Mental health services in Australia (and in most western countries) have undergone considerable changes in the past 20 years. These changes have included the closing or downsizing of the old tertiary institutions and a move towards community treatment of people with a mental illness (consumers). Consumers no longer live in hospitals; as a consequence housing has become an important aspect of their lives. Research has demonstrated that when consumers live in good quality housing of their own choosing they report improved quality of life, more satisfying supportive social relationships, and have fewer admissions. People with schizophrenia are the largest psychiatric diagnostic group treated by the public health system in Australia. As a result of their illness people with schizophrenia often have difficulty in maintaining reasonable quality accommodation and supportive social relationships. A review of the available literature on housing options indicates that, for people with a mental illness, boarding houses are the least desirable type of community housing and that living in their own home is the most desirable. These were the two types of housing chosen for the study. Aims of the study This study aimed to explore the impact of housing on the mental health of people with schizophrenia. Study Design Stage 1 For the initial stage of the project archival data was used to investigate the relationship between types of accommodation and illness patterns of people with schizophrenia. The hypotheses for stage 1 of the project were: 1. Admission rates will be significantly different for people with schizophrenia who are discharged to a private home when compared to those discharged to a boarding house. 2. Length of stay in hospital will not be significantly different for people with schizophrenia discharged to a private home when compared to those discharged to a boarding house. 3. Symptoms, as measured by scores on HoNOS scale, will be significantly different for people with schizophrenia living in a private home when compared to those living in a boarding house. 4. The level of functioning, measured using an LSP 16, will be significantly different for people with schizophrenia living in a private home when compared to those living in a boarding house. Inclusion Criteria The subjects included were between 18 and 65 years of age and had a principal diagnosis of schizophrenia. Findings Findings indicate that people with schizophrenia are more likely to be admitted to hospital if discharged to a boarding house. Surprisingly, results also indicated that while there were no differences in the level of psychiatric symptoms experienced, people with schizophrenia living in boarding houses had less access to social support, meaningful activities and work and had lower levels of global functioning. These findings contradict the conventional wisdom that people with schizophrenia resort to living in boarding houses because of their level of disability. Stage 2 Stage 2 of the study further explored the impact of housing type on the mental health of people with schizophrenia by examining the experience of thirteen people living independently in private homes or in a boarding house. The study aimed to use the experiences of the participants to develop a grounded theory explanation of the impact of housing on people with schizophrenia. Findings from Stage 2 indicated a strong desire amongst all participants to live in their own home. Participants living in their own home had access to more opportunities and resources for staying well than participants living in boarding houses. Those participants who lived in their own home felt they belonged, they felt safe and most importantly they had greater opportunities to make and maintain supportive social relationships with friends and family. Participants reported that stable housing and supportive relationships helped them to stay well.

Globally the population is ageing and as a consequence people are living longer with multiple chronic conditions. A range of factors, including decreased lengths of hospital stay and a greater focus on community based care, has lead to an increasing acuity of patients admitted to acute care settings, many with complex care needs. To date, models of nursing care in acute settings have been configured to focus on acute, procedural care and do not meet the unique needs of the older person. In order to ensure optimal health outcomes of older hospitalised people, nursing care needs to be responsive to the priorities and needs of patients and their families. This study sought to collaboratively develop a model of nursing care with nurse clinicians to improve the care of older people in the acute care setting. Model development was driven by an action research framework, using evidence-based principles and a comprehensive needs assessment. A three phased, mixed method design was embedded within the overarching conceptual and philosophical framework of action research. The first phase of the study comprised a needs assessment and allowed appraisal of the needs of patients as perceived by patients, carer’s and nurses, this was performed using the Caring Activity Scale [CAS](1). Qualitative data and semi-structured interviews added depth to the survey data and qualified responses by confirming that patients thought that nurses did the best they could within a culture of busyness, while patients strived to maintain and sustain their own independence. Managing the discharge process and carer burden arose mainly from the carer semi-structured interviews only. Data revealed significant differences between patients, carer’s and nurses in relation to priority and satisfaction with care. Patients did not place a large importance on discharge care which contrasted with the focus of nursing initiatives. During the subsequent phases of the study a collaborative approach, using action research principles, was used to develop and implement a model of nursing care. A key feature of this model was the introduction of a team structure with a focus on patient centred care. Significant differences were identified in the pre model and post model patient groups in relation to satisfaction with care, with the post model group more satisfied than the pre group model group. Further, improvements in functional status and medication knowledge were demonstrated among patients cared for under the new model. This study has demonstrated that developing a model of care appropriate to the needs of patients, carer’s and nurses can be achieved through the use of action research principles. Study data illustrates the importance of collaboration, empowerment and change management principles in driving clinical improvement and patient satisfaction with care. The findings also underscore the importance of promoting and educating patients and carers as well as nurses about the importance of discharge planning to optimise post-discharge health outcomes. / Doctor of Philosophy (PhD)

