Coronary heart disease is the leading cause of death and a major cause of morbidity in New Zealand. Although the mortality rates are now declining, they remain high by international standards and there is considerable scope for the prevention of coronary heart disease. There is a paucity of New Zealand data on the aetiology of this disease. The Auckland Heart Study is a case-control study of coronary heart disease which was designed to determine whether a range of variables including; smoking, passive smoking, hypertension, exercise, alcohol, serum lipids, and dietary and psychosocial factors, are related to coronary heart disease in New Zealand. Other factors examined included respiratory infection, sex hormones and serum vitamins. The study also documented the prevalence of the major risk factors in the Auckland adult population so as to examine trends in risk factors since the 1982 Auckland Risk Factor Study. The study was conducted between 1 March 1986 and 3 May 1988. There were two case groups: non fatal myocardial infarction cases and coronary death cases; and two control groups: myocardial infarction controls and coronary death controls. Participants were aged 25-64 years.

Doctor of Philosophy (PhD) / After two decades of public management reform, the ‘new accountability’ of performance measurement is a routine feature in the relationships between Australian government agencies and the non-profit organisations they fund to provide child and family services. While performance measurement offers to resolve tensions about how governments manage the quality and productivity of contracted services, the indicators they commonly adopt raise well-documented practical, political and epistemological challenges in social services. Left unresolved, these challenges risk biasing representations of service performance, by emphasising the most tangible dimensions of service activities (such as measures of client throughput) over relationship building and care. Capturing only part of service activity compromises the usefulness of performance data for managing quality and outcomes, and denies policy makers critical information about the value and meaning of care in users’ lives. This thesis identifies and critically explores one set of challenges for performance measurement: the role of service users. Uniquely, I explore how user involvement in social service evaluation can make visible how these services enhance the quality of family and personal life. Using a case study of family support services in New South Wales, the research makes a series of empirical and theoretical contributions to problems of user involvement in social service evaluation. Firstly, the research examines the performance indicators currently used by government to monitor the efficiency and effectiveness of family support services in NSW. This shows that performance indicators in family support capture output more thoroughly than outcome, and confirms the minimal role that service users play in assessing service quality and outcomes. But while service users are largely excluded from participation in performance measurement, theoretical perspectives as diverse as managerialism and feminism treat service users as well placed to capture and report otherwise elusive information about care quality and outcomes. Further, participation in evaluation facilitates the exercise of users’ rights to self-expression and self-determination in the social service delivery and policy process. After identifying the widespread exclusion of service users’ perspectives from performance measurement in NSW family support, the thesis makes its more substantial contribution, in documenting findings from a detailed study involving adult family support service users (parents) and their workers (the ‘Burnside Study’). This qualitative study was conducted in four socio-economically disadvantaged service delivery sites located around New South Wales. Using focus group, interview and observational methods and a modified grounded theory approach, the study contributes exploratory evidence of what these service users think of, and how they think about service quality, outcomes, and evaluation in family support. The parents’ accounts of using family support capture their unfulfilled social ideals and the broader visions of the justice they hoped these social services would help them achieve. Their criteria for measuring service outcomes and service quality, and their views on evaluation methods embody core themes that social theorists have struggled to analyse, about the purpose of social services and the nature of ‘a good life’. The theoretical framework I develop highlights the role of family support in the context of service users’ struggles for social justice, and in particular, their struggles for self-realisation, recognition and respect (Honneth, 1995). The research extends theories of recognition beyond publicly articulated social movements to those struggles in social life and social politics that exist in what Axel Honneth terms the ‘shadows’ of the political-public sphere (2003a: 122). After establishing a conceptual framework that facilitates deeper interpretation of users’ perspectives, I present the findings in three categories: users’ perspectives on service outcomes; users’ perspectives on service quality; and users’ perspectives on evaluation methods. The findings show how service users define ‘service outcomes’ in the context of their struggles for recognition and respect, highlighting the contribution welfare services and welfare professionals make beyond the managerial ‘Three E’s’ of economy, efficiency, and effectiveness. Further, the findings confirm the importance of ‘helping relationships’ to the quality of service delivery in family support, despite the invisibility of service relationships in existing performance indicators. The complexity of worker-client bonds highlights the difficulty of evaluating social services using simple numerical counts of client or service episodes, and plays into broader debates about strategies for revaluing care work, and the role of care recipients. Finally, the findings show the role performance measurement processes and methods might play in facilitating users’ struggles for recognition. Users identified a role for evaluation in making visible the contribution of family support in pursuing their social justice goals, and saw evaluation as an opportunity in itself to facilitate recognition and respect. Overall, the thesis offers concrete evidence about how family support service users experience and define service quality and outcomes, and how they see their own role in evaluating the services they use. The research shows how users’ perspectives both contest and confirm the ‘new accountability’ of performance measurement, pointing to new directions, and further challenges, for conceptualising – and evaluating – social services.

