Background: Individuals with intellectual and/or developmental disabilities (IDD) are experiencing longer life expectancies with the majority requiring the ongoing support of family caregivers into adulthood. Medicaid is the primary funding source for supports and services for adults with IDD. Growing Medicaid expenditures and goals to improve quality of care are driving more states to move their Medicaid fee-for-service programs into a managed care model. The stated goals of Medicaid managed long-term services and supports (MLTSS) are to improve care coordination and access to care while controlling costs, but the evidence regarding these outcomes is limited and mixed. Given the level of uncertainty about MLTSS for adults with IDD and their family caregivers, best practices recommendations have been produced by the federal government and advocacy agencies to help guide future MLTSS implementation efforts. These best practice recommendations combined with the continued expansion of MLTSS in the states, provided an opportunity to further explore implementation of MLTSS to inform both policy and practice. One state which recently reformed their Medicaid program to MLTSS and which has been referred to as a bellwether state is Kansas. The MLTSS program in Kansas, titled “KanCare”, is the first for adults with IDD to integrate across health, behavioral health, and LTSS while also contracting through three private-for-profit managed care organizations (MCOs). Aims: The objective of this study was to describe the current implementation of MLTSS for adults with IDD and their family caregivers in one state, Kansas. Study aims were as follows: 1) To understand the rationale behind and what actually happened with MLTSS implementation for adults with IDD in Kansas; 2) To understand how service coordination providers and family caregivers perceived care coordination and access to services for adults with IDD in MLTSS; 3) To understand how family caregivers and their roles were recognized in MLTSS for adults with IDD. Methods: A single case embedded design case study approach was used with in-depth semi-structured interviews completed with state/regional level representatives (N=13), MLTSS service coordination providers (N=7), and family caregivers of adults with IDD (N=11). Data collection and analysis were guided by the unified theory of family quality of life (FQOL) and Bronfenbrenner’s ecological model. The framework method was used to structure the data analysis process. Member checking was completed to ensure accuracy of results. Findings: Regarding aim one, respondents identified reducing costs and improving care quality as the rationale behind MLTSS, but these were outcomes not yet realized given the early stages of implementation. At the time of this study, the Managed Care Organizations (MCOs) were continuing to work on expanding provider networks and to provide additional services to address health disparities amongst individuals with IDD. Study participants identified the importance of adequate planning and stakeholder engagement to reduce confusion and fear when transitioning into MLTSS. Addressing aim two, timely and accessible consumer education, clear care coordination processes, and provider network adequacy were identified as important to influence the challenges experienced to date in care coordination and access to services. Regarding aim three, participants acknowledged the important role of family caregivers. At the current stage of the KanCare implementation, participants reported lack of formal processes for family caregiver assessment and a need for more proactive family support services planning. Conclusion: Lessons learned from this implementation experience include the importance of having long planning timelines and including stakeholder feedback into the design of MLTSS programs. Care coordination holds promise to better integrate care, but more research is needed to understand best practices for the provision of care coordination in MLTSS. In order to address access to services, MLTSS programs will need to work and build provider capacity and provider networks. MLTSS programs will also need to formally recognize the role of family caregivers by incorporating the use of family caregiver assessments to proactively plan for support needs.

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Since the definition of the wiretap channel by Wyner in 1975, there has been much research to investigate the communication security of this channel. This thesis presents some further investigations into the wiretap channel which improve the reliability of the communication security. The main results include the construction of best known equivocation codes which leads to an increase in the ambiguity of the wiretap channel by using different techniques based on syndrome coding. Best known codes (BKC) have been investigated, and two new design models which includes an inner code and outer code have been implemented. It is shown that best results are obtained when the outer code employs a syndrome coding scheme based on the (23; 12; 7) binary Golay code and the inner code employs the McEliece cryptosystem technique based on BKC0s. Three techniques of construction of best known equivocation codes (BEqC) for syndrome coding scheme are presented. Firstly, a code design technique to produce new (BEqC) codes which have better secrecy than the best error correcting codes is presented. Code examples (some 50 codes) are given for the case where the number of parity bits of the code is equal to 15. Secondly, a new code design technique is presented, which is based on the production of a new (BEqC) by adding two best columns to the parity check matrix(H) of a good (BEqC), [n; k] code. The highest minimum Hamming distance of a linear code is an important parameter which indicates the capability of detecting and correcting errors by the code. In general, (BEqC) have a respectable minimum Hamming distance, but are sometimes not as good as the best known codes with the same code parameters. This interesting point led to the production of a new code design technique which produces a (BEqC) code with the highest minimum Hamming distance for syndrome coding which has better secrecy than the corresponding (BKC). As many as 207 new best known equivocation codes which have the highest minimum distance have been found so far using this design technique.

