Design thinking ability is vital for engineers who are tasked with solving society's toughest sustainable development challenges. Prior research identified that the percentage of design thinkers among freshmen engineering students is greater than the percentage among the general population. However, engineering education's lack of attention to fostering creative ability may cause the design thinking ability of senior engineering students to suffer. The research addressed in this thesis compares the design thinking ability of engineering students across age groups, and compares design thinking ability between the design disciplines of engineering and architecture. To draw design thinking comparisons between these groups, a survey with a nine item design thinking instrument was distributed nationally to freshmen engineering students (n= 2,158), senior engineering students (n= 1,893), and senior architecture students (n= 336). The survey instrument was validated by conducting confirmatory factor analysis on the senior engineering and senior architecture samples' data. The Analysis of Variance (ANOVA) test was utilized to statistically compare scores across sample groups. Both the freshmen engineering students (2.80) and senior architecture students (3.30) scored significantly higher on the design thinking scale than senior engineering students (2.59). These results have important implications for engineering educators as engineering education may contribute to a decrease in design thinking among senior engineering students. A lower design thinking score among seniors was consistent across all engineering sub-disciplines and should be of concern to engineering educators, since design thinking skills are critical for the development of engineering solutions to grand societal challenges. / Master of Science / Design thinking is a way of thinking about the design process which places the user at the center of the design. Thinking about design in this way is a vital ability for engineers and other design professionals to develop because it enables them to solve “wicked” problems like sustainable development challenges. Wicked problems are those which are difficult to solve due to the number of conflicting components involved. Prior research has found that design thinkers are more prevalent among engineering students in their first year of study than among students in other majors. However, engineering education does not attribute much attention to the development of creative ability which could cause the design thinking ability of engineering students in their final year of study to be worse than the ability of those in their first year, as well as worse than the ability of students who study other design disciplines like architecture. This study compared the design thinking abilities of engineering students in their final year of study to engineering students in their first year and to architecture students in their final year. The goal of making these comparisons was to explore if engineering education helps or hinders the development of design thinking. A survey with nine questions related to design thinking was distributed nationwide. The data from the survey was collected and statistically analyzed. The results showed that the design thinking ability of engineering students in their final year was significantly lower than the ability of first year engineering students and significantly lower than the ability of final year architecture students. A decrease in design thinking ability between freshmen and senior year must be addressed by engineering educators. The National Academy of Engineers and industry leaders are calling for the development of engineers who are design thinkers, and the results of this paper suggest that some changes may need to occur within the engineering education curriculum to accommodate this need.

No / Rational, aim, and objectives: A positive patient safety culture in maternity units is linked to higher quality of care and better outcomes for mothers. However, safety culture varies across maternity units. Analyses of variation in safety culture using statistical process control (SPC) methods may help provider units to learn from each other's performance. This study aims to measure patient safety culture across maternity units in Oman using SPC methods. Methods: The 36-item Safety Attitude Questionnaire (SAQ) was distributed to all doctors, nurses, and midwifes working in ten maternity care units in Oman's hospitals and analysed using SPC methods. The SAQ considers six domains: job satisfaction, perception of management, safety climate, stress recognition, teamwork, and work condition. Results: Of the 892 targeted participants, 735 (82%) questionnaires were returned. The overall percentage of positive safety responses in all hospitals ranged from 53% to 66%, but no hospital had the targeted response of above 75%. Job satisfaction had the highest safety score (4.10) while stress recognition was the lowest (3.17). SPC charts showed that the overall percentage of positive responses in three maternity units (H1, H7, and H10) was above and one (H4) was below the control limits that represent special cause variation that merits further investigation. Conclusion: Generally, the safety culture in maternity units in Oman is below target and suggests that considerable work is required to enhance safety culture. Several maternity units showed evidence of high/low special cause variation that may offer a useful starting point for understanding and enhancing safety culture.

