Abstract In today’s business world, the delivery of superior information technology services has become an important deliverable for successful organisations. This study focuses on the end user perception of information technology service quality in manufacturing organisations. The study focuses on one manufacturing organisation, namely Nissan South Africa, a supplier of quality vehicles to South African customers. The main research problem describes the necessity of having a tool in place that can measure users’ perception of information technology service quality. The two subproblems describe the change of perception regarding information technology service quality when measured from a functional area or designation level perspective. The functional area represents the various departments within an organisation and the designation level, the hierarchical position of the employee within an organisation. A broad literature review is conducted and a theoretical foundation is developed and relevant service quality models are reviewed and adjusted in order to construct a model to measure information technology from a service quality perspective. The information has been collected by means of a questionnaire, which was distributed to approximately 1200 users. i i The overall perception of the information technology service quality, as experienced by the Nissan user base, is rated as above average customer satisfaction. No significant differences are identified between the demographic levels and the dimensions of the service quality model. Even though the model used in this study provides a good indication of the information technology service quality, it needs to be refined on a continuous basis in order to ensure that it is aligned with the dynamic nature of information technology.

Meeting the heath care needs of patients is becoming more complex as individuals are living longer and often with multiple chronic health conditions. In Canada, the majority of patients will die in hospitals (Statistics Canada, 2009), many on medical units. Studies of hospital care have shown that end-of-life care (EOLC) could be improved. Qualitative nursing research studies on EOLC in hospital medical units have been few. More needs to be known about nurses’ experience of providing EOLC within the medical unit environment. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology using van Manen’s (1990) approach guided the methodology and analysis of the findings. Face to face interviews with 10 nurses on two hospital medical units were audio-recorded, transcribed and analyzed. The underlying essence of these nurses’ experience was that of “battling a tangled web”. Battling a tangled web represented the nurses’ struggles in attempting to provide EOLC in an environment which was not always conducive to it. Seven themes were generated from the analysis of the data: caring in complexity, caught in a tangled web, bearing witness to suffering, weaving a way to get there: struggling through the process, creating comfort for the patient, working through the dying process with the family, and finding a way through the web. These findings add to our growing knowledge of nurses’ roles and actions as part of EOLC. It also highlights nurses’ perceived facilitators and barriers to EOLC within the medical environment.

Background: Advance care planning (ACP) is a method used for patients to express in advance their preferences, beliefs and values for life-sustaining treatments at the end-of-life. With growing ethnocultural diversity in Canada, health care providers are managing an increasing number of diverse beliefs/values that are commonly associated with preferences for mechanical ventilation (MV) at the end-of-life. The aim of this project is to explore methods used by health care providers to set care plans for MV with ethnocultural populations. Methods: Qualitative analysis of semi-structured interviews with open-ended questions and two clinical vignette components was conducted with eight (8) health care providers who engage in ACP. Participants were recruited using a snowball-sampling approach from five acute-care hospitals within the Ottawa region. Results: Three major themes emerged from collected dataset: 1) Goals of care across illness trajectories, 2) Respecting beliefs, values, and wishes for care, and 3) Cross-cultural support in ACP. Using a value-based approach in ACP was described as an effective method for managing and interpreting diverse beliefs/values that impact decisions for MV. However, organizational, systemic, and personnel barriers that exist continue to hinder the provision of cross-cultural ACP across health settings. Contexte: La planification préalable des soins (PPS) est une méthode utilisée par les patients et les familles pour exprimer à l'avance leurs préférences liées aux traitements de prolongation de vie. En raison de la diversité ethnoculturelle croissante au Canada, les professionnels de la santé sont confrontés à des croyances et valeurs différentes, souvent associées à une préférence pour l’initiation et le maintien de la ventilation mécanique (VM) en fin de vie. L'objectif de ce projet consiste à explorer les stratégies utilisées par les professionnels de la santé lors des discussions associées à la VM auprès d'une clientèle multiculturelle. Méthodes: Huit (8) participants (médecins et infirmières) impliqués dans la PPS ont accepté de participer à une entrevue semi-structurée avec des questions ouvertes et deux scénarios cliniques. Les participants ont été recrutés à l'aide de la méthode d’échantillonnage par réseau (« boule de neige ») de cinq hôpitaux de la région d'Ottawa. Résultats: Trois grands thèmes ont émergé des entrevues: 1) les objectifs de soins à travers les trajectoires de la maladie, 2) le respect des croyances, valeurs et souhaits pour les soins, et 3) le soutien dans la PPS en contexte interculturel. Lors de la PPS, utiliser une approche basée sur les valeurs a été décrite comme une méthode efficace pour interpréter et prendre en compte les diverses croyances et valeurs qui ont une influence sur les décisions liées à la VM. Cependant, les barrières systémiques, organisationnelles et personnelles continuent d'entraver les services associés à la PPS en contexte interculturel dans les établissements de santé.

