Extreme rainfall statistics are important for the design and management of the water resource infrastructure. The standard approach for extreme rainfall event severity assessment is the Intensity-Duration-Frequency (IDF) method. However, this approach does not consider the spatial context of rainfall and consequently does not properly describe rainfall storm severity, nor rarity. This study provides a critical account of the current standard practice and presents an approach that takes into consideration both the spatial context of rainfall storms, and indirectly incorporates runoff to produce a representative approach to assessing urban rainfall storm severity in terms of flood potential. A stepwise regression analysis was performed on a dataset of individual rainfall storm characteristics to best represent documented basement floodings in the City of Edmonton. Finally, the urban rainfall storm flood severity index was shown to be most representative of the documented basement floodings' severity when compared to that of the IDF method.

Extreme rainfall statistics are important for the design and management of the water resource infrastructure. The standard approach for extreme rainfall event severity assessment is the Intensity-Duration-Frequency (IDF) method. However, this approach does not consider the spatial context of rainfall and consequently does not properly describe rainfall storm severity, nor rarity. This study provides a critical account of the current standard practice and presents an approach that takes into consideration both the spatial context of rainfall storms, and indirectly incorporates runoff to produce a representative approach to assessing urban rainfall storm severity in terms of flood potential. A stepwise regression analysis was performed on a dataset of individual rainfall storm characteristics to best represent documented basement floodings in the City of Edmonton. Finally, the urban rainfall storm flood severity index was shown to be most representative of the documented basement floodings' severity when compared to that of the IDF method.

To advance social work practice and decrease the research practice gap, this dissertation followed a model development paradigm consisting of several phases. Based on the task-centered model of social work practice and motivational interviewing, a new combined model was construed. The two underlying models were analyzed and synthesized, using technical eclecticism as the integrative approach. The resulting combined model was described by guidelines and manualized. To test the combined model in an applied setting, a study was designed in collaboration with social workers at a substance abuse counseling center. There, the combined model intervention was implemented in an outpatient medication assisted treatment program dispensing methadone and buprenorphine to a mainly African-American population. The agency program aimed at detoxification, but also provided methadone maintenance. It offered additional groups and acupuncture. Ten clients and four social work practitioners participated in the intervention study. The study used a mixed-method approach in data collection and analysis. Client practitioner verbal interaction was recorded using digital audio recording. The digital audio files were loaded directly into Atlas.ti software to be used for analysis. Qualitative data analysis with Atlas.ti was performed for two research tasks, a) assessing implementation fidelity of the manual based intervention and b) exploring model development aspects to improve model guidelines. Treatment fidelity was analyzed through deductive coding and frequency counts. Model development analysis was performed similar to a grounded theory model and used content analysis and constant comparison methodologies. Addiction Severity Index and Readiness Ruler, urine drug screens, problem change, and task accomplishment ratings were used as quantitative outcome measures to produce time series data in order to chart individual case progress in a single system design. After testing the intervention, a focus group with participating practitioners was conducted. Overall beneficence with clients improving and progressing successfully in the program was found. The integration of the underlying models was deemed successful. Their elements were found to be complementary and intricately linked. Crucial for successful implementation is that the program environment supports and accepts client choices. Model guidelines were reviewed and improved for further field testing.

