BACKGROUND: Cancer is primarily a disease of older adults with sixty percent of all incidences occurring in individuals 65 years and over. Coping with cancer may entail additional challenges for older adults due to co-morbidities, declining mobility, reduced social networks and ageism. To date, the majority of research examining supportive care needs has focused on younger women with breast cancer. Little attention has been paid to older adults’ experience with cancer, particularly with respect to psychosocial support. PURPOSE: The aims of the present studies were twofold: (1) to learn more about peer support services in Ontario, specifically: the type and location of available programs; extent of utilization by older adults; and factors that might facilitate or inhibit use by older adults; and (2) to gain a better understanding of the experiences and challenges facing older adults living with cancer, strategies and resources used to meet these challenges, unmet support related needs, as well as awareness of support services, principally peer support. METHODS: First, peer support services in Ontario were identified through an environmental scan. Subsequently, interviews were conducted with 24 key contacts from a purposeful sample (based on type and geographic location) of 30 of these groups. Next, surveys were administered to participants (n=220) and facilitators (n=39) from these groups to establish a profile of current peer support users and deliverers, and examine the extent to which older adults (age ≥ 65) utilized these services. Finally, a preliminary, in-depth, qualitative exploration from the perspective of older adults living with cancer was conducted through a focus group (n=6) and interviews with 20 older adults. RESULTS: The environmental scan yielded a total of 177 peer support cancer programs across Ontario; predominately group-based (93%). Most were located in urban centers. Few programs targeted colon cancer. In the 30 groups examined, breast and prostate cancer were the most common focus (60%). Group facilitators were primarily female (75%) and most had personally experienced cancer (77%). The male facilitators were older (p <.05) and most likely to lead the prostate groups. None of the programs systematically collected client information. Clients ranged in age from 25 to 91 years (mean = 64 ± 10.7). Many were long-term cancer survivors (average five years post diagnosis). Overall, less than half the clients were aged 65 or older. Clients over age 65 were predominately men (86%; p <.001) with prostate cancer. Almost 70% of program directors and over 90% of facilitators were unaware most individuals with cancer are over the age of 65. Interview participants were recruited primarily through the Canadian Cancer Society (CCS). Not surprisingly, 46% had participated in peer support. Older adults identified several challenges with respect to physical functioning, sexuality, emotional distress, and obtaining information. Participants utilized a variety of resources to meet informational and emotional challenges including, the Internet and the support of family and friends. Accessing routine follow-up care after the transition from ‘patient’ to ‘survivor’ was a significant unmet need. CONCLUSIONS: The findings support the premise that cancer peer support services may be under-utilized by older adults, particularly older women. The reasons for these findings remain unclear although ageism may be a factor. Due to the reliance on a convenience sample, qualitative findings that older adults were generally able to meet their supportive care needs cannot be generalized to all older adults living with cancer. Large organizations such as the CCS need to begin systematically collecting demographic and other information on clientele to enhance program planning and delivery. Further research studies on older adults living with cancer are needed to examine their supportive care needs.

