The study of health disparities and the social determinants of health has resulted in the call for public health researchers to investigate the mid- and upstream factors that influence the incidence of chronic diseases (Adler & Rehkopf, 2008; Berkman, 2009; Braveman P. , 2006; Braveman & Gottlieb, 2014; Krieger, 2011; Rose, 1985). Social ecological models (SEMs) provide important conceptual tools to inform this research and practice (Krieger, 2011; Golden & Earp, 2012; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008; Glanz, Rimer, & Lewis, 2002). These models can help us look at the social and physical environments in rural Arizona communities and consider how health policies and environmental interventions address mediating factors, such as disparities in access to fresh food, that contribute to ill health in marginalized, rural, populations. Rural residents are at greater risk for obesity than their urban counterparts (Jackson, Doescher, Jerant, & Hart, 2006; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008). And while human life expectancy has steadily increased over the past thousand years, current projections indicate that the rise in obesity-related illnesses will soon result in its decline (Olshansky, et al., 2005). One reason for this decline, may be the reduced availability of healthy food – an important predictor of positive health outcomes including reduced obesity and chronic disease - in many parts of the United States (Brownson, Haire-Joshu, & Luke, 2006; Ahen, Brown, & Dukas, 2011; Braveman & Gottlieb, 2014; Braveman, Egerter, & Williams, 2011). The United States Department of Agriculture (USDA) defines food deserts as geographic areas in which there is limited access to grocery stores and whose populations have a high rate of poverty. In Arizona, 24% of the rural census tracts are considered food deserts; compared to an average of eight percent of rural census tracts across the nation (United States Department of Agriculture, 2013). Food deserts are one example of the upstream factors influencing the health of rural populations. Local health departments have been encouraged through the National Association for City and County Health Officials (NACCHO) and through the Public Health Accreditation Board (PHAB) to conduct community health assessments (CHAs) in order to identify unique contexts and community resources, health disparities, and the social determinants of health as well as potential areas for advocacy, policy change, environmental interventions, and health promotion interventions. Public health challenges like chronic diseases, which have multiple causes, can be explored in-depth through CHAs. CHAs often contain recommendations for action and/or are followed by community health improvement plans (CHIPs) which help local health departments prioritize resources and set measurable goals. In Florence, AZ recommendations made in a CHA are being acted upon by a non-profit agency, the Future Forward Foundation (3F). This investigation explores two interrelated issues regarding the use of CHAs and CHIPs as practical tools to set public health priorities. First, what makes a CHA useful to rural public health practitioners? What methods of conducting a CHA and subsequently analyzing the data results in actionable policy recommendations and/or environmental level interventions? Second, to what extent can public health agencies engage nontraditional partners to work in partnership to address the social determinants of health? As an example, I will look at the impact of a volunteer-based non-profit agency, located in a rural food desert on improving the social and physical nutrition environment as recommended by a local CHA. This inquiry will provide insights to public health practitioners seeking to identify and implement policy and environmental change addressing complex, multi-causal, public health issues, and provide insights regarding engaging nontraditional partners who may not self-identify as public health agencies.

Problem: Due to the promises of retailer benefits, self-service technologies (SSTs) are becoming a common sight in the Swedish grocery retail setting. The mere installation of SSTs is yet not enough to make the consumer adopt them.  Purpose: By asking, “how is the consumer’s attitude towards technology affecting his/her acceptance of the grocery retail self-scanning system”, the purpose of this thesis is to explore the effect of the technology readiness theory on the technology acceptance model. Thus, practically investigate how and why some consumers accept, whereas other consumers reject SSTs.  Theory: The direct mediating effect of four consumer-specific technology adoption predictors: optimism, innovativeness, insecurity and discomfort, are investigated in relation to two system-specific technology adoption predictors: perceived usefulness and perceived ease of use. Throughout the theoretical framework, and in combination with SST literature, eight hypotheses are constructed.  Method: A positivist research approach with a deductive reasoning is adopted. To answer the hypotheses, a quantitative method implemented through a survey strategy is chosen. Statistical testing of the 192 collected answers follows the quantitative data gathering.  Conclusion: The results show that multiple consumer-specific characteristics have a direct mediating effect on perceived usefulness and perceived ease of use. Thus, the consumer’s attitude towards technology plays a significant role in the consumer’s propensity to accept SSTs, such as the grocery retail self- scanning system. This implies that retailers aiming at developing efficient and competitive self-service strategies should pro-actively consider the “techno-ready” consumer attributes. In particular: optimism and discomfort.

Master of Public Health / Department of Human Nutrition / Sandra B. Procter / HIV/AIDS is one of the most devastating health concerns of the developing world, especially in sub-Saharan Africa (SSA). To address individual food insecurity and malnutrition, numerous small-scale nutrition and agriculture interventions have been implemented. This study compared the CTC Community Garden Project in Maai Mahiu, Kenya (n=15) and the HelpMercy Nutrition and Food Security Project (seed distribution) in Macha, Zambia (n=64), after one year. Study objectives included assessing food security in Maai Mahiu, determining beneficiaries' perceived usefulness of the interventions, comparing and evaluating the interventions, determining the importance of education in the interventions, and making recommendations for improvement. A survey in Maai Mahiu used a modified FAST tool to determine food security for beneficiaries (n=15) and non-participants (n=50). The majority of respondents were determined food insecure (without hunger), indicating a need for improved access to food/land. To determine outcomes and make comparisons, intervention outcome and beneficiary 'perceived usefulness' were measured using two verbally administered surveys, two focus groups, and two interviews with translation. Qualitative and quantitative results demonstrated differences between beneficiary perceptions of the interventions. No association was observed between perceived usefulness of the two studies (χ2). A backward elimination logistic regression model of the HelpMercy intervention showed that attendance at community-based nutrition and agriculture education sessions (CBES), household size, and number of seed types planted were predictors of perceived usefulness. Households who attended at least one CBES were more likely to perceive the intervention as useful (χ2 for trend, p=0.007), and there was a linear relationship between number of CBES attended and perceived usefulness (Mann-Whitney, p=0.008). Results may support research that agriculture interventions are more effective when combined with nutrition education. Perceived barriers and benefits differed significantly between the two programs. 60.3% of HelpMercy beneficiaries and 40.0% of CTC beneficiaries perceived the interventions as useful. Program improvements are possible, and further research is needed to better understand the impact and potential benefits of small-scale nutrition and agriculture interventions for HIV-affected populations in SSA.

Title: Sustainability accounting - A qualitative study about the understanding, usefulness and relevance of sustainability reporting based on an employee perspective. Problematization: There has been previous research about sustainability reporting through an external point of view. There is however a gap in research about sustainability reporting from an employee perspective. Purpose: The purpose of this study is to develop a better comprehension of how employees perceive the information presented in sustainability report and if they feel that the report is aimed for them or external stakeholders. Frame of reference: This episode began with previous research about the three qualitative characteristics that are used when creating a financial report. The framework of GRI is also presented. Lastly the stakeholder theory and stakeholder dialogue are introduced. Method: This study has a qualitative approach where 10 semi-structured interviews have been held to collect data. Research: The employees have a better understanding of the information related to the social and environmental issues. Furthermore they only consider the information regarding the environment to be useful in their daily work. The employees believe that the environmental and social part of the report is relevant while the economic could not be assessed by the employees. Conclusions: Diagrams, thorough explanations and knowledge of the subject increased the understanding of the report. The economical part can be further understood if there is more extensive content. The information becomes useful when they can directly use it in their daily work and when they feel that the information is aimed for them. They need to receive the information through meetings for it to be useful for them. They had little previous knowledge of the economical part and were there for not able to assess the relevance of the report's content while the environmental and the social area were relevant because the content has currently been highlighted in newspapers and debates.

La conception concourante de produits matériels centrée sur l’homme est basée sur une collaboration entre le concepteur mécanicien, l’ergonome et le designer industriel. Cette collaboration souvent difficile peut être facilitée par l’utilisation d’objets intermédiaires de conception, tels que la Réalité Virtuelle (RV). Néanmoins, bien que largement utilisée dans l’industrie, la RV souffre d’un déficit d’acceptation de la part des concepteurs de produits. Dans le cadre de ces travaux, nous proposons d’utiliser la RV sous la forme d’outils immersifs d’assistance à la convergence multidisciplinaire développés selon une démarche anthropocentrée en fonction des besoins spécifiques à chaque projet de conception de produits. Afin d’optimiser les délais de développement, nous proposons une méthodologie de conception d’applications immersive dédiée : la méthodologie ASAP(As Soon As Possible). Une première série expérimentale a été conduite dans le cadre de contrats industriels d’études et de recherche afin de valider la faisabilité de la méthodologie et l’efficacité des outils développés.Une deuxième série expérimentale a été effectuée sur plus de 50 sujets dans le cadre de projets, cette fois, pédagogiques qui ont nécessité le développement de 12 applications. Elle a permis de valider quantitativement l’influence des outils immersifs sur l’efficacité perçue des phases de convergence interdisciplinaires ainsi que l’influence de l’approche proposée sur l’acceptation de la RV par les concepteurs de produits. Ces travaux de thèse présentent une première approche qui, selon nous, permettra à terme, de faire évoluer l’usage de la RV vers une intégration plus forte au sein des processus de conception de produits avec, par exemple, une plus large utilisation des applications immersives de modélisation 3D, réelles sources d’innovation. / Human centered and concurring product design is based on the collaboration between mechanical engineers, human factor experts and industrial designers. This collaboration is often difficult and can be eased through the use of intermediary objects such as Virtual Reality (VR). Nevertheless, even though VR is widely used in the industry, it suffers from a lack of acceptance by product designers. In the context of this research work, we suggest to use VR in the form of immersive multidisciplinary convergence support tools. These tools are developed in accordance with an anthropocentered approach, as a function of each specific product design project’s needs. In order to optimize development times, we propose a dedicated immersive software design methodology : the ASAP methodology (As Soon As Possible). A first experiment, aiming to demonstrate the feasibility of the ASAP methodology and the effectiveness of the implemented immersive tools, has been conducted in the context of industrial product design projects. A second experiment, involving more than 50 participants, has been conducted in the context of educational product design projects and led to the development of 12 immersivetools. It demonstrated quantitatively the contribution of immersive tools to the perceived effectiveness of interdisciplinary convergence phases and the contribution of the ASAP methodology on the acceptation of VR by product designers. This research work describes a first approach that could, according to us, allow abetter integration of VR within product design processes.

<p>This paper is concerned with the newly reformed national English test for Chinese college students, called the College English Test (CET) Band 4 (or Level 4). By comparing the test before and after it was reformed, there will be a close examination with regard to the aspects of test reliability, construct validity, authenticity, interactiveness, impact and practicality. With an extra focus on how vocabulary and grammar are tested, the paper aims to investigate the extent to which the new system is considered useful and how effective it is in testing vocabulary and grammar.</p>

<p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p><p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring.</p><p>Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara <em>golden standard</em> samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF).</p><p>Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81).</p><p>Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p> / <p>Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.</p>

During the last decade, anticipated and realized benefits of mobile and wireless information and communication technology (ICT) for different business purposes have been widely explored and evaluated. Also, the significance of ‘user acceptance’ mechanisms through ‘perceived usefulness’ of ICT applications has gained broad recognition among business organizations in developing and adopting new ICT capabilities. However, even though technology usefulness is regularly highlighted as an important factor in ICT projects, there is often a lack of understanding of what the concept involves in the practical work context of the actual users, and how to deal with the issues of usefulness in organizational ICT development processes. This doctoral thesis covers a 1,5 year case study of a mobile computing development project at a Swedish international construction enterprise. The company’s mobile ICT venture addressed the deficient ICT use situation of management practitioners in construction site operations. The study portrays the overall socially shaped development process of the chosen technology and its evolving issues of usefulness for existing construction site management practice. The perceived usefulness of mobile computing tools among the ‘user-practitioners’ is described as emergence of ‘meaningful use’ based on initial expectations and actual experiences of the technology in their situated fieldwork context. The studied case depicts the ongoing and open-ended conversational nature of understanding adequate ICT requirements in work practice, and the negotiation of mobile computing technology design properties between users and developers over time towards the alignment of diverse personal, professional and organizational needs and purposes of ICT use. The studied introduction of mobile computing technology in construction site management fieldwork practice serves as an illustrative actual example of how to interpret, understand and approach issues of usefulness and user acceptance of ICT resources in operative work contexts when managing ICT development processes in organizations. / QC 20100825

This paper is concerned with the newly reformed national English test for Chinese college students, called the College English Test (CET) Band 4 (or Level 4). By comparing the test before and after it was reformed, there will be a close examination with regard to the aspects of test reliability, construct validity, authenticity, interactiveness, impact and practicality. With an extra focus on how vocabulary and grammar are tested, the paper aims to investigate the extent to which the new system is considered useful and how effective it is in testing vocabulary and grammar.

Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. / Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.