This thesis focuses on the development of design constraints for use in analyzing the capacity of the residential units' floor areas in Open Building projects. Two cases are used to demonstrate the use of these constraints: a vacant office building (Kales Building) being converted to residential occupancy; a new multi-story building the lower floors of which are hotel rooms and the upper floors are residential condominium units.The thesis suggests that these constraints and the capacity analysis of residential floor areas associated with them can assist design teams, at the beginning of similar projects; provide important "added value" to clients, and contribute to the long term "sustainability" or adaptability of buildings.The first part of the thesis addresses the question of how to design a residential base building which can accommodate an optimal number and variety of fit-out unit layouts. The answer to the question links to the need for design constraints and points to their use in capacity analysis.The second part of the thesis focuses on the deduction of "constraint-designing" for Open Building residential layout. Plumbing systems, which are one of the most significant barriers to the application of Open Building, are specifically and more deeply studied in this part. A series of constraints are developed, which can generally assist in designing and analyzing floor plate capacity. . It is akin to learning to know the rules before starting a game.The third part of the thesis focuses on the demonstration of the uses of constraints in the design process of the conversion of an abandoned office building to residential uses.The last part of the thesis demonstrates the use of constraints and capacity analysis in a new multi-story condo project.In short, the paper is initially concerned with both the design concept and its application into detail levels in one of the many issues. It is a study of methods and technical rules of designing floor plan layouts when capacity analysis is the aim. / Department of Architecture

Highly skilled nurses amongst the OR team, are needed in the operating room (OR) to ensure optimal patient safety. Shortages in experienced OR nurses and a stressful working environment prove to have a negative influence on effective safe patient care as well as a negative effect on nurses’ own well-being. The research focused on the effectiveness of sensory stimulation therapy (SST) to strengthen the well-being of nurses in the OR of a private hospital in the North-West Province. SST, better known as Snoezelen™, is a blend of sight, sounds, textures, aromas and motion providing stimulation to the primary senses (Collier, McPherson, et al., 2010:698). The five primary senses are gently stimulated without any intellectual activity needed. A particular aim with SST is to improve the well-being of individuals by setting them at ease. The well-being of OR nurses was studied from a resilience viewpoint assuming that, if exposure to stressors was limited and the individual did have an opportunity to recover, stressors may have a positive, toughening effect. Well-being and resilience was used interchangeably in the study. The objectives of the study were to explore and describe OR nurses‟ needs for SST, to explore and describe OR nurses’ suggestions with regard to the implementation of SST in an OR and to explore and describe the effectiveness of a SST intervention to strengthen the well- being of OR nurses in a private hospital in the North-West Province. An explorative, descriptive quasi-experimental design within a quantitative approach was used. Seventy two participants from two private hospitals in the North-West Province voluntarily participated in the research. A pre-/post-test design was used. One pilot group, one intervention group and one comparison group were identified. Participants from all three the participating groups completed a self administered resilience scale questionnaire before and after the implementation of a SST intervention. Before the intervention 100% participants from the pilot group, 100% participants from the intervention group and 96% participants from the comparison group completed the self administered resilience scale questionnaire. Participants of the intervention group also completed a self report questionnaire from which their needs could be determined and suggestions were made on the implementation of a SST intervention. A 98% response rate was obtained for these self report questionnaires. After the intervention the intervention group’s participants were invited to write narratives regarding their experiences after visiting the SST room. The intervention was implemented for a period of two consecutive months in the OR of one of the private hospitals. After the intervention an 88% response rate from the pilot group, 100% response rate from the intervention group and a 63% response rate from the comparison group, completing self administered resilience scale questionnaires, were obtained. Data was analysed with the assistance of a statistical consultant at the North-West University in Potchefstroom by using STATISTICA (version 10) and SPSS (version 20, release 20.0.0) (StatSoft Inc., 2011, SPSS Inc., 