This project, which used a qualitative, explanatory case-study design explored the transition to practice of new graduate Registered Nurses (RNs) and Registered Practical Nurses (RPNs) in long-term care (LTC). Specifically, this study focused on the self-described transition to practice experience of the new graduate nurse (NGN), the contextual factors present in LTC that influenced this transition to practice, and how the transition experience was similar and different for the new graduate RN and RPN. Both NGNs and LTC directors were included in the study. In total, 7 NGNs and 2 LTC directors participated in semi-structured interviews. The NGN participants were employed as a nurse in one of the two LTC sites and had been working as a nurse for less than one year. Data were collected through Key Informants (NGNs and LTC directors), and Key Documents (LTC policies and orientation material). Results of this study introduced six contextual factors present in LTC that influence the transition to practice of NGNs and five processes that, as a result of the contextual factors, accelerate the transition to practice experience. This described accelerated transition to practice refutes the previously universally applied transition to practice theory and contributes new knowledge and understanding to the transition to practice experience of the NGN in LTC and more specifically how the new graduate RPN experiences transitioning. The findings also described the many similarities and some differences between the transition to practice experience of the new graduate RN and RPN in LTC. With increasing demands on the long-term care sector, these findings will be of interest to a broad audience including policy makers, educators, LTC directors and administrators, as well as nursing students and NGNs. It is anticipated that these results will direct further research on this topic, and inform policy, practice, and educational programs. / Thesis / Master of Science (MSc)

Long-term care facility network in Ontario, and in Canada as a whole, encounters critical issues regarding balancing demand with capacity. Even worse, it is faced with rising demand in the coming years. Moreover, there is an urgent need to provide long-term care for patients in their own language (particularly French). This study proposes a dynamic Mixed-Integer Linear Programming model based on the current standing of the long-term care system in Ontario, which simultaneously optimizes the time and location of constructing new long-term care facilities, adjusting the capacity (namely, human resources and beds) of each facility dynamically, and the assignment of patients to the facilities based on their demand region, gender, language, and age group over a finite time horizon. We apply the diversity-support constraints, based on patients’ gender and language, to save patients from loneliness and to comply with the Canadian values of providing care. Finally, we validate the model by performing a case study in Hamilton, Ontario. An extensive set of numerical analyses are explored to provide deeper insights into the whole issue. One set of such analysis is an extensive simulation study to examine the effect of distributional uncertainty in some of the input parameters on the optimal results, hence providing a much more realistic understanding of the optimization model. / Thesis / Master of Science (MSc)

Background 50% of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm such as Clostridiodes difficile infection and antibiotic-resistant organisms. Antimicrobial Stewardship (AS) interventions plays an important role in optimizing antibiotic use. Most studies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)-focused AS intervention at a LTCF with the secondary objective of exploring the pharmacist’s potential role(s) in this intervention. Methods A qualitative approach using conventional content analysis was used. Through purposeful sampling, we recruited different healthcare providers and administrators at Kensington Gardens. Interviewees attended focus groups or one-on-one interviews. Data were collected using a semi-structured interview guide. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barrier and facilitator themes were identified from the transcripts and mapped using the COM-B (capability, opportunity, motivation and behaviour) model (Michie et al). Similarly, themes were identified from the transcripts regarding the pharmacist’s roles in this intervention. Results Sixteen participants were interviewed. Most barriers and facilitators mapped to the opportunities domain of the COM-B model. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. Furthermore, the pharmacist can play a role in education and antibiotic selection. Conclusions A UTI-focused antimicrobial stewardship intervention in LTCF should consider strategies to improve access, knowledge, communication and collaboration in its design, having sufficient resources and addressing external factors in order to optimize the intervention’s success. Pharmacists can play a role in education and antibiotic selection. / Thesis / Master of Science (MSc) / Half of antibiotics prescribed in long-term care are not needed, leading to increased harm. It is unclear which strategies should be used to improve antibiotic prescribing. This project aims to identify facilitators, barriers and strategies in identifying and managing urinary tract infection in a long-term care facility as well as exploring the role of the pharmacist in this setting. We conducted focus groups and interviews to gather information and analyzed the transcripts to determine barrier and facilitator themes relating to urinary tract infection management and the role of the pharmacist. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. In addition, the pharmacist can play a role in education and antibiotic selection.