Sammanfattning Syftet med studien var att skapa en deskriptiv bild över de tre utvalda sårbarhetsfaktorer (tävlingsoro, sömnsvårigheter och fysiska skador) samt undersöka eventuella samband och skillnader mellan dessa gällande elever som läser specialidrott på Riksidrottsgymnasium (RIG). Studiens frågeställningar var: 1) Vilken fysisk skadefrekvens (överbelastning respektive traumatisk skada) har RIG-elever haft under det senaste året? 2) I vilken grad upplever RIG-elever tävlingsoro inför och under tävling/match? 3) I vilken grad upplever RIG-elever sömnsvårigheter? 4) Vilka samband eller skillnader finns mellan de tre valda sårbarhetsfaktorerna? 5) Vilka skillnader i skadefrekvens, skadetyp, sömnsvårigheter och tävlingsoro finns mellan årskurserna? Metod Elektronisk enkätundersökning användes som verktyg för mätbara data genom slutna enkätfrågor. De formulär som använts för den elektroniska enkätundersökningen var CSAI-2 (tävlingsoro), ISI (Sömnsvårigheter) samt fysisk skadefrånvaro enligt definition av Tranæus (2013). Inbjudan till att delta i studien skickades ut till samtliga RIG i Sverige, totalt 40 skolor. Av dessa tackade 18 skolor ja till deltagande, 8 tackade nej och 14 svarade inte på inbjudan. Av den totala populationen deltog 336 riksidrottsgymnasieelever från 24 olika idrotter. Svaren från enkäten presenteras dels i deskriptiv kvantitativ karaktär och dels i en analytisk del. Resultat Inom populationen hade 70 procent varit frånvarande på grund av fysiska skador under året (48 procent på grund av en överbelastnings- och 22 procent på grund av en traumatisk skada), varav 41 procent var frånvarande från träning, tävling eller match längre än en vecka.  Markanta sömnbesvär rapporterades hos 15 procent av eleverna. På CSAI-2 skalan hade självförtroende ett medelvärde på 22,3 ± 5,9 poäng, somatisk oro 18,6 ± 5,6 poäng, kognitiv oro 17,6 ± 4,8 poäng. Statistiska analysen visade signifikanta samband mellan skadefrånvaro, ISI och CSAI-2, förutom mellan somatisk oro och skadefrånvaro. Inga signifikanta skillnader i någon aspekt fanns mellan årskurserna. Slutsats Studiens slutsats är att fysiska skador har ett samband med sömnstörningar och att tävlingsoro korrelerar med både fysiska skador och sömnen negativt. Resultatet kan hjälpa lärare och tränare att få förståelse för dessa faktorer kan behöva uppmärksammas i starten av unga elitidrottares uppväxt. / Abstract The aim of this study was to get a descriptive view of the area and to investigate possible relationships/differences between the three selected vulnerability factors for students who study sports at a Riksidrottsgymnasium (RIG). The study aimed to answer the following questions: 1) To what physical injury rate (overload or traumatic injury) have RIG students had in the past year? 2) To what extent do RIG students experience anxiety before and during competition / match? 3) To what extent do RIG students experience sleep difficulties? 4) What are the relationships or differences between the three selected vulnerabilities? 5) What differences in rate of injury, type of injury, insomnia and anxiety are between grades? Method Electronic survey was used as a tool for measurable data through closed questionnaires. The form that the study used for the electronic survey was CSAI-2 (Anxiety), ISI (Injury) and physical injury severity according to the same definition as Tranæus (2013). The invitation to participate in the study was sent to all RIGs in Sweden, a total of 40 schools. Out of these 40 schools 18 schools accepted to participate in the study, 8 schools voted to not participate and 14 did not respond. Of the total population, 336 high school athletics students participated in 24 different sports. The answers from the questionnaire are presented in a descriptive quantitative character and an analytical part. Results In the population, 70 percent were absent due to physical injuries, of which 41 percent were absent from training, competition or match longer than one week. 48 percent of all students had an overload injury and 22 percent traumatic injury in the past year. 15 percent showed significant sleep disorders. Self-confidence had an average of 22.3 ± 5.9 points, somatic concern, 18.6 ± 5.6 points, cognitive concern, 17.6 ± 4.8 points. Statistical analysis showed significant results between injury absence, ISI and CSAI-2 aside from somatic concern and injuries. Regarding differences between grades, the results showed no diferences in any aspects. Conclusion The conclusion of this study is that physical injuries are associated with sleep disorders and that anxiety is correlated negatively with both physical injuries and sleep. The result can help teachers and coaches to understand these factors may need to be noted at the start of young elite athletes.

Managed care plans purport to improve the health of their members with chronic diseases. How has the growing adoption of Medicare Advantage (MA), the managed care program for Medicare beneficiaries, affected the progression of chronic disease? The literature is rich with articles focusing on managed care organizations' impacts on quality of care, access, patient satisfaction, and costs. However, few studies have analyzed these impacts with respect to market penetration of Medicare managed care. The objective of this research has been to analyze the relationships between the market penetration of MA plans and the progression of chronic diseases among Medicare beneficiaries. The Chronic Disease Severity Index scale (CDSI) was constructed to represent beneficiaries' overall chronic disease states for survey or claims-based data, when more direct clinical measures of disease progression are not available. Using the CDSI on the MEPS survey dataset from AHRQ, we sought to assess the impacts of MA market penetration and other covariates on the overall chronic disease state of Medicare beneficiaries from 2004 through 2008. Though the model explains much of the variation in CDSI change, the author expected the multilevel model would show that MA penetration explains a significant level of variation in CDSI change. However, this hypothesis was not substantiated, and the findings suggest that unmeasured factors may be contributing to additional unexplained heterogeneity. Policymakers should explore opportunities to refine the current MA program. The MA program costs the federal government more than the Traditional Fee-for-Service Medicare program, and there is no definitive evidence that outcomes differ. Within both programs, there is opportunity to experiment with different models of payment, healthcare service delivery and care coordination. The Patient Protection and Affordable Care Act (ACA) contains provisions for innovative demonstration projects in delivery and payment. The effectiveness of these ACA initiatives must be monitored, both for impacts on health outcomes and for economic effects. This research can inform future approaches to outcomes assessment using the CDSI, and multilevel modeling methodologies similar to those employed here. Firms offering MA health plans would be prudent to proactively demonstrate their value to beneficiaries and taxpayers. They should explore means of better monitoring and reporting the longitudinal outcomes of their enrolled beneficiaries. Demonstrating that they can bring value in terms of improved health outcomes will help insure their long-term survival, both in the marketplace and in the political arena. / Graduation date: 2012