nÃo hà / Unit root tests have been widely used to validate or reject economic modelâs hypotheses. Because of this, many authors have created different versions of this kind of test in order to generate statistics which are more precise in identifying the presence of a unit root. Some authors have increased the power of these statistics using panel data. However, the use of panel data brings the possibility of dependence between cross-sections, this has been initially handled by the independence between cross-sections hypothesis. Only the second generation tests consider dependence between cross-sections. Nevertheless, in the literature there is no test which allows changes in the dependence between cross-sections over time. Thus, this paper uses Monte Carlo experiments to analyze the small sample properties of some statistics used to identify the presence of a unit root. It is noticed that the size of these statistics has a large distortion when the level of dependence between cross-sections changes. / Teste de raiz unitÃria tem sido muito importante no sentido de validar ou rejeitar as hipÃteses dos modelos econÃmicos. Devido essa importÃncia, diversos autores tÃm criado diferentes versÃes desse teste, a fim de gerar estatÃsticas que sejam mais precisas em identificar a presenÃa de raiz unitÃria. Usando dados em painel, alguns autores conseguiram aumentar o poder dessas estatÃsticas. No entanto, o uso de dados em painel trÃs a possibilidade de dependÃncia cross-section nos dados, fato esse inicialmente tratado pela hipÃtese de independÃncia cross-section. Somente nos testes chamados de segunda geraÃÃo à que se trata dependÃncia cross-section. Entretanto, nÃo hà na literatura nenhum teste que permita mudanÃas nesse nÃvel de dependÃncia ao longo do tempo. Com isso, esse trabalho pretende avaliar, por meio de um experimento de Monte Carlo, as propriedades de pequenas amostras de algumas estatÃsticas usadas para identificar a presenÃa de raiz unitÃria. Percebe-se que o tamanho dessas estatÃsticas sofre uma grande distorÃÃo para as situaÃÃes de mudanÃa no nÃvel de dependÃncia cross-section.

Made available in DSpace on 2015-03-05T19:11:30Z (GMT). No. of bitstreams: 0 Previous issue date: 29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O propósito desta dissertação foi verificar se o Modelo de Precificação de Ativos de Capital baseado no Consumo (CCAPM) é consistente com os dados de quatro países latino-americanos: Brasil, Chile, Colômbia e México. Para alcançar este objetivo foi realizada uma regressão cross-sectional dos prêmios de risco médios sobre os betas de consumo de cada ativo em cada país analisado. Adicionalmente, de forma análoga a Lintner (1965) e Levy (1978), foi verificado se a variável ‘variâncias residuais’ mostrava-se estatisticamente significante nas regressões cross-sectional, o que seria inconsistente com o modelo. Os resultados empíricos, baseados em estimativas corrigidas para o problema dos erros nas variáveis, demonstram que há uma relação estatisticamente significativa entre os prêmios de risco médios e os betas de consumo nos países acima mencionados, com exceção do México. Apesar disto, o poder explicativo do modelo, dado pelo coeficiente de determinação R2 ajustado, foi muito baixo em todos os países. Quanto à v / The purpose of this thesis is to verify whether the Consumption based Capital Asset Pricing Model (CCAPM) is consistent with the data from four Latin-American countries: Brazil, Chile, Colombia, and Mexico. In order to reach this goal, a cross-sectional regression of the consumption betas on the mean excess returns of each asset is performed for each country analyzed. Also, similar to the studies of Lintner (1965) and Levy (1978), it is verified whether the variable ‘residual variance’ has statistical significance in the cross-sectional regressions, which would be inconsistent with the model. Empirical results showed that there is a statistical significant relationship between mean excess returns and consumption betas in the countries cited above, with exception of Mexico. Despite this, the explanatory power of the model, given by the adjusted coefficient of determination (R2), is very small in all countries. Concerning the variable ‘residual variance’, it is statistically significant for the Brazilian and Me

