There is a paucity of scientific evidence into the lived experience of people who have a history of injecting drug use and are living with leg ulceration. Portraying the true voice of injecting drug users (IDUs) through narrative means is a novelty in contemporary literature. The representation of the life and the person behind the leg ulcer, having experienced addiction, is original from a purist narrative perspective. This study, led from the perspective of a nurse-researcher leading in the field of wound management, offers a unique opportunity to gain a rare glimpse into the daily life of IDUs, as reported in their own words. The aim of this study was to explore the experience of injecting drug users living with leg ulceration using qualitative methodology. A naturalistic paradigm framed the design by allowing participants to control the data in an unrestricted an open manner without direct intrusion form the researcher. Qualitative methodology was central to collecting data on life experience and feelings. The ethics process detailed a rigorous application to explore the professional, ethical virtues from the perspective of an insider-outsider working with sensitive data in a marginalised population. Diaries were kept and recorded by participants over four weeks in their routine daily life; this was followed by semi-structured interviews. The diaries allowed a unique insight into the past, present and future of IDUs and how their ulcer affected their lives. The diaries also facilitated a means of reflection on themselves and their wounded body. The interviews offered an opportunity to explore in detail the diary entries and other stories participants wished to share. The study recruited twelve participants from leg ulcer clinics set in London; three women and nine men older than 18 years of age (median age of 52 years; range 35 - 62 years). Ten completed the data collection process; two of the participants, aged 61 and 62 years, were married. Gatekeepers working with IDUs with leg ulceration were central to the process of engagement and recruitment. Participants welcomed the design as an opportunity to voice and share their journey of living with an open wound. The findings revealed the detailed suffering participants endured living with their ulcer: pain, shame and stigma were clearly voiced in their narratives. The majority of participants had experienced some form of stigma during their life and this was exacerbated as they were drug users. The self-blame and punishment triggered by this felt stigma was a detriment to the health of participants. Those in contact with specialist wound care services saw a significant improvement in wound healing and this had a positive impact on their wellbeing and their overall outlook on life. Participants also voiced enacted-stigma experienced from encounters in health practice. These negative experiences exacerbated the self-stigma. Findings also portrayed the multiple characteristics and talents of participants including humour, art and resilience. This research contributes to science and practice by understanding the lives of IDUs living with leg ulceration. It provides a platform from which to engage both generalists and specialists who care for these patients and has the potential to influence medical and social policy-making and clinical practice in this field. By means of narrative inquiry, this study may challenge the conventional social stereotypes, the taboos and the stigma still experienced by this patient group in health care.

Orientador: Érico Bruno Viana Campos / Banca: Andréia Schmidt / Banca: Sandro Caramaschi / Resumo: O desenvolvimento de novas tecnologias, especialmente da internet, é uma característica marcante da sociedade pós-moderna. Além disso, o narcisismo também se mostra como uma característica social importante, refletindo os ideais individualistas incentivados pela mídia. Entretanto, percebe-se uma escassez de estudos nacionais que se propõem a relacionar o uso de internet e características narcísicas da personalidade. Com isso, o presente estudo teve como objetivo investigar o uso de internet e características narcísicas da personalidade em estudantes universitários, além de verificar a existência de uma possível correlação entre tais aspectos. Trata-se de uma pesquisa descritiva, de natureza quantitativa. A pesquisa foi conduzida em uma universidade pública do interior paulista. Participaram do estudo 106 estudantes universitários matriculados no primeiro ou segundo anos dos diversos cursos de graduação, com idade média de 20,41 anos. Foram utilizados os instrumentos: Questionário Sociodemográfico, Teste de Dependência de Internet (Internet Addiction Test, IAT) e o Inventário de Personalidade Narcisista (Narcissistic Personality Inventory, NPI-16). Os dados foram analisados de forma quantitativa e submetidos à análise estatística descritiva e inferencial. Como resultado, foi confirmado o grande uso de internet entre os jovens universitários, especialmente das redes sociais e aplicativos de troca de mensagens. Porém, foram encontradas pontuações médias consideradas baixas tanto... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The development of new technologies, especially the internet, is a hallmark of postmodern society. In addition, narcissism also shows itself as an important social feature, reflecting the individualistic ideals encouraged by the media. However, there is a shortage of Brazilian studies that propose to relate the use of internet and narcissistic characteristics of the personality. Thus, the present study aimed to investigate the use of internet and narcissistic characteristics of personality in university students, in addition to verifying the existence of a possible correlation between such aspects. It is a descriptive research, with a quantitative nature. The research was conducted at a public university in the interior of São Paulo. A total of 106 university students enrolled in the first or second year of the various undergraduate courses, with a mean age of 20.41 years, participated in the study. The instruments were: Sociodemographic Questionnaire, Internet Addiction Test (IAT) and Narcissistic Personality Inventory (NPI-16). Data were analyzed quantitatively and submitted to descriptive and inferential statistical analysis. As a result, the great use of the internet among young university students, especially social networks and messaging applications, was confirmed. However, mean scores considered low in both IAT and NPI were found, which does not qualify students as either dependent or narcissistic. Moreover, after the Spearman's ρ test, it was concluded that there is ... (Complete abstract click electronic access below) / Mestre

