Children’s lifestyle has changed significantly during the recent decades, with an increasing prevalence of obesity as one outcome. Parents are usually the most influential people in young children’s lives. The overall aim of this thesis was to investigate parental perspectives on factors associated with 3-6 year-old children’s lifestyle, regarding eating habits and physical activity. Another objective was to compare different approaches to conducting postal questionnaires in terms of response rate, time consumption and cost-efficiency. The samples in the four studies were parents of 6-year-olds (n=158), parents of 3-year-olds (n=873), parents of 4-year-olds (n=30) and parents of 3-year-olds (n=353). In the first study, a questionnaire regarding practices and attitudes towards their child’s lifestyle, perceived obstacles and desired support was used. The second study included the Swedish Parenthood Stress Questionnaire (SPSQ), the Relationship Questionnaire (RQ) and the CFQ (Child Feeding Questionnaire). Parents also reported their child’s TV-viewing habits. The child’s measured height, weight and BMI were obtained from a register, BASTA. In the third study, focus group interviews were performed. The fourth study investigated three types of consent given for participation in a survey. The results showed that parents’ attitudes towards children’s lifestyle, in general, were “healthier” than their reports of their child’s daily practices. The practices differed depending on the parents’ educational background. Significant and dose-dependant associations were found between perceived maternal stress and children’s overweight, but also underweight. Parents felt that they were mainly responsible for their preschool child’s lifestyle. However, parents described challenges that limited and obstructed them from providing their child with a healthy lifestyle, citing the need to receive professional and peer support, while also requesting support from society. Allowing respondents to actively decline participation yielded a higher response rate and proved to be the most cost-efficient method for conducting a postal questionnaire.

The purpose of this thesis is to describe logistics collaboration in supply chains. During the past two decades, a new trend towards integration and collaboration in supply chains has been recognised among researchers as well as among business practitioners. This philosophy is called supply chain management and has received enormous attention in logistics research. Collaboration based on supply chain management is expected to reduce total cost and improve service towards the supply chain’s end customers at the same time. The argumentation in existing literature is however seldom underpinned by more rigorous empirical material and becomes therefore conceptual and superficial. Furthermore, it is incongruous about what actually is done when companies collaborate and what more specific effects are achieved. Therefore more research, especially survey based, is needed in order to verify existing literature. In this thesis the perspective of a focal company is taken in order to concretise the ideas from supply chain management and investigate what it means for an individual company. Based on supply chain management literature, a questionnaire was constructed which focused on the content of the collaboration and its driving forces, barriers and effects. Furthermore, differences between triadic collaborations, i.e. collaborations where both the supplier and customer of the focal company are involved, and dyadic collaborations (collaboration with either a supplier or a customer) were investigated. The questionnaire was mailed to 482 Swedish manufacturing companies which had a turnover of more than SEK 100 Million per annum and with more than 100 employees. This population was considered as a typical target group for the supply chain management literature. 177 usable answers were received which gives a response rate of 37.8%. The results from this study are summarised in five propositions. It is proposed that the content of logistics collaboration in the Swedish manufacturing companies’ supply chains is rather operative in its character and does not reach the strategic level that is advocated by the literature. In particular, the degree of process approach in the collaborations is low. This area has a great potential for improvements. The results also indicate that the intensity of the collaboration, i.e. frequency of information sharing, degree of joint operative planning of involved supply chain activities, and process approach, are positively related to the effects experienced of the collaboration. The relation between joint strategic planning and the operative collaboration issues is however weak and does not seem to influence the effects experienced as a consequence of the collaboration. Furthermore, engagement from top management is recognised as an important driver for successful collaboration. Top management involvement means an increased internal focus on the collaboration and facilitates more intensive collaboration. Finally, differences in attitude and behaviour are recognised depending on whom the collaboration partner is. The study shows that the traditional way of managing supply chain relations still dominates, where the focal company “demand what he wants” upstream much more than in the case for downstream relations. Such differences according to SCM literature should not exist and can be considered as a serious threat for SCM based collaboration. / <p>The ISBN is incorrect in the printed version but corrected in the electronic version. ISRN/Report code: LiU-Tek-Lic 2005:35.</p>

This research study was divided into three phases. Phase I included 157 university undergraduate students. It was designed to assess the content (face) validity of the Leisure Exercise Efficacy Scale (LEES). Phase II consisted of 240 university undergraduates. This phase investigated the internal consistency, factorial structure, and construct validity of the LEES. Phase III was the main study, a total of 331 university undergraduate students were involved. It has three objectives: 1) to examine the theoretical relationships among the variables of "leisure exercise efficacy", "leisure exercise motives", "leisure exercise barriers", and "leisure exercise behaviours" of university students using Social Cognitive Theory as the framework; 2) to assess the effect of a required physical education program, with interventions based on Bandura's self-efficacy theory, on the leisure exercise behaviours of university students; and 3) to examine the role that the Hong Kong environment plays and identify possible ways to increase university students' participation in leisure exercise. Path analysis results showed that leisure exercise efficacy was a significant and direct predictor of leisure exercise behaviours 3 months after the commencement of the semester. The re-specified Model of University Students' Leisure Exercise Behaviours was found to be tenable. However, repeated measures analysis of variance results showed that there were no significant 3-way interaction effects (Group x Gender x Assessment Time) or 2-way interaction effects (Gender x Assessment Time) (Group x Assessment Time) for all variables. Qualitative results showed three perceived leisure exercise barriers: 1) time; 2) attitudes towards exercise; and 3) structural. Three general dimensions emerged from the qualitative data to increase university students' participation in leisure exercise: 1) reinforcement of leisure exercise efficacy; 2) enhancement of leisure exercise motives; and 3) encouragement of a university sports culture. Practical implications of the research findings and recommendations for future research are given in this study.