Background: An essential component of managing the health care system effectively as the population ages is to provide care to seniors in the care setting that can best meet their needs. The majority of seniors wish to remain at home, to maintain their independence. Informal caregivers (family, friends and neighbours) provide as much as 80% of care to seniors who reside at home. The absence of or loss of an informal caregiver and/or a decline in a senior’s health may necessitate a change in care setting. Supportive Housing (SH) is a rapidly emerging alternative care setting for seniors who can no longer have their needs met at home. Objective: The objectives of this dissertation were: to provide a comprehensive description of the profile of SH clients in Ontario; to determining the role of SH in the continuum of care; to develop an algorithm to support care placement decisions; and to explore the longitudinal outcomes of SH clients including quality of life, and long-term care placement. The following four research questions were addressed: What are the socio-demographic and clinical characteristics of persons currently residing in SH units in Ontario? How do the profiles of current SH clients differ from the profiles of persons residing in other care settings? What changes occur in the appropriateness of SH to meet care needs over time? What factors are associated with discharge from SH to a long-term-care facility (LTC)? Methodology: The research questions were answered primarily using two Ontario interRAI data sets: A pilot sample of 1,720 SH clients collected using the interRAI Community Health Assessment and a sample of 29,790 Community Care Access Centre (CCAC) clients collected as part of normal clinical practice from clients residing in residential care setting, including SH. Data from LTC (N=832) and complex continuing care (CCC; N=425) clients in the Mississauga-Halton (MH) LHIN were also used. Data on care placement decisions were collected using a Staff Rating Form (N=332 in SH). Results: SH clients are a relatively light-care population who require support with instrumental activities of daily living (IADLs) and tend to lack an informal caregiver. SH clients who receive care from a CCAC are in the minority but represent a much more clinically complex sub-population. According to staff members, the majority (80%) of SH clients are appropriately placed; of the remaining 20%, 17% were prematurely admitted to SH and would be best cared for at home, a further 3% require LTC placement. Moreover, about 10% of seniors who receive care in the MH LHIN, have been inappropriately placed and would be best cared for in a SH unit. A Decisions Support Algorithm for SH (DASH) was developed to inform care placement decisions in Ontario. The algorithm was based on both resource availability and client care needs. Level of impairment in: IADLs, cognition, continence and score on the MAPLe algorithm (an interRAI prioritization algorithm; see Figure 11), were found to be significant predictors of care placement. Poor QoL was relatively rare (~5%) among SH clients and regression analysis was used to determine the variables associated with a decline in QoL. Finally, survival analysis determined that 20% of SH clients are discharged to LTC within one year. Age, dependence on others to perform IADLs, bladder incontinence, cognitive impairment, and higher MAPLe scores were associated with this discharge. Conclusions: Analyses in this dissertation have clearly indicated the need for a standardized assessment instrument in this sector. Arbitrary decisions around eligibility and discharge criteria for supportive housing have led to inappropriate placement of clients and confusion over the role supportive housing is to play in the continuum of care. Evidence-informed care placement decisions should consider client care needs as well as both the availability of formal and informal support. An integrated health information system, such as the interRAI instruments, facilitates a culture of evidence and improves communication across the care continuum. SH is a rapidly emerging alternative care setting for seniors. If managed carefully, SH has the potential to help address many health system level concerns as the population ages. It is hoped that this dissertation has answered some key questions and also inspired further research into an important and growing field.

The effective use of formative assessment practices has resulted in some of the largest gains in student learning ever documented (Meisels, 2006; Davies 2007; Black & Wiliam 2006, 1998; Marzano 2006). Given this support in the literature for the connection between improving classroom assessment and increasing student learning, the critical question among school leaders no longer seems to be, "what classroom practices best improve student learning?" Instead, leaders interested in student learning through classroom assessment are increasingly driven to inquire into the conditions that will best foster effective assessment practices in the classroom.<p> The purpose of this study was to take cases of schools where changes in classroom assessment practices had increased student learning, and to examine both the practices of leadership that supported the assessment initiatives, and the ways in which these leaders were connected. In recent studies of school improvement efforts focused on classroom assessment, Wiliam (2004, 2007) and Reeves (2007) concluded that teachers required support across the entire school system in order to embed effective formative assessment practices into their instructional repertoire. Hargreaves (1999) and Fullan (2005) defined this type of systemic support as lateral and overall capacity. While Goleman (2006) and Barabasi (2009) pointed to the influence of the social network of learners surrounding an initiative, Fullan (2005) warned that learning networks also require quality and implementation controls in order to sustain changes. Wiliam (2007) defined this tension between educators learning from one another and being openly responsible for sharing new practices as supportive accountability (p. 199).<p> This study sought to inquire into leadership networks and leadership practices that supported schools in which an assessment initiative had resulted in improved student learning. Two elementary schools were selected for study following a nomination process by central-office staff. A chain-sampling methodology was used to identify individuals who were seen to play an important leadership role in initiating and sustaining assessment efforts in each school. In all, qualitative data were generated from interviews with ten participants, eight from within the selected schools, and two central-office support staff.<p> This study revealed several major themes in the leadership practices of leaders inside the schools: engagement in a range of formal and informal professional learning experiences by teachers and school administrators; application of assessment for learning principles to the overall work of the initiative; engagement in a multi-level learning community; and the integration of school and system-level plans. Additionally, participants described a cross-role network of leadership supports that seemed to infuse teachers and staff with the positive energy required to maintain a high level of commitment to the initiative. While all participants described feelings of frustration and discomfort with the elements of accountability to their peers, they also described valuing the high levels of active support they received from other teachers, school administrators, and central-office staff. Leadership practices within the context of a network or pattern of leadership relationships aimed at fostering effective levels of supportive accountability seem to be most effective.

