This exploratory study sought to identify factors which motivate individual participation in volunteer services for the Long-Term Ombudsman Program of the Volunteer Center of Riverside County.

This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing facilities that were not connected to a hospital or part of a continuing care retirement community to find a correlation, if any, between emergency preparedness and CMS star rating. The theoretical foundation for the research was the diffusions of innovation theory, which addresses innovation that is communicated between members of a team or social group, inclusive of gaining knowledge of an innovation, persuading others to move toward that innovation, team decision making on the innovation, and implementation/confirmation of that innovation. The statistical analysis provided inconclusive answers to research questions. The potential social change from this study is it may inform nursing home administrators of the 4 most frequent E-tag deficiencies found in this research; and their nonlinear relationship to total bed count and variables such as individual Medicare star rating categories so that administrators can apply this new knowledge to their field in general and their facility in particular; to achieve better overall disaster preparedness coordination.

Long-Term Evolution (LTE) is the latest development in wide area cellular mobile network technology. In contrast with the earlier generations of circuit-switched mobile networks, LTE is all-IP packet-switched network. Both voice and data are sent inside IP packets. Voice over IP (VoIP) is used to provide voice service to LTE users. The speech frames are encapsulated into real-time protocol (RTP) packets and sent over the network. The underlying UDP and IP layers prepend their headers to this small RTP packet resulting in a relatively high overhead. The small size of the RTP packets containing voice/audio leads to an overhead problem as the protocol overhead is in addition to the large LTE frame overhead, thus wasting network resources. This master’s thesis project proposes to multiplex RTP and data packets at the user’s device as a solution to reduce the overhead. Moreover, the capability of modern user devices to switch between several interfaces (such as LTE and WLAN), is taken into account and the multiplexing of multiple traffic flows or a single traffic flow are studied in the case of a vertical handover. Performance and cost metrics are used to evaluate different potential demultiplexing points, and then the best possible demultiplexing point is identified. The results of this evaluation show that several demultiplexing points can be used based on the operator’s needs. The increased packet payload size increases the energy efficiency of LTE and may avoid the need of the UE to switch to WLAN to save power. In addition, to ensure high quality of service for VoIP traffic, the simultaneous use of multiple interfaces is efficient if the multiplexer is enabled. The multiplexing solution proposed by this thesis is also fully compatible with any virtual private network encapsulation protocol. / Long-Term Evolution (LTE) är den senaste tekniken inom mobil långdistanskommunikation. Jämfört med tidigare generationer av kretskopplade mobila nätverk, är LTE IP paketförmedlande nätverk. Både röstsamtal och datapaket skickas enkapsulerade i IP paket. Voice over IP (VoIP) används för att transportera röstsamtal över IP nätverket. Röstsekvenser enkapsuleras i Real Time Protocol (RTP) paket och skickas över nätverket. De underliggande lagerna som UDP och IP infogar sin huvudinformation i de små RTP paketen vilket gör att kommunikationen blir ooptimerad. De små RTP paketen som innehåller ljudinformation leder till att det blir ooptimerat tillsammans med LTE i och med att man lägger på huvudinformation för varje lager. I det här examensarbetet förslår vi att multiplexa RTP och datapaket tillsammans direkt i användarens enhet för att minska huvudinformationen. Dessutom diskuterar vi möjligheten att byta mellan olika kopplingar (som LTE och WLAN) samt att multiplexa flerfaldig eller singel trafik under en vertikal överlämning. Prestanda och kostnadsmätningar används för att evaluera olika potentiella sammankopplingspunkter, för att kunna ta reda på den bästa sammankopplingspunkten.  Resultatet av detta examensarbete visar på att flera sammankopplingspunkter kan användas beroende på operatörens behov. Den ökade storleken på nyttolasten ökar effektiviteten av LTE nätverken och minskar risken för att behöva byta UE:n till WLAN för att spara energi.  Utöver det ovannämnda kan simultan användning av olika kopplingar användas för att öka kvaliteten på VoIP trafik. Multplexlösningen som föreslås i det här examensarbete är dessutom fullt kompatibel med virtuella privata nätverksenkapsulerande protokoll.

