SCORE-15 är ett självskattningsformulär som avser att mäta familjens samspel utifrån tre teman; styrkor, problem och kommunikation. Det har tagits fram i England, där det används i forskning och kliniskt familjeterapeutiskt arbete. Denna studie validerar mätinstrumentet SCORE-15:s användbarhet i Sverige, genom att undersöka 70 icke kliniska familjer. Vi har jämfört de icke kliniska familjernas SCORE-15 resultat med resultat från 159 kliniska familjer i Sverige. En jämförelse har även gjorts med tidigare forskningsresultat från England och Irland. För att få en spridning av testet till icke kliniska familjer har familjer i Stockholms, Östergötlands och Kronobergs län ombetts fylla i SCORE 15. Tjugotvå personer fyllde i ett retest efter 1–2 veckor. Studien visar att det går att skilja icke kliniska familjer från kliniska familjer. / SCORE-15 is a self-report questionnaire, purposed at measuring the family's interaction based on three themes: strengths, problems and communication. It was developed in England, where it is currently used in family therapy research and clinical work. Our study validates the SCORE-15 instrument’s applicability in Sweden by investigating 70 non-clinical families. We compared SCORE-15 results from non-clinical families with results from 159 clinical families in Sweden. A comparison was also made with previous research from England and Ireland. In order to get a statistical spread, non-clinical families in Stockholm, Östergötland and Kronobergs län were asked to fill in the SCORE 15 test. Twenty-two persons filled in a retest after 1-2 weeks. The study shows that it is possible to distinguish non-clinical families from clinical families.

Les maladies complexes telles que les maladies cardio-Vasculaires (MCV) sont influencées par des facteurs génétiques et environnementaux. L’estimation du risque cardio-Vasculaire chez un individu est généralement évaluée par la sommation des facteurs de risque reconnu des MCV (p. ex. l’âge, le sexe, le tabac, la pression artérielle et le cholestérol). Dernièrement, plusieurs bio-Marqueurs ont été examiné pour leur aptitude à améliorer la prédiction des maladies cardio-Vasculaires au-Delà des facteurs de risques traditionnels. L’intérêt de découvrir de nouveaux loci est incité notamment par les découvertes qui émergent des études d'association pangénomique (GWAS) qui permettent de tester l’association de variation génétique au risque de contracter une maladie commune. Les GWAS ont considérablement amélioré notre connaissance de l'architecture génétique des maladies cardio-Vasculaires, à ce jour plus de 50 variations génétiques sont formellement associées à des maladies cardio-Vasculaires, de même plus de 200 marqueurs génétiques seraient associés à des facteurs de risque cardiovasculaire traditionnels (p. ex. le taux sanguin des lipides, la pression artérielle, l’indice de masse corporelle et le diabète de type 2). Le succès remarquable de ces études d’association, qui a permis l’identification de nombreux bio-Marqueurs, a conduit à une réévaluation des données génétiques dans le but de définir des informations cliniquement utiles pour limiter et mieux prédire les risques de maladies, grâce à une application plus efficace des stratégies de prévention. Dans cette thèse, nous examinons tout d'abord une nouvelle approche pour étudier l'architecture génétique de l'hypertension artérielle (HTA; facteur de risque majeur des maladies cardiovasculaires prématurées), puis nous avons constitué plusieurs modèles pour prédire le risque de développer une maladie coronarienne (MC; type le plus commun de MCV), enfin nous avons déterminé une base génétique commune du principal prédicteur de complications cliniques des maladies coronariennes – l'athérosclérose subclinique - afin d'ajouter une valeur pronostique supplémentaire en plus des scores de risque traditionnels à différents âges. Nous avons estimé l'héritabilité de la première mesure de la pression artérielle systolique (PAS) à ~25%/~45% et à ~30%/~37% pour la pression artérielle diastolique (PAD) chez les sujets d’origine Européenne (N = 8901) et d’origine Africaine (N = 2860) faisant respectivement partie de la cohorte Atherosclerosis Risk in Communities (ARIC), en accord avec les études antérieures. Par ailleurs, nous avons développé un moyen de combiner un score de risque génétique (SRC) – somme des effets génétiques parmi un ensemble de marqueurs – avec une évaluation indépendante du risque clinique, en utilisant un système d'équations log-Linéaire. Nous avons employé cet outil à la prédiction de la maladie coronarienne (MC) dans la cohorte ARIC. L'ajout d'un score de risque génétique (SRG) à un score de risque clinique (SRC) améliore à la fois la discrimination et l'étalonnage des maladies coronariennes dans la cohorte ARIC, et révèle par la même comment cette information génétique influence l'évaluation des risques ainsi que l’approche clinique. Enfin, parmi 1561 cas et 5068 contrôles (de la présence ou non de calcifications coronaires), faisant partie de plusieurs ensembles de données cliniques et génétiques disponibles via la base de données NCBI de Génotypes et Phénotypes (dbGAP), nous avons constaté qu’une augmentation d'un écart-Type dans le score de risque génétique de 49 bio-Marqueurs de MC est associée à 28 % d’augmentation de risque de développer une athérosclérose coronarienne subclinique diagnostiquée à un stade avancé (p=1.43x10-16). Cette augmentation du risque est significative dans chaque catégorie d'âge (de 15 ans en 15 ans) (0,01 > p > 9.4x10-7) et a été remarquablement similaire dans toutes les catégories d'âge (test d'hétérogénéité p = 0.98). (...) / Complex diseases such as cardiovascular disease (CVD) are influenced by both genetic and environmental factors. Estimation of an individual’s cardiovascular risk usually involves measurement of risk factors correlated with risk of CVD (e.g. age, sex, smoking, blood pressure, and total cholesterol). Lately, several biomarkers have been evaluated for their ability to improve prediction of cardiovascular disease beyond traditional risk factors. The interest in novel loci is propelled notably by emerging discoveries from the advent of genome-Wide association studies (GWAS) of genetic variants associated with risk for common diseases. GWAS has greatly enhanced our knowledge of the genetic architecture of cardiovascular disease, yielding over 50 variants confirmed to be associated with CVD to date, as well as over 200 associated with traditional cardiovascular risk factors (e.g. lipids, blood pressure, body mass index, and type 2 diabetes mellitus). This recent and continuing success in discovering increasing numbers of robustly associated genetic markers has led to reassessment of whether genetic data can provide clinically useful information by refining risk prediction and moderating disease risk through a more efficient application of prevention strategies. In this thesis, we first address novel approach to survey the genetic architecture of hypertension (i.e. major risk factor for premature CVD), then construct risk prediction models for coronary artery disease (CAD; i.e. most common type of CVD) and finally establish a common genetic basis of the strongest predictor of clinical complications of CAD, subclinical atherosclerosis, to add incremental prognostic value above traditional risk scores across a range of ages. We show that, for first visit measurements, the heritability is ~25%/~45% and ~30%/~37% for systolic (SBP) and diastolic blood pressure (DBP) in European (N=8,901) and African (N=2,860) ancestry individuals from the Atherosclerosis Risk in Communities (ARIC) cohort, respectively, in accord with prior studies. Then we present a means to combine a polygenic risk score - genetic effects among an ensemble of markers - with an independent assessment of clinical risk using a log-Link function. We apply the method to the prediction of coronary heart disease (CHD) in the ARIC cohort. The addition of a genetic risk score (GRS) to a clinical risk score (CRS) improves both discrimination and calibration for CHD in ARIC and subsequently reveal how this genetic information influences risk assessment and thus potentially clinical management. Finally, Among 1561 cases and 5068 controls, from several clinical and genetic datasets available through the NCBI's database of Genotypes and Phenotypes (dbGAP), we found a one SD increase in the genetic risk score of 49 CAD SNPs was associated with a 28% increased risk of having advanced subclinical coronary atherosclerosis (p = 1.43 x 10-16). This increase in risk was significant in every 15-Year age stratum (.01 > p > 9.4 x 10-7) and was remarkably similar across all age strata (p test of heterogeneity = 0.98). We obtained near identical results and levels of significance when we restricted the genetic risk score to 32 SNPs not associated with traditional risk factors. Accordingly, common variation largely recapitulates the known heritability of blood pressure traits. The vast majority of this heritability varies by chromosome, depending on its length, and is largely concentrated in intronic and intergenic regions of the genome but widely distributed across the common allele frequency spectrum. Respectively, our proposed method to combine genetic information at established susceptibility loci with a nongenetic risk prediction tool facilitates the standardized incorporation of a GRS in risk assessment. (...)