The sense of calling has emerged as a burgeoning research interest for the past decade due to its tight connection to the meaning of work. However, the mechanism of the sense of calling, especially how it works in the work context remains unclear. This study aims at enhancing the understanding and knowledge of what the concept of calling is and how to apply it into organizations. Therefore, a cross-level model was proposed and the antecedents and consequences of calling along with the influence of organizational factors were examined. Data were collected from 24 organizations consisted of 186 employees, and hierarchical linear modeling techniques were applied to test the hypotheses. As a result, it is found that with certain personality traits (i.e., Extraversion, Agreeableness, Conscientiousness and Openness), one¡¦s sense of calling is more easily to be discovered. On the other hand, it is also likely to foster or develop one¡¦s sense of calling through organization¡¦s manipulation (i.e., the emphasis of CSR and the supportive climate). More importantly, the positive impact of sense of calling on an individual¡¦s performance has been demonstrated. Consequently, by considering both organizational-level and individual-level factors into the mechanism of calling, a valuable insight and application of an individual¡¦s sense of calling in the work context have been established.

The purpose of this study is to understand the satisfaction of the resident who live in the Da Ai Village about the permanent supportive house and their living environment. The subjects are: 1.The satisfaction of the environment quality of their ¡@ ¡@neighborhood. 2.To understand the demand of the resident about the ¡@environmental improvement. 3.To analyze the satisfaction and their demand to their ¡@ neighborhood and further offer the strategy and ¡@ ¡@suggestion to improve. This study investigated the resident aged over 20 who lived in Da Ai Village. Purposive Sampling method was applied in the survey. Total 400 questionnaires were released in 731 household. 395 valid ones were returned. After compile and analyze the data, we obtained the results as follow: 1.For the living environment quality, there are five structures: the interior environment of the house, the exterior environment of the house, culture and entertainment, public utility, and safety management. The average of the overall satisfaction is 83.54%. (1)For interior environment of the house: the most satisfied: the number of the room; the most unsatisfied: the privacy. (2)For exterior environment of the house: the air quality; the most unsatisfied: the landscape image of the neighborhood. (3)For the culture and entertainment: the most satisfied: parks; the most unsatisfied: religion center. (4)For the public utility: the most satisfied: fire facilities; the most unsatisfied: social affairs service. (5)For the safety management: the most satisfied: community friendship; the most unsatisfied: security and order. 2.The priority of the improvement needs in safety, convenient, comfortable, health caring and religion are: (1)For safety: Surveillance video recording. (2)For convenient: Bus station. (3)For comfortable: Sound insulation. (4)For health caring: Children day care. (5)For religion: Portal image. In order to urge the government to speed up the improvement progress of the Da Ai Village after Morokot Typhoon, this study offer suggestions as follow: 1.Establish good coordination and integration system. 2.Setting specific examine procedure in order to clarify the right and obligation. 3.To respect multi-culture and to consider the resident¡¦s actual needs. 4.To explain and communicate the improvement procedure and detail of the village