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Thesis (M.H.A.)--University of Michigan, 1958.

Thesis (M.S.)--Rochester Institute of Technology, 2009. / Typescript. Includes bibliographical references (leaves 53-56).

Thesis (M.H.A.)--University of Michigan, 1958.

Thesis (D.P.H.)--University of Oklahoma. / Bibliography: leaves 52-53.

Thesis (doctoral)--La Salle University, 2003. / ProQuest dissertations and theses ; AAT 3108290. Includes bibliographical references (leaves 33-37).

This DPhil thesis consists of three related but independent chapters discussing the question of admission and access to higher education. Chapter 1 explores the extent to which the underrepresentation of students from certain population groups at highly selective universities, can be explained by poor information and high non-monetary application costs, and how the universities' admission policies may affect outcomes. This chapter takes a positive approach and proposes a theoretical model to explore the implications of implementing alternative admission policies. Motivated by the results that arise from this exploration, Chapter 2 proceeds with a normative approach, proposing a general framework to study the optimal selection policy from a pool of applicants, taking into account that the pool of applicants is endogenous. This, it is argued, allows a characterisation of the optimal form of discrimination in university admissions. Chapter 3 studies the relationship between tuition fees and academic selectivity, by developing a different, although somewhat related model of monopolistic competition, where universities compete for students by simultaneously selecting prices and admission standards.

Mobile communication systems have continued to evolve by the release of new standards for HSPA and the release of new standards for LTE in release 8 and release 9. The new releases aim at providing higher data rates to accommodate the envisioned services of 3GPP in voice, data, image transmission, video, multimedia service and broadband services. Catering for a wide variety of services to satisfy the demands imposed on mobile networks by the user diversity and demanding applications, the air interface has been identified as the major bottleneck in the mobile networks. Network planning engineers and operators are deploying the new air interfaces in the same cell sites, which gives rise to several internetworking issues among the different air interfaces from radio resources management to service call continuity issues due to user's mobility and changing point of attachment. Deployment of different air interfaces coupled with traffic diversity requests further complicates the managements of the mobile networks. One of The main objectives of this research is to propose and evaluate solutions that address the internetworking of the different radio air interfaces in proposing a call admission control algorithm that can utilize different air interfaces capabilities and to determine which traffic types are better suited to be serviced by an interface. The proposed algorithm will consider the availability of the interface, the load of the network and the user equipment capabilities. Another main objective of this research is to propose and evaluate solutions that address changing the point of attachment of the users due to mobility in the form of handover algorithm. The proposed algorithm will consider the coverage of the node, direction and speed of the user, the network load, the air interface availability and the user equipment capabilities. Another main objective of this research is to design and implement a simulation system which includes all 3GPP standardized technologies. The simulation tool was designed as a discrete event simulation (DBS) system which includes all the standardized air interface technologies and services. The simulation tool was designed using Visual C# to take advantage of the object oriented capabilities of the Windows environment and libraries. The simulation tool was essential in evaluating the proposed algorithms in the first two objectives.