Este estudo se insere no contexto de práticas e políticas voltadas para as medidas socioeducativas em meio aberto. A pesquisa envolve a experiência das Oficinas Socioeducativas do Programa de Prestação de Serviços à Comunidade – PPSC/UFRGS, que atende adolescentes que cumprem a medida socioeducativa de Prestação de Serviços à Comunidade - PSC e que opera essa política pública, conforme o Estatuto da Criança e do Adolescente. Trata-se de uma pesquisa que aponta para uma descrição analítica, tomando o relato da experiência com as Oficinas Socioeducativas com adolescentes que cumprem a medida de PSC como foco de análise. A proposta metodológica deste estudo está orientada pela perspectiva da pesquisa-intervenção, que propõe uma relação pesquisador/objeto pesquisado dinâmica e que produz os próprios caminhos da pesquisa. Buscamos promover a discussão sobre as repercussões da experiência da oficina na relação do adolescente com a medida socioeducativa em dois momentos: na Oficina Zoom e com o projeto de fotografia FotoZoom – vidas em conversa, movimentos em foco. A partir da aproximação com a experiência do Oficinar apresentamos a busca pelos diferentes conceitos que existem sobre os modos de oficinar e produzimos um diálogo conceitual com o nosso modo de oficinar – as Oficinas do PPSC, considerando também as diretrizes que orientam a política de medida socioeducativa. A experiência evidencia que as oficinas socioeducativas têm se constituído uma prática metodológica do PPSC/UFRGS junto aos adolescentes que acompanha no processo de execução da medida de PSC. Também, as oficinas possibilitam uma intervenção educativa e que se estabelece no processo de relação com os adolescentes. Também, as oficinas possibilitam uma intervenção educativa ao acolher os percursos desses adolescentes que as compõem, seus projetos de futuro, suas perspectivas de vida, suas histórias, suas imagens, suas infrações, e assim, constituindo-se em um plano coletivo que oportuniza a relação consigo, com o outro, o exercício de estar em grupo, a experiência do criar, o acesso a novas informações e a reflexão sobre o vivido e sobre outras possibilidades de vida. / This study fits into the context of practices and policies aimed at the educational measures in an open environment. The research involves the experience of the workshops Socioeducational of the Programa de Prestação de Serviços à Comunidade-PPSC/UFRGS--abiding by social provision of Prestação de Serviços à Comunidade - PSC -and operates the public policy of the statute confome Children and Adolescents. This is research that points to an analytical description, taking account of experience with Socioeducational Workshops with adolescents who meet the measure of PSC as the focus of analysis. The proposed methodology of this study is guided by the prospect of intervention research, which suggests a relationship between researcher / researched object dynamics and produces its own avenues of research. We seek to promote discussion on the implications of the workshop experience in relation to adolescent social-educational measure on two occasions: at the workshop and the zoom photography project FotoZoom life - in conversation, moves into focus. From the approach to the experience of workshops presented by the search that there are different concepts about the ways of workshopping and produce a conceptual dialogue with our way of workshopping - the Workshops of the PPSC also considering guidelines that guide the policy of these institutions. Experience shows that social and educational workshops have been as a methodological practice of PPSC / UFRGS with teens that accompanies the process of implementing the measure of PSC Also, the workshops allow an educational intervention and that established in the relationship process with adolescents. Also, the workshops allow an educational intervention to accommodate the paths of those teens that make them up, his future projects, your outlook on life, their histories, their images, their infractions and thereby constituting a collective plan to nurture the relationship I can, with others, being in the exercise group, the experience of creating, accessing new information and reflection on their experience and other ways of life.

