Drop-in centers for individuals with serious and persistent mental illness offer a unique and perhaps under-recognized environment option for adjunct treatment. The current study examines and evaluates components thought to be a part of an enriched drop-in center experience that contribute to positive member outcomes through the effects of empowerment. These components include self-help, peer support, and creative expression. Outcomes were evaluated based on quality of life, self-worth, and symptom reduction. Such data are necessary in promoting the growth and development of drop-in centers and identification of components that contribute to positive member outcomes. Participants (n=101) were administered a series of measures including The Multidimensional Scale of Perceived Social Support, The Empowerment Scale, The Rosenberg Self-Esteem Scale, The World Health Organization Quality of Life-BREF, The BASIS-32™, and a series of questions created for the purposes of the current study regarding creative expression and self-help. The psychometric properties of each measure were evaluated and reviewed. Additionally, mean differences between normative data and participant means were examined and demographic data were analyzed. It was hypothesized from the literature that self-help, peer support, and creative expression would have significant indirect effects on all of the proposed outcome variables through the effects of empowerment. Results revealed significant indirect relationships between peer support and all of the outcome variables through the effects of empowerment and between self-help and all of the outcome variables through the effects of empowerment. No significant relationships were found between creative expression and any of the outcome variables through the effects of empowerment. These findings suggest that peer support and self-help may be instrumental in achieving positive outcomes through the effects of empowerment. Centers that offer experiences to enhance self-help and peer support will subsequently enhance feelings of empowerment in members, which relates to higher levels of self-worth, higher levels of quality of life, and lower levels of psychiatric symptomatology. Further implications of such findings and suggestions for continuation of this research are discussed in detail.

Farmers will supply the raw ingredients for the emerging cellulosic ethanol industry. The long-term relationship between a farmer and a processing firm is expected to be contractual. A processing firm has an incentive to sign long-term contracts to ensure a cost-efficient level of raw ingredient supply. However, farmers generally prefer to operate with either no contract or a short-term contract in order to maintain options for adjustments in future acreage allocations due to changes in relative prices. Of interest in this research is to understand the incentives of farmers and calculating the efficient level of the “inflexibility premium”, which a processing firm must provide to a farmer when a long term contract is signed. A stochastic dynamic programming model is solved and with the help of Microsoft Excel numerically evaluated to illustrate the marginal inflexibility premium is increasing with contract length and the level of price variability, and is decreasing with the size of acreage adjustment costs. / Land and Food Systems, Faculty of / Graduate

Long-term residential care (LTRC) is a complex sociopolitical milieu where people from diverse backgrounds come to live and work together. In recent years health care restructuring has resulted in the closure of facilities; health care policy has narrowed the population that accesses LTRC so that only those who are the most medically and socially complex are admitted; and there has been a transformation of the work force, a workforce that is mainly comprised of Women of Colour and is among the lowest paid in health care. The purpose of this study was to critically examine the organization of care in LTRC within this context. The theoretical perspective guiding the study was informed by postcolonialism, postcolonial feminism, intersectionalities, and Foucaudian epistemology. The method of inquiry for the study was critical ethnography, which allowed for critical analysis of `taken for granted' assumptions in the organization of care. Over a period of ten months, I was immersed in two LTRC facilities in the Lower Mainland of British Columbia. Field work consisted of approximately 218 hours of participant observation. I conducted 51 interviews with administrators, family members, residents, and staff. I reviewed relevant provincial policies and facility-based policies and procedures. I also collected quantitative data related to resident transitions in the health care system (for example, admissions, discharges, and hospital admissions), and staffing levels. Findings from this study were discussed in three key themes. First, a systematic decommissioning of citizenship occurred for residents and staff in this setting. Second, the impact of health care restructuring over the past decade had important consequences for relationships between residents, family, and staff. Third, relational care took place in `stolen' moments that occurred despite heavy workloads. All of these themes were underscored by intra-gender oppression, relations of power, and influenced by discourses of ageism and corporatism, which ultimately played out in day to day interactions between those who live and work there. Recommendations from this study included: addressing the entrenched hierarchies in nursing, further examination of the public-private funding model in LTRC, and the introduction of an independent ombudsperson to ensure consistent, high quality care across the LTRC sector. / Applied Science, Faculty of / Nursing, School of / Graduate

Sport for development programs are becoming increasingly popular to address a variety of social issues such as poverty, lack of education, gender equality, and conflict within marginalized communities. Within Canada, many sport for development programs are created for Aboriginal peoples, as they are considered marginalized communities. However, there is a dearth of research on what the actual impacts of sport for development programs are on the recipients of the program, as well as on those who provide the program. My thesis, which is written in the publishable paper format, is comprised of two papers. Using a case study approach in paper one, I explore the impacts that Alberta’s Future Leaders Program’s (AFL) youth leadership retreat has had on its participants (Aboriginal youth). Similarly, using a case study approach in paper two, I explore if/how working for AFL had lasting impacts on the former employees, known as youth workers and arts mentors. Together, the two papers in this thesis show the need for a deeper look into the actual impacts sport for development programs yield, provide insights into some of the lasting impacts AFL has had on its participants, and address the importance of long-term evaluation for sport for development programs.