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objectives: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource-constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of pleural tuberculosis in Peru. Methods: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis. Besides pleural fluid analysis, patients underwent closed pleural biopsy for reaching a final diagnosis through combining microbiological and histopathological criteria. We evaluated the performance of the CPRs against this composite reference standard using classic indicators of diagnostic test validity. Results: We found 15 eligible CPRs, of which 12 could be validated. Most included ADA, age, lymphocyte proportion and protein in pleural fluid as predictive findings. A total of 259 patients were included for their validation, of which 176 (67%) had PT and 50 (19%) malignant pleural effusion. The overall accuracy of the CPRs varied from 41% to 86%. Two had a positive likelihood ratio (LR) above 10, but none a negative LR below 0.1. ADA alone at a cut-off of ≥40 IU attained 87% diagnostic accuracy and had a positive LR of 6.6 and a negative LR of 0.2. Conclusion: Many CPRs for PT are available. In addition to ADA alone, none of them contributes significantly to diagnosis of PT.

À Zabbar, un village maltais du Nord-Est, la banda Maria Mater Gratiae et la banda San Mikiel, rivales depuis leur fondation, en 1883, sont intégrées dans la vie villageoise et animent la fête patronale de Santa Maria Mater Gratiae, tous les ans, le 8 septembre. La musique des bandas – des marches – est une musique populaire, festive, religieuse et écrite. Elle ne joue pas seulement un rôle décoratif ou d’utilité ni de stricte nécessité sociale, elle constitue un véritable fait social total. Elle s’inscrit dans une pratique collective du quotidien et produit des sociabilités multiples, des échanges, des univers sonores, un imaginaire musical riche en mouvement. La première partie de cette thèse, d’un caractère ethnographique, décrit le contexte musical du village, en mettant l’accent sur les bandas, leur siège – le kazin –, leur histoire, leur rôle dans le contexte musical maltais. Dans une deuxième partie, la musique des bandas se révèle être au centre d’échanges - des musiciens et des partitions – et de rivalités dans l’espace villageois et de l’île. Enfin, après une description de la musique dans la fête et une étude comparée qui montre l’origine même de ces formations dans la double histoire des orchestres de cuivre et d’harmonie, une dernière partie est consacrée à l’analyse musicale et a pour but de découvrir la logique de ces musiques paraliturgiques / In Zabbar, a village in north-east Malta, two bandas, Maria Mater Gratiae and San Mikiel, have been rivals since they were founded in 1883. They are part and parcel of village life and bring life to the Santa Maria Mater Gratiae village festival each year, on the 8th of September. The music of bandas, of marches, is a popular, festive, religious, written music. Its role is neither decorative nor utilitarian, nor is it a strict social necessity, it is an actual complete social fact. It is part of a collective pratice in daily life and produces multiple sociabilities, exchanges, musical worlds, an imaginary musical universe full of movement. The first part of this thesis, which is ethnographic, describes the musical context of the village, drawing attention to the bandas, their seats (or kazin), their history, the role they play in the Maltese musical context. In the second part, banda music is discovered to be central to exchanges (musicians and music scores) and rivalries within the village space and the island itself. Then comes a description of the music within the festival and a comparative study meant to show how the bandas found their origins in the history of brass bands and orchestras. Finally, a last part is dedicated to musical analysis and aims at discovering the logic within those paraliturgical musics.