Il presente progetto di ricerca si è focalizzato sul processo di capitalizzazione, ovvero la condivisione di eventi positivi con il/la partner, da cui ci si aspetta una risposta attiva al fine di prolungare ed aumentare i benefici derivanti dall’evento stesso. L’articolazione in tre studi, di carattere quantitativo, ha permesso di approfondire la conoscenza dell’oggetto di ricerca utilizzando diverse metodologie. Il primo studio ha indagato, attraverso un disegno cross-sectional, la struttura della Perceived Responses to Capitalization Attempts scale (PRCA) e, attraverso un disegno longitudinale, i benefici intrapersonali ed interpersonali che derivano dagli stili di risposta di capitalizzazione nel tempo. Il secondo e il terzo studio, attraverso il diary method, hanno approfondito il processo di capitalizzazione attraverso l’introduzione di due aspetti innovativi nel processo: la differenziazione tra eventi positivi interni ed esterni alla relazione e la distinzione tra modalità di comunicazione più o meno esplicita dell’evento positivo. Nello specifico, il secondo studio si è focalizzato sui primi due elementi del processo di capitalizzazione (gli eventi positivi e i tentativi di capitalizzazione), mentre il terzo studio ha riguardato gli ultimi due elementi del processo (le risposte ai tentativi di capitalizzazione e la percezione di responsività da parte del/della partner). / The present research project focused on capitalization, that is the process through which people share good news with the partner, who in turn responds in an “active” way to maximize the benefits of the event. Three different studies approached this research object through different methodologies. The aims of the first study were to investigate, through a cross-sectional design, the structure of the Perceived Responses to Capitalization Attempts (PRCA) scale and to examine, through a longitudinal design, the intrapersonal and interpersonal benefits arising from the capitalization responses over time. The second and the third study, through diary methods, attempted to investigate two unexplored aspects of the capitalization process: the differentiation of the type of positive events (internal vs. external to the couple) and the distinction of the type of communication of the event (implicit vs. explicit). Specifically, the second study focused on the first two elements of the capitalization process (positive events and attempts to capitalization), while the third study concerned the last two elements of the process (responses to capitalization attempts and responsiveness).

BACKGROUND: Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. METHODS: Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. RESULTS: The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CONCLUSIONS: CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

Knee osteoarthritis (OA) is the commonest form of lower limb OA with a lifetime risk of over 40%. It is a disease characterised by symptoms such as pain and loss of function. In addition there are typical structural features on both radiographs and MRI. Knee OA represents a spectrum of disease, ranging from early preclinical cartilage change to established full thickness disease. Anteromedial knee OA is a particular phenotype of knee OA where disease is confined to the medial compartment. Whilst end stage arthritis is treated reliably with joint arthroplasty, those with early stage disease are treated with a variety of non- surgical interventions with varying success. This thesis is concerned with understanding the disease of patients that have early radiographic changes but symptoms not controlled by conservative measures. Up to 150 of these patients a year present to the Nuffield Orthopaedic Centre, Oxford. They have been described as being in the “Treatment Gap”. A series of validation studies were performed to determine the optimal method for diagnosing cartilage defects within the knee. The three commonest diagnostic methods were examined for their validity. Arthroscopic assessments of cartilage lesions demonstrated a moderate level of intra and inter observer reliability. In contrast, radiographs and MRI demonstrated high levels of reliability. When using MRI as a criterion standard, both radiographs and arthroscopic assessment were found to have poor accuracy. Based on the work in this thesis a formal definition of the cartilage changes exhibited in early knee OA was proposed. A cross sectional cohort of 100 patients with the symptoms and radiological features of early knee OA were identified. Their pain and function profile was compared to two comparison groups of patients at the end stage of knee OA (defined by the need for partial or total arthroplasty). In up to 78% of individual cases those with early OA had pain and function profiles as bad as those with end stage disease. The cross sectional symptoms of early knee OA demonstrate a marked discordance with their mild radiographic changes. The same cohort was extended to 125 patients. They were followed over one year with monthly PROM assessments to determine how symptoms change over time. 43% of patients experience a clinical improvement over 12 months, 31% experience a clinical deterioration and 26% remain unchanged. The range in OKS variation over 12 months was on average 12 points, with clinically relevant variation occurring on 45% of monthly measurements. Patients with early knee OA can expect to experience considerable variation in their symptoms over 12 months and this must be considered when planning interventions. A number of patients with early knee OA were noticed to demonstrate medial meniscal extrusion. Using data from the Osteo Arthritis Initiative (OAI) a nested case control study was designed to determine how the presence of meniscal extrusion in an otherwise normal knee affects the risk of developing knee OA over the next 48 months. This demonstrated an Odds Ratio of 3.5, suggesting that meniscal extrusion is a considerable risk factor for the development of OA. The presence of a knee injury or operative intervention to the index meniscus was shown to increase this risk. Many phenotypes of OA are known to demonstrate familial aggregation. In an attempt to determine where the earliest structural changes occur in medial compartment knee OA, a cohort of patients selected only for their family history of the disease were developed. This cohort was compared to spouse controls for the presence of knee OA, as well as meniscal extrusion and long leg alignment. In addition, a functional analysis of their cartilage was performed. This cohort was not shown to be at increased risk of disease compared to controls. Discussion of the possible reasons for this finding is presented. Early knee osteoarthritis is a considerable clinical problem. This thesis has aided the understanding of the condition by firstly defining the radiological description of these patients. Secondly, their cross sectional and longitudinal symptom profile have been described for the first time. In addition, the presence of an extruded meniscus has been demonstrated as a substantial risk factor for the disease. Finally, family history has not been demonstrated as a risk factor for the disease within the limits of the study described here. Future work has been proposed.

