How are homeless individuals, who have no access to private space yet still have the same needs of dwelling as the rest of us, regarded when they exercise their right to dwell? This question guided my research of Edmontons Tent City, which emerged during the summer of 2007. Interviews with twenty-two individuals, including with encampment residents, service providers, and state officials, informed a broader understanding of why the encampment emerged at the time that it did; how Edmontons public spaces accommodate the homeless; and, how Tent City shaped municipal and provincial policy on housing and homelessness. Homeless campers saw Tent City as home, while state management focused on excluding homeless campers from the downtown public space to restore order to the streets of Edmonton, as well as their positive public image. Tent City constituted a claim by homeless campers to occupy public space and be represented as part of the public but hitherto this has been met with increased strategies of dispersement and exclusion rather than with an expansion of citizenship rights. I argue that Tent City illuminates the states preoccupation with regulating the visibility of homeless individuals rather than focusing on the dwelling needs of homeless campers.

Thesis (M.A.R.)--Emmanuel School of Religion, 1994. / Vita. Includes bibliographical references (leaves 79-80).

Diss.--Marburg.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18201号 / 人健博第18号 / 新制||人健||2(附属図書館) / 31059 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 二木 淑子, 教授 坪山 直生, 教授 桂 敏樹 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Frailty is a multifaceted, geriatric syndrome that is associated with age-related declines in functional reserves resulting in increased risks of in-hospital death, readmissions and discharge to nursing homes. The risks associated with frailty highlights the need for providers to be able to quickly, and accurately, assess someone’s frailty level. Previous studies have shown that bedside clinician assessment is not a reliable or valid way to determine frailty, meaning that a more reliable, valid and concise method is needed. We developed a prediction model using discharge ICD-9/ICD-10 diagnostic codes and other demographic variables to predict Reported Edmonton Frail Scale scores. Participants were from the Baystate Frailty Study, a prospective cohort design study among elderly patients greater than 65 years old who were admitted to a single academic medical center between 2014 and 2016. Three different predictive models were completed utilizing the LASSO approach. The adjusted r-square increased across the three models indicating an increase in the predictive ability of the models. In this study of 762 hospitalized patients over the age of 65 years old, we found that a frailty prediction model that included ICD codes only had a poor prediction ability (adjusted r-square=0.10). The prediction ability improved 2-fold after adding demographic information, a comorbidity score and interaction terms (adjusted r-square=0.26). This study provided additional insights into the development of an automatic frailty assessment, something which is currently missing from clinical care.

Many North American suburban shopping malls have become under-performing retail islands drifting in oceans of asphalt parking lots. This thesis examined three potential future scenarios for the aging retail shopping mall landscape; 1. Maintaining status quo 2. Upgrading the property for a mixed-use neighbourhood centre 3. Implementing strategies for attainable sustainability targets These scenarios were examined using a proposed retrofit of Edmonton, Canada’s Westmount Centre as a case study, to determine if this retrofitting approach could be a pilot for other districts. The principles of 2030 District (2030 District, 2012) guided this thesis, a concept which proposed that by 2030 all newly constructed districts be energy neutral and that existing districts be retrofitted to use less than 50% of the energy that they presently consume. The Spider charts developed by Haas & Troglio (Haas & Troglio, 2011) were used to create strategies that included incorporating existing proven, economically viable technologies to the proposed retrofit. The three resulting scenarios were then evaluated using Leadership in Energy and Environmental Design - Neighbourhood Design, version 4 (LEED-ND v4), to make a case for raising the threshold for sustainability and mitigation measures when planning new and retrofit projects in North America (USGBC, 2014). The goal of the thesis was to find a solution that holistically meets the goals of LEED-ND, where partnerships between numerous stakeholders provide a business model for urban sustainability, which includes planning, implementation and verification (2030 District, 2012). By examining proven sustainability measures and applying them to the normative scenario, makes the case that strategic implementation during a situation of opportunity, through timely stakeholder interaction, will result in a district that is both sustainable (environmentally, socially and economically) and provides a good return on investment. This thesis is a starting point for the iterative process, a compelling argument and business case for further investigation and action for Westmount Centre and by extension, to other retail districts.

