Wellness in older adults

Understanding perception of wellness in older adults is a question to be understood against the backdrop of concerns about whether global ageing and the ‘bulge’ of ageing baby boomers will increase health care cost beyond what modern economies can deal with. Older adults who age in a healthy way and who take responsibility for their own health offer a positive alternative and change the perception that older adults are a burden on their society’s health system. The concept of successful ageing introduced by Rowe and Kahn (1987; 1997) suggested that older adults age successfully if they avoid disease and disability, maintain high cognitive and physical functioning and remain actively engaged with life. This concept, however, did not reflect older adults’ own perceptions of what constitutes successful ageing or how perceptions of wellness or health-related quality of life influenced the older adult’s understanding of his or her own health and ageing. A research project was designed to examine older adults’ perceptions of wellness in order to gain an understanding of the factors that influence perception of their own wellness. Specifically, the research wanted to explore two aspects: whether belonging to a unique organisation, in this instance a Returned Services Club, influenced perceptions of wellness; and whether there are significant gender differences for the perception of wellness. A mixed method project with two consecutive studies was designed to answer these questions: a quantitative survey of members of a Returned Services Club and of the surrounding community in Queensland, Australia, and a qualitative study conducting focus groups to explore findings of the survey. The results of the survey were used to determine the composition of the focus groups. The participants for the first study, (N=257), community living adults 65 years and older, were chosen from the membership role of a Returned Services Club or recruited by personal approach from the community surrounding the Services Club. Participants completed a survey that consisted of a perception of wellness instrument, a health-related quality of life instrument, and questions on morbidities, modifiable life style factors and demographics. Data analysis found that a number of individual factors influenced perception of wellness and health-related quality of life. Positive influences were independent mobility, exercise and gambling at non-hazardous levels, and negative influences were hearing loss, memory problems, chronic disease and being single. Membership of the Services Club did not contribute to perception of wellness beyond being a member of a social group. While there may have been an expectation that members of an organisation that is traditionally associated with high alcohol use and problematic gambling may have lower perceptions of wellness, this study suggested that the negative influences may have been counteracted by the positive effects of social interaction, thus having neither negative nor positive influences on perception of wellness. There were significant differences in perception of wellness and in health-related quality of life for women and men. The most significant difference was for women aged 85-90 who had significantly lower scores for perception of wellness than men or than any other age group. This result was the impetus for conducting focus groups with adults aged 85-90 years of age. Focus groups were conducted with 24 women and four men aged 85-90 to explore the survey findings for this age group. Results from the focus groups indicated that for older adults perception of wellness was a multidimensional construct of more complexity than indicated by the survey instrument. Elite older women (women over 85 years of age) related their perception of wellness to their ability to do what they wanted to do, and what they wanted to do significantly more than anything else, was to stay connected to family, friends and the community to which they belonged. From the focus group results it appeared that elite older women identified with the three elements of successful ageing – low incidence of disability and disease, high physical and cognitive functioning, and active engagement with life – but not in a flat structure. It appears that for elite older women good physical and mental health function to enable social connectedness. It is the elements of health that impact on the ability to do what they wanted to do that were identified as key factors: independent mobility, hearing and memory - factors that impact on the ability to interact socially. These elements were only identified when they impacted on the person’s ability to do what they wanted to do, for example mobility problems that were managed were not considered a problem. The study also revealed that older women use selection, optimisation and compensation to meet their goal of staying socially connected. The shopping centre was a key factor in this goal and older women used shopping centres to stay connected to the community and for exercise as well as shopping. Personal and public safety and other environmental concerns were viewed in the same context of enabling or disabling social connectedness. This suggested that for elite older women the model of successful ageing was hierarchical rather than flat, with social connectedness at the top, supported by cognitive functioning and good physical and mental health. In conclusion, this research revealed that perception of wellness in older adults is a complex, multidimensional construct. For older adults good health is related to social connectedness and is not a goal in itself. Health professionals and the community at large have a responsibility to take into account the ability of the older adult to stay socially connected to their community and to enable this, if the goal is to keep older adults healthy for as long as possible. Maintaining or improving perception of wellness in older adults will require a broad biopsychosocial approach that utilises findings such as older adults’ use of shopping centres for non-shopping purposes, concerns about personal and environmental safety and supporting older adults to maintain or improve their social connectedness to their communities.