Work-life issues have been concerned by employees and employers from decades ago. The family structure has been transformed for the work style and most practices have been changed with human resource policy. However, the organizational climate of work and life is not clear and few of organizations implement comprehensive evaluation for the work-life culture. This research proceeds the cross-level analysis by using the hierarchical linear model which provides more precise outcomes. Besides, supervisor support has been recognized one of social supportive and informal organizational supportive resources, included by the work-life culture. Because of the unclear conception of informal organizational support, this research talks about the relationship of supportive supervisor behavior and organizational work-life policy. Furthermore, supervisor support comes up with employees¡¦ subjective well-being. Many scholars recognize employees who have supervisor support experience can reduce work-family conflict and turnover rate. Reasonably, job search behavior is the priority of voluntary quitting and job choosing, which helps to understand the process of employees¡¦ mind changing. To sum up, this research emphasizes on the influence among supportive supervisor behavior to work-life integration policy, subjective well-being and job search behavior. There are three dimensions for individuals, departments and organizations, combing employees¡¦ subjective well-being and objective job research behavior, excluding individual segmentation preference and segmentation support of workplace so as to strengthen the casual relationship and impersonal evaluation.

No description available.

¡iABSTRACT¡j Three internal fixed network companies started operations one after another in July, 2001. Instantly, telecommunication market is running into a state of intense competition in our country. Besides comparing with each company's price and the quality of product, customers also take the services into consideration. It is thus important to attract customers by conducting the cost and the services for telecommunication companies. That means, it is important to find the differences between products and the services. Thus, to remain a good relationship with customers is indispensable for a successful business. ¡§Call Center¡¨ is the key of the service. According the research, the operational efficacy of the service department is growing quickly. The growing domain is not only increasing the limit but also increasing the content. Thus, the business managers must have different views about their agents. The agents are no more low human resources. A good agent will benefit a focal point of strategic market by training. Call center will be from a ¡uCost Center¡vto a ¡uProfit Center¡v. Besides transmitting to the customers the ideas of the company, the products, the services and the operating ideals, the agents are also the moment of key point between the company and the customers. It needs to go with officials and managers, if an agent wants the customers to feel satisfied. To create the best values and products, the other personnel must help the agents. This research is an exploration, take company A as an example, of the moment of quality of inbound operation that customers call for telecommunication's Call Center with internal customers¡¦ viewpoints and external customers¡¦ suggestions of quality. To do a deeper constructional exploration systematically what kind of serviceable quality does customers need, this research utilizes the technique of QFD (quality Function Deployment) and found: First, customers request the quality of voice (external metrics). The important items are to handle questions correctly, answering rate, and the ability to solve problems. Second, the important items of service quality (internal metrics) include average handling time, percentage of calls handle on the first calls, the capability of solution, percentage of abandonment, and the ability of specializing knowledge. Third, functions of supportive system that effect on the servicing quality (concerning metrics). There are eight important items about it. It Includes the investigation of customer satisfaction, thrust out promote activity, setting up the evaluation of servicing quality, productivity of agents, handling of current working situation, setting up the objective and the measuring standard of servicing quality, thinking highly of call center, and handling of the unexpectedly events. According the documents and the operating system of call center and to promote the service quality, it offers suggestions of the operating system and methods to improve the countermeasure of management. It proves the crucial point of importance of total service systems.

