This master´s thesis includes characterization of activities of long-term assets audit. The goal of thesis is completion of audit on state university. Result is suggestion for auditor how to proceed during audit of long-term assets.

Previous researchers, especially on large enterprises, have revealed that debt financing structure influences enterprise performance. Though the issue has been extensively researched, micro, small, and medium-sized enterprises (MSMEs) have traditionally been operating differently as compared to large enterprises in terms of their financial decisions, ownership and management style, and behaviour. Therefore, this study will explore the gaps encountered by all MSMEs to grow their businesses. These include forms and type of industry, firm size, asset tangibility, and a firm’s current assets in relation to its current liabilities and profitability level. The study examines the influence of financing structures on performance of micro, small and medium-sized enterprises (MSMEs) in South Africa. The ordinary least squares (OLS) technique of measurement is applied to examine the effects of financing structure on performance across various industrial sectors in the years 2013, 2014 and 2015. The findings in this study indicate an increase in the use of leverage to drive the influence of total debt on performance in all industrial sectors of MSMEs in South Africa. From the cross-sectional regression analysis, the results show that financing structure has a negative effect on the profitability of MSMEs, although not absolutely. The findings show that the size of the enterprise, asset tangibility, and the ratio of current assets to current liabilities are the most influential of borrowing decisions in total debt, short-term debt, and long-term debt. A significantly negative effect is observed for long-term debt, while short-term debt (STDR) exhibits a significantly positive effect. Thus the influence on MSMEs’ leverage on performance is driven by the usage of short-term debt. The variables of size of the firm, and ratio of current assets to current liabilities, do not have the same effect in all debt levels; the significance is substantially higher for long-term debt than for total debt and short-term debt. On the other hand, our empirical results suggested that transactional costs, and an asymmetric information problem in smaller firms, may lead to a mainly negative influence on size and total debt. The asset structure on profitability observed across the years showed mixed experiences. The ratio of current assets to current liabilities was found to be positive and significant on long-term debt and short-term debt leverage.

Indiana University-Purdue University Indianapolis (IUPUI) / Pain prevalence in nursing home (NH) residents is high. Studies report up to 85.0% of NH residents experience pain and up to 58.0% experience persistent pain. Pain in NH residents can lead to decreased happiness, quality of life, and life satisfaction. Traditionally, pain has been studied in relation to specific comorbid conditions or pain subtypes (nociceptive, neuropathic) with little consideration for the dynamic (temporal) nature of pain. Current pain subtypes are clinically linked to recommended pain treatments and provide insight into underlying mechanisms. However, current pain subtypes are limited by their focus on pain origin, do not include severity or duration of the pain experience, and do not illustrate how the course or trajectory of pain changes over time. Understanding the trajectory of pain experience can provide opportunities to alter the course of pain experience, improve residents’ quality of life and prevent adverse outcomes. This dissertation provides the first evidence of four distinct pain trajectories among NH residents including persistent pain which was associated with several resident characteristics and clinically relevant diagnosis. Using residents’ characteristics associated with persistent pain, such as a history of fracture or contracture, may improve care planning based on early identification or risk stratification and can improve mitigation of persistent pain. To identify and characterize pain trajectories in NH residents, the following activities were completed (1) systematic review of the literature related to prevalence of pain and associated factors in NH residents, (2) cross-sectional analysis of secondary data to examine prevalence of pain, persistent pain, and factors associated with pain in NH residents, and (3) a longitudinal retrospective analysis of secondary data using group-based trajectory modeling to identify, quantify, and characterize NH pain trajectories. The findings from this study highlight the prevalence and complexity of pain in NH residents.