One of the assumptions upon which modern portfolio theory is based is the efficient market hypothesis which postulates that market prices fully reflect all available information, which implies that an abnormal return cannot be made. Evidence has amassed in contradiction to the efficient market hypothesis as demonstrated by Jegadeesh and Titman (1993); Mohanram (2005); Montier (2009) and Piotroski, (2000). However these studies demonstrated earning an abnormal return by buying an asset as opposed to selling an asset. Evidence by Altman (2000) and Beneish, Lee and Nichols (2013) affirmed that abnormal returns may be earned by selling a declining asset. There has been no published work conducted on the South African market pertaining to an instrument that may be used to detect a decline in share price due to prior earnings manipulation, thereby providing the scope of this research. In recent years the focus of the discipline of asset pricing has shifted away from theoretical modelling towards empirical analysis. The C-score by Montier (2008) is a binary earnings manipulation detection model, designed to identify stocks that may be shorted for an abnormal return. An exploratory study of stocks on the Johannesburg Stock Exchange (JSE) from 2002 to 2010 was conducted. Vital focus areas included the resources and industrials sector. Results of this research prove that C-score is insufficient as a stand-alone tool for detecting shortable stocks on the JSE. Whilst negative relative returns were earned for certain holding periods of certain sectors, a consistent trend could not be isolated. / Dissertation (MBA)--University of Pretoria, 2013. / pagibs2014 / Gordon Institute of Business Science (GIBS) / MBA / Unrestricted

The Zambian government, through the Ministry of Agriculture and Cooperatives (MACO), provides maize seed and fertilizers to farmers at heavily subsidised prices under the Farmer Input Support Programme (FISP). MACO’s narrow evaluation of FISP, based on estimated production without quantifying the significant changes in production and other critical socioeconomic factors, fails to adequately highlight and service the benefits of subsidies to intended beneficiaries. Furthermore, MACO estimates of the impact of FISP never consider the question of how much beneficiary farmers would have produced in its absence, leading to potentially misleading assessments. The key question addressed in this study is whether using more rigorous econometric methods that account for heterogeneity in socioeconomic factors between participants and non-participants would still confirm the positive impact of FISP on maize productivity and poverty reduction, hence justifying the huge government expense on the programme. The study utilised cross-sectional data obtained from 497 randomly selected households, collected in 2011 from six provinces of Zambia to assess the causal effect of FISP on beneficiary households’ maize yields and asset accumulation. The data was analysed using well-grounded matching techniques that account for differences in observable characteristics between programme participants and non-participants. The study also tested for possible unobserved selection effects using the Rosenbaum bounds. The results indicated that participating in FISP increased maize yields and assets accumulation and hence might directly or indirectly positively affect beneficiary poverty levels. There were also no influences of unobserved characteristics on the estimated maize yield and asset level differences between participants and non-participants. On average, FISP increased maize yields by about 451 kg per hectare, with an improvement of about 0.5 on the wealth index (score used to rank households according to asset levels). The positive impact on maize yields and asset accumulation on the participating farmers therefore justifies government’s continued implementation of FISP. / Dissertation (MScAgric)--University of Pretoria, 2014. / lk2014 / Agricultural Economics, Extension and Rural Development / MScAgric / Unrestricted

I examine the impact of a health insurance program for the poor implemented in Indonesia in 2005 on labor supply and informal work measured by employment status outside of the private and public formal sector. As a first step to its ambitious plan for universal coverage, this program extended subsidized health insurance coverage to a large proportion of Indonesia’s poor and near-poor population. Using a rich longitudinal survey, I estimate the average treatment effect on the treated using a combined propensity score matching method with difference in differences. The richness of the data allows me to control for a set of observable characteristics used by the government to allocate the benefit as well as an extensive combination of controls at the individual, household and community level. I find a significant negative impact on labor supply. This impact is driven by women, both at the intensive and extensive margin of labor supply. These results are in line with the fact that individuals with higher value for health insurance are more inclined to modify their labor market behavior. This decrease in labor supply has important policy implications as it may cause a negative impact on economic development, poverty and socioeconomic status of women. The results are not suggestive of an impact on informality. This lack of an effect on informal status is encouraging for developing countries in the verge of implementing universal care reform.