211). Results indicated that there was no statistical difference between the three participating groups regarding their resilience before the intervention. However, after the intervention, the intervention group demonstrated a statistical increase in their resilience levels. Based on these results, as well as on conclusions of relevant literature and the feedback from participants in their written narratives, recommendations were formulated with regard to nursing education, nursing practice and further research. Briefly it means that there should be more consideration for OR nurses’ well-being by means of a SST program providing for their needs. Recommendations included the benefits of a SST room in a hospital environment as well as complete instructions on how to create and to furnish such a room. Attributes of resilience, factors influencing resilience levels and methods to increase resilience levels in the workplace should be included in a regular in-service training program. For future research the researcher recommended further studies in order to determine the resilience levels in various departments of private hospitals. This could mean the successful implementation of a SST room in other departments as well which will eventually lead to the improved well-being of all nursing staff. The researcher is willing to act as a consultant if the need arises for the comparison groups to implement a SST intervention in their different departments. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Highly skilled nurses amongst the OR team, are needed in the operating room (OR) to ensure optimal patient safety. Shortages in experienced OR nurses and a stressful working environment prove to have a negative influence on effective safe patient care as well as a negative effect on nurses’ own well-being. The research focused on the effectiveness of sensory stimulation therapy (SST) to strengthen the well-being of nurses in the OR of a private hospital in the North-West Province. SST, better known as Snoezelen™, is a blend of sight, sounds, textures, aromas and motion providing stimulation to the primary senses (Collier, McPherson, et al., 2010:698). The five primary senses are gently stimulated without any intellectual activity needed. A particular aim with SST is to improve the well-being of individuals by setting them at ease. The well-being of OR nurses was studied from a resilience viewpoint assuming that, if exposure to stressors was limited and the individual did have an opportunity to recover, stressors may have a positive, toughening effect. Well-being and resilience was used interchangeably in the study. The objectives of the study were to explore and describe OR nurses‟ needs for SST, to explore and describe OR nurses’ suggestions with regard to the implementation of SST in an OR and to explore and describe the effectiveness of a SST intervention to strengthen the well- being of OR nurses in a private hospital in the North-West Province. An explorative, descriptive quasi-experimental design within a quantitative approach was used. Seventy two participants from two private hospitals in the North-West Province voluntarily participated in the research. A pre-/post-test design was used. One pilot group, one intervention group and one comparison group were identified. Participants from all three the participating groups completed a self administered resilience scale questionnaire before and after the implementation of a SST intervention. Before the intervention 100% participants from the pilot group, 100% participants from the intervention group and 96% participants from the comparison group completed the self administered resilience scale questionnaire. Participants of the intervention group also completed a self report questionnaire from which their needs could be determined and suggestions were made on the implementation of a SST intervention. A 98% response rate was obtained for these self report questionnaires. After the intervention the intervention group’s participants were invited to write narratives regarding their experiences after visiting the SST room. The intervention was implemented for a period of two consecutive months in the OR of one of the private hospitals. After the intervention an 88% response rate from the pilot group, 100% response rate from the intervention group and a 63% response rate from the comparison group, completing self administered resilience scale questionnaires, were obtained. Data was analysed with the assistance of a statistical consultant at the North-West University in Potchefstroom by using STATISTICA (version 10) and SPSS (version 20, release 20.0.0) (StatSoft Inc., 2011, SPSS Inc., 211). Results indicated that there was no statistical difference between the three participating groups regarding their resilience before the intervention. However, after the intervention, the intervention group demonstrated a statistical increase in their resilience levels. Based on these results, as well as on conclusions of relevant literature and the feedback from participants in their written narratives, recommendations were formulated with regard to nursing education, nursing practice and further research. Briefly it means that