As a result of the constant efforts to improve mobile system performance and spectral efficiency, the 3GPP standardization forum is currently defining new architectural and functional requirements that hope to ensure long-term evolution (specifically defined as the “Long-Term Evolution (LTE) concept”) and general future competitiveness of the 2G and 3G radio access technologies. Previous discussions on LTE efficiency have been focused on general assumptions on signaling overhead and overall system capacity, based on experience from existing mobile systems. However, as 3GPP standardization has become more mature (although not yet settled), there is a need to investigate how different potential LTE services will be affected by the use of available overhead information and basic scheduling algorithms. This thesis investigates the lower protocol layers’ overhead impacts on the downlink for different packet switched services, in an LTE radio access network (RAN). Results show that the use of RTP/TCP/IP header compression (ROHC) is the single most important factor to reduce payload overhead, for packet sizes of ~1kB or smaller. However, for packets larger than ~1 kB, the use of ROHC becomes insignificant. Protocol headers – including the AMR frame header, RLC/MAC headers, and CRC where applicable – remain the largest part of payload overhead regardless of packet size and header compression (ROHC). For VoIP over the UDP protocol (with ROHC), RLC/MAC headers constitute the largest part of protocol headers. For TCP/IP applications (without ROHC), TCP/IP headers are predominant. Services that require packet sizes beyond ~1 kB will require about the same power per payload bit regardless of percentage of payload overhead. / Som ett resultat av ständiga ansträngningar att förbättra såväl prestanda som spektrumeffektivitet för mobila system, definierar 3GPPs standardiseringsforum nya krav på arkitektur och funktionalitet. Dessa är avsedda att säkerställa långsiktig utveckling (explicit definierat som konceptet “Long-Term Evolution (LTE)”, samt framtida konkurrenskraft för både 2G och 3G som radioaccess-teknologier. Tidigare diskussioner rörande effektivitet inom LTE har fokuserat på allmänna antaganden vad gäller kontrolldata för signallering och övergripande systemprestanda. Dessa har i sin tur baserats på erfarenheter från existerande mobilsystem. När standardiseringen inom 3GPP mognar uppstår nu ett behov av att undersöka hur olika tjänster inom LTE påverkas, av såväl hur man använder den kontrollinformation som finns tillgänglig, som av basala algoritmer for schemaläggning av resurser. Denna rapport undersöker påverkan från lägre protokoll-lagers kontrollinformation på nerlänken hos olika paket-kopplade tjänster inom ett radioaccessnät för LTE. Resultaten visar att användandet av ROHC (som packar kontrollinformation för protokollen RTP/TCP/IP), är det ensamt viktigaste bidraget till minskad kontrollinformation i relation till informationsbitar för paketstorlekar upp till c:a 1kB. För större paket är vinsten med ROHC dock försumbar. Kontrollinformation för protokoll – inkluderat data avsett för AMR-tal-ramen, RLC/MAC-protokollen, samt CRC – utgör för övrigt en stor del av kontrollinformationen relativt informationsbitar, oavsett paketstorlek och packning av kontrolldata. Tjänster som kräver paketstorlekar på över c:a 1 kB kräver uppskattningsvis samma mängd energi per informationsbit, oavsett andelen kontrollinformation.

In Ontario, the population of older adults is increasing. While the provincial government is taking action to address increasing demand on health systems, older adults are still suffering the consequences of a health system that is not able to meet their complex care needs. Older adults face barriers to continuity of care including difficulties with memory, reliance on informal caregivers, frailty, and difficulties scheduling appointments. These barriers also exist within the long-term care setting. Long-term care facilities are making efforts to provide more effective care, including designing care approaches aimed to meet the complex care needs of older adults. Aspects of a goal-oriented approach suggest that it has the potential to reduce fragmentation and positively impacting continuity of care. However, the impact of goal-oriented care on continuity of care in a long-term care setting has yet to be explored. This thesis uses an exploratory case study methodology to describe how a goal-oriented care approach influenced continuity of care in a long-term care setting, as perceived by residents, staff, and administrators. The case study setting is the Perley & Rideau Veterans Health Centre in Ottawa, Ontario, where the SeeMe program, a frailty-informed approach with a goal-oriented component, was recently introduced. Factors associated with the SeeMe program and other organizational factors perceived to facilitate and inhibit informational, relational and management continuity were identified. Aspects of the SeeMe program that facilitated informational continuity were: goals-of-care meetings with residents, their care team and family; care conferences that helped residents understand their care options; and, procedures that ensured consistency in where resident’s goal information is stored. Aspects that facilitated relational continuity were: understanding residents’ values and preferences; staff increasing awareness of the program for families; and, integration of the family perspective into a resident’s care. Program aspects that facilitated management continuity were: discussions that led to informed decision-making; use of assessments as a reference tool in the case of an acute health event; discussions that empowered residents to talk to external care providers; and, creation of a structure that facilitated consistencies in care. These factors can be targeted when designing care approaches aimed to improve continuity in long-term care settings.