No description available.

<p>In February 2011, a wave of creative direct action swept across postal depots in the city of Edmonton which saw rank-and-file workers organizing outside of the channels of formal-legal unionism. Fighting against management’s imposition of compulsory overtime as a staffing measure, Letter Carriers and other “outside” postal workers relied on solidarity and resistance at the point of production in a successful campaign to put an end to this practice. The relevance of this particular struggle to the Canadian labour movement is twofold. First, the intensified workloads of Edmonton postal workers reflect a wider shift in the nature of employment relationships away from the existence of employer support as part of the rise of neoliberal capitalism. Second, the choice of workers to organize at a distance from the historically militant Canadian Union of Postal Workers reveals both the predicament facing labour of a highly restrictive formal labour relations system as well as an alternative path of resistance. For Edmonton postal workers, this path was forged in large part as a result of the influence of IWW dual-carder organizers and, more specifically, their introduction of a mode of union praxis known as solidarity unionism</p> / Master of Arts (MA)

No description available.

Introdução. Embora existam diferentes estratégias para a prestação de cuidados paliativos ao paciente com câncer, pouco se conhece sobre a efetividade desses modelos. Objetivos. Comparar os efeitos da equipe de cuidado paliativo integrada ao cuidado tradicional com o cuidado tradicional sozinho no controle de sintomas em paciente com câncer avançado hospitalizado. Método. Estudo longitudinal composto por dois grupos não randomizados. 73 pacientes foram admitidos para a equipe de cuidado paliativo integrada ao cuidado tradicional (Grupo ECP) e comparados a 75 atendidos no modelo de cuidado tradicional (Grupo CT). Os sintomas foram avaliados pela Escala de Avaliação de Sintomas de Edmonton (ESAS), a satisfação por escala numérica verbal (0-10), a funcionalidade pela Escala de Desempenho Funcional Físico Karnofsky (KPS) e a adequação analgésica pelo Índice de Manejo da Dor (IMD). Os pacientes foram avaliados na admissão, após 24 e 48 horas. O desfecho primário foi a melhora clinica significativa de 2 pontos na intensidade da dor e da náusea em 48 horas, comparados com a admissão. Os dados demográficos, os sintomas e sua redução foram comparados entre os Grupos pelo Teste Exato de Fisher ou Mann Whitney. O Teste de Wilcoxon analisou alterações dos sintomas intragrupos. A regressão múltipla de Poisson controlou fatores de confusão para a melhora do sintoma. O nível de significância adotado foi de 5%. Resultados. A prevalência de sintomas foi alta em ambos os grupos: no Grupo ECP a variação foi de 43.8% (depressão) a 87.7% (sensação de bem estar), e no Grupo CT, de 24% (dispneia) a 85.5% (dor). A magnitude dos sintomas, pelo escore da mediana, foi importante em ambos os Grupos: na admissão, no Grupo ECP, variou entre 5.5 (sensação de bem estar) a 8.0 (ansiedade, apetite, constipação e tristeza), e no Grupo CT, variou de 6.0 (sensação de bem estar e dispneia) a 9.0 (perda do apetite). A mediana de sobrecarga de sintomas, avaliada pelo ESAS, foi de 50.0 em ambos os grupos. Na análise de 24 horas (intragrupo), no Grupo ECP cinco sintomas (dor, náusea, perda do apetite, dispneia, prejuízo do sono) e sobrecarga de sintomas foram reduzidos (p<0.05), enquanto no Grupo Grupo CT três sintomas (dor, náusea e prejuízo do sono) foram reduzidos (p<0.05). Na análise de 48 horas (intragrupo), dez sintomas e sobrecarga de sintomas no Grupo ECP foram reduzidos (p<0.05), enquanto quatro sintomas melhoraram no Grupo CT (p<0.05). A regressão múltipla mostrou que a dor (RR= 2.2 [IC95%1.27-3.81]) e bem estar (RR=4.6 [IC95% 1.34-15.88]) reduziram 2 pontos e foi favorável somente no Grupo