The purpose of this study was to compare couples in different phases of marriage with the primary goal of contributing to our understanding of marital quality throughout the life span. Rusbult's investment theory (Rusbult, 1980, 1983; Rusbult & Buunk, 1993), which predicts specific outcomes concerning relationship satisfaction, commitment, and stability, served as the guiding theory behind this effort. Assumptions derived from the theory were tested with couples in three distinct phases of marriage selected from the first wave of the National Survey of Families and Households (Sweet, Bumpass, & Call, 1988). Short-term couples consisted of husbands and wives married between 4 and 6 years, intermediate couples consisted of those married between 20 and 25 years, and long-term couples consisted of those married 45 years or more. Couples were compared with regard to four specific aspects of their relationships: conflict frequency, conflict resolution, satisfaction, and perceptions of the quality of alternatives to their current marriages. Data generated from spouses' averaged scores were analyzed using a series of one-way ANOVAs and paired t-tests. Results from this sample of respondents clearly revealed that long-term couples engaged in less conflict, utilized different conflict resolution strategies, were more satisfied with their marriages, and perceived alternatives to their relationships as less favorable than younger couples. In addition, when husbands' and wives' scores on the above measures were compared, long-term couples exhibited fewer differences than younger couples. Findings from this study are discussed in light of existing research and theory. / Ph. D.

We propose a framework for managing changes in Long term Composed Services (LCSs). The key components of the proposed framework include a Web Service Change Management Language (SCML), change enactment, and change optimization. The SCML is a formal language to specify top-down changes. It is built upon a formal model which consists of a Web service ontology and a LCS schema. The Web service ontology gives a semantic description on the important features of a service, including functionality, quality, and context. The LCS schema gives a high-level overview of a LCS's key features. A top-down change is specified as the modification of a LCS schema in the first place. Change enactment is the process of reacting to a top-down change. It consists of two subcomponents, including change reaction and change verification. The change reaction component implements the proposed change operators by modifying a LCS schema and the membership of Web services. The change verification component ensures that the correctness of a LCS is maintained during the process of change reaction. We propose a set of algorithms for the processes of change reaction and verification. The change optimization component selects the Web services that participate in a LCS to ensure that the change has been reacted to in the best way. We propose a two-phase optimization process to select services using both service reputation and service quality. We present a change management system that implements the proposed approaches. We also conduct a set of simulations to assess the performance. / Ph. D.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Future generation cellular networks are expected to deliver an omnipresent broadband access network for an endlessly increasing number of subscribers. Long term Evolution (LTE) represents a significant milestone towards wireless networks known as 4G cellular networks. A key feature of LTE is the implementation of enhanced Radio Resource Management (RRM) mechanism to improve the system performance. The structure of LTE networks was simplified by diminishing the number of the nodes of the core network. Also, the design of the radio protocol architecture is quite unique. In order to achieve high data rate in LTE, 3rd Generation Partnership Project (3GPP) has selected Orthogonal Frequency Division Multiplexing (OFDM) as an appropriate scheme in terms of downlinks. However, the proper scheme for an uplink is the Single-Carrier Frequency Domain Multiple Access due to the peak-to-average-power-ratio (PAPR) constraint. LTE packet scheduling plays a primary role as part of RRM to improve the system’s data rate as well as supporting various QoS requirements of mobile services. The major function of the LTE packet scheduler is to assign Physical Resource Blocks (PRBs) to mobile User Equipment (UE). In our work, we formed a proposed packet scheduler algorithm. The proposed scheduler algorithm acts based on the number of UEs attached to the eNodeB. To evaluate the proposed scheduler algorithm, we assumed two different scenarios based on a number of UEs. When the number of UE is lower than the number of PRBs, the UEs with highest Channel Quality Indicator (CQI) will be assigned PRBs. Otherwise, the scheduler will assign PRBs based on a given proportional fairness metric. The eNodeB’s throughput is increased when the proposed algorithm was implemented.