INTRODUCTION: Acute severe ulcerative colitis (ASUC) is a severe complication of ulcerative colitis (UC) that is associated with significant morbidity, treatment refractoriness and need for colectomy. Patients who do not adequately respond to the initial intravenous steroid therapy receive medical rescue therapy with infliximab or cyclosporine or undergo surgery for their refractory disease. However, there is limited guidance on management of steroid responders in this setting. While it is well established that Crohn’s disease (CD) is progressive and benefits from early institution of immunosuppressive therapy, such a paradigm is less well established in UC and thresholds for therapy escalation remain poorly defined. In immunosuppression-naïve patients, whether a single hospitalization for ASUC is a sufficient threshold to escalate to immunomodulator or biologic therapy is unknown. METHODS: From a single tertiary referral center, we identified all patients with ASUC hospitalized for intravenous steroids who were immunosuppression naïve (new UC diagnosis, no therapy, or 5-aminosalicylate (5-ASA) therapy) at their index hospitalization. We excluded patients who were refractory to steroids and initiated medical rescue therapy or required surgery during the index hospitalization. Our primary exposure of interest was initiation of biologic therapy within 1 month of hospital discharge or immunomodulator therapy (thiopurine, methotrexate) within 3 months. Our primary outcomes were need for colectomy within 12 months following hospitalization. Secondary outcomes include re-hospitalization rate within 12 months and late colectomy ( between 91-365 days). RESULTS: Our study included a total of 133 immunosuppressive-naïve ASUC patients among whom 56 (42%) escalated therapy to thiopurine (93%) or biologic (7%) post-hospitalization. The median age of the cohort was 29 years (range 16 – 88 years) and 46% were male. 82 patients (62%) had pancolitis on disease distribution. 38% and 58% were noted to have moderate to severe disease on sigmoidoscopic evaluation. Thirteen patients (10%) underwent surgery by 1 year. At 12 months, there was no difference in the rate of colectomy among those with therapy escalation (13%) compared to those who did not undergo such escalation (8%, unadjusted OR= 1.69 p=0.53). This lack of difference remained robust on multivariable regression analysis and propensity score adjusted models (OR 0.90, 95% confidence interval (CI) 0.18 – 4.45). There was no difference in the rates of hospitalization within 1 year (OR 2.24 95% CI 0.16 – 4.22) or in the time to colectomy between the two groups (log-rank p=0.27). CONCLUSION: Immunosuppression-naïve ASUC patients who respond to intravenous steroids remain at high risk for colectomy with 10% (13/133) receiving such surgery within 1 year. Therapy escalation was not associated with a reduction in this risk. There is an important need for larger prospective studies defining the benefit of early therapy escalation in UC, and appropriate thresholds for the same.