Modelling and execution of asset management process via workflow automation

An Asset Management (AM) life-cycle constitutes a set of processes that align with the development, operation and maintenance of assets, in order to meet the desired requirements and objectives of the stake holders of the business. The scope of AM is often broad within an organization due to the interactions between its internal elements such as human resources, finance, technology, engineering operation, information technology and management, as well as external elements such as governance and environment. Due to the complexity of the AM processes, it has been proposed that in order to optimize asset management activities, process modelling initiatives should be adopted. Although organisations adopt AM principles and carry out AM initiatives, most do not document or model their AM processes, let alone enacting their processes (semi-) automatically using a computer-supported system. There is currently a lack of knowledge describing how to model AM processes through a methodical and suitable manner so that the processes are streamlines and optimized and are ready for deployment in a computerised way. This research aims to overcome this deficiency by developing an approach that will aid organisations in constructing AM process models quickly and systematically whilst using the most appropriate techniques, such as workflow technology. Currently, there is a wealth of information within the individual domains of AM and workflow. Both fields are gaining significant popularity in many industries thus fuelling the need for research in exploring the possible benefits of their cross-disciplinary applications. This research is thus inspired to investigate these two domains to exploit the application of workflow to modelling and execution of AM processes. Specifically, it will investigate appropriate methodologies in applying workflow techniques to AM frameworks. One of the benefits of applying workflow models to AM processes is to adapt and enable both ad-hoc and evolutionary changes over time. In addition, this can automate an AM process as well as to support the coordination and collaboration of people that are involved in carrying out the process. A workflow management system (WFMS) can be used to support the design and enactment (i.e. execution) of processes and cope with changes that occur to the process during the enactment. So far few literatures can be found in documenting a systematic approach to modelling the characteristics of AM processes. In order to obtain a workflow model for AM processes commonalities and differences between different AM processes need to be identified. This is the fundamental step in developing a conscientious workflow model for AM processes. Therefore, the first stage of this research focuses on identifying the characteristics of AM processes, especially AM decision making processes. The second stage is to review a number of contemporary workflow techniques and choose a suitable technique for application to AM decision making processes. The third stage is to develop an intermediate ameliorated AM decision process definition that improves the current process description and is ready for modelling using the workflow language selected in the previous stage. All these lead to the fourth stage where a workflow model for an AM decision making process is developed. The process model is then deployed (semi-) automatically in a state-of-the-art WFMS demonstrating the benefits of applying workflow technology to the domain of AM. Given that the information in the AM decision making process is captured at an abstract level within the scope of this work, the deployed process model can be used as an executable guideline for carrying out an AM decision process in practice. Moreover, it can be used as a vanilla system that, once being incorporated with rich information from a specific AM decision making process (e.g. in the case of a building construction or a power plant maintenance), is able to support the automation of such a process in a more elaborated way.

Theory and development of GPS integrity monitoring system

This thesis discusses various aspects of the integrity monitoring of GPS applied to civil aircraft navigation in different phases of flight. These flight phases include en route, terminal, non-precision approach and precision approach. The thesis includes four major topics: probability problem of GPS navigation service, risk analysis of aircraft precision approach and landing, theoretical analysis of Receiver Autonomous Integrity Monitoring (RAIM) techniques and RAIM availability, and GPS integrity monitoring at a ground reference station. Particular attention is paid to the mathematical aspects of the GPS integrity monitoring system. The research has been built upon the stringent integrity requirements defined by civil aviation community, and concentrates on the capability and performance investigation of practical integrity monitoring systems with rigorous mathematical and statistical concepts and approaches. Major contributions of this research are: • Rigorous integrity and continuity risk analysis for aircraft precision approach. Based on the joint probability density function of the affecting components, the integrity and continuity risks of aircraft precision approach with DGPS were computed. This advanced the conventional method of allocating the risk probability. • A theoretical study of RAIM test power. This is the first time a theoretical study on RAIM test power based on the probability statistical theory has been presented, resulting in a new set of RAIM criteria. • Development of a GPS integrity monitoring and DGPS quality control system based on GPS reference station. A prototype of GPS integrity monitoring and DGPS correction prediction system has been developed and tested, based on the A USN A V GPS base station on the roof of QUT ITE Building.