This thesis used attachment theory and the common sense model of illness as theoretical backgrounds to examine the mechanisms that contribute to the quality of the support seeking behaviour and social interactions between patients with type 2 diabetes and their partners. Specifically, this thesis examined actor and spouse effects of working models of attachment on health outcomes, and illness perceptions on health outcomes for both patients and partners. Furthermore, it determined if support seeking, supportive interactions, and negative interactions mediated between the attachment and health outcomes and illness perception and health outcomes. At study entry, 70 patients with type 2 diabetes and their partners completed measures on attachment, illness perceptions, support seeking, receipt of supportive interactions and of negative interactions, satisfaction with support received, and health outcomes. Health outcomes included psychological distress and physical health for patients and partners, and diabetes well-being for patients only. Six months later, participants again completed measures on supportive and negative interactions, satisfaction with support received, and health outcomes. The data were examined both cross-sectionally (including mediational analyses) and longitudinally. The cross-sectional analyses revealed a number of actor and spouse effects in the relationships between attachment and health outcomes, and illness perceptions and health outcomes. Patients who scored higher on attachment-anxiety experienced higher levels of psychological distress and lower levels of diabetes well-being. Also, the partners of these patients experienced higher levels of psychological well-being. Furthermore, covert support seeking behaviour and negative interactions were found to be significant mediators between patient attachment-anxiety and patient psychological distress and diabetes well-being. In addition, support satisfaction mediated the relationship between patient attachment-anxiety and patient psychological distress. Illness perceptions, specifically timeline cyclical perceptions, were also shown to be related to health outcomes, and receipt of negative interactions. Patients and partners who scored higher on timeline cyclical experienced higher levels of psychological distress. Also receipt of negative interactions mediated the relationship between timeline cyclical and psychological distress. Some significant changes over time found when the data were examined longitudinally. For example, patients who scored higher on attachment-anxiety at study entry experienced higher levels of psychological distress over time, and had a partner who also experienced higher levels of psychological distress over time. In addition, partners who scored higher on personal control and who had a spouse (patient) who scored higher on timeline cyclical at study entry experienced higher levels of psychological distress overt time. Taken together, both the cross-sectional and longitudinal findings emphasize the contribution of the partner and his or her interactions with the patient to patient well-being. In the same manner, the results also highlight the effect of the patient’s illness on the partner’s well-being. These findings have important practical implications, especially for practitioners who aim to design intervention to help patients and their partners better adapt to the patient’s illness.

Promising teaching approaches for developing students’ mathematical competencies include the approach of teaching mathematics through problem solving. Orchestrating a whole-class discussion of students’ ideas is an important aspect of teaching through problem solving. There is a wide consensus within the field that it is very challenging for the teacher to conduct class discussions that both build on student ideas and highlight key mathematical ideas and relationships. Further, fostering argumentation in the class, which is important for students’ participation, is also a grand challenge. Teachers need support in these challenges. The aim of the thesis is to characterize challenges and support for mathematics teachers in orchestrating productive problem-solving whole-class discussions that focus on both mathematical connection-making and argumentation. In particular, it is investigated how Stein et al.’s (2008) model with five practices – anticipating, monitoring, selecting, sequencing and connecting student solutions – can support teachers to handle the challenges and what constitutes the limitations of the research-based and widely-used model. This thesis builds on six papers. The papers are based on three intervention studies and on one study of a mathematics teacher proficient in conducting problem-solving class discussions. Video recordings of observed whole-class discussions as well as audio-recorded teacher interviews and teacher meetings constitute the data that are analyzed. It is concluded in the thesis that the five practices model supports teachers’ preparation before the lesson by the practice of anticipating. However, making detailed anticipations, which is shown to be both challenging and important to foster argumentation in the class, is not explicitly supported by the model. Further, the practice of monitoring supports teachers in using the variety of student solutions to highlight key mathematical ideas and connections. Challenging aspects not supported by the monitoring practice are, however, how to interact with students during their exploration to actually get a variety of different solutions as a basis for argumentation. The challenge of selecting and sequencing student solutions is supported for the purpose of connection-making, but not for the purpose of argumentation. Making mathematical connections can be facilitated by the last practice of connecting, with the help of the previous practices. However, support for distinguishing between different kinds of connections is lacking, as well as support for creating an argumentative classroom culture. Since it is a great challenge to promote argumentation among students, support is needed for this throughout the model. Lastly, despite the importance and challenge of launching a problem productively, it is not supported by the model. Based on the conclusions on challenges and support, developments to the five practices model are suggested. The thesis contributes to research on the theoretical development of tools that support teachers in the challenges of orchestrating productive problem-solving whole-class discussions.