Funding of services to residents in publicly funded long-term care (LTC) facilities has historically rested upon a list of physical needs. However, more than 60% of residents in nursing homes have dementia; a condition in which physical needs are only a part of the overall clinical picture. Since past funding formulas focused primarily on the physical characteristics of residents, the Ontario government has adopted the RUG (Resource Utilization Groups)-III (34 Group) for use in LTC facilities which follows the adoption of the Minimum Data Set (MDS) 2.0 assessment instrument. Some still question whether the newer formula adequately reflects the care needs of residents with dementia despite its validation in many countries. The purpose of this study was to determine the comprehensiveness of the RUG-III (34 Group) in addressing the needs of residents with dementia living in LTC. First, a critical systematic review of the literature was conducted to determine the needs of residents with dementia. Numerous electronic databases were searched for articles published between January 2000 and September 2010, and later cross-referenced. Second, needs identified from the literature were matched to the items of the RUG-III which are selected variables of the MDS 2.0. Third, the priority of the items in the RUG-III was analysed in accordance with the importance of the identified needs. The documented needs were taken from 68 studies and classified into 19 main categories. The needs most supported by the literature were the management of behavioural problems, social needs, the need for daily individualized activities/care and emotional needs/personhood. Among the needs identified, activities of daily living (ADLs), cognitive needs and general overall physical health met the most RUG-III items. These needs were found to be well represented within the system. Other needs of importance such as social needs are not thoroughly considered in the grouping methodology though matched to MDS variables. The fact that these needs are not well addressed in the RUG-III poses concerns. Future research is needed to validate the significance of these needs. Considerations should be made as to the adequacy of the funding system and the allocation of funding.

Server consolidation is currently widely employed in order to improve the energy efficiency of data centers. While being a promising technique, server consolidation may lead to resource interference between applications and thus, reduced performance of applications. Current approaches to account for possible resource interference are not well suited to respect the variation in the workloads for the applications. As a consequence, these approaches cannot prevent resource interference if workload for applications vary. It is assumed that having models for the resource utilization and power consumption of applications as functions of the workload to the applications can improve decision making and help to prevent resource interference in scenarios with varying workload. This thesis aims to develop such models for selected applications. To produce varying workload that resembles statistical properties of real-world workload a workload generator is developed in a first step. Usually, the measurement data for such models origins from different sensors and equipment, all producing data at different frequencies. In order to account for these different frequencies, in a second step this thesis particularly investigates the feasibility to employ quantile functions as model inputs. Complementary, since conventional goodness-of-fit tests are not appropriate for this approach, an alternative to assess the estimation error is presented.:1 Introduction 2 Thesis Overview 2.1 Testbed 2.2 Contributions and Thesis Structure 2.3 Scope, Assumptions, and Limitations 3 Generation of Realistic Workload 3.1 Statistical Properties of Internet Traffic 3.2 Statistical Properties of Video Server Traffic 3.3 Implementation of Workload Generation 3.4 Summary 4 Models for Resource Utilization and for Power Consumption 4.1 Introduction 4.2 Prior Work 4.3 Test Cases 4.4 Applying Regression To Samples Of Different Length 4.5 Models for Resource Utilization as Function of Request Size 4.6 Models for Power Consumption as Function of Resource Utilization 4.7 Summary 5 Conclusion & Future Work 5.1 Summary 5.2 Future Work Appendices / Serverkonsolidierung wird derzeit weithin zur Verbesserung der Energieeffizienz von Rechenzentren eingesetzt. Während diese Technik vielversprechende Ergebnisse zeitigt, kann sie zu Ressourceninterferenz und somit zu verringerter Performanz von Anwendungen führen. Derzeitige Ansätze, um dieses Problem zu adressieren, sind nicht gut für Szenarien geeignet, in denen die Workload für die Anwendungen variiert. Als Konsequenz daraus folgt, dass diese Ansätze Ressourceninterferenz in solchen Szenarien nicht verhindern können. Es wird angenommen, dass Modelle für Anwendungen, die deren Ressourenauslastung und die Leistungsaufnahme als Funktion der Workload beschreiben, die Entscheidungsfindung bei der Konsolidierung verbessern und Ressourceninterferenz verhindern können. Diese Arbeit zielt darauf ab, solche Modelle für ausgewählte Anwendungen zu entwickeln. Um variierende Workload zu erzeugen, welche den statistischen Eigenschaften realer Workload folgt, wird zunächst ein Workload-Generator entwickelt. Gewöhnlicherweise stammen Messdaten für die Modelle aus verschienenen Sensoren und