The use of cardiovascular risk scores remains the foundation for risk stratification to guide clinical management. Clinicians have access to several cardiovascular risk scores in practice settings. While having several risk scores with different risk factors may provide more information, it does not imply accuracy of the cardiovascular risk score used to calculate individual patient cardiovascular risk. The objective of this study was to compare the Framingham Risk score, Reynolds Risk scores, and the Pooled Cohort Risk Equation (3 commonly used equations) scores with respect to ability to predict cardiovascular events in a diverse ethnic population. Additionally, the potential predictive utility of three novel risk factors (carotid intima media thickness, peripheral arterial tonometry and vasa vasorum) was examined in relation to ability to improve 10-year cardiovascular risk prediction. A secondary analysis of the longitudinal prospective study cohort known as Heart Strategies Concentrating On Risk Evaluation (Heart SCORE) was conducted. The cardiovascular risk scores of study participants who did and did not experience a cardiovascular event composite index consisting of myocardial infarction, death, stroke, acute ischemic stroke, or revascularization were assessed using methods of calibration and discrimination overall and by race and gender. When examining performance of the 3 risk scores, the overall 10-year absolute predicted cardiovascular risk varied substantially (e.g. approximately 2-fold) and this wide variation in predicted 10-year cardiovascular risk was present across race and gender. Nonetheless, despite the wide variation in estimates of absolute risk, the 3 cardiovascular risk score equations were strongly associated with future cardiovascular risk overall and by race and gender. There was some indication that the Reynolds risk score was the most accurate measure of future cardiovascular risk. The 3 novel risk factors examined did not significantly improve 10-year cardiovascular risk prediction above and beyond the standard demographic and clinical variables used in these well-known equations.

This note proposes the continuous treatment approach as a valuable alternative to propensity score matching for evaluating economic effects of merger and acquisitions (M&As). This framework allows considering the variation in treatment intensities explicitly, and it does not call for an arbitrary definition of cutoff values in traded ownership shares to construct a binary treatment indicator. We demonstrate the usefulness of this approach using data from European M&As and by relying on the example of post-M&A employment effects. The empirical exercise reveals some heterogeneities over the whole distribution of acquired ownership shares and across different types of M&As and country groups.

Over a period of time, it has been studied that a mobile “edge-cloud” formed by hand-held devices could be a productive resource entity for providing a service in the mobile cloud landscape. The ease of access to a pool of devices is much more arbitrary and based purely on the needs of the user. This pool can act as a provider of an infrastructure for various services that can be processed with volunteer node participation, where the node in the vicinity is itself a service provider. This representation of cloud formation to engender a constellation of devices in turn providing a service is the basis for the concept of Mobile Ad-hoc Cloud Computing. In this thesis, an architecture is designed for providing an Infrastructure as a service in Mobile Ad-hoc Cloud Computing. The performance evaluation reveals the gain in execution time while offloading to the mobile ad-hoc cloud. Further, this novel architecture enables discovering a dedicated pool of volunteer devices for computation. An optimized task scheduling algorithm is proposed that provides a coordinated resource allocation. However, failure to maintain the service between heterogeneous networks shows the inability of the present day networks to adapt to frequent changes in a network. Thus, owing to the heavy dependence on the centralized mobile network, the service related issues in a mobile ad-hoc cloud needs to be addressed. As a result, using the principles of Software Defined Networking (SDN), a disruption tolerant Mobile Ad-hoc Cloud framework is proposed. To evaluate this framework a comprehensive case study is provided in this work that shows a round trip time improvement using an SDN controller.