The population of older adults is growing worldwide, particularly in North America. Health information technology (HIT) is a group of technologies and systems that enhance care by electronically storing, managing, and exchanging data. HIT presents opportunities to support older adults' healthcare needs in communities and long-term care (LTC) environments. Despite their potential benefits, these technologies remain limited in LTC and older adults' healthcare contexts. Evidence is scattered on the factors that affect older adults' adoption of HIT. Little research has investigated the adoption of these technologies by formal healthcare providers and the technologies' impacts on LTC. A multi-method approach was employed in this thesis research, using a combination of a systematic qualitative review, an inductive semi-qualitative Delphi survey, and a quantitative deductive study to manage each research question in order to address these gaps. The systematic literature review used the PRISMA guidelines to identify and critically appraise studies that examined the effect of various HIT adoption factors among older adults in the community. The search involved five databases and a combination of keywords, resulting in the selection of critically appraised articles based on their evidence level and research rigor. A coding scheme was developed to extract information from the selected articles. The results showed that the main factors affecting HIT adoption by older adults relate to performance expectancy, effort expectancy, and high price/cost value. It also highlighted the importance of considering privacy/security and product design when evaluating HIT adoption by older adults. In light of the limited available studies on HIT adoption and impacts in the context of LTC, a Delphi study was developed to collect data from key formal healthcare providers (i.e., nurses) working in LTC at one of the largest and most progressive older adult healthcare facilities in Ontario, Canada. The Delphi study aimed to identify and prioritize the key factors that affect nurses' adoption of new technologies in support of older adults' care. A panel of nurses was solicited to participate in the Delphi study, which involved three rounds of data collection: brainstorming, narrowing down, and ranking. A total of 20 nurses completed the Delphi study, and the top factors that the LTC nurses identified were mainly related to the organizational and technological dimensions, including the complexity of HIT, the training and support provided, the interoperability of HIT systems, the cost of implementation, and the availability of HIT infrastructure. For the last part of this research, quantitative secondary data analysis was conducted on a Canadian national survey of nurses to examine their perceived impacts of HIT adoption by nurses in LTC. The survey included questions related to the current state of electronic medical records (EMR) and EMR adoption, the state of virtual care technologies, attitudes and perceptions related to access and the impact of the adoption of digital health technologies in practice, benefits and effects of EMR adoption, and barriers preventing nurses from getting total value from electronic health. A subset of 166 nursing homes/long-term care facilities/older adult residences and homecare nurses were selected for this analysis. Data management and analysis were conducted using IBM SPSS v28. The results showed that HIT adoption by nurses in LTC was positively associated with perceived benefits and organizational support. However, HIT adoption was negatively associated with perceived complexity and privacy/security concerns. This thesis research suggests that HIT adoption by older adults and nurses in LTC is complex and multifaceted, requiring attention to individual, organizational, and technological factors. There is a need for improved communication and collaboration among LTC team members and better working conditions to improve staff well-being and reduce turnover. The findings from the systematic review and Delphi study contribute to the theoretical understanding of the factors influencing the adoption of HIT in LTC facilities. The survey results provide valuable insights into the current state of HIT use in LTC facilities and can be used to inform the development of targeted interventions to improve HIT adoption and use. Overall, this study contributes to the growing body of knowledge on HIT adoption in LTC facilities and provides important recommendations for policymakers, administrators, and LTC staff to improve the use of HIT and ultimately enhance the quality of the care supplied to LTC residents.