This thesis presents the Simple Internet of Things Enabler (SITE), a smart home solution that allows users to specify and centrally control IoT smart objects. Unlike most existing systems, SITE supports End-User Development (EUD). It includes features that make the system accessible to users that do not possess a background in Information Technology (IT). Hence, it defines a simple language for the specification of control rules for smart objects. It also provides a user interface to graphically illustrate data received from smart objects. Furthermore, we present the SITE architecture and describe the components that enable users to define, register, and operate smart objects within a smart home environment. Since deploying applications on the cloud renders many advantages pertaining to data security, robustness, and elasticity of resources, we additionally propose a cloud-based architecture for SITE. In this case, SITE acts as a service hosted on a cloud platform that realizes monitoring and control of a smart home remotely. Moreover, since most of the objects in any environment are not inherently smart, we propose a framework that affords “everyday” objects the necessary modules to measure and report their state. Hence, users realize the smart objects using a transducer network framework that supports the amalgamation of multiple transducers into a single smart object. To make these objects easily reconfigurable, we apply a plug and play mechanism to enable the clustering of any number of transducers. We propose an algorithm that dynamically detects added and removed transducers from a smart object. To assess the usability of SITE, we conduct an empirical study involving 20 participants belonging to two user groups: users with technical training (IT users) and users without technical training (Non-IT users). We demonstrate that both user groups can satisfactorily build smart objects and define control rules in a smart home environment using SITE.

Cette thèse porte sur l’évaluation et la caractérisation non destructives (END/CND) par ultrasons de matériaux composites contribuant en partie au concept de contrôle santé structural (SHM). Plus particulièrement, les phénomènes d’adhésion et de vieillissement de structures sandwichs composites à âme en nid d’abeille sont d’un intérêt déterminant pour l’aéronautique. Les propriétés liées à ces deux phénomènes ont été étudiées à l’aide de modèles théoriques, de simulations numériques et de résultats expérimentaux. Sur la base de travaux antérieurs, les ondes de Lamb ont permis de caractériser l’adhésion et le vieillissement. Des simulations complémentaires par éléments finis ont été menées avec le logiciel Comsol Multiphysics©. Des défauts d’adhésion tels que les délaminages ou décohésions ont pu être détectés et localisés au moyen de la Transformée de Fourier à Court Terme (TFCT) par fenêtre glissante, par simulation et par l’expérience. Dans la perspective de cadences d’END industrielles, les transducteurs multiéléments permettent une inspection et une caractérisation locales du collage. À titre de comparaison, la modélisation par série de Debye (DSM) a permis de résoudre localement le problème inverse sur un plan de coupe d’un composite à nid d’abeille. Le vieillissement de structures sandwichs a été étudié dans un premier temps par ondes de Lamb dans l’air et dans un second temps par mesure d’impédance électromécanique via un transducteur en contact avec les échantillons. Les résultats de modélisation et expérimentaux montrent que les fréquences et largeurs de résonances varient suivant le taux de porosités, illustrant la sensibilité de ces méthodes au vieillissement. / This thesis focuses on the ultrasonic non-destructive testing and evaluation (NDT&E) of composite materials contributing in part to the concept of structural health monitoring (SHM). Specifically, adhesion phenomena and aging of composite sandwich core honeycomb structures are of crucial interest for aeronautics. The properties related to these two phenomena were studied using theoretical models, numerical simulations and experimental results. Based on previous works, using Lamb waves allow to characterize adhesion and aging. Additional simulations were carried out with the finite element software Comsol Multiphysics©. Adhesion defects such as delamination or debonding at the interfaces have been detected and located by means of the Short Term Fourier Transform (STFT) by sliding window, both numerically and experimentally. In view of NDT industrial rates, phased array transducers allow inspection and characterization of local bonding. By comparison, the Debye series method (DSM) was conducted locally to solve the inverse problem of a cut plane of a honeycomb composite. First, sandwich structure aging was investigated using Lamb waves in the air. Second, the aging was evaluated by measuring the electromechanical impedance of a transducer in contact with the samples. These experimental results show that the resonance frequencies and widths variations depend on the degree of porosity, indicating the sensitivity of these methods to the aging.