Este estudo se insere no contexto de práticas e políticas voltadas para as medidas socioeducativas em meio aberto. A pesquisa envolve a experiência das Oficinas Socioeducativas do Programa de Prestação de Serviços à Comunidade – PPSC/UFRGS, que atende adolescentes que cumprem a medida socioeducativa de Prestação de Serviços à Comunidade - PSC e que opera essa política pública, conforme o Estatuto da Criança e do Adolescente. Trata-se de uma pesquisa que aponta para uma descrição analítica, tomando o relato da experiência com as Oficinas Socioeducativas com adolescentes que cumprem a medida de PSC como foco de análise. A proposta metodológica deste estudo está orientada pela perspectiva da pesquisa-intervenção, que propõe uma relação pesquisador/objeto pesquisado dinâmica e que produz os próprios caminhos da pesquisa. Buscamos promover a discussão sobre as repercussões da experiência da oficina na relação do adolescente com a medida socioeducativa em dois momentos: na Oficina Zoom e com o projeto de fotografia FotoZoom – vidas em conversa, movimentos em foco. A partir da aproximação com a experiência do Oficinar apresentamos a busca pelos diferentes conceitos que existem sobre os modos de oficinar e produzimos um diálogo conceitual com o nosso modo de oficinar – as Oficinas do PPSC, considerando também as diretrizes que orientam a política de medida socioeducativa. A experiência evidencia que as oficinas socioeducativas têm se constituído uma prática metodológica do PPSC/UFRGS junto aos adolescentes que acompanha no processo de execução da medida de PSC. Também, as oficinas possibilitam uma intervenção educativa e que se estabelece no processo de relação com os adolescentes. Também, as oficinas possibilitam uma intervenção educativa ao acolher os percursos desses adolescentes que as compõem, seus projetos de futuro, suas perspectivas de vida, suas histórias, suas imagens, suas infrações, e assim, constituindo-se em um plano coletivo que oportuniza a relação consigo, com o outro, o exercício de estar em grupo, a experiência do criar, o acesso a novas informações e a reflexão sobre o vivido e sobre outras possibilidades de vida. / This study fits into the context of practices and policies aimed at the educational measures in an open environment. The research involves the experience of the workshops Socioeducational of the Programa de Prestação de Serviços à Comunidade-PPSC/UFRGS--abiding by social provision of Prestação de Serviços à Comunidade - PSC -and operates the public policy of the statute confome Children and Adolescents. This is research that points to an analytical description, taking account of experience with Socioeducational Workshops with adolescents who meet the measure of PSC as the focus of analysis. The proposed methodology of this study is guided by the prospect of intervention research, which suggests a relationship between researcher / researched object dynamics and produces its own avenues of research. We seek to promote discussion on the implications of the workshop experience in relation to adolescent social-educational measure on two occasions: at the workshop and the zoom photography project FotoZoom life - in conversation, moves into focus. From the approach to the experience of workshops presented by the search that there are different concepts about the ways of workshopping and produce a conceptual dialogue with our way of workshopping - the Workshops of the PPSC also considering guidelines that guide the policy of these institutions. Experience shows that social and educational workshops have been as a methodological practice of PPSC / UFRGS with teens that accompanies the process of implementing the measure of PSC Also, the workshops allow an educational intervention and that established in the relationship process with adolescents. Also, the workshops allow an educational intervention to accommodate the paths of those teens that make them up, his future projects, your outlook on life, their histories, their images, their infractions and thereby constituting a collective plan to nurture the relationship I can, with others, being in the exercise group, the experience of creating, accessing new information and reflection on their experience and other ways of life.