there should be more consideration for OR nurses’ well-being by means of a SST program providing for their needs. Recommendations included the benefits of a SST room in a hospital environment as well as complete instructions on how to create and to furnish such a room. Attributes of resilience, factors influencing resilience levels and methods to increase resilience levels in the workplace should be included in a regular in-service training program. For future research the researcher recommended further studies in order to determine the resilience levels in various departments of private hospitals. This could mean the successful implementation of a SST room in other departments as well which will eventually lead to the improved well-being of all nursing staff. The researcher is willing to act as a consultant if the need arises for the comparison groups to implement a SST intervention in their different departments. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

A well-functioning, energy-efficient ventilation system is of vital importance to offices, not only to provide the kind of comfortable, healthy indoor environment necessary for the well-being and productive work performance of occupants, but also to reduce energy use in buildings and the associated impact of CO2 emissions on the environment. To achieve these goals impinging jet ventilation has been developed as an innovative ventilation concept. In an impinging jet ventilation system, a high momentum of air jet is discharged downwards, strikes the floor and spreads over it, thus distributing the fresh air along the floor in the form of a very thin shear layer. This system retains advantages of mixing and stratification from conventional air distribution methods, while capable of overcoming their shortcomings. The aim of this thesis is to reach a thorough understanding of impinging jet ventilation for providing a good thermal environment for an office, by using Computational Fluid Dynamics (CFD) supported by detailed measurements. The full-field measurements were carried out in two test rooms located in a large enclosure giving relatively stable climate conditions. This study has been divided into three parts where the first focuses on validation of numerical investigations against measurements, the second addresses impacts of a number of design parameters on the impinging jet flow field and thermal comfort level, and the third compares ventilation performance of the impinging jet supply device with other air supply devices intended for mixing, wall confluent jets and displacement ventilation, under specific room conditions. In the first part, velocity and temperature distributions of the impinging jet flow field predicted by different turbulence models are compared with detailed measurements. Results from the non-isothermal validation studies show that the accuracy of the simulation results is to a great extent dependent on the complexity of the turbulence models, due to complicated flow phenomena related to jet impingement, such as recirculation, curvature and instability. The v2-f turbulence model shows the best performance with measurements, which is slightly better than the SST k-ω model but much better than the RNG k-ε model. The difference is assumed to be essentially related to the magnitude of turbulent kinetic energy predicted in the vicinity of the stagnation region. Results from the isothermal study show that both the SST k-ω and RNG k-ε models predict similar wall jet behaviours of the impinging jet flow. In the second part, three sets of parametric studies were carried out by using validated CFD models. The first parametric study shows that the geometry of the air supply system has the most significant impact on the flow field. The rectangular air supply device, especially the one with larger aspect ratio, provides a longer penetration distance to the room, which is suitable for industrial ventilation. The second study reveals that the interaction effect of cooling ceiling, heat sources and impinging jet ventilation results in complex flow phenomena but with a notable feature of air circulation, which consequently decreases thermal stratification in the room and increases draught discomfort at the foot level. The third study demonstrates the advantage of using response surface methodology to study simultaneous effects on changes in four parameters, i.e. shape of air supply device, jet discharge height, supply airflow rate and supply air temperature. Analysis of the flow field reveals that at a low discharge height, the shape of air supply device has a major impact on the flow pattern in the vicinity of the supply device. Correlations between the studied parameters and local thermal discomfort indices were derived. Supply airflow rates and temperatures are shown to be the most important parameter for draught and stratification discomfort, respectively. In the third part, the impinging jet supply device was shown to provide a better overall performance than other air supply devices used for mixing, wall confluent jets and displacement ventilation, with respect to thermal comfort, heat removal effectiveness, air exchange efficiency and energy-saving potential related to fan power.