In the medical context, it is an accepted (yet controversial) fact that doctors may sometimes legitimately hasten death when providing palliative care to dying patients. Or even, in relation to treatment decisions leading to withdrawal or omission, some doctors may choose death over life for certain patients and yet we seldom hear of doctors in the dock for intentional killing. Where complicity in suicide is concerned, it seems that the compassionate lay person has little reason to be fearful of criminal reprisal. The question, however, of whether a person suspected of complicity in suicide, or a doctor suspected of intentionally causing the death of a patient, will be greeted by sympathy or condemnation is a legal minefield. A range of diverse legal, moral and circumstantial factors will determine firstly, whether one is prosecuted and secondly, whether one will be subject to juridical disapproval and possible incarceration. This thesis sets out to explore whether continued obfuscation, together with turning a blind eye to possible breaches of the law, is the best approach to the moral dilemma over what should be permitted in assisted dying and end-of-life law. This is not a rhetorical question with a trite answer. Such obfuscation may be viewed as having certain advantages. This thesis explores the legal and ethical issues in the context of recent developments, societal concerns and international influences in order to examine whether the current legal position in respect of homicide and complicity in suicide is tenable. The analysis invites the conclusion that whilst some legal change is both desirable and necessary, any legal reform should seek to facilitate a cautious compromise that reflects the legitimate concerns of those opposed to legal change.

Community health care aides form the largest group of home health care providers in Canada. There is an increasing trend in Canada towards more home deaths. Home Care and the health care aides that provide this care are an integral component of this movement. An Interpretive Descriptive study was undertaken to identify community health care aides’ experiences of support as they provide end-of-life care to those dying at home. Three themes emerged from the data: 1) Striving to provide the best care, 2) Connections, and 3) Loss. Findings suggest that relationships form an important part of the health care aides' work and are intertwined throughout all the themes identified in this study. Health care aides in the community often feel undervalued and unsupported by the larger health care team. Comparatively little research has been undertaken to examine the unique experiences of the community health care aides providing end-of life care, compared to research on the health care aides providing end-of-life care in the long-term care setting and to research on nurses providing end-of-life care in the community. Community health care aides have unique challenges and characteristics and this study was undertaken to address this gap. / Graduate

Background: Palliative care can be given to patients with progressive, incurable disease. In palliative care the patient is seen in a holistic perspective, the goal is to prevent and relieve physical, psychological, social and existential suffering. The four cornerstones of palliative care are symptom relief, teamwork, communication/relation and support to next of kin. The nurse in palliative care builds a relationship with the patient and next of kin. The nurse also works with symptom relief and informing patient and next of kin. Next of kin to patients in palliative care often put themselves aside to care for the patient and wish to be with the patient until the end of the patients’ life. Aim: The aim of the study was to describe next of kins’ need for support from the nurse in end-of-life care in hospitals. Method: A literature study based on nine qualitative articles retrieved through systematic search in database Cinahl. The articles were analysed with a five-step method. Results: Two categories emerged in the results. The first was A respectful nurse, with the subcategories Emotional support, To be together and The patient is well taken care of. The second was To be involved as next of kin with the subcategories To be informed and Participation. Conclusion: Next of kin to patients in end-of-life care need a nurse who cares for them, enables them to be with the patient and participate in the patients’ care, guides and informs them in the end-of-life process and takes good care of the patient.