Le secteur des télécommunications mobiles a connu une croissance très rapide dans un passé récent avec pour résultat d'importantes évolutions technologiques et architecturales des réseaux sans fil. L'expansion et l'hétérogénéité de ces réseaux ont engendré des coûts de fonctionnement de plus en plus importants. Les dysfonctionnements typiques de ces réseaux ont souvent pour origines des pannes d'équipements ainsi que de mauvaises planifications et/ou configurations. Dans ce contexte, le dépannage automatisé des réseaux sans fil peut s'avérer d'une importance particulière visant à réduire les coûts opérationnels et à fournir une bonne qualité de service aux utilisateurs. Le dépannage automatisé des pannes survenant sur les réseaux sans fil peuvent ainsi conduire à une réduction du temps d'interruption de service pour les clients, permettant ainsi d'éviter l'orientation de ces derniers vers les opérateurs concurrents. Le RAN (Radio Access Network) d'un réseau sans fil constitue sa plus grande partie. Par conséquent, le dépannage automatisé des réseaux d'accès radio des réseaux sans fil est très important. Ce dépannage comprend la détection des dysfonctionnements, l'identification des causes des pannes (diagnostic) et la proposition d'actions correctives (déploiement de la solution). Tout d'abord, dans cette thèse, les travaux antérieurs liés au dépannage automatisé des réseaux sans-fil ont été explorés. Il s'avère que la détection et le diagnostic des incidents impactant les réseaux sans-fil ont déjà bien été étudiés dans les productions scientifiques traitant de ces sujets. Mais étonnamment, aucune référence significative sur des travaux de recherche liés aux résolutions automatisées des pannes des réseaux sans fil n'a été rapportée. Ainsi, l'objectif de cette thèse est de présenter mes travaux de recherche sur la " résolution automatisée des dysfonctionnements des réseaux sans fil LTE (Long Term Evolution) à partir d'une approche statistique ". Les dysfonctionnements liés aux paramètres RRM (Radio Resource Management) seront particulièrement étudiés. Cette thèse décrit l'utilisation des données statistiques pour l'automatisation du processus de résolution des problèmes survenant sur les réseaux sans fil. Dans ce but, l'efficacité de l'approche statistique destinée à l'automatisation de la résolution des incidents liés aux paramètres RRM a été étudiée. Ce résultat est obtenu par la modélisation des relations fonctionnelles existantes entre les paramètres RRM et les indicateurs de performance ou KPI (Key Performance Indicator). Une architecture générique automatisée pour RRM 8 a été proposée. Cette dernière a été utilisée afin d'étudier l'utilisation de l'approche statistique dans le paramétrage automatique et le suivi des performances des réseaux sans fil. L'utilisation de l'approche statistique dans la résolution automatique des dysfonctionnements des réseaux sans fil présente deux contraintes majeures. Premièrement, les mesures de KPI obtenues à partir du réseau peuvent contenir des erreurs qui peuvent partiellement masquer le comportement réel des indicateurs de performance. Deuxièmement, ces algorithmes automatisés sont itératifs. Ainsi, après chaque itération, la performance du réseau est généralement évaluée sur la durée d'une journée avec les nouveaux paramètres réseau implémentés. Les algorithmes itératifs devraient donc atteindre leurs objectifs de qualité de service dans un nombre minimum d'itérations. La méthodologie automatisée de diagnostic et de résolution développée dans cette thèse, basée sur la modélisation statistique, prend en compte ces deux difficultés. Ces algorithmes de la résolution automatisé nécessitent peu de calculs et convergent vers un petit nombre d'itérations ce qui permet leur implémentation à l'OMC (Operation and Maintenace Center). La méthodologie a été appliquée à des cas pratiques sur réseau LTE dans le but de résoudre des problématiques liées à la mobilité et aux interférences. Il est ainsi apparu que l'objectif de correction de ces dysfonctionnements a été atteint au bout d'un petit nombre d'itérations. Un processus de résolution automatisé utilisant l'optimisation séquentielle des paramètres d'atténuation des interférences et de packet scheduling a également été étudié. L'incorporation de la "connaissance a priori" dans le processus de résolution automatisé réduit d'avantage le nombre d'itérations nécessaires à l'automatisation du processus. En outre, le processus automatisé de résolution devient plus robuste, et donc, plus simple et plus pratique à mettre en œuvre dans les réseaux sans fil. / The mobile telecommunication industry has experienced a very rapid growth in the recent past. This has resulted in significant technological and architectural evolution in the wireless networks. The expansion and the heterogenity of these networks have made their operational cost more and more important. Typical faults in these networks may be related to equipment breakdown and inappropriate planning and configuration. In this context, automated troubleshooting in wireless networks receives a growing importance, aiming at