The salinity distribution in an inverse estuary (where the sea water is concentrated by the estuary water) possesses its own uniqueness due to excessive net freshwater loss and restricted circulation. The study of long-term balance of salinity can contribute to a better understanding of the mixing and transport properties in such a distinct type of water body (i.e., inverse estuary water), and can provide valuable information for sound water management and environmental assessment. The Persian Gulf is chosen to be the study region, as it is a typical large-scale inverse estuary with severe shortages of freshwater resources and has been of significant research interest during the past several decades. For basin-wide examinations of a large-scale inverse estuary, analytical solutions are typically unavailable and field measurements are expensive, so numerical modeling as well as validation with available data is the main focus in this thesis. Firstly, the salinity distribution in the Persian Gulf is simulated with 8 different schemes, and the obtained results are compared with the World Ocean Atlas 2013 (WOA13) data. The comparisons can validate the utilization of the numerical model in predicting the salinity distribution in a large-scale inverse estuary. Given that results are affected by the choice of the numerical scheme, a performance analysis of candidate schemes is performed. The most appropriate scheme for the Persian Gulf is figured out in this stage. Secondly, the validated scheme is used for the prediction with respect to the long-term salinity response of the Persian Gulf to the climate change and anthropogenic activities. The results show that without mitigation measures taken, the salinity in the Persian Gulf will continually increase with time. The long-term and basin-wide simulations that will be presented in this thesis are expected to be more useful than previous studies (which were generally limited in time from hours to a few months) in terms of inspecting long-term characteristics. The performance of various numerical schemes has been assessed for the first time through a practical case study, which can contribute to a better understanding of the applications and characteristics of these schemes. Besides, the long-term salinity variations in the Persian Gulf are predicted for the next half-century, and this is the first numerical prediction of the long-term salinity response of the Persian Gulf to climate changes and anthropogenic activities.

Abstract Early sport specialization is a phenomenon that continues to be practiced in today’s youth sports environment. The purpose of this study was to explore practices around early specialization within the minor hockey context in Eastern Ontario. More specifically, the goal of this thesis was to better understand parental perspectives on specialization versus diversification relative to their child’s experience in the sport of ice hockey. Additionally, this study aimed to uncover the rates of specialization in Minor Peewee AA ice hockey players in Eastern Ontario and the factors that influence those who specialize. A concurrent embedded mixed-methods procedure was employed for this study; a total of 114 survey responses and 15 semi-structured interviews formed the study sample. Findings in the study reveal a large majority of parents foster specialization in their child as 87% (n=114) of survey participants identified as having a child who specializes in the sport of ice hockey. However, interview data revealed that parents favor development through diversification. Individual influences such as parents and coaching staff were found to be contributing factors to the phenomenon of specialization. Further, the availability of resources within the hockey context was additionally found to influence specialization. Finally, Hockey Canada’s current position was cogitated with the results to reveal a strong inclination towards elite development. Results indicate a need for parent and coach education regarding their role in early specialization and their support for diversification of sport experiences. It is of particular importance during the transitioning years in particular where stakeholders (parents, coaches, administration) foster the sense of well-rounded development of a participating child not just for the preparation for the elite stages of sport but for overall wellness of the individual.

0 / SPK / specialcollections@tulane.edu

Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.

Each year, hospitalizations from long-term care (LTC) settings occur, in part, due to underdeveloped nursing assessment skills, ineffective communication with primary care providers (PCPs), and delayed intervention. Through staff development nursing education, the quality and timeliness of care can be improved. The practice question that guided this doctoral project focused on whether evidence-based research information would assist in decreasing LTC-to-hospital admission rates through improved nursing assessment skills and better communication with PCPs. Using the logic model, the effectiveness of a program was evaluated and the impact of interventions on a predicted outcome was determined. Sources of evidence included obtaining best practice research information from scholarly nursing journals and official nursing websites. Analytical strategies included a review of the literature to examine data from nursing journals, websites, and other publication sources in addition to the use of a synthesis matrix that classified different ideas rated by the Cochrane Consumer Network. The findings of this project might contribute to positive social change by fostering improved patient assessments, enhanced communication with PCPs, early intervention, and decreased LTC-to-hospital admission rates through the improvement of nursing practice policy.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19890号 / 医博第4139号 / 新制||医||1016(附属図書館) / 32967 / 京都大学大学院医学研究科医学専攻 / (主査)教授 川上 浩司, 教授 福原 俊一, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM