationally diverse graduate students, at a Midwestern university on four dimensions: teaching strategies (to include delivery), curriculum inclusiveness, international responsiveness, and curriculum improvements. The research study design consisted of the mixed methods Follow-up Explanations Model (QUAN emphasized) complemented by the With-in Stage Mixed Model. A pragmatic paradigm guided the collection and analysis of the study's census data (survey and focus groups). A newly developed WED Curriculum Responsiveness Survey (.850 Cronbach's alpha index) containing closed- and open-ended questions facilitated data collection from all the population. Three follow-up focus groups gathered qualitative data for explaining the survey quantitative results. Study participants comprised all graduate students with at least one year continuous enrollment from fall 2007 to spring 2008 in a WED program at a Midwestern university. A total of 69 (44% response rate) participants responded to the census survey comprising three main study groups: U.S. majority, U.S. minority, and International students. At this snapshot in time and based on study findings of students' perceptions, WED curriculum responsiveness to culturally and internationally diverse graduate students at a Midwestern university appeared to be inadequate. This was evident in the resulting overall weak correlation in the most used and most responsive teaching strategies to students' learning style preferences in its WED program. Further, U.S. minority and international students generally perceived cultural insensitivity to occur sometimes to quite often respectively in teaching delivery and the WED curriculum content to be typically aligned to the interests of the dominant group (Caucasians). All student groups (U.S. majority, U.S. minority, and international) found a limited representation of international perspectives on WED course topics. These findings imply that students experienced much intellectual and cultural bondage with a U.S.-centric curriculum in their graduate studies that does not fully preparing them for today's global marketplace. Students' suggestions for reversing these trends were to diversify/internationalize WED curriculum content, diversify teaching styles, hire diverse faculty, and provide faculty diversity training. These suggestions were strongly supported by the theoretical and empirical literature on critical race theory, critical education theory, curriculum inclusiveness, multicultural education, and internationalization in U.S. higher education.

CHAPTER 1: Introduction: The most common craniofacial congenital anomaly is the cleft lip and/or palate (CLP). The CLEFT-Q is the first condition-specific comprehensive patient reported outcome instrument (PROM) for patients with CLP. Other measures used in assessment of patients with CLP are Child Oral Health Impact Profile (COHIP) and Cleft Hearing, Appearance and Speech Questionnaire (CHASQ). The development and validation of the CLEFT-Q have been completed in three phases. In phase I, 138 patients with CLP from six countries were interviewed, and data were used to form 13 scales measuring appearance, facial function and health-related quality of life (HR-QOL). In phase II, scales were field-tested internationally with 2434 patients to examine reliability and validity as well as develop a common scoring algorithm for international use. Phase III, the focus of this thesis, aimed to examine further construct validity and responsiveness of the CLEFT-Q scales. CHAPTER 2: Methods: Patients were recruited at six cleft centres in Canada, USA and UK between January 2018 and October 2019. The sample included patients aged 8-29 seeking rhinoplasty, orthognathic, cleft lip scar revision and alveolar bone graft (ABG) operations. Before and six months after surgery, participants were asked to complete the CLEFT-Q scales relevant to their operation and two other PROMs frequently used in cleft research, i.e., COHIP and CHASQ. Cross-sectional construct validity was examined by testing prespecified hypotheses about expected relationships between CLEFT-Q, CHASQ and COHIP instruments. Internal responsiveness was examined using the distribution-based method. Data were analysed using paired sample t-tests and calculation of effect sizes (ESs) and minimally important differences (MIDs). CHAPTER 3: Results: Examination of cross-sectional construct validity of the CLEFT-Q scales using the COHIP and CHASQ subscale resulted in 39/53 (74%) hypotheses having been supported by the results. The required sample size to examine responsiveness using the anchor-based approach was not reached. Assessment of internal responsiveness using the distribution-based approach demonstrated that the appearance scales were highly responsive to change following cleft-specific surgeries, with statistically significant results and ESs ranging from 0.4 (small) to 1.8 (large). Change on the CLEFT-Q HR-QOL scales was not statistically significant. As predicted, the ESs on scales measuring facial aspects most affected by rhinoplasty and orthognathic surgeries were larger than the ESs on scales measuring facial aspects least affected by these surgeries. MIDs for each scale in each operation were determined. CHAPTER 4: Discussion: Assessment of cross-sectional construct validity demonstrated that CLEFT-Q performs as it was intended when compared with other similar measures (i.e., CHASQ and COHIP). The CLEFT-Q appearance scales were responsive to change following rhinoplasty, orthognathic and cleft lip scar revision operations. As predicted, the CLEFT-Q appearance scales did not detect change following the ABG operation as this operation does not result in visible difference. As hypothesized, the CLEFT-Q HR-QOL scales were less responsive to change than appearance scales as HR-QOL is a more distal construct than appearance in relation to the cleft-related surgeries performed. The preliminary MIDs estimated by the distribution-based approach should be confirmed in studies with diverse CLP populations and larger sample sizes using the anchor-based approach. The findings of this phase III study build on the results of another CLEFT-Q validation study, which demonstrated the ability of the CLEFT-Q scales to detect differences between groups with varying surgical status, i.e., need surgery, have had surgery and never needed surgery. CHAPTER 5: Conclusion: Cross-sectional construct validity of the CLEFT-Q scales was supported by most prespecified hypotheses. The CLEFT-Q scales were found to be responsive to change. MIDs were determined. The results of this phase III study should be confirmed in a larger and more culturally diverse patient population. Future studies to examine reproducibility and measurement error as well as external responsiveness of the CLEFT-Q scales may be beneficial to add to the psychometric evaluation process. / Thesis / Master of Science (MSc)