Individuals with a foreign background are particularly financially exposed group in society,who are more likely to receive financial assistance. This study investigates long-term welfarerecipients with a foreign background and their path to self-sufficiency from the perspective ofthe social workers. The study answers two main questions: Firstly, what factors contribute tolong-term acceptance of aid among individuals with a foreign background? Secondly, whatdoes social workers' work look like with long-term welfare recipients with a foreignbackground? The study is based on a qualitative methodological approach, through semi-structured interviews with five social workers from various municipalities within theStockholm area who work within their respective units for financial assistance. The empirical data have been processed with thematic analysis, and the presented results havebeen analyzed with the theoretical frameworks of capital theory and empowerment. Theresults of this study show that both individual- and structural factors can contribute toindividuals with a foreign background getting stuck as long-term welfare recipients. Some ofthe factors are, for example, lack of language skills, low education level, segregation, alimited social network and the demands of the labor market. The results also show that socialworkers' work with long-term welfare recipients who have foreign background is mainlyabout motivational work and finding new individual-strengthening ways to help the clientsbreak their dependence on benefits, where the work can be particularly challenging with thistarget group. In conclusion, this study has contributed to an enhanced understanding of along-term welfare recipients among individuals with a foreign background and how socialworkers work in relation to these clients. / Individer med utländsk bakgrund är en särskilt ekonomiskt utsatt grupp i samhället som istörre utsträckning blir aktuella för att erhålla ekonomiskt bistånd. Syftet med denna studie äratt undersöka långvariga biståndstagare med utländsk bakgrund och deras väg ut till egenförsörjning utifrån socialsekreterarnas perspektiv. Studien besvarar de två framtagnafrågeställningarna; Vilka faktorer bidrar till ett långvarigt biståndstagande hos individer medutländsk bakgrund? och Hur ser socialsekreterarnas arbete ut med långvariga biståndstagarehos individer med utländsk bakgrund? En kvalitativ metod är grunden för empirin i dennastudie genom semistrukurerade intervjuer med fem socialsekreterare som arbetar inomenheten för ekonomiskt bistånd i olika kommuner inom Stockholmsområdet.  Empirin har bearbetats med tematisk analys där det presenterade resultatet sedan haranalyserats med stöd av de två teoretiska utgångspunkterna kapitalteorin och empowerment.Denna studies resultat visar att både individuella och strukturella faktorer kan bidra till attindivider med utländsk bakgrund fastnar i ett långvarigt biståndstagande. Några av defaktorerna är exempelvis bristande språkkunskaper, låg utbildningsnivå, segregation,begränsat socialt nätverk och arbetsmarknadens krav. Dessutom visar resultaten attsocialsekreterarnas arbete med de långvariga biståndstagarna som har utländsk bakgrundfrämst handlar om motiverande arbete och hitta nya individstärkande vägar för att hjälpaklienterna att bryta sitt bidragsberoende, där arbetet kan vara särskilt utmanande med dennamålgrupp. Denna studie har därmed givit ökad kunskap om långvariga biståndstagare blandindivider med utländsk bakgrund och hur socialsekreterare arbetar i relation till dessaklienter.

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Electrochromic thin films can effectively regulate the visible and infrared light passing through a window, demonstrating great potential to save energy and offer a comfortable indoor environment in buildings. However, long-term durability is a big issue and the physics behind this is far from clear. This dissertation work concerns two important parts of an electrochromic window: the anodic and cathodic layers. In particular, work focusing on the anodic side develop a new Ni oxide based layers and uncover degradation dynamics in Ni oxide thin films; and work focusing on the cathodic side addresses materials rejuvenation with the aim to eliminate degradation. In the first part of this dissertation work, iridium oxide is found to be compatible with acids, bases and Li+-containing electrolytes, and an anodic layer with very superior long-term durability was developed by incorporating of small amount (7.6 at. %) of Ir into Ni oxide. This film demonstrated sustained cycle-dependent growth of charge density and electrochromic modulation even after 10,000 CV cycles. The (111) and (100) crystal facets in Ni oxide are found to possess different abilities to absorb cation and/or anion, which yields different degrees of coloration and this is very significant for the electrochromic properties. The degradation of charge capacity in Ni oxide has an inevitable rapid decay in the first hundreds of cycles, subsequently combined with a more gradual decay, which is independent of applied potential and film composition. The consistent phenomenon can be very well modeled by power-law or stretched exponential decay; however the two models are indistinguishable in the current stage. Interestingly, in both models, the power-law exponent is 0.2 ≤ p ≤ 0.8, with most of the values around 0.5, in line with normal or anomalous diffusion models. The second part of dissertation work deals with cathodic WO3 and TiO2. WO3 suffers from ion trapping induced degradation of charge capacity and optical modulation upon electrochemical cycling. This speculation is strongly supported by direct evidence from Time-of-Flight Elastic Recoil Detection Analysis (ToF-ERDA). Most importantly, this ion trapping induced degradation can be eliminated by a galvanostatic de-trapping process. Significant ion-trapping takes place when x exceeds ~0.65 in LixWO3. The trapped ions are stable in the host structure, meaning that the ions cannot de-trap without external stimuli. The similar work done on TiO2 significantly complements and extends the work on the recuperation of WO3; the difference is that the trapped ions in host TiO2 seem to be less stable compared with the trapped ions in WO3.     Overall, this dissertation presents a refined conceptual framework for developing superior electrochromic windows in energy efficient buildings.