Introduktion Patientsäkerhet är en viktig del i arbetet med att upprätthålla en god kvalitet inom hälso- och sjukvården och inte minst inom riskfyllda områden som anestesi- och operationssjukvård. Operationsprocessen kan stödjas genom användandet av ett kliniskt informationssystem, ett så kallat operationsplaneringssystem. Vad som dock inte finns väl beskrivet är hur ett sådant här informationssystem skulle kunna bidra till en säkrare vård. Syfte: Syftet med studien var att beskriva processen och vilken betydelse ett operationsplaneringssystem hade för patientsäkerheten på en operationsavdelning utifrån personalens perspektiv. Metod: En empirisk studie med kvalitativ ansats genomfördes och analyserades med riktad innehållsanalys enligt Hsieh & Shannon. Tjugosex intervjuer genomfördes utifrån nio olika befattningar relaterade till operationsprocessen på tre olika sjukhus i mellersta och södra Sverige Resultat: Processen av kirurgska ingrepp bestod av tre olika faser; planering, genomförande och uppföljning. Extern planering hanterades av kirurgisk avdelning eller mottagning. Den interna planeringen hanterades av operationsavdelningen och för att kunna fullfölja planeringen genomfördes en interorganisationell planering. Faktorer att ta hänsyn till under den första fasen var ändringar och bristande planering. Den verkställda planeringen utgjorde arbetsunderlaget vid genomförandet av operationerna. Uppföljningen var mestadels produktionsinriktad och patientrelaterad vårduppföljning saknades. Patientsäkerhet handlade om två saker, perspektiv och betydelse. Patientsäkerhetsperspektivet beskrevs utifrån patient-, organisations- och medarbetareperspektiv. Betydelsen av ett operationsplaneringssystem för patientsäkerheten var relaterad till information, kontrollfunktioner, organisation och förändringar. Konklusion: Patientsäkerheten garanterades av den personal som arbetade i operationsprocessen och inte av operationsplaneringssystemen. Utveckling av säkerhetsfunktioner i operationsplaneringssystemen skulle kunna bidra till ökad patientsäkerhet. / Introduction: Patient safety is an important part in the performance of good quality in healthcare and particularly in critical areas like anesthesia and surgery. The process of surgery can be supported by an operating room information system, but there is no adequate description of how a system like this will support a safer care of the patient. Purpose: The aim of the present study is to describe the process and importance of an operating room information system for the patient safety in operating rooms from the perspective of employees. Method: An empirical study with a qualitative onset was implemented and analyzed using directed content analysis according to Hseih & Shannon. Twenty six interviews were performed from nine different positions during the process of surgery in three different hospitals in mid- and southern Sweden. Results: Operating room management included planning, surgery and evaluation. Extern planning was handled by the surgery ward or reception and intern planning by the surgery department. To complete the process there was an inter-department coordination and planning. Changes and insufficient planning had to be taken into account during this process of planning surgery. Executed planning functioned as the working document during the day of surgery. Evaluation was considered as mostly production-oriented and patient-related evaluation was missing. Two areas emerge from patient safety, perspective and significance. The importance of an operating room information system related to patient safety was information, safety controls, organization and changes. Conclusion: Patient safety was guaranteed by employees who worked in the process of surgery and not by the operating room information systems. Development of safety functions in operating room information system may improve patient safety.

This thesis presents a spatial sound rendering system for the use in immersive virtual environments. Spatial sound rendering aims at artificially reproducing the acoustics of a space. It has many applications such as music production, movies, electronic gaming and teleconferencing. Conventionally, spatial sound rendering is implemented by digital signal processing algorithms derived from perceptual models or simplified physical models. While being flexible and/or efficient, these models are not able to capture the acoustical impression of a space faithfully. On the other side, convolving the sound sources with properly measured impulse responses produces the highest possible fidelity, but it is not practically useful for many applications because one impulse response corresponds to one source/listener configuration so that the sources or the listeners can not be relocated. In this thesis, techniques for measuring multichannel room impulse responses (MMRIR) are reviewed. Then, methods for analyzing measured MMRIR and rendering virtual acoustical environment based on such analysis are presented and evaluated. The analysis can be performed off-line. During this stage, a set of filters that represent the characteristics of the air and walls inside the acoustic space are obtained. Based on the assumption that the MMRIR acquired at one "good" position in the target space can be used to simulate the late reverb at other positions in the same space, appropriate segments that can be used as reverb tails are extracted from the measured MMRIR. The rendering system first constructs an early reflection model based on the positions of the listener-source pair and the filters derived, then combines with the late reverb segments to form a complete listener-source-room acoustical model that can be used to synthesize high quality multi-channel audio for arbitrary listener-source positions. Another merit of the proposed framework is that it is scalable. At the expense of slightly degraded rendering quality, the computational complexity can be greatly reduced. This makes this framework suitable for a wide range of applications that have different quality and complexity requirements. The proposed framework has been evaluated by formal listening tests. These tests have proven the effectiveness in preserving the spatial quality while positioning the listener-source pair accurately, as well as justified the key assumptions made by the proposed system.