ECP. Verificou-se melhor adequação da analgesia no Grupo ECP comparado ao CT (p<0.05). A satisfação do doente foi elevada e similar em ambos os grupos. Conclusão. Os doentes de ambos os grupos mostraram grande sobrecarga de sintomas e somente o sintoma dor foi adequadamente controlado pelo Grupo ECP. Os resultados encontrados demandam análise de fatores da estratégia de tratamento que possam melhorar a efetividade das ações, como avaliação sistematizada dos sintomas em curtos períodos e estratégias que permitam ajuste rápido da terapêutica quando necessário. / Introduction. Although there are many different strategies for provision of palliative care to patients with cancer, little is known about the effectiveness of these modalities. Objective.To compare the effects of a palliative care team integrated with traditional care to traditional care alone on symptom control in inpatients with advanced cancer. Method. Longitudinal study composed of two non-randomized groups. Seventy-three patients were admitted to the palliative care team integrated to traditional care (PCT Group) and compared to 75 patients treated in the traditional care model (TC Group). Symptoms were assessed by the Edmonton Symptom Assessment Scale (ESAS), satisfaction with treatment by the verbal numeric scale (0-10), performance status by the Karnofsky Performance Status Scale (KPS) and analgesic adequacy by the Pain Management Index (PMI). Patients were assessed upon admission, and after 24 and 48 hours. The primary outcomes were significant clinical improvements of 2 points in pain intensity and nausea in 48 hours, compared to admission. The demographic data, symptoms, and reduction in symptoms were compared between the groups by using Fisher\'s or Mann Whitneys Exact Tests. The Wilcoxon test examined the intragroup alteration of symptoms. The Poisson multiple regression controlled for confounding factors of improvement in symptoms. A p-value of 0.05 indicated statistical significance for all analyses. Results. The prevalence of symptoms at admission was high in both groups. In the PCT Group, it ranged from 43.8% (depression) to 87.7% (loss of well-being) and, in the TC Group, it ranged from 24% (dyspnoea) to 85.5% (pain). The magnitude of median score of symptoms was substantial in both groups: at admission for the PCT group, it ranged from 5.5 (sense of well-being) to 8.0 (anxiety, appetite, constipation, sadness), while for the TC Group, it ranged from 6.0 (sense of well-being and dyspnoea) to 9.0 (loss of appetite). The median score of the symptom burden assessed by ESAS was 50.0 in both groups. In 24 hours (intragroup), the PCT Group had significant reductions in intensity of five symptoms (pain, nausea, loss of appetite, dyspnoea, and sleep disturbance) and symptom burden, while the TC Group had significant reductions in intensity of three symptoms (pain, nausea, and sleep disturbance). In 48 hours (intragroup), the PCT Group had significant reductions in intensity of ten symptoms and symptom burden and while the TC Group had significant improve in intensity of four symptoms. Multiple regression analysis showed that pain (RR = 2.2 [95% CI 1.27-3.81]) and loss of well-being (RR = 4.6 [95% CI 1.34-15.88]) were reduced by two points and it was significantly more favourable only in the PCT Group. The PMI revealed better adequacy of analgesia in the PCT Group. Satisfaction was high and similar in both groups. Conclusion. Patients with advanced cancer in both groups showed a pronounced burden of symptoms and only pain was properly controlled in the PCT Group. The results indicate that factors that can improve treatment strategy should be implemented to improve the effectiveness of clinical assistance. Examples of factors that can improve treatment are frequent and systematic assessment of symptoms in short periods, and strategies that allow for timely adjustment of therapy when necessary.