Messgeräten, welche jeweils mit unterschiedlichen Frequenzen Daten erzeugen. Um diesen verschiedenen Frequenzen Rechnung zu tragen, untersucht diese Arbeit insbesondere die Möglichkeit, Quantilfunktionen als Eingabeparameter für die Modelle zu verwenden. Da konventionelle Anpassungsgütetests bei diesem Ansatz ungeeignet sind, wird ergänzend eine Alternative vorgestellt, um den durch die Modellierung entstehenden Schätzfehler zu bemessen.:1 Introduction 2 Thesis Overview 2.1 Testbed 2.2 Contributions and Thesis Structure 2.3 Scope, Assumptions, and Limitations 3 Generation of Realistic Workload 3.1 Statistical Properties of Internet Traffic 3.2 Statistical Properties of Video Server Traffic 3.3 Implementation of Workload Generation 3.4 Summary 4 Models for Resource Utilization and for Power Consumption 4.1 Introduction 4.2 Prior Work 4.3 Test Cases 4.4 Applying Regression To Samples Of Different Length 4.5 Models for Resource Utilization as Function of Request Size 4.6 Models for Power Consumption as Function of Resource Utilization 4.7 Summary 5 Conclusion & Future Work 5.1 Summary 5.2 Future Work Appendices

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Contexte et objectifs : Les services de santé sexuelle et reproductive des adolescents (SSRA) ont fait l’objet de peu d’études au Niger. Cette thèse avait pour objectif d’analyser les relations entre les capacités des organisations, la mobilisation et l’utilisation des ressources en SSRA. La thèse propose tout d’abord une description rétrospective des interventions en SSRA et une analyse de l’offre des services de SSRA et du profil des acteurs impliqués dans la conception et la mise en œuvre des interventions en SSRA pour comprendre le contexte de l’étude. Méthodologie : Une revue documentaire narrative et des entrevues individuelles ont été réalisées pour examiner l’historique des interventions en matière de SSRA mises en œuvre au Niger depuis 1975 jusqu’en 2021. De même, cela nous a permis d’identifier les acteurs impliqués et leur rôle dans le processus de mise en œuvre de ces interventions (article 1). Des données secondaires ont été utilisées à travers un modèle Generalized estimating equation (GEE) et une approche comparative entre trois pays : Burkina Faso, Ghana et Niger pour analyser le profil des structures de santé, l’offre du panier de services planification familiale (PF) aux adolescents non mariés et les déterminants de cette offre (article 2). Des données primaires ont été collectées auprès de 250 organisations ayant mis en œuvre des interventions en SSRA sur la période de 2017 à 2021 au Niger. Ces données ont été utilisées pour analyser la relation entre les capacités organisationnelles et la mobilisation des ressources (article 3) en utilisant un modèle de régression logistique multinomiale ordonnée. De même, ces données ont été utilisées pour analyser la relation entre les capacités organisationnelles et l’utilisation effective et efficiente des ressources mobilisées. Un modèle Logit binaire a été estimé pour examiner la relation entre les capacités organisationnelles et l’utilisation effective des ressources mobilisées (article 4). Enfin, un modèle de frontière stochastique et un modèle de Tobit ont été utilisés pour déterminer les scores d’efficience technique et analyser la relation entre les niveaux des capacités des structures de santé et leurs scores d’efficience technique dans l’utilisation des ressources pour offrir les produits et services de SSR aux adolescents (article 5). Résultats : Les résultats de cette thèse font ressortir dans un premier temps un éventail d’interventions en SSRA mises en œuvre et d’acteurs avec des profils variés qui sont impliqués dans le processus d’élaboration et la mise en œuvre de ces interventions au Niger. Les décennies 2000 et 2010 ont constitué les périodes où la plupart des interventions ont été mises en œuvre pour améliorer la SSRA. L’État demeure l’acteur principal, mais il est accompagné techniquement et financièrement par d’autres acteurs. Parmi ces derniers, il y a les bailleurs de fonds constitués par des institutions des Nations unies comme le Fonds des Nations Unies pour la population (UNFPA), l’Organisation mondiale de la santé (OMS) et la Banque Mondiale, des gouvernements des pays amis du Niger, des fondations et des institutions de recherche. L’État reste la deuxième source de financement. Toutefois, bien que beaucoup d’efforts aient été consentis pour améliorer l’accès aux services de SSRA, des adolescents non mariés éprouvent des difficultés d’accès, car beaucoup de structures de santé n’offrent pas ces services à cette population. Au Niger, seuls 29% des structures de santé ont déclaré offrir le panier de services de PF aux adolescents non mariés en 2017 contre 70% et 60% respectivement au Burkina Faso et au Ghana. Plusieurs facteurs expliquent cette offre. Parmi ces derniers, il y a le genre du premier responsable dont les résultats montrent que les structures de santé dirigées par les femmes ont plus de chance d’offrir le panier de services PF aux adolescents non mariés que celles dirigées par un homme. De plus, l’analyse de profil effectuée sur ces structures montre une hétérogénéité. Au Ghana, par exemple, on trouve un profil plus diversifié composé des centres de santé, des hôpitaux et polycliniques et des « Community-based Health Planning and Services » (CHPS) tandis qu’au Burkina Faso et au Niger, ce sont plutôt des structures de santé du premier niveau. Le