Background; It is important from a public health perspective to gain a greater understanding of young people's daily lives, their living conditions and lifestyles to promote for a healthy future.  Today is online gaming a large part of young people's daily lives, however, online games especially MMORPGs (Massively multiplayer online role-playing game) are more prominent in the case of a problematic gaming. Previous research has shown negative health consequences and implications such as truancy and poorer school performance among some of the players. Aim; The study aimed to investigate gaming among young people and the relationship between gaming, well-being in the school, truancy and health.  Method; The study has a deductive quantitative approach with a cross-sectional design and populationbased data from the Liv och hälsa ung 2012 was used.  Results and Conclusion; The study showed that the majority of young people never to rarely play, however when it comes to boys it is more common as 1149 out of a total of 2080 played two to seven days per week. Further investigations revealed links between truancy and gaming, among those who truant has increased odds to play in comparison than those who do not truant. No significant correlation was found regarding health and games where the game was the dependent variable in the logistic regression / Bakgrund; Det är viktigt ur ett folkhälsoperspektiv att få en ökad förståelse kring ungdomars vardag, deras livsvillkor och levnadsvanor för att främja för en hälsosam framtid.  Idag är dataspelandet online en stor del av ungdomars vardag, dock är online spel framförallt datarollspel såsom Massively multiplayer online role-playing game (MMORPG) mer framträdande när det gäller ett problematiskt spelande. Tidigare forskning har påvisat negativa hälsokonsekvenser och följder så som skolk och sämre skolprestation hos vissa av spelarna. Syfte; Studien syftade till att undersöka spelande bland ungdomar i Västmanland och sambandet mellan spelande, trivsel i skolan, skolk samt hälsa.  Metod; Studien har en deduktiv kvantitativ ansats med en tvärsnittsdesign och populationsbaserad data från Liv och hälsa ung studien 2012 användes.  Resultat och Slutsats; Studien påvisade att majoriteten av ungdomarna aldrig till sällan spelar, dock är killarna mer utmärkande då det kommer till spelande och 1149 av totalt 2080 uppger att de spelar cirka två till sju dagar per vecka. Vidare framkom samband mellan skolk och spel, då de som skolkar har ökade odds för att spela i jämförelse än de som inte skolkar. Inga signifikanta samband framkom gällande hälsa och spel där spel utgjorde den beroende variabeln i logistisk regression.

ABSTRACT Background: The Rwandan government has set family planning (FP) as one of the goals and strategies to improve the health of the population. However, unmet needs for modern contraceptive methods are still a problem, as is the variance of modern contraceptive use among the five regions of Rwanda.   Aim: This study aimed at assessing key factors that contribute to the variance of modern contraceptive use between five regions of Rwanda. Methods: This study was a secondary analysis of the Rwanda Demographic health survey, 2010. A total of 492 clusters (urban/rural), composed by 12,792 households were selected in the survey; 13,790 women of reproductive age were systematically selected from selected households and interviewed about maternal and reproductive health issues. 6834 married women or living with their partners at the time of the survey were selected for this study. Results: Socio-economic and demographic characteristics of women, access to family planning (FP) information and women’s empowerment were associated with the variance of modern contraceptive use between the regions. Women’s empowerment was positively associated with modern contraceptive use in all regions. Access to information was associated with modern contraceptive use in all regions except in the North region (AOR: 1.24, 95%CI: O.8- 1.92). Conclusion: This study highlights that the variance of modern contraceptive use was associated to the way in which FP factors are associated with modern contraceptive use vary between regions and how different FP factors occur among regions. Further researches are needed to investigate potential factors on supply side that influence such variance.

Stroke is a common and multifaceted disease that often involves motor deficits in the upper limb. This thesis investigated reliability and validity of existing clinical assessments of upper limb function in persons with post-stroke symptoms and in non-disabled controls. Study I was conducted in a clinical setting where the Motor Evaluation Scale of Upper Extremity in Stroke patients (MESUPES) was assessed in persons post-stroke by two physiotherapists selected from a group of four.  Study II-IV took place in a motion analysis laboratory with an optoelectronic system. Kinematic measures and clinical measures were used to investigate the validity of the Arm Posture Score (APS), the Finger-to-Nose test (FNT), and the Standardised Nine Hole Peg test (S-NHPT) in persons post-stroke and non-disabled controls.   The results showed that the MESUPES had a high inter-rater reliability while the concurrent validity was not fully confirmed. MESUPES has a maximum score of 58 and the minimal detectable change ranged from 5 to 8 for a confidence level of 80% and 95%. The Arm Posture Scores, which include either four or six arm movement variables, were able to distinguish between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls. The total movement time of the FNT, which is a coordination test, was able to distinguish persons post-stroke from controls, at least at a group level. Movement smoothness, accuracy and compensation, obtained from kinematic analysis, were the most discriminative variables for the FNT. Smoothness was most strongly correlated with the timed FNT and had the greatest association with the variance of the timed FNT. For the S-NHPT, which is a dexterity test involving grasping and reaching, the movement times, smoothness and compensation discriminated between the stroke group and the control group. Persons post-stroke spent considerably more time in the grasp-related parts of the task compared to controls. Smoothness and upper limb impairments had the strongest correlation with the S-NHPT.   In conclusion, the clinical measures used within stroke rehabilitation seem valid and reliable, although some limitations are highlighted by the kinematic assessment. MESUPES was shown to be a reliable assessment of upper limb movement quality after stroke. The kinematic analysis revealed that the timed FNT does not have sufficient discriminative validity at an individual level. The timed FNT reflected speed-related aspects of pointing movements such as smoothness and length of the deceleration phase, but should not be used as an overall measure of upper limb coordination after stroke. The timed S-NHPT demonstrated sufficient discriminative validity and reflected smoothness and upper limb impairments. For both the FNT and S-NHPT, kinematic analysis showed that the clinical outcomes of those tests (time of performance) did not adequately detect qualitative aspects of the upper limb movements after stroke such as possible compensatory movements. Therefore, clinical assessments that capture qualitative aspects of upper limb movements would improve the assessment of upper limb coordination and dexterity after stroke. In addition, 3D movement analysis provided unique information about upper limb function after stroke, not least in persons with mild post-stroke impairments. The APS, for instance, which quantifies how much the arm swing during gait deviates from normal, discriminated between persons with stroke and non-disabled persons. Such subtle deviations are not possible to quantify with the human eye.