The internet has enabled billions of online transactions with customers transacting in real-time from various geographical points, while ecommerce could make more for Quebec traders dealing in various commodities. Quebec's ecommerce is still underdeveloped. This thesis seeks to understand the factors behind an e-consumer making a purchasing decision on a Quebec ecommerce site by using the Online Purchase assessment tool (OPAT) model to pinpoint emerging e-commerce trends, a literature review, and a questionnaire to discover the reality of why consumers purchase online. It discovered that e-commerce is not well-developed in Quebec because platforms use French and leave out English-speaking shoppers, most residents prefer physical shopping, and poor pricing strategies by foreign ecommerce platforms. This study aims to uncover why the Quebec retail industry is underdeveloped when it has enormous potential to lead among Canadian provinces. It evaluates consumer purchasing behaviors from online stores based on three moments that happen during the purchasing process. Summarily, it measures the first moment a retailer visits the platform, when they decide to purchase, and loyalty when they return to purchase again. It also provides recommendations for Quebec retailers regarding factors to consider when setting up their ecommerce stores to be successful.

Early exposure to abuse, neglect, and household dysfunction is linked to long-term detrimental effects on mental and physical health. Most research examines community adult samples, which do not adequately describe the experiences of youths involved with child protection, social service agencies, and the criminal justice system. Research regarding the effect of cumulative adversity on sex offending youths is needed to inform treatment and responses to abuse, maltreatment, and household dysfunction in their early development. We also know little regarding how other factors – such as environmental responsiveness, availability of health care services, and regional or area differences in exposure to adversity – affect such outcomes. Our current study investigates the prevalence of childhood trauma and maltreatment using the Adverse Childhood Experience (ACE) survey in a sample of juvenile sex offenders in residential treatment. Important research questions include: 1) rates of maltreatment, violence exposure, and familial dysfunction in these youths; 2) frequency of placement in foster care, prior residential treatment, or other out-of-home placements and the relationship of childhood adversity and/or aggressive behavior by the juvenile; and 3) rates of childhood adversity, length of exposure, and environmental responsiveness to trauma as the result of rural vs. urban origin of the youth. We are currently collecting data from archival records of male adolescents who have received residential care and sexual offender treatment at a youth treatment center since the facility’s start in 2003. The expected participant pool includes approximately 500 juveniles referred for residential sex offender treatment for periods ranging from six months to three years. Data collection began in November 2014, and our current preliminary subsample (n = 30) is approximately 6.7% of the anticipated total. These participants are primarily White (9.67%) with a mean age of 14.77 years old (SD=1.43) at admission. Data collection is ongoing, and we expect to have 40-45% of data collection (est. n = 200) completed by October 2015. Our findings thus far suggest that these juveniles have experienced higher rates of adverse childhood experiences than the general adult population, as reported in the literature. All 30 sampled have experienced at least one adverse event, and over 86% experienced four or more adversities (see Table 1). The average first out-of-home placement occurred at 9.5 years of age, with an average of 5.87 years spent in out-of-home placements prior to admission to the treatment facility. Preliminary statistics indicate differences in rates of adversities between metropolitan areas, non-core urban population areas, and rural areas using the rural-urban continuum codes outlined by the U.S.

Faculty members from Brigham Young University's special education/ESL program participated in professional development centered on increasing multicultural competence. The primary investigator interviewed faculty members regarding their perceptions of professional development. After conducting the interviews, faculty members' feedback was coded to determine whether or not the professional development aided them in infusing more culturally sensitive practices into the curriculum and created a more sensitive learning environment for students from diverse backgrounds. Researchers also coded the faculty members' feedback to determine if faculty members felt they have changed at an individual/personal level in terms of how they view their own cultural background as well as how they view their students' cultural backgrounds. Information is summarized, providing insight into factors that strengthen professional development, ultimately increasing cultural competence. Additionally, suggestions are made to improve consultation skills and build stronger rapport with those from diverse backgrounds and at the university level, more effectively recruiting and retaining diverse students in school-based professions, including special education programs.

The purpose of this study was to examine how implicit family process rules are related to observed child emotional responsiveness with child self regulation as a possible mediating variable. Data from Wave 1 of the Flourishing Families project was used and included 337 two parent families and a target child between the ages of 10 and 13. Mother and father perception of family implicit rules were used to measure family implicit rules; child and mother report of the child's self regulation were used to measure self regulation, and child's emotional responsiveness to mother and father were taken from coding data. The Iowa Family Interaction Rating Scales (Melby, et. al., 1998) were used to code the behavior of the child with mother and with father. Multiple Group Comparison using AMOS 16 was used to compare differences based on child gender. Results showed that family implicit rules were positively related to emotional responsiveness to mother for both sons and daughters and to emotional responsiveness to father for sons but not for daughters. Family implicit rules were positively related to child self regulation for both sons and daughters, and self regulation was related to both emotional responsiveness to mother and to father. Results indicated child self regulation significantly mediated the relationship between family implicit rules and emotional responsiveness to mother as well as the relationship between implicit rules and emotional responsiveness to father. Implications for family therapy are discussed.