The objective of this study was to discover biopsychosocial concepts from primary care that were statistically related to inappropriate emergency room use by using natural language processing tools. De-identified free text was extracted from a clinic in Guelph, Ontario and analyzed with MetaMap and GATE. Over 10 million concepts were extracted from 13,836 patient records. There were 77 codes that fell within the realm of biopsychosocial, were very statistically significant (p < 0.001) and had an OR > 2.0. Thematically, these codes involved mental health and pain related biopsychosocial concepts. Similar to other literature, pain and mental health problems are seen to be important factors of inappropriate emergency room use. Despite sources error in the NLP procedure, the study demonstrates the feasibly of combining natural language processing and primary care data to analyze the issue of inappropriate emergency room use. This technique could be used to analyze other, more complex problems. / Graduate

The particular characteristics of Pinter’s theatre such as the theme of violence, the competitive interpersonal relationships, the implied unwillingness in communication between the characters and the distinctive use of silences and pauses, distinguish his work from the writers of the absurd. Pinter makes particular use of “Silences” and “Pauses” as theatrical techniques that present a non-verbal way of communication in his plays. The frequent use of these particular techniques in Pinter’s dialogue has urged some critics to coin new expressions such as “Pinteresque” or “Pinter Pause” in the vocabulary of drama to specify Pinter’s technique. One of the important objectives in this essay is to point out the fundamental significance and function of the “Silences” and “Pauses” in Pinter’s work and point out their distinction. I will discuss how the silences and pauses function in Pinter’s theatre as a non-verbal way of communication by creating fragments in the dialogue.   The plays which will be analyzed in this essay are: The Room, The Dumb Waiter, The Birthday Party and The Caretaker. My objective in this essay is to explore the context of these plays with regards to the theme of menace. In the first chapter, I mainly aim to explore the menacing context of these plays regarding the structure of menace and the ways it takes place in each play separately. This analysis will be presented in relation to the spatial territory in which the characters are confined. My aim is also to describe why menace is presented in a theatrical sense. I have chosen to quote some significant passages of each play in each section to illustrate my purposes in the first chapter. The aim of the second chapter is to define the character types involved in the presentation of menace, “The Intruders” and “The Victims”, and to analyze the strategies their use in encounters with each other. After describing the character types I will explore in detail how “The Intruders” use linguistic strategies to confuse and subdue their victims and finally victimize them and how “The Victims” use strategies to cope with menace in order to survive. There are some passages quoted from the plays to facilitate the purpose of the second chapter. The objective in the third chapter is to define “Silences” and “Pauses” as theatrical techniques used in form of non-verbal communication between the characters. I will discuss, based on Peter Hall’s definition, how these techniques are significant in understanding a Pinter play for the readers and the actors who perform them on stage, and will further explore the function of “Silences” and “Pauses” and their distinction in the context of the plays in question in this essay.

The purpose of this study is to describe and analyze the places importance for young people with disabilities. The study’s central questions are what type of places they visit and what characterizes them. It is also about answering the questions why the places are visited and what meaning this has for participation and identity. The study´s central concept is room/place, participation and identity. Knowledge review will be based on the key concepts. The collection of the empirical material has been inspired by the ethnographic methodology,which in this study included seven observation sessions and six interviews. The result shows that the boys mainly visited two different places. This is about the publicand non-public places. Public places can be described as a place for everyone and the nonpubliconly for people with disabilities. The boys show more participation towards publicplaces which can provide activities, fellowship and well-being. Both places can offer participation, but are dependent on other factors, which in this case is about activities and visitors. None of the places shows identity, but rather the interaction between the individual and the environment. Participation doesn’t necessarily show the personal identity. In the lastchapter the importance is highlighted through a perspective of social work activity. First andforemost the public places potential is highlighted and it´s limitations for participation and theidentity process. Secondly, it is also a discussion about future planning in daily socialpedagogic practice, both on an individual and society level.