Self-management interventions enhance the health self-management techniques and physical and psychological health outcomes among people with long-term health conditions (LTHCs). Few individuals from South Asian backgrounds attended the pilot phase of one such intervention: the Expert Patients Programme (EPP), a community-based self-management course. This raised concerns about exacerbating health inequalities. South Asian people have increased prevalence and severity of certain musculoskeletal conditions, yet little is known about their experiences of living with and self-managing these. This research aimed to rectify these omissions, by describing Punjabi Sikh women's experiences of living with and self-managing arthritis, and identifying barriers and facilitators to EPP. Three studies explored White and Punjabi Sikh EPP tutors‟ experiences of delivering EPP to South Asian attendees, and Punjabi Sikh women's experiences of living with and self-managing arthritis, both before and after they attended a Punjabi-language EPP. White and Punjabi Sikh tutors' sometimes dichotomous experiences of delivering EPP to South Asians, captured barriers to South Asian people's attendance, engagement and self-management. Facilitators identified included the need for sensitive tailoring of the Course, involving the Punjabi Sikh community. The Punjabi Sikh women's vibrant experiential accounts revealed the detrimental psychological and physical consequences that arthritis had upon their lives. Highly versatile in their proactive arthritis self-management prior to attending EPP, participants' refined techniques encompassed combinations of medication and Indian remedies, empowered by their religious and spiritual values. Following EPP attendance, the participants reported psychological and physical improvements in their arthritis. Thus, this Study established Punjabi Sikh 4 Abstract women's inherent acceptance of the concept of self-management, and, notwithstanding its current limitations, the likely appropriateness of EPP. Every Study represents a novel contribution to knowledge. Meaningful engagement with Punjabi Sikh community-members may produce a culturally-competent intervention that could better improve this group's physical and psychological outcomes, thus addressing one small area of health inequalities.

Master of Science / Division of Biology / John M. Blair / Temperate grasslands are among the most threatened biomes in the world, with the largest historical losses due to conversion to agricultural land. While much of this biome has already been converted, there is concern the last remaining remnants in North America will be converted in response to increasing demand for crops used for ethanol production. Thus, restoring grasslands post-anthropogenic disturbance is increasingly important for conserving grassland biodiversity. Two major challenges for prairie restorations are establishing the many subdominant and rarer species found in native prairie, and offsetting the typical decline in richness and diversity over time as restorations age. Repeated seed addition of targeted species is commonly used to override low and declining plant richness and diversity. While this is generally effective early in restoration (i.e., as communities are establishing), its effectiveness in later stages (i.e., when established communities are often losing diversity) remains unknown. I investigated plant community responses to combinations of resource manipulations and disturbances coupled with a seed addition in a 15-yr old restored grassland to test the hypothesis that spatial resource heterogeneity increases the rate of colonization into established prairie restoration communities. Seeds were added to a long-term restoration experiment involving soil depth manipulations (deep, shallow) crossed with nutrient manipulations (reduced N, ambient N, enriched N). Seedling emergence was generally low and only 8 of the 14 forb species added were detected in the first growing season. I found no effect of increased resource heterogeneity on the abundance or richness of seedlings. There was a significant nutrient effect (p<0.1, α=0.1) on seedling abundance, with higher emergence in the enriched N than the ambient N treatment. I also found unexpected nutrient effects on richness, diversity and Mean C (Mean C = Σ CoCi*Ai, where CoC=Coefficient of Conservatism and A=relative abundance of the ith species). All values, except Mean C, were higher in the enriched N treatment than in either the reduced or ambient N treatments. Mean C was lowest in the enriched N treatment, and highest in the whole-plot control, suggesting that the majority of species contributing to higher richness and diversity in the enriched N treatment were “weedier” species. In a separate