Shelter is one of mans most basic needs and the progression of its development over time has had to deal with an ever increasingly complex world that even now places renewed demands on the way we build, live, and work. The location of the site is at Kew Bridge, London, United Kingdom. It is at the important landmark junction of Kew Bridge north circular road and Kew Bridge road, with the immediate context consisting of 3 to 4 storey high built fabric to the north and west boundaries of the site. The Kew Bridge road slipway forms the eastern boundary of the site adjacent Kew Bridge, and the River Thames forms the southern boundary of the site. The aim of the project is to evaluate the existing condition of high-rise residential developments and to compare this to leading environmentally sensitive projects, which utilise sustainable development strategies and renewable energy sources. These strategies and energy sources will be applied in the residential high-rise typology in the form of the Kew Bridge Urban Village. / Dissertation (MArch (Prof))--University of Pretoria, 2005. / Architecture / unrestricted

Recreational organizations that deliver activities to youth within their communities can provide an effective setting for positive youth development (PYD) endeavours due to being fun, engaging, and an environment where skill-building is inherent. However, not all recreational organizations offering PYD aimed programs are successful and many are cancelled after a short amount of time. A framework or guide for (1) promoting PYD through community recreation and (2) evaluating and identifying PYD outcomes does not yet exist. This research seeks to develop a model to inform recreational program design to bring about positive developmental outcomes in youth participants using empirical data collected from three successful organizations. Both one-on-one interviews and a focus group with youth participants and adult staff were utilized following a qualitative multiple case study approach. Data collected was concerned with the positive developmental outcomes experienced by youth participants in the organizations and mechanisms used to realize these outcomes. The key themes, derived through inductive and deductive analyses, are presented as a five-step logic model. These themes help identify the intended results of programs along with the resources and processes needed to achieve these results, thus making this study’s findings easy to integrate into recreational programming. The model’s process factors included a series of inputs (i.e., contextual factors and external assets) and activities (i.e., direct and indirect strategies). Findings identified as intended PYD outcomes included outputs (i.e., objective measurable indicators), short-term outcomes (i.e., life skills), and long-term impacts (i.e., the four Cs including life skill transfer and contribution). This study elaborates on concepts identified in previous research that are conducive to PYD while bringing them together into a framework for designing recreational programs with the goal of promoting positive developmental outcomes in youth. However, further testing through quantitative, longitudinal, and intervention research may be needed.

This diploma thesis is about career pages of companies which belong into field of HR marketing. The goal of this thesis is to analyse the career pages and then based on the analysis specify best practices. Next step will be according to best practices design new solution for career pages of xPORT Business Accelerator VSE.

