No description available.

Digitized by Kansas Correctional Industries

Providers are encouraged to view patients with chronic disease as ??partners?? in their care, and to collaborate with them in developing care plans. Yet there is little guidance in how collaboration should occur, and little evidence that collaborative care improves patient outcomes. Related models and measures of patient centred care and shared decision making have not been developed specifically for the context of chronic disease care. This thesis aimed to develop a theoretical understanding of how providers and patients make decisions in chronic disease care planning, how patients experience involvement in care planning, and to develop a measure of patient involvement. It consists of two studies: a qualitative study to develop a grounded theory of decision-making in diabetes care planning, and a scale development and psychometrics study. The qualitative study involved 29 providers and 16 patients with diabetes. It found that providers were concerned with a process described as ??managing patient involvement to do the right thing??, while patients were concerned with ??being involved to make sure care is appropriate??. This led to the theory of ??delivering respectful care??, a grounded theory that integrates provider and patient perspectives by showing how providers and patients can resolve their concerns while achieving mutually acceptable outcomes. Central to this theory is the process of finding common ground, while the key conditions are provider responsiveness and an ongoing, trusting and respectful provider-patient relationship. The Collaborative Care Planning Scale (CCPS), based on these findings, is a patient self-report scale that measures patients?? perceptions of involvement in care planning. After piloting the CCPS was tested amongst 166 patients with diabetes. Exploratory factor analysis resulted in a 27-item scale comprising two factors: ??receiving appropriately personalised care?? and ??feeling actively involved in decision-making??. Psychometrics tests revealed the CCPS has adequate internal consistency and test-retest reliability, and findings support construct validity. ??Delivering respectful care?? enriches understanding of the nature of collaboration in chronic disease care, and identifies those elements necessary to ensure patients receive best possible care. The CCPS provides the means for measuring what patients say they value, and is thus an important measure of quality chronic disease care.

In the field of sustainable manufacturing, a wide range of research has been carried out to attain the more effective use of natural resources and the reduction of environmental impacts during the whole product life cycle. This goal can be best achieved by promoting multiple-reuse of parts, sub-assemblies, or entire products. However, the decision toward reusing an old product depends on a variety of parameters with many uncertainties. Therefore, a comprehensive model to assess the reusability of products prior to the reuse decision is urgently needed. The objective of this research has been to develop a comprehensive assessment model, integrating technical, environmental, social, and economic aspects to evaluate the reusability of industrial products. The assessment model consists of four sub-models, which are a methodology to assess the quality and reliability of products, a model to translate the social responsibility aspect into warranty cost, a methodology to integrate environmental costs, and an economic model to accumulate total life cycle cost as the basis of the evaluation. The model also facilitates trade-offs between the factors to investigate the possibility to improve the reusability of a product. To apply the assessment model in the real business environment, a set of decisionmaking methodologies under different take-back scenarios has been developed as a guideline for manufacturers. Furthermore, as the existence of uncertainty in the reuse strategy is undeniable, a methodology to integrate uncertainties into the assessment model is also developed. The model validation, using three real cases collected from industrial partners on consumer and commercial products, has confirmed the applicability of the model to provide a useful tool to evaluate products at the end of their life cycle. The model also enables decision makers to disclose the risk associated with the decision, thus improving the quality of the decision. The results are in good agreement with the basic theory that the reuse and remanufacturing strategy is highly recommended from both environmental and economic reasons.

n/a

Thesis (Ph. D.)--Washington State University, December 2007. / Includes bibliographical references (p. 198-231).

This research investigated the relationship of predisposing attributes of preretirees to the perceived importance of locational preferences during the first ten years of retirement. Multiple regression analyses and a Chi-square test were used to determine if seven predisposing attributes were related to ten locational preferences. Data were analyzed from a age-stratified random sample of 1003 preretirees age 40-65 in the three western states of Idaho, Oregon, and Utah. The data were collected in a mail survey in 1990 by the Western Regional Agricultural Experiment Station Committee (W-176). Gender, education, and income were significantly related to respondents' perceived importance of low cost of living. Females, individuals with lower income, and those with less education indicated a higher perceived importance for low cost of living. Gender and income were significantly related to respondents' perceived importance of employment opportunities. Employment opportunities were more important for females and individuals with lower income. Older respondents and females indicated a greater importance for convenience and care amenities. Older respondents, females, and respondents who had not moved, placed more importance on close proximity to family. Females and respondents with higher levels of education indicated greater importance for personal enrichment opportunities. The perceived importance of recreation was greater for males, younger respondents, and respondents with higher income and education. As age increased, the perceived importance for warm temperatures increased. Health was significantly related to perceived importance of accessible medical facilities, but there was no significant difference in health status and desired types of medical services. The findings of this study may assist policy makers, community planners, and the business sector in understanding the heterogeneous nature of the aging population. It may also assist in responsive long-range planning in accommodating future elderly. / Graduation date: 1994

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: School of Social Work. Bibliography: leaves 278-297. Also available online via the Internet.

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains vi, 65 p. Includes abstract. Includes bibliographical references (p. 45-50).

Risk based audit (RBA) approaches represent a major trend in current audit methodology. The approach is based on risk analysis used to identify business strategy risk. The RBA has created a new set of research issues that need investigation. In particular, this approach has important implications for risk identification and risk assessment. The success of the RBA approach is contingent on understanding what factors improve or interfere with the accuracy of these risk judgments. I examine how budget constraints and decision aid use affect risk identification and risk assessment. Unlike previous budget pressure studies, I cast budget constraints as a positive influence on auditors. I expect more stringent budget constraints to be motivating to the auditor as they provide a goal for the auditor to achieve. I also expect budget constraints to induce feelings of pressure leading to the use of time-pressure adaptation strategies. When auditors have use of a decision aid, they take advantage of these motivational goals and/or use beneficial adaptive strategies. Overall, I find that auditor participants tend to be more accurate when identifying financial statement risks compared to business risks. Budget constraints have no effect on risk identification for financial or business risks; they also have no effect on financial risk assessments. On the other hand, business risk assessments are improved by implementing more stringent budget constraints, but only when a decision aid is also provided. Budget constraints can affect performance through a goal theory route or a time-pressure adaptation route. I investigate the paths through which budget constraints improve business risk assessments under decision aid use. I find that budget constraints directly affect performance, supporting a goal theory route. However, I do not find that budget constraints are mediated by perceived budget pressure as expected. Auditors appear to use a positive adaptive strategy to respond to perceived budget pressure, however perceived budget pressure is not induced by providing a more stringent budget.