There are many terms used to describe pressure ulcers: pressure sores, decubitus ulcers, bedsores, and pressure necrosis or ischaemic ulcers. Essentially they all describe damage to the patient's skin and underlying tissue. The nursing literature abounds with information about the risk, grading, prevention and treatment of pressure ulcers. These ulcers are a problem in hospital and long term care facilities, and are a major cause of morbidity. In the hospital setting they contribute to an extended length of stay and by doing so 'block' the bed for use by another patient. The ulcers are difficult to treat, are an ongoing cause for pain and discomfort for the patient and can be a strain on hospital finances. Pressure ulcers are not unique to modern times, as they have been discovered on the remains of an Egyptian mummified body (Armstrong & Bortz 2001). This would suggest that the problem dates back to the Pharoahs, and has continued to be a challenging problem throughout the centuries (Bridel 1992). The escalating costs of treating these ulcers today, has brought about an emphasis on the risk factors, prevention and the appropriate interventions, rather than an acceptance of these ulcers as a tolerable ondition (Bridel 1992). In the operating room, nurses are faced with unique challenges when caring for their patients. This is due to difficulty in caring for patients under the influence of the anaesthesia required for surgery, long periods of forced immobility and the inability of the patient to perceive pain and discomfort from the pressure of the hard surface of the operating room table. These problems are increased by nurses' inability to gain access to the patient because of the sterile drapes required to cover the patient for surgery. Armstrong and Bortz (2001) present information from one study in which it is stated that surgical patients have 90% greater chance of developing pressure ulcers than medical patients. One reason for this may be due to the limited information available in regard to the most effective support surface to place on top of the operating room table. This gap in information is problematic for operating room nurses as it limits their ability to select the most effective item of equipment, and determine if the chosen equipment reduces pressure on tissue intra- operatively. The most effective operating room table mattress used and the skills and knowledge of the operating room nurse about the aetiology and prevention of pressure ulcer prevention, are important aspects of nursing care and can influence patient outcomes. The potential for complications to occur may be dependent on single or combined factors such as the patient's age, disease processes, nutritional status and mobility. Preparatory and supportive nursing interventions for surgical procedures based on best available evidence, nursing experience and patient preference, can reduce the incidence of pressure ulcer development in the perioperative environment. This doctoral portfolio contains four separate sections related and linked together by a common theme - pressure ulcer prevention in the perioperative environment. This first section of the portfolio situates the topic and provides a brief overview of the portfolio. The second section is a critical review of the literature pertaining to the most commonly used operating room table mattresses, and the effectiveness of these mattresses in the prevention of pressure ulcer development. This review highlighted a lack of quality research in this area, and while many evaluations have been undertaken to determine the effectiveness of perating room table mattresses, the results are contradictory concerning the patients, exposures and interventions. Because of issues related to the methodological quality of published research in this area a systematic review using meta- analysis was not possible rather a critical review of the research literature is used. The third section of the portfolio reports on a hermeneutic ethnography of the perceived skills and knowledge of nurses in the prevention of pressure ulcer development in the perioperative environment. This study was designed to determine if pressure ulcer prevention forms an aspect of the everyday practice of perioperative nurses. This review has highlighted the need for operating room nurses to review practices when caring for patients in the perioperative environment particularly in respect of pressure ulcer prevention. The fourth and final section of the portfolio summarises the research and provides recommendations for nursing practice and further research in the area of pressure ulcer prevention in the perioperative environment. / Thesis (D.Nurs.)--Department of Clinical Nursing, 2004.