Este estudo se insere no contexto de práticas e políticas voltadas para as medidas socioeducativas em meio aberto. A pesquisa envolve a experiência das Oficinas Socioeducativas do Programa de Prestação de Serviços à Comunidade – PPSC/UFRGS, que atende adolescentes que cumprem a medida socioeducativa de Prestação de Serviços à Comunidade - PSC e que opera essa política pública, conforme o Estatuto da Criança e do Adolescente. Trata-se de uma pesquisa que aponta para uma descrição analítica, tomando o relato da experiência com as Oficinas Socioeducativas com adolescentes que cumprem a medida de PSC como foco de análise. A proposta metodológica deste estudo está orientada pela perspectiva da pesquisa-intervenção, que propõe uma relação pesquisador/objeto pesquisado dinâmica e que produz os próprios caminhos da pesquisa. Buscamos promover a discussão sobre as repercussões da experiência da oficina na relação do adolescente com a medida socioeducativa em dois momentos: na Oficina Zoom e com o projeto de fotografia FotoZoom – vidas em conversa, movimentos em foco. A partir da aproximação com a experiência do Oficinar apresentamos a busca pelos diferentes conceitos que existem sobre os modos de oficinar e produzimos um diálogo conceitual com o nosso modo de oficinar – as Oficinas do PPSC, considerando também as diretrizes que orientam a política de medida socioeducativa. A experiência evidencia que as oficinas socioeducativas têm se constituído uma prática metodológica do PPSC/UFRGS junto aos adolescentes que acompanha no processo de execução da medida de PSC. Também, as oficinas possibilitam uma intervenção educativa e que se estabelece no processo de relação com os adolescentes. Também, as oficinas possibilitam uma intervenção educativa ao acolher os percursos desses adolescentes que as compõem, seus projetos de futuro, suas perspectivas de vida, suas histórias, suas imagens, suas infrações, e assim, constituindo-se em um plano coletivo que oportuniza a relação consigo, com o outro, o exercício de estar em grupo, a experiência do criar, o acesso a novas informações e a reflexão sobre o vivido e sobre outras possibilidades de vida. / This study fits into the context of practices and policies aimed at the educational measures in an open environment. The research involves the experience of the workshops Socioeducational of the Programa de Prestação de Serviços à Comunidade-PPSC/UFRGS--abiding by social provision of Prestação de Serviços à Comunidade - PSC -and operates the public policy of the statute confome Children and Adolescents. This is research that points to an analytical description, taking account of experience with Socioeducational Workshops with adolescents who meet the measure of PSC as the focus of analysis. The proposed methodology of this study is guided by the prospect of intervention research, which suggests a relationship between researcher / researched object dynamics and produces its own avenues of research. We seek to promote discussion on the implications of the workshop experience in relation to adolescent social-educational measure on two occasions: at the workshop and the zoom photography project FotoZoom life - in conversation, moves into focus. From the approach to the experience of workshops presented by the search that there are different concepts about the ways of workshopping and produce a conceptual dialogue with our way of workshopping - the Workshops of the PPSC also considering guidelines that guide the policy of these institutions. Experience shows that social and educational workshops have been as a methodological practice of PPSC / UFRGS with teens that accompanies the process of implementing the measure of PSC Also, the workshops allow an educational intervention and that established in the relationship process with adolescents. Also, the workshops allow an educational intervention to accommodate the paths of those teens that make them up, his future projects, your outlook on life, their histories, their images, their infractions and thereby constituting a collective plan to nurture the relationship I can, with others, being in the exercise group, the experience of creating, accessing new information and reflection on their experience and other ways of life.

<p>Research shows the significance that communication patterns, beliefs, and behaviors hold within a multitude of relationship types. Unfortunately, the same research also shows that effective or positive communication is still not occurring as often as we think. Communicative interaction breaks down, fails, or is utilized negatively more often when emotionally charged topics are at the forefront of the conversation, most often due to reported personal discomfort. This negative interaction, and the subsequent breakdown in communication, can foster a snowball effect – decreasing relationship and sexual satisfaction. This study was aimed to discover how perceived comfort levels contributes to the lack of communication of certain topics and how it is affecting relationship and sexual satisfaction. The type of communicative process that occurs will affect the sexual satisfaction and relationship satisfaction. Through an online survey, participants anonymously responded to statements related to these concepts in order to test relationships. Overall, it was found that respondents’ participation in self-monitoring, as well as what method of communication they use, strongly influenced their comfort disclosing on different topics. Their comfort did not have significant influence on their then communication process. It was also found that communication processes influence couple’s relationship and sexual satisfaction. These results urge marriage and family therapists to update their clinical toolboxes and add self-monitoring to their conceptualization when working with couples. </p>

Masters of Art / Knowledge Management (KM) has developed over the years into a mainstream organisational necessity to achieve success and organisational effectiveness. The goal of this study is to assess KM and organisational learning within religious organisations especially Pentecostal Churches. This study is based on both qualitative and quantitative research design, employing a case study research method. The study population was the 120 congregational members of Christian Faith Revival Ministries of South Africa, located in Tafelsig, Mitchell’s Plain, Cape Town. Quantitative and qualitative data was collected using questionnaire and Interview. Analysis was done using SPSS and Atlas.ti.