Network applications and Internet services fail all too frequently. However, end users cannot effectively identify the root cause using traditional troubleshooting techniques due to the limited capability to distinguish failures caused by local network elements from failures caused by elements located outside the local area network. To overcome these limitations, we propose a new approach, one that leverages collaboration of user machines to assist end users in diagnosing various failures related to Internet connectivity and poor network performance. First, we present DYSWIS ("Do You See What I See?"), an automatic network fault detection and diagnosis system for end users. DYSWIS identifies the root cause(s) of network faults using diagnostic rules that consider diverse information from multiple nodes. In addition, the DYSWIS rule system is specially designed to support crowdsourced and distributed probes. We also describe the architecture of DYSWIS and compare its performance with other tools. Finally, we demonstrate that the system successfully detects and diagnoses network failures which are difficult to diagnose using a single-user probe. Failures in lower layers of the protocol stack also have the potential to disrupt Internet access; for example, slow Internet connectivity is often caused by poor Wi-Fi performance. Channel contention and non-Wi-Fi interference are the primary reasons for this performance degradation. We investigate the characteristics of non-Wi-Fi interference that can severely degrade Wi-Fi performance and present WiSlow ("Why is my Wi-Fi slow?"), a software tool that diagnoses the root causes of poor Wi-Fi performance. WiSlow employs user-level network probes and leverages peer collaboration to identify the physical location of these causes. The software includes two principal methods: packet loss analysis and 802.11 ACK number analysis. When the issue is located near Wi-Fi devices, the accuracy of WiSlow exceeds 90%. Finally, we expand our collaborative approach to the Internet of Things (IoT) and propose a platform for network-troubleshooting on home devices. This platform takes advantage of built-in technology common to modern devices --- multiple communication interfaces. For example, when a home device has a problem with an interface it sends a probe request to other devices using an alternative interface. The system then exploits cooperation of both internal devices and remote machines. We show that this approach is useful in home networks by demonstrating an application that contains actual diagnostic algorithms.

It is projected that by the year 2033, 41% of the population in the United Kingdom will be aged 60 and over, compared to 17% in 2010. However, as people get older, age-related impairments to working memory and cognition, as well as sensory impairments, mean that older adults struggle to adopt new information technology systems, which have become integral to everyday life in recent years. The research presented here investigates, across a series of three large scale experiments, how Embodied Conversational Agents (ECAs) can be used in virtual world applications, addressing three important domains of application space, to understand how ECAs may be used to engage with older users. The Virtual Banking Experiment investigates whether or not ECA gender or age portrayal has an effect on overall usability of virtual world applications for older users. The results of the experiment show that older users do not exhibit a significant preference for a particular ECA gender, however they do exhibit a preference for interacting with younger ECAs when compared with older ECAs in these applications. Results of the Entertainment Experiment show that scripting the interaction, between older users and ECAs in a virtual world quiz game, significantly improved the usability of these virtual world gaming applications employing ECAs as interlocators. The Social Support Experiment investigated three styles of providing advice to older users as part of a virtual advice bureau service. The results of the experiment show that older users prefer to receive advice from ECAs that has not been presented as having been obtained from real-world experiences.

This dissertation focuses on the ACCESS Framework which is an open source software framework designed to address four issues with regards to older and novice users with accessibility needs – that they often do not know what support is available within their systems, that they often do not know how to change those settings they know exist, that they often lack the confidence to make the changes they know how to make, and are often unable to physically enable accessibility support.The software discussed in this dissertation serves as a bridge between what users are expected to know and what they actually know by assuming the responsibility for identifying user accessibility requirements and making those changes on the user?s behalf. User interaction with the framework is limited to either expressing approval or disapproval with regards to corrective action. Individual corrections are deployed as plug-ins within this tool.Four studies were conducted during this research. Three of these studies were aimed at evaluating the ACCESS Framework directly with the remaining study being an exploration of a cognitive support tool deployed using the framework. Two of these studies involved participants attempting to perform specific, well-defined tasks on systems that had been configured to the extremes of what was possible with operating system settings. These tasks were attempted with and without the support of the framework. The final study was a focus group in which issues of the framework were discussed by individuals who had been through the experimental trials.The research provided strong evidence that this is an effective mechanism for accessibility configuration when there is a strong match between identified accessibility needs and available operating system support. The system was seen as understandable, useful and appropriate by individuals who had been through the experimental trials. The research provided strong evidence that this is an effective mechanism for accessibility configuration when there is a strong match between identified accessibility needs and available operating system support. The system was seen as understandable, useful and appropriate by participants, with a majority stating that they would be willing to use a similar system on their own machines.