secteur privé est aussi assez présent alors qu’il ne l’est qu’à une proportion très marginale (moins de 1%) au Burkina Faso et au Niger. Par ailleurs, les résultats indiquent une relation positive entre les niveaux des capacités des organisations et leur niveau de mobilisation des ressources financières. Autrement dit, plus les organisations améliorent leur niveau des capacités, plus leur niveau de mobilisation des ressources financières est important. Toutefois, la relation diffère d’une dimension des capacités organisationnelles par rapport à une autre. Elle est plus importante pour les capacités managériale et opérationnelle et moins prononcée pour les capacités en leadership et adaptative. Il se dégage également une relation positive entre le niveau des capacités organisationnelles et l’utilisation effective des ressources financières mobilisées pour offrir des services de SSR aux adolescents ou pour réaliser des activités en SSRA. Par exemple, lorsqu’une organisation augmente son niveau de capacités organisationnelles augmente d’une unité, sa probabilité d’utiliser effectivement les ressources financières mobilisées augmente de 1,7%. Il apparait aussi que les structures de santé qui offrent les services de santé sexuelle et reproductive aux adolescents ont en moyenne un score d’efficience technique de 58%. Ce score est plus important chez les structures de santé dirigées par les femmes que celles dirigées par les hommes. De même, les structures de santé qui améliorent simultanément le niveau de leurs capacités : managériale, opérationnelle, adaptative et en leadership ont un score d’efficience technique plus important que celles qui ne l’ont pas fait. Toutefois, la relation entre ces capacités diffère d’une dimension à une autre. Contribution : Les résultats de cette thèse améliorent les connaissances sur l’analyse des interventions en SSRA dans les pays en développement. Ils constituent aussi un ensemble de données probantes sur lesquelles les acteurs impliqués dans la problématique de la SSRA peuvent s’appuyer pour mieux concevoir et mettre en œuvre les interventions en SSRA, capables de rendre les services de SSRA disponibles, accessibles et utilisables. / Background and objectives: Adolescent sexual and reproductive health (ASRH) services have been little studied in Niger. The aim of this thesis was to analyze the relationship between organizational capacity and the mobilization and use of ASRH resources. The thesis begins with a retrospective description of ASRH interventions and an analysis of ASRH service provision and the profile of actors involved in the design and implementation of ASRH interventions to understand the context of the study. Methodology: A narrative literature review and individual interviews were conducted to examine the history of ASRH interventions implemented in Niger from 1975 to 2021. This also enabled us to identify the actors involved and their role in the process of implementing these interventions (article 1). Secondary data were used through a generalized estimating equation (GEE) model and a comparative approach between three countries: Burkina Faso, Ghana and Niger to analyze the profile of health facilities, the supply of the family planning (FP) basket of services to unmarried adolescents and the determinants of this supply (article 2). Primary data were collected from 250 organizations that had implemented ASRH interventions between 2017 and 2021 in Niger. These data were used to analyze the relationship between organizational capacity and resource mobilization (article 3) using an ordered multinomial logistic regression model. Similarly, these data were used to analyze the relationship between organizational capacity and the effective and efficient use of mobilized resources. A binary Logit model was estimated to examine the relationship between organizational capabilities and the effective use of mobilized resources (article 4). Finally, a stochastic frontier model and a Tobit model were used to determine technical efficiency scores and to analyze the relationship between health facility capacity levels and their technical efficiency scores in the use of resources to provide SRH products and services to adolescents (article 5). Findings: The results of this thesis first highlight a range of ASRH interventions that have been implemented and actors with varied profiles who are involved in the process of developing and implementing these interventions in Niger. The decades 2000 and 2010 were the periods when most interventions were implemented to improve ASRH. The state remains the main actor, but it is supported technically and financially by other actors. These include donors such as United Nations agencies like the United Nations Population Fund (UNFPA), the World Health Organisation (WHO) and the World Bank, governments of countries friendly to Niger, foundations and research institutions. The State remains the second largest source of funding. However, although a great deal of effort has been made to improve access to ASRH services, unmarried adolescents still have difficulty gaining access, as many health facilities do not offer these services to this population. In Niger, only 29% of health facilities reported offering the FP basket of services to unmarried adolescents in 2017, compared with 70% and 60% respectively in Burkina Faso and Ghana. Several factors explain this offer. One of these is the gender of the primary caregiver, the results of