As early as 2014, mobile network operators' spectral capacity will be overwhelmed by the demand brought on by new devices and applications. To augment capacity and meet this demand, operators may choose to deploy a Dynamic Spectrum Access (DSA) overlay. Spectrum regulation is following suit, with regulators attempting to incorporate spectrum sharing through the design of spectrum access rules that support DSA. This dissertation explores the idea of DSA applied to Long Term Evolution Advanced (LTE+) networks. This idea is explored under functional, architectural, and spectrum policy aspects. Under the functional and architectural aspects of this topic, the signaling and functionality required by such an overlay have not yet been fully considered in the architecture of an LTE+. This dissertation presents a Spectrum Accountability framework to be integrated into LTE+ MacroNet and HetNet architectures, defining specific element functionality, protocol interfaces, and signaling flow diagrams required to enforce the rights and responsibilities of primary and secondary users. We also identify and propose three DSA management frameworks for LTE+ HetNets: Spectrum Accountability Client Only, Cell Spectrum Management, and Domain Spectrum Management. Our Spectrum Accountability framework may serve as a guide in the development of future LTE+ network standards that account for DSA. We also quantify, through simulation and integer programs, the benefits of using DSA channels to augment capacity under a scenario in which LTE+ network can opportunistically use TV and GSM spectrum. In our first experiment, we a consider a scenario where three different operators share the same cell site with LTE+ equipment and a Dynamic Spectrum Access (DSA) band to augment spectral capacity. Our experiments show that throughput can increase by as much as 40%. We develop integer programs to model the assignment of spectrum channels to both a MacroNet and HetNet. In our selected scenario, we observe TV white spectrum provides the largest gain in performance for both Nets: 27% for MacroNet and 9% increase for the HetNet over our measured ranges. Although the gains in using opportunistic use of GSM is more modest, 10% and 2% for the Macro and HetNet, respectively, we believe that these gains will significantly increase as operators continue to migrate users to LTE+, thus freeing up portions of the bands currently used for GSM service. In our final analytical model, we create integer program sets to represent the different three DSA management frameworks for LTE+ HetNets and compare their results. Under the spectrum policy aspects, this dissertation develops a decision-theoretic framework for regulators to assess the impacts of different spectrum access rules on both primary and secondary operators. We analyze access rules based on sensing and exclusion areas, which in practice can be enforced through geolocation databases. Our results show that receiver-only sensing provides insufficient protection for primary and co-existing secondary users and overall low social welfare. On the other hand, combining sensing information of only the transmitter and receiver of a communication link provides dramatic increases in system performance. The performance of using these link end points is relatively close to that of using many cooperative sensing nodes associated to the same access point and large link exclusion areas. We hope these results will prove useful to regulators and network developers in un and developing rules for future DSA regulation. / Ph. D.

An initial public offering (IPO) represents a significant event in a firm’s lifecycle, marking the transition from being a privately held company to a publicly traded entity by offering its shares to the public for the first time. Several previous studies have shown that, from an investor point of view, IPOs posits the opportunity to earn substantial return, and that they also tend to underperform long-term. In recent years, stock market volatility has fluctuated considerably due to factors such as the global pandemic and geopolitical conflicts. These factors have led to varying stock market returns, affecting individuals' savings. Additionally, the number of investors in Sweden has grown substantially over the past decade. This, combined with the relatively unexplored nature of market volatility in IPO research, has laid the foundation for this study's focus. Therefore, the purpose of this study is to assess the impact market volatility has on the initial return and the long-term risk-adjusted return of IPOs in Sweden.  To fulfill this purpose, analyses have been undertaken to investigate the relationship between IPO short- and long-term returns and market volatility between 2019 and 2022. This timeframe encapsulates two years experiencing low market volatility (2019 and 2021), and two years experiencing higher market volatility (2020 and 2022). The data sample consists of 165 firms when measuring short-term returns, and 162 firms when measuring long-term returns, who have all had their IPO within this timeframe and are all listed on the Swedish stock market. To further contribute to the literature, the study incorporates the Efficient Market Hypothesis (EMH), Prospect Theory, and the Winner´s Curse Theory. These are three well-established and contrasting theories within IPO research which are introduced to see how well their perspectives align with the study's findings.  The empirical results from the statistical analyses showed varied outcomes. While a statistically significant difference could be identified between certain years, the majority did not. Since the majority of the tests conducted could not find a significant difference in return between high and low volatile years, market volatility at the time of an IPO does not significantly influence the return. Consequently, the findings suggest that employing an investment strategy that involves investing in IPOs based on market volatility levels is not superior to other strategies. These findings give investors deeper insights into how IPOs and their timing are influenced by market conditions and can therefore aid them in making more informed decisions.

No / We examine short- and the long-term price effect associated with the FTSE 100 index revisions. We control for both heteroskedastic nature of the residual and the change, between the estimation and the test period, in the beta coefficient of the standard market model. Our findings reveal no relationship between the long-term price reversals and the change in the discount rate, as approximated by the beta coefficient of the market model. Overall, we provide strong evidence in favour of the price pressure hypothesis, where the price increase (decrease) gradually starting before the announcement an inclusion (exclusion) and reverses completely in less than two weeks after the index revision date.