Hepatitis C virus (HCV) infection is the most common blood-borne infection in the United States (U.S.). The largest increases of incidence for HCV infection are reported in the Appalachian region. This study aimed to 1) examine the prevalence and trends of HCV infection in the U.S. from 1999 to 2012; 2) investigate barriers to HCV infection treatment in Northeast Tennessee and the U.S.; and 3) study characteristics and risk factors for HIV-infection and HCV-infection in Northeast Tennessee. In the U.S., data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2012 to study the prevalence of HCV infection and barriers to treatment. In Northeast Tennessee, hepatitis C and HIV/AIDS data were obtained from National Electronic Disease Surveillance System (NEDSS) and enhanced HIV/AIDS Reporting System (eHARS). Descriptive statistics and multiple logistic regression models were used for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were reported. There was an estimated 3.8 million people having HCV antibody in the U.S. in 2012. No significant change was found in the prevalence of HCV infection during 1999 – 2012. The leading barrier to the treatment was cost issues in the U.S. (50.0%) and Northeast Tennessee (25.0%), respectively. HCV patients without symptoms in Northeast Tennessee were more likely to be untreated (OR: 3.08, 95% CI: 1.10-8.60) and patients without health insurance in the U.S. were more likely to be untreated than their counterparts (OR: 3.38, 95% CI: 1.14-10.05). The incidence of acute hepatitis C peaked in 2012-2013 in Northeast Tennessee, while the incidence of HIV/AIDS increased by 100% from 2013 to 2015. More injection drug users (IDUs) and less men who have sex with men (MSM) were observed in patients with HCV infection than in those with HIV infection (IDUs: 50.63% vs.16.38% p

ABSTRACT Botanic Garden User Outcomes: A Means-End Investigation Christopher Lee Wassenberg This study explored the outcomes that Leaning Pine Arboretum users experience from visiting the botanic garden. Understanding visitor motivations and benefits has been a focus in the field of outdoor recreation, and the subject of a number of botanic garden and green space visitor studies. Previous studies have found that visiting a botanic garden can serve as a coping strategy for dealing with and reducing life stress (Holbrook, 2010; Kohlleppel, Bradley, & Jacob, 2002; Maller, Townsend, Pryor, Brown, & St Leger, 2005) and that visiting public outdoor green spaces led visitors to experience greater exposure to natural spaces and to have meaningful experiences with others (Burgess, Harrison, & Limb, 1988). This study employed means-end theory (Gutman, 1982) to investigate the link between garden attributes and user outcomes. In-person interviews were conducted with 83 garden visitors during the summer of 2011. Researchers coded the interview data to identify participants’ reported attributes, consequences, and values. Intercoder reliability was conducted to ensure validity of the results. Coded data were entered into the Laddermap (Gengler & Reynolds, 1995) computer software program to be analyzed. Implication matrixes were created to determine the number of times concepts were linked. From the implication matrixes, hierarchical value maps (HVMs) were developed to display the results graphically. HVMs show the strength of links between attributes, consequences, and values, and were used to compare results from different visitor groups within the study. These groups included males and females, students and non-students, and first time and return visitors. The findings revealed that participants felt that the botanic garden and plants were the most meaningful garden attributes. These garden attributes led participants to experience the consequences new experiences and learning stress and relief and relaxation. Having experienced these meaningful consequences allowed participants to reach the most frequently mentioned values: transference and improved quality of life. The study found important links between attributes, consequences, and values, including the consequences escape and stress relief and relaxation, and the consequence new experiences and learning, and the value transference. Important differences were also found between the attribute, consequence, and value chains of multiple visitor groups. Botanical garden and arboretum mangers may use this study to improve visitor experiences and outcomes. A better understanding of visitor benefits and outcomes can help managers understand the needs of current visitors, potential visitors, and potential garden supporters. In turn, garden visitors who have better experiences may be more inclined to provide funding or other support to conserve and preserve their local gardens. Based on the results garden managers should maintain a broad range of healthy, well-displayed plants; exert high-levels of detail to all aspects of garden operations; continue to provide opportunities for full visitor immersion; and offer unified, accessible interpretation of garden spaces and plants. Additionally, these results may be used to validate funding requests and guide allocation of funding. Keywords: Botanic garden users, outcomes, means-end theory, Leaning Pine Arboretum