reducing the operational cost and providing high-quality services for the end-users. Automated troubleshooting can reduce service breakdown time for the clients, resulting in the decrease in client switchover to competing network operators. The Radio Access Network (RAN) of a wireless network constitutes its biggest part. Hence, the automated troubleshooting of RAN of the wireless networks is very important. The troubleshooting comprises the isolation of the faulty cells (fault detection), identifying the causes of the fault (fault diagnosis) and the proposal and deployement of the healing action (solution deployement). First of all, in this thesis, the previous work related to the troubleshooting of the wireless networks has been explored. It turns out that the fault detection and the diagnosis of wireless networks have been well studied in the scientific literature. Surprisingly, no significant references for the research work related to the automated healing of wireless networks have been reported. Thus, the aim of this thesis is to describe my research advances on "Automated healing of LTE wireless networks using statistical learning". We focus on the faults related to Radio Resource Management (RRM) parameters. This thesis explores the use of statistical learning for the automated healing process. In this context, the effectiveness of statistical learning for automated RRM has been investigated. This is achieved by modeling the functional relationships between the RRM parameters and Key Performance Indicators (KPIs). A generic automated RRM architecture has been proposed. This generic architecture has been used to study the application of statistical learning approach to auto-tuning and performance monitoring of the wireless networks. The use of statistical learning in the automated healing of wireless networks introduces two important diculties: Firstly, the KPI measurements obtained from the network are noisy, hence this noise can partially mask the actual behaviour of KPIs. Secondly, these automated healing algorithms are iterative. After each iteration the network performance is typically evaluated over the duration of a day with new network parameter settings. Hence, the iterative algorithms should achieve their QoS objective in a minimum number of iterations. Automated healing methodology developped in this thesis, based on statistical modeling, addresses these two issues. The automated healing algorithms developped are computationaly light and converge in a few number of iterations. This enables the implemenation of these algorithms in the Operation and Maintenance Center (OMC) in the off-line mode. The automated healing methodolgy has been applied to 3G Long Term Evolution (LTE) use cases for healing the mobility and intereference mitigation parameter settings. It has been observed that our healing objective is achieved in a few number of iterations. An automated healing process using the sequential optimization of interference mitigation and packet scheduling parameters has also been investigated. The incorporation of the a priori knowledge into the automated healing process, further reduces the number of iterations required for automated healing. Furthermore, the automated healing process becomes more robust, hence, more feasible and practical for the implementation in the wireless networks.

Although research has been conducted on the short-term effects of natural and human-made disasters on individuals and families, few researchers have examined the experiences of families during the recovery and rebuilding process when stressors may continue on many levels, sometimes for years later. The aim of this qualitative study was to explore the experience of recovery for families during the 3-year period following Superstorm Sandy in 2012 through the theoretical lens of Bronfenbrenner's bio-ecological perspective. A narrative approach was used in order to understand the experience of natural disaster recovery and the meaning of recovery and coping for these families. Families in the surrounding area of Long Beach, New York were invited to participate. Six families who experienced Superstorm Sandy shared their experiences through interviews. Common themes were found among participants during the preparation for the storm, throughout the storm, and again during identified stages in the recovery process. Participants displayed both positive and negative coping styles and rated the helpfulness of various interventions. Findings from the study suggest that future researchers should focus on understanding the individual factors that may affect the decision to prepare for and evacuate during a large-scale natural disaster. The results of this study can be used by support services staff to develop and target interventions that address the common themes identified during the long-term recovery process. More effective interventions may lessen the length and intensity of suffering. Additionally, highlighting the importance of disaster preparedness may encourage individuals and communities to better prepare for disasters, possibly diminishing damage and losses.