There are an estimated 5 million family caregivers supporting persons suffering from advanced heart failure (AHF) which constitutes the final stage of cardiovascular disease and is the primary cause of death for 1 in 8 Americans. AHF caregivers are instrumental in monitoring symptoms, promoting adherence, communicating with healthcare providers and making treatment choices for their care recipients (CRs) at the end of life. What little is known about the AHF caregiver experience comes from surveys, instruments and structured interviews and tends to exclude caregivers of CRs with advanced disease. The purpose of this interpretive phenomenology was to elicit the meaning of caring for a spouse with AHF and is the first of its kind in the US. Seven older spouses caring for persons with NYHA class III-IV HF recruited by the Advance Practice RN of a large regional hospital participated in 3 reflective interviews over the course of 2 months. Grounded in the Philosophy of Ethics by Paul Ricoeur and using a method based on his Theory of Interpretation, their reflections revealed the essence of the caregiver experience as "being fearfully vigilant, at the mercy of the disease while worrying about that which remains unspoken". Separate inquiries invited participants to explore the meaning of symptom interpretation which was likened to "a walk in the fog on the rocky shore by a treacherous river"; and communication which illuminated caregivers' ethical intention in caring for themselves and their loved ones. The fourth and final research question explored caregivers' meaning making in the experience, symptom interpretation and communication over time which uncovered several missed opportunities for advance care planning. Findings support and add to recent models in palliative care, shared care and advance care planning in AHF. This study gives healthcare providers insight into the challenges to respect, self esteem and autonomy encountered by aging couples in the context of AHF. Participants identified personal learning needs related to being a caregiver, symptom interpretation, and managing clinical and emotional manifestations of AHF. Naming specific barriers in communication with their CRs as well as with healthcare providers they called for relationship counseling for the CG-CR dyad, and to be respected as part of the team by healthcare providers. Participants gave moving examples of how current models of care failed to meet their needs, with urgent implications for coordinated care by an interdisciplinary team of healthcare providers. This study identified the need for more phenomenological inquiry to understand (1) implications of CR's cognitive fluctuations on decision making for preferences of care, (2) CRs' personality changes attributed to an awareness of death being near, (3) the need to retain a purpose in living both as individuals and as a couple, and (4) how CRs reconcile daily choices in illness management and adherence with preferences for care at the end of life.

abstract: The International Energy Agency (IEA) anticipates the global energy demand to grow by more than 25% by 2040, requiring more than $2 trillion a year of investment in new energy supply (IEA, 2018). With power needs increasing as populations grow and climate extremes become more routine, power companies seek to continually increase capacity, improve efficiency, and provide resilience to the power grid, such that they can meet the energy needs of the societies they serve, often while trying to minimize their carbon emissions. Despite significant research dedicated to planning for industrial projects, including power generation projects as well as the pipeline projects that enable power generation and distribute power, there are still endemic cost overruns and schedule delays in large scale power generation projects. This research explores root causes of these seemingly systemic project performance issues that plague power generation projects. Specifically, this work analyzes approximately 770 power and pipeline projects and identifies how project performance indicators (i.e., cost and schedule performance) as well as planning indicators, compare in two regulatory environments, namely nonregulated and regulated markets. This contributes explicit understanding of the relationship between project performance and regulatory environment, both quantitatively and qualitatively, to the pipeline and power project planning and construction bodies of knowledge. Following an understanding of nonregulated versus regulated markets, this research takes a deeper dive into one highly-regulated power sector, the nuclear power sector, and explores root causes for cost overruns and schedule delays. This work leverages gray literature (i.e., newspaper articles) as sources, in order to analyze projects individually (most academic literature presents data about an aggregated set of projects) and understand the public perception of risks associated with such projects. This work contributes an understanding of the risks associated with nuclear power plant construction to the nuclear power plant construction body of knowledge. Ultimately, the findings from this research support improved planning for power and pipeline projects, in turn leading to more predictable projects, in terms of cost and schedule performance, regardless of regulatory environment. This enables power providers to meet the capacity demands of a growing population within budget and schedule. / Dissertation/Thesis / Doctoral Dissertation Civil, Environmental and Sustainable Engineering 2020