As psychological well-being, or mental health, is a key factor to academic performance, schools are in a pivotal position to provide needed services to improve the well-being of individual students, parents, and teachers, as well as school-wide wellness. Research has shown positive outcomes related to psychological symptom reduction, but academic outcomes are less prevalent. Due to the increasing need for services, schoolbased mental health (SBMH) programs are being developed to combine the resources and expertise of SBMH professionals and community agency mental health professionals to serve these needs. In an effort toward developing a statewide Communities of Practice Model for the state of Utah, an internet survey was developed to identify the current practices that are being implemented with schools in Utah. This study explored the current and possible types of school based and community services within a multi-tier service system approach at each tier level (universal, at-risk, and intensive) delivered to elementary and secondary students, the outcomes expected to be impacted by these partnerships, and the barriers and key factors associated with effective program iv implementation. The sample included 32 school district respondents from 21 districts and 19 community agency respondents from 18 agencies throughout the state. Results revealed that 18 of the 21 districts are involved in a SBMH partnership implementing a broad range of collaborative activities, assessments and interventions that vary between tier levels. Specific practices, barriers, and implications for SBMH services and future research are discussed.

<p>Public health infrastructure (PHI) serves as the core foundation for essential public health and its services. However, the U.S. PHI has been weakened by understaffing, underfunding, limited resources and partnerships, and outdated data and information systems over the past few decades. The recent COVID-19 pandemic exacerbated its vulnerability and weakened nature, resulting in increased health disparities and worse health outcomes in general for the nation. The goal of this study was to identify elements of local PHI that are associated with the completion of 20 key public health activities while adjusting for state differences. Cross-sectional secondary data were acquired and linked from two national surveys of local health departments, the National Profile of Local Health Departments survey and the National Longitudinal Survey of Public Health Systems. In total, 20 multivariable logistic regression models were created to analyze the relationships between variables. State fixed effects were used in multivariable models to control for state differences. It was found that state differences affected the correlations of infrastructure variables. Several staffing elements, abilities to provide certain services, and participation in certain types of actions were strongly correlated with the completion of best practice activities. These findings will add to the discussion of what the minimum necessary elements of PHI may be.</p>

This thesis examines the implications of age relations for older people’s negotiations of formal home care, family/friend caregiving, and self-care. Age relations constitute social processes, cultural discourses, and everyday practices that produce and sustain relations of inequality between and among people of different ages. Despite the overwhelming focus on care in the sociology of aging and in political discussions of aging societies, scholars have not clearly articulated how age relations shape, and are shaped by, experiences of later life care. Moreover, despite evidence that older people receive care from both formal care providers and family/friend caregivers—and that they continue to practise self-care when they receive care from others—we know little about the ways older care recipients negotiate the intersections that exist between these systems of care. Using data from a grounded theory study that involved qualitative interviews with 34 people aged 65 to 100 receiving home care in Ontario, this thesis considers how older people negotiate the intersections of formal home care, family/friend caregiving, and self-care, and how age relations can be used to understand experiences of later life care. Findings suggest that older care recipients attempt to strike a balance between self-care, formal home care, and family/friend caregiving, to access care that reflects their needs, preferences, and timelines. In doing so, they negotiate the tensions and contradictions that exist between the realities of impairment, illness, and care needs in later life; and the desire to remain self-sufficient and avoid “burdening” others with care needs. These findings provide insight into the everyday practices through which older people construct age relations in the context of care: when participants negotiate care arrangements, I suggest that they both reproduce and challenge the social processes and cultural discourses that are at the basis of age relations. Access to social and/or financial resources, however, had consequences for participants’ negotiations of care and of age relations. / Thesis / Doctor of Philosophy (PhD)