The first essay of this dissertation analyzes the claim that a Marshallian total surplus optimum characterizes a second-best Pareto optimum in a general equilibrium model with price makers. The main result of this essay is that a Marshallian total surplus optimum corresponds to a second-best Pareto optimum when (i) the consumer's preferences are quasi-linear with respect to a numeraire, and (ii) for all other markets except the one under consideration, first-best (or Paretian) optimality conditions are satisfied. The second essay characterizes the optimal regulatory policy for point-source pollution emissions when firms are competing in Cournot fashion in the product market and have private information about their own cost. It is shown that the optimal regulatory policy benefits from the strategic interaction between the firms in the output market even though the firms' private information is uncorrelated. The firms strategic interaction in the output market acts as an information correlation externality that mitigates the wellknown "rent-extraction efficiency" trade-off. Each firms' opportunity to over-report their costs is reduced because the output market's strategic interaction reduces the profitability of infra-marginal units if they do. The main result shows that optimal environmental regulations discriminate between firms of given industry. Moreover, it is shown that if the regulator believes that firm A is always more likely to be efficient than firm B (in the sense of first-order stochastic dominance) and that both firms are equally efficient ex post, then firm A faces a higher marginal tax than its competitor. In light of this result, it is argued that the model provides theoretical foundations for grandfather clauses in environmental regulations. / Arts, Faculty of / Vancouver School of Economics / Graduate

Preventing impairment of waterbodies requires control, reduction and interception of contaminant losses at the field and subwatershed level. Three specific research objectives were accomplished in this study: 1) compare the HSPF-predicted flow, sediment, total nitrogen (TN) and total phosphorus (TP) loads resulting from simulation of spatially distributed site-specific and county-level disaggregated land use data at subwatershed and watershed levels, 2) evaluate the effects of site-specific and county-level disaggregated BMP data on modeled BMP responses in HSPF-predicted flow, sediment, TN and TP loads at the watershed level, and 3) analyze the long-term effects of the two spatial BMP datasets on achieving the Chesapeake Bay Total Maximum Daily Load (TMDL) goals for sediment, TN and TP. Site-specific data are derived from the local watershed inventory while disaggregated data are based on county-level aggregated data that are distributed to portions of river segments that intersect each county. The study site was the Upper Opequon Watershed in northern Virginia. Results for each research objective are as follows: (1) HSPF-predicted flow, sediment, TN and TP were higher using disaggregated land use data in subwatersheds at monthly and annual time-steps. (2) Predicted load reductions were higher with site-specific BMP data than with disaggregated data for the study watershed. (3) Current levels of cost-shared BMP implementation in the Upper Opequon Watershed using either site-specific or county-level disaggregated BMP datasets do not meet the Chesapeake Bay TMDL goals. Increasing BMP implementation level to 100% of the available land also failed to meet TMDL target goals. Generally, use of disaggregated land use data does not accurately represent the existing watershed conditions. Further, for the study watershed, use of disaggregated county-level BMP data poorly represented actual watershed conditions, which resulted in higher pollutant yields and higher levels of BMPs needed to meet water quality goals. The study suggests that site-specific land use and BMP data must be used during TMDL implementation planning to maintain credibility with local stakeholders and improve the accuracy of the developed implementation plans. / Ph. D.

The Best Loser System (BLS) in Mauritius is a component of the electoral system where candidates are selected by established procedure on the basis of their race or community to stand as members of parliament It is as a tool to protect minority interests. The main research question is the following : what are the human rights implications and the prospect of reform of the BLS in Mauritius? / A Dissertation submitted to the Faculty of Law University of Pretoria, in partial fulfilment of the requirements for the degree Masters of Law (LLM in Human Rights and Democratisation in Africa). Prepared under the supervision of Mr Angelo Matusse, Faculty of Law, Universidade Eduardo, Mondlane Mocambique. / Thesis (LLM (Human Rights and Democratisation in Africa))--University of Pretoria, 2009. / http://www.chr.up.ac.za/ / Centre for Human Rights / LLM

Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of Knowledge Transformation improved the nurses' knowledge and their practice related to PI prevention in the ICU, as well as to translate evidence into nursing practice. A literature review was conducted on PI prevention to inform the project. The project provided an educational program for intensive care nurses on PI prevention and determined, based on participants' pre- and posttest responses, that nurses' knowledge improved as a result of participation. This project, involving 55 nurses, includes information on the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) measuring pressure knowledge which resulted in an 85% improvement on injury prevention, 76% in wound description, as well as, 62% in the Braden Scale. Improvements in knowledge and practice resulting from nurses' participation in an evidence-based education session on PI prevention may bring positive social change to the organization at which this project was conducted.