The purposes of this study were: (1) to determine which characteristics of male alcoholics are related to treatment success and length of stay in long-term treatment, and (2) to assess the efficacy of predicting outcome and length of stay on the basis of patient characteristics, The study was performed post hoc on 265 patients discharged from a 6- to 12-month residential alcoholism program on the grounds of a state hospital. After an extensive literature review, 19 predictor variables were selected which were most consistently related to outcome and length of stay in previous studies of shorter rehabilitation programs. Data for predictor variables were obtained from psychological testing, admission interview notes, anamneses, and symptom ratings, Treatment outcome at 6-month follow-up was assessed dichotomously (success - failure) and numerically (number of abstinence and social adjustment criteria met) based on questionnaire responses and second-hand information. Sample size varied across analyses, as cases were deleted for missing data. Compared to patients who failed to benefit, treatment successes were less antisocial (p < .01) and reported fewer alcoholic withdrawal symptoms (p < .05, n = 131). The results also suggest that successes were less angry than failures (this variable reached significance in the analyses which were given the most consideration, and showed consistent trends in other analyses). Patient characteristics unrelated to treatment outcome were age, socioeconomic status, social stability, number of arrests, age at onset of drinking problem, problematic drinking by patients' parents, length of longest previous period of sobriety, number of previous alcoholism treatments, previous regular A.A. attendance, overall mental health, neuroticism, depression, obsessive compulsive traits, latent schizophrenia, IQ, and defensiveness. A four-variable discriminant function produced 70.23% correct classification of outcome (r = .34, p < .01, n = 131), but the 33.3% false negative rate raises a question about using the function as an acceptance criterion. The pattern of results implies that the longterm program fosters social integration, but does not overcome the effects of severe personality disorders or physical addictions. Only IQ was related to length of stay, with more intelligent subjects remaining in treatment longer (p < .05, n = 233). Weak but statistically significant prediction of length of stay was obtained with a nine-variable regression equation (r = .34, p < .01, n = 199).

Bakgrund: Långvarig smärta är ett vanligt symtom bland befolkningen och ett folkhälsoproblem. Kvinnor drabbas i större utsträckning än män av diagnoser kopplade till långvarig smärta. Rapporter visar att vården inte är jämställd på flera sätt, exempelvis föreligger könsskillnader i vårdtillgång gällande väntetider samt åtgärder och vårdkvalitet mellan kvinnor och män. Fysioterapeuter inom primärvård och slutenvård möter ofta patienter med långvariga smärttillstånd. Att behandla patienten utifrån vad som är bäst för patienten och inte diskriminera utifrån till exempel kön är en del av de etiska regler som fysioterapeuter ska förhålla sig till. Syfte: Syftet med denna studie var att undersöka fem fysioterapeuters erfarenheter och upplevelser av jämställdhet i vården av patienter med långvariga smärttillstånd.  Metod: En kvalitativ design med semistrukturerade intervjuer tillämpades. Fem fysioterapeuter verksamma inom slutenvård och primärvård rekryterades till studien genom ett strategiskt urval. Data från intervjuerna bearbetades med kvalitativ innehållsanalys. Resultat: Analysen genererade sex kategorier och fjorton underkategorier. De sex kategorierna bestod av Fysioterapeuters syn på jämställdhet varierar, Fysioterapeuter strävar efter jämställd vård, Jämställdhet – Två sidor av ett mynt, Strukturella orättvisor i sjukvård och hos myndigheter, Förändring krävs inom sjukvården för jämställd vård och Vården ojämlik idag även på grund av andra faktorer än kön.  Slutsats: Fysioterapeuterna ansåg att smärtvården idag är inte jämställd och kvinnor missgynnas. Sjukvården bör fortsätta arbeta med strukturella problem och vårdgivarens eget ansvar bör understrykas. / Background: Long-term pain is a common symptom among the population. Women are affected to a greater extent than men by diagnoses linked to long-term pain. Reports show that healthcare is not equal in several ways, such as the gender difference in the availability of care and the quality of care between women and men. Physiotherapists in primary care and inpatient care often meet patients with long-term pain conditions. Treating the patient based on what is best for the patient and not discriminate based on gender are parts of the ethical rules that physiotherapists must relate to.  Aim: The aim of this study was to examine five physiotherapists' experiences of gender equality in the care of patients with long-term pain conditions. Method: A qualitative design with semi-structured interviews was applied. Five physiotherapists active in inpatient and primary care were recruited to the study through a strategic selection. A qualitative content analysis was used to process the data. Results: The analysis generated six categories and fourteen subcategories. The six categories consisted of Physiotherapists' views on gender equality vary, Physiotherapists strive for gender equal healthcare, Gender equality - Two sides of a coin, Structural injustices in healthcare and with authorities, Change is required in healthcare for gender equality and Healthcare is unequal today due to other factors than gender. Conclusion: The physiotherapists considered that healthcare today is not equal, and women are in a disadvantaged. Healthcare should continue to work with structural problems and the caregiver's own responsibility should be emphasized.