which show that female-headed health facilities are more likely to offer the FP basket of services to unmarried adolescents than those headed by a man. In addition, the profile analysis carried out on these facilities shows heterogeneity. In Ghana, for example, we find a more diversified profile made up of health centres, hospitals and polyclinics, and Community-based Health Planning and Services (CHPS), whereas in Burkina Faso and Niger, it is more likely to be first-level health facilities. The private sector is also well represented, whereas in Burkina Faso and Niger it is very marginal (less than 1%). Furthermore, the results indicate a positive relationship between the capacity levels of the organizations and their level of mobilization of financial resources. In other words, the more organizations improve their level of capacity, the greater their level of mobilization of financial resources. However, the relationship differs from one dimension of organizational capabilities to another. It is stronger for managerial and operational capabilities and less pronounced for leadership and adaptive capabilities. There is also a positive relationship between the level of organizational capacity and the effective use of financial resources mobilized to provide SRH services to adolescents or to carry out ASRH activities. For example, when an organization increases its level of organizational capacity by one unit, its probability of using the financial resources mobilized increases by 1.7%. It also appears that health facilities offering sexual and reproductive health services to adolescents have an average technical efficiency score of 58%. This score is higher for female-run facilities than for male-run facilities. Similarly, health facilities that simultaneously improve their managerial, operational, adaptive and leadership capacities have a higher technical efficiency score than those that do not. However, the relationship between these capabilities differs from one dimension to another. Contribution: The results of this thesis improve knowledge on the analysis of ASRH interventions in developing countries. They also provide a body of evidence on which ASRH stakeholders can draw to better design and implement ASRH interventions, capable of making ASRH services available, accessible and usable.

Apache Spark is a popular open-source distributed processing framework that enables efficient processing of large amounts of data. Apache Spark has a large number of configuration parameters that are strongly related to performance. Selecting an optimal configuration for Apache Spark application deployed in a cloud environment is a complex task. Making a poor choice may not only result in poor performance but also increases costs. Manually adjusting the Apache Spark configuration parameters can take a lot of time and may not lead to the best outcomes, particularly in a cloud environment where computing resources are allocated dynamically, and workloads can fluctuate significantly. The focus of this thesis project is the development of an auto-tuning approach for Apache Spark configuration parameters. Four machine learning models are formulated and evaluated to predict Apache Spark’s performance. Additionally, two models for Apache Spark configuration parameter search are created and evaluated to identify the most suitable parameters, resulting in the shortest execution time. The obtained results demonstrates that with the developed auto-tuning approach and adjusting Apache Spark configuration parameters, Apache Spark applications can achieve a shorter execution time than when using the default parameters. The developed auto-tuning approach gives an improved cluster utilization and shorter job execution time, with an average performance improvement of 49.98%, 53.84%, and 64.16% for the three different types of Apache Spark applications benchmarked. / Apache Spark är en populär öppen källkodslösning för distribuerad databehandling som möjliggör effektiv bearbetning av stora mängder data. Apache Spark har ett stort antal konfigurationsparametrar som starkt påverkar prestandan. Att välja en optimal konfiguration för en Apache Spark-applikation som distribueras i en molnmiljö är en komplex uppgift. Ett dåligt val kan inte bara leda till dålig prestanda utan också ökade kostnader. Manuell anpassning av Apache Spark-konfigurationsparametrar kan ta mycket tid och leda till suboptimala resultat, särskilt i en molnmiljö där beräkningsresurser tilldelas dynamiskt och arbetsbelastningen kan variera avsevärt. Fokus för detta examensprojekt är att utveckla en automatisk optimeringsmetod för konfigurationsparametrarna i Apache Spark. Fyra maskininlärningsmodeller formuleras och utvärderas för att förutsäga Apache Sparks prestanda. Dessutom skapas och utvärderas två modeller för att söka efter de mest lämpliga konfigurationsparametrarna för Apache Spark, vilket resulterar i kortast möjliga exekveringstid. De erhållna resultaten visar att den utvecklade automatiska optimeringsmetoden, med anpassning av Apache Sparks konfigurationsparameterar, bidrar till att Apache Spark-applikationer kan uppnå kortare exekveringstider än vid användning av standard-parametrar. Den utvecklade metoden för automatisk optimering bidrar till en förbättrad användning av klustret och kortare exekveringstider, med en genomsnittlig prestandaförbättring på 49,98%, 53,84% och 64,16% för de tre olika typerna av Apache Spark-applikationer som testades.