As technology becomes ever more pervasive, the challenges of home automation are increasingly apparent. Seamless home control, home monitoring and home programming by the end user have yet to enter the mainstream. This could be attributed to the challenge of developing a fully autonomous and extensible home system that can support devices and technologies of differing protocols and functionalities. In order to offer programming facilities to the user, the underlying rule system must be fully independent, allowing support for current and future devices. Additional challenges arise from the need to detect and handle conflicts that may arise among user rules and yield undesirable results. Non-technical individuals typically struggle when faced with a programming task. It is therefore vital to encourage and ease the process of programming the home. This thesis presents Homer, a home system that has been developed to support three key features of a home system: control, monitoring and programming. Homer supports any third-party hardware or software service that can expose its functionality through Java and conform to the Homer interface. Stand-alone end user interfaces can be written by developers to offer any of Homer's functionality. Where policies (i.e. rules) for the home are concerned, Homer offers a fully independent policy system. The thesis presents a custom policy language, Homeric, that has been designed specifically for writing home rules. The Homer policy system detects overlaps and conflicts among rules using constraint satisfaction and the effect on environment variables. The thesis also introduces the notion of perspectives to ease user interactivity. These have been integrated into Homer to accommodate the range of ways in which a user may think about different aspects and features of their home. These perspectives include location, device type, time and people-oriented points of view. Design guidelines are also discussed to aid end user programming of the home. The work presented in this thesis demonstrates a system that supports control, monitoring and programming of the home. Developers can quickly and easily add functionality to the home through components. Conflicts can be detected amongst rules within the home. Finally, design guidelines and a prototype interface have been developed to allow both technically minded and non-technical people to program their home.

Quality end-of-life care in the adult critical care remains a high priority for numerous professional agencies and organizations due to advanced technologies that sustain or extent life, regardless of life quality. The purpose of this study was to describe how family members of patients in adult critical care attain awareness that their loved one is dying or near death in the adult critical care setting. Two research questions were addressed: 1) What is the human-environment health process of knowing that end-of-life is imminent by family members of patients in the adult critical care area?, and 2) What factors influence the human-environment health process of knowing that end-of-life is imminent by family members in the adult critical care area? A Glaserian grounded theory design was utilized to conduct this retrospective study. Both primary (interviews) and secondary (poem, nursing art, song, media and film) data sources supported the emerging theory. The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care contained six phases: Patient's Near Death Awareness, Dying Right in Front of Me, Turning Points in the Patient's Condition, No Longer the Person I Once Knew, Doing Right by Them, and Time to Let Go. Influencing factors associated with this process were discussed as process facilitators and hindrances. Supportive nursing behaviors and actions as well as family member's emotional, behavioral, and physical reactions to having a critically ill family member were also discussed. This substantive theory will guide nursing education, practice, and research in the creation of nursing interventions, instrumentation, protocols, and policies and procedures aimed at providing cost effective quality end-of-life care in this specialized area of care.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / End‐of‐life (EOL) care and decision‐making in pediatrics is a challenging and complex aspect of patient care experienced by residents and physician attendings. Previous studies have evaluated determinants that contribute to physicians’ attitudes towards EOL care as well as preparedness of students and residents in EOL decision‐making. However, the determinants contributing to a physician’s ability to make such decisions and feel confident in addressing EOL issues are dynamic. Recognizing that decision‐making changes over time, identifying when these changes occur may demonstrate the need for educational interventions for medical students and residents early in their career to help prepare them for EOL decision‐making. A longitudinal assessment of changes in attitudes and knowledge of EOL discussions and how they impact EOL decision‐making was not previously evaluated. This preliminary study establishes a baseline for medical student, resident, and attendings for EOL decision‐making and those factors that contribute to their decisions. This preliminary data has demonstrated a difference amongst attendings compared to residents and students. Despite low probability of survival, residents and students are more likely to select more aggressive management options when compared to attendings. Data obtained after completion of future surveys will show when decision‐making changes, which factors contribute to these changes and their significance in making decisions, and when participants are comfortable addressing EOL care.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / American Indians and American Native (AI/AN) populations have faced health disparities for a period of time. Although their incidence for some chronic diseases such as cancer, may be lower than the general population, they suffer from the poorest survival rates of any ethnic group. As the AI/AN populations age and live longer with chronic disease as seen with the rest of the general population, the discussion of palliative care is becoming more important. Currently, there is not a lot of literature about palliative care that is specific to the AI/AN population. The paucity of research serves as an impetus to learn and examine the need of available palliative care resources for the AI/AN populations. We present the analysis of twenty interviews with staff members of local hospice organizations and hospitals. The interview questions ask participants about their views and experiences in delivering palliative care. Through these discussions, we investigate the current needs, social and cultural barriers, and the infrastructure of how palliative care is accessed and delivered.

This thesis aims to make feminist theory an integral part of hospital ethics committee ("HEC") decisionmaking. Specifically, the feminist theories discussed in this thesis prioritize an awareness of social context. The small-scale study conducted for this thesis found that HECs already consider social context to some extent but that they may also be open to more systematic integration. As opposed to courts, HECs provide a space where innovative alternatives (e.g., feminist approaches) to principalist bioethical decisionmaking can be tested. In order to encourage the development of such alternatives, this thesis has proposed a framework for the relationship between courts and HECs so that patients can benefit from the strengths of both entities in ways that have not been possible in the past.

Methyl bromide fumigation, a common method used to combat soil borne pathogens in commercial tomato cultivation, was to be limited by the Montreal Protocol due to concerns of ozone depletion. Alternative methods to protect tomatoes against diseases include grafting. However, short grafted transplants may expose the scion to the soil. To avoid scion exposure, hypocotyl elongation of two tomato rootstocks 'Maxifort' and 'Aloha' via end-of-day far-red (EOD-FR) was examined in terms of light quality (red to far-red ratio, or R/FR) and dose (product of far-red intensity and duration). In EOD-FR light quality experiments, 'Aloha' seedlings were exposed to unfiltered and filtered incandescent light with an R/FR of 0.5 and 0.05 respectively. The resulting hypocotyl elongation was higher in filtered light than either the unfiltered light or the untreated control. Hypocotyl elongation response to EOD-FR dose in 'Aloha' and 'Maxifort' was affected by both far-red intensity and treatment duration. A saturating response was also found within a far-red dose between 0–8 mmol•m⁻²•d⁻¹ and modeled using non-linear regression with a three parameter Michaelis-Menten equation to estimate the far-red dose required to obtain near-maximum hypocotyl elongation for 'Aloha' and 'Maxifort'. The far-red dose required was affected by cultivar and experimental period. None of the EOD-FR treatments affected plant mass or stem diameter. To conclude, for maximum hypocotyl elongation using EOD-FR, the lower R/FR would increase the effectiveness of the treatment. The far-red dose should preferably be at 4–8 mmol• m⁻²•d⁻¹.

End users must regularly agree to lengthy software agreements prior to installing software or using software services. However, despite the fact that these agreements contain terms of direct concern to users—e.g., data collection policies—software agreements are typically read by less than 2% of the population [30]. This thesis presents techniques and heuristics for improving the presentation and visual design of software agreements, to better capture reader attention and improve comprehension. In contrast to other techniques, these techniques are applied to the full agreement content, rather than a summary, as summaries have been found to distract readers from the full content of the agreement [44,56]. This thesis introduces two techniques for improving software agreements: narrative pictograms and textured agreements. Narrative pictograms are a pictorial technique designed to improve the communication of agreement terms to non-native readers of the language of an agreement. An experimental study shows that they can successfully communicate the basic concepts of a data collection policy without words. Textured agreements are visually redesigned software agreements that highlight information relevant to users. A pair of experimental studies shows that they increase both reading time—by 30 seconds, from 7 in the first experiment and 20 in the second—and comprehension of agreement content—by 4/16 points, from 0. Finally, a solid understanding of users’ attitudes towards specific agreement content is needed to inform the design of improved software agreements. To that end, this thesis presents an analysis of EULAscan, an online community of anonymous reviewers of software agreements. An open coding is used to categorize 191 EULAscan reviews. From this analysis, functionality emerges as the most prevalent concern. The wide variety of other concerns across reviews suggests that static designs of software agreements would inadequately serve a large population of users. Instead, this thesis proposes a focus on end-user tools that identify and highlight clauses of possible interest to a given user—for example, terms that the user has not seen before.

Introduction: Despite the public and policy attention on ensuring access to health care for all Canadians, research continues to identify inequities in access to cancer care services. The objectives of this thesis are to define inequity in access to colorectal cancer (CRC), as well as to measure inequity in access to radiotherapy and end-of-life care. Methods: This study examined income-, geography-, sex-, and age-related inequity in access to CRC services along the continuum of care, using the Horizontal Inequity Index. Specifically, we measured and compared inequity in access CRC services in Nova Scotia using linked administrative databases. Results: We have identified that age- and geography-related inequity in access to radiotherapy and end-of-life care are the most consistent for CRC patients in Nova Scotia. Discussion: The clear distinction between inequity and inequality in this study provides indication to policy makers that the variations in access, may be of social concern.

Tailgating (maintaining an inadequate headway) is a major road safety concern that emerges because drivers tend to misperceive their following distance. Drivers seldom receive enough feedback to correct this error, leaving them vulnerable to rear-end collisions. While there have been attempts to address this issue through vehicle automation and warning systems, these approaches have not been sensitive to the needs of young drivers. The present investigation sought to implement a headway evaluation system: an in-vehicle display designed to provide motorists with real-time as well as aggregate headway feedback. This system was designed to teach drivers to recognize safe headways and to motivate adherence. Compared to drivers selecting their own headway or those attempting to count a two second headway, drivers using the headway evaluation system maintained longer headways that would be conducive to collision avoidance. This system may be beneficial as a training device for new drivers. / AUTO21, the Ontario Innovation Trust, the Canada Foundation for Innovation, and the Natural Sciences and Engineering Research Council of Canada

Background: The growth in the number of individuals with end-stage renal disease has implications in terms of both the health of individuals, especially older adults (aged 65 years and older), and the capacity of the health care system to provide adequate treatment needed by these patients. Much has been written regarding the pathophysiology of end-stage renal disease as well as how modern advances in technology have contributed to the ‘dialysis world’. However, the literature is sparse in relation to how older adults experience end-stage renal disease and the technological complexity of dialysis in their daily lives. Objective: The purpose of this study was to explore the meaning of being hemodialysis-dependent for the older adult living with end-stage renal disease. Method: A descriptive method using a qualitative interviewing approach was used. Systematic focused thematic analysis guided by the Crisis of Physical Illness conceptual model allowed for the findings to surface. Data sources included individual interviews, direct observation of participants and the hemodialysis unit, along with field notes. A purposive sample of nine participants was obtained from two different hemodialysis units, both operated by Kingston General Hospital. Data were analyzed using the Colaizzi method. Findings: Five themes were identified by the participants: The Will to Live, Recognition of a Lifetime Commitment, Learning to Live with Technology, The Yin and Yang of Dialysis, and Transcending Dialysis. Conclusions: End-stage renal disease and thrice weekly hemodialysis treatment have an impact on the daily life of older adults and their ability to cope with the changes. This study revealed that despite the restrictions of being on hemodialysis, all of the participants had the will to live and some expressed the need for further education using a variety of strategies that would meet the specific needs of this population. A more in-depth understanding of how older adults experience hemodialysis is needed to provide adequate care/resources for this special population. / Thesis (Master, Nursing) -- Queen's University, 2011-09-15 13:02:28.548