experiment, I found no effect of small-scale disturbances (aboveground biomass removal or soil disturbance) on seedling abundance or seedling richness. I did find a marginal effect of disturbance type on seedling richness (p=0.11, α=0.1), with higher seedling richness in the soil disturbance than the aboveground biomass removal treatment. I did not find any disturbance effects on community response variables. These results indicate that recruitment from seed additions into well-established restored communities is relatively low in the first year following a seed addition, regardless of resource availability and heterogeneity. Follow-up studies to determine recruitment rates in subsequent years are needed to elucidate whether recruitment responses are driven more by individual species differences or by environmental mechanisms.

This article describes the psychometric properties of the WHOQOL-OLD (an add-on module to the World Health Organization's Quality of Life measure for older people) in a South African sample. International literature cites three short versions of the WHOQOL-OLD instrument. The psychometric properties associated with these three short versions of the WHOQOL-OLD are also described. The unique challenges posed by ageing populations are evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). Regardless of integration policies in post-apartheid South Africa, especially in terms of housing arrangements, the majority of long-term care facilities in South Africa remain to be occupied predominantly by white older people. For this reason the participants of this study were mostly older white South Africans. It is, however, projected that this picture will change in future times due to more aggressive transformation-driven policies. A national audit of residential care facilities by the Department of Social Development in 2010 indicated a need for psychosocial interventions since the QoL of residents was found to be undetermined. QoL research in South Africa has largely been conducted from socio-economic and health-care perspectives and has tended to focus on specific societies in which older people are usually not explicitly included. Evidence exists of various qualitative studies among older people living in long-term care facilities, from a psychological perspective. However, the short supply of quantitative studies in this setting is significant. The lack of measurements developed for an older population also resulted in an increasing need for the development of gerontological QoL measurements with sound psychometric properties. Internationally, various measures of QoL utilised in older age groups have become increasingly popular. This study took particular interest in the WHOQOL-OLD instrument. Under the auspices of the World Health Organization Quality of Life group, a collaborative effort among numerous researchers from various countries has led to the development of a measure focussing on the QoL in older population cohorts. The initial development of the generic WHOQOL measures of quality of life occurred in 15 different centres worldwide, excluding South Africa. In the development of an add-on module, 22 centres around the world were involved (again excluding South Africa). It cannot be assumed that measuring instruments developed in a Western context are applicable in an African context. South Africa is a very diverse nation - the majority of ethnic groups lead a collectivistic existence. As a result the determination of the psychometric properties of such instruments, for use within South Africa, was needed. It is of importance to note that the participants of this study were more individualistically inclined, which is comparable to Western societies. This study was the first step in exploring the instrument’s reliable use within South Africa. Surveys were completed by 176 older people who were fluent in both Afrikaans and English. Participants of the study resided in long-term care facilities in Potchefstroom in the North-West province of South Africa. Their ages varied between 61 and 95 and the mean age of participants was 77 years. Of the respondents, 50 were male and 126 were female. All reported average to good health and cognitive ability. The current study found encouraging results related to the original factor structure of the WHOQOL-OLD as well as the three shorter versions of this instrument. Results from the data of the current sample seem to fit the original structure model well. The reliabilities associated with the various sub-dimensions point to a reliable instrument. The original WHOQOL-OLD questionnaire with its 24 items or any of the three short versions of this instrument can therefore be utilised in a South African context. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2015