Swedish municipalities invest enormous amounts of resources in health information systems (HIS) in order to have a competitive edge, reduce cost in operations, faster storage and retrieval of patient information, foster transparency, efficiency and effectiveness in service delivery. This study examines the major challenges faced by the system end-users after the implementation of the new health information systems in the elderly and care homes in a municipality in a southern region of Sweden.  The rationale for the examination is derived from the discovery that the municipality is yet to fully utilize the new-HIS, despite huge investments in procurement, supervision and training of users.  The major reason why this topic was chosen was due to the challenges encountered while working as a care giver staff in one municipality in a southern region of Sweden. In this study, The technology acceptance model (TAM ) is used to better understand the current working of the new-HIS.   Mixed methods are utilized to conduct the case study; semi structured interviews and questionnaire survey. The findings of this study are presented in the findings chapter and have shown many shortcomings in the use of the new-HIS such as limited supervision from top management, inadequate skills, inadequate computers, long procedures thus time wasting, insufficient resources like financing and policies among others as further discussed in the research findings chapter in this report.  Finally, this study proposes the findings as contributions to the study of challenges faced by end-users after the introduction and reception of the new-HIS by the given case study; and it propagates share of experiences and lessons to be learned.

Over the last thirty years the meaning of the word 'wilderness' has changed in Australia, and it has come under sustained attack on philosophical, cultural, political and ‘justice’ grounds. This thesis investigates the 'Wilderness Knot’ – the confusion and tangled meanings around ‘wilderness’. In the literature this ‘knot’ is comprised of at least five strands; philosophical, political, cultural, justice and exploitation. Normally people focus only on the last of these strands, its economic exploitation. The methodology is qualitative, involving participatory action research (PAR) and hermeneutic phenomenology. The PAR was done with the Blue Mountains Wilderness Network near Sydney, which investigated the confusion around ‘wilderness’, and sought to reduce this by entering into dialogue with supporters, critics and community members interested in wilderness issues, notably the local Aboriginal Traditional Owners (TOs). Eleven in-depth interviews with scholars (including critics) of wilderness were carried out to feed into this PAR. The hermeneutic phenomenology made use of the wilderness journals of five of the Network, and sought to gain a deeper understanding of the experience of wilderness itself, and also the lived experience of encountering the wilderness knot. The PAR provided many insights into the knot, especially regarding the need for dialogue to reduce the confusion. It demonstrated the delicacy needed to gain meaningful dialogue over an issue which raises real passions about social and environmental justice. It took three years to develop meaningful dialogue between TOs and conservationists. The spectra of issues entangled in ‘the land’ and ‘wilderness’ are presented textually and diagrammatically, as are the ways forward to untangle meanings and reduce confusion. The political naivety of academia is discussed in regard to ‘wilderness as lanai’ (considering increasing threats). There is a need for greater rigour in identifying which meaning of ‘wilderness’ is actually being referred to. There is also merit in promoting recognition that ‘wilderness’ is in fact a tribute to past indigenous land practices, not a disregard of indigenous history. The idea of shared ‘custodianship’ or stewardship is suggested as a way forward. The wilderness knot can indeed be loosened, as this thesis demonstrates. However, it will be an ongoing project for all those involved. The art to keeping ‘wilderness as lanai’ is not just ‘eternal vigilance’ it is an eternal ongoing dialogue about its meaning and values. / Doctor of Philosophy (PhD)

This dissertation examines revisitation behaviour in the context of non-transactional websites. A holistic framework based on theories from repeat purchase behaviour and satisfaction was developed and tested. This study is among the first to consider revisitation as analogous to repeat purchase behaviour. The premise of the model is that revisitation is determined through an evaluation of prior visits and that the elements influencing revisitation included satisfaction, involvement (site, product category and medium) and social influences. Five non-transactional websites were examined with the selection based on the website typology developed in this thesis - a typology that will benefit website research as it provides a consistent and generic framework. Data were collected using a crosssectional web-based online survey via the homepage of the websites. Since satisfaction is considered to be a central factor in traditional repeat purchase behaviour and in website use, the antecedents of satisfaction were also examined. Overall the findings support the importance of content quality as a factor in satisfaction and even though website users are increasingly more proficient, ease of use is still an influential factor as is the attitude to the brand that the site supports. It was found that the users??? motives for using the site affected the relationship between the quality of the perceived benefits and satisfaction. If the motivation to use the site was for information, then the impact of information quality on satisfaction was weaker than the impact of entertainment quality on satisfaction. Alternatively, if the motivation was for entertainment, then once again the impact of information quality on satisfaction was weaker than that of entertainment quality. Initial model testing showed that the only factor to influence revisitation behaviour was enduring site involvement. Cognizant of the dangers of ???data driven theory???, the relationship of the elements was reassessed. The resultant model shows that product category involvement directly influences enduring site involvement and that enduring site involvement is a central construct operating as a direct and a mediating influence between each of satisfaction, social influence, medium involvement and website revisitation.