Abstract Background The National Health and Medical Research Council and the Royal Australian College of General Practitioners recommend exclusive breastfeeding for the first six months of an infant’s life and continued breastfeeding with the addition of appropriate complementary food until at least 12 months. While most Australian women initiate breastfeeding, many wean earlier than recommended due to breastfeeding difficulties. As most women consult their GP frequently in the first six months postpartum, GPs are in an ideal position to provide encouragement, evidence-based information and advice that breastfeeding women need. In addition, women are more likely to initiate and continue to breastfeed if their doctor supports and encourages them to do so. The limited Australian data available question whether GPs have the skills to be able to effectively assist breastfeeding women, although no research has specifically addressed the breastfeeding knowledge or attitudes of Australian GPs. Additionally, there are no data detailing the breastfeeding training available to medical students, GP registrars or GPs. Aim This study aimed to identify the breastfeeding educational needs of Australian GP registrars and to develop a relevant and applicable breastfeeding educational resource within the context of these identified needs. Research design Triangulation methodology, using more than one data source and qualitative and quantitative data-collection methods, was chosen for this study to give a richer, more inclusive and wider reaching understanding of the issues involved than could be obtained by using one method alone. Therefore, to meet the aims of the study, a three phase mixed-method project with triangulation of data was designed. Phase 1 had three distinct data-collection arms: a quantitative survey of medical school curricula; focus groups with medical students from two Queensland medical schools; and interviews with eight GP registrars. Data from Phase 1 provided information about breastfeeding attitudes, knowledge needs and learning opportunities, and informed the development of a questionnaire sent to final-year GP registrars Australia-wide (Phase 2). The aim of this phase was to ascertain the GP registrars’ breastfeeding attitudes and knowledge gaps. Phase 3 used the outcomes of Phases 1 and 2 to design an educational resource that would meet the needs of GP registrars. Results Breastfeeding was included in the curricula of most of the Australian medical schools surveyed (n = 10). Many medical schools relied on contact between the student and patients to provide clinical experience and practical knowledge. Medical students and GP registrars reported marked variability in breastfeeding learning opportunities. Although both groups had positive breastfeeding attitudes, participants had differing opinions regarding doctors’ involvement in infant feeding decisions and the type of support and information offered to women. Overall, the breastfeeding attitudes of the 161 GP registrars who returned the questionnaire were positive (mean 3.99, 1 = least positive, 5 = most positive). However, while the mean breastfeeding knowledge score was 3.40, (1 = minimum score, 5 = maximum score) 40 percent of the knowledge items were incorrectly answered by more than half the cohort. Approximately 40 percent of the registrars were confident and thought they were effective assisting breastfeeding women. Nevertheless, only 23 percent thought they had had sufficient breastfeeding training. Registrars who thought their previous training was inadequate had lower knowledge scores, were less confident and perceived that they were less effective than the remainder of the cohort. A new finding from this study was that Australian-born registrars had more positive breastfeeding attitudes and higher knowledge scores than their overseas-born counterparts. In addition, while parents with more than 26 weeks’ personal breastfeeding experience (self or partner) had more positive breastfeeding attitudes and higher breastfeeding knowledge, confidence and perceived effectiveness scores, parents with less experience had less positive attitudes and poorer knowledge than non-parent participants. Similar to previous studies, gender had no effect on breastfeeding knowledge or attitudes. Using adult learning principles, a five-session, case-based breastfeeding educational resource addressing the knowledge deficits identified in the previous phases of the study was developed. Evaluation activities before and after each session, as well as exercises designed for reflection and critical thinking, were an integral part of the resource. Conclusion This study found that the breastfeeding training of Australian medical students and GP registrars was inadequate and, regardless of their positive breastfeeding attitudes, resulted in registrars being ill-prepared to assist breastfeeding women. Based on the training needs identified in the study and in the literature, an educational resource was developed that presented information within real-life case-based scenarios. Additional background information provided logic and rationale for diagnosis, management and treatment. While the implementation of the resource is outside the scope of this thesis (but will be the focus of post-doctoral work), it is believed that the resource has the potential to provide GP registrars with training opportunities to improve their breastfeeding knowledge and skills, thus better meeting the needs of breastfeeding women.

People I Know is a conceptual visual arts project which involves collecting and archiving information with the intention of extending the notion of portraiture and identity beyond the frame of the body. The collection is a body of collaged material that is a substitute for the body of the sitter, characterizing them. My practice methodology is a combination of collage and collection which allows for a wide field of research and an interdisciplinary approach. These works could be considered case studies of people I know; in object, text, and sculpture; brought together in installation.

Doctor of Philosophy (PhD) / Exercise and physical activity have many benefits for adults with cystic fibrosis (CF), including the potential to aid mucus clearance, improve lung function, exercise capacity and quality of life. Despite the recommendations from consensus documents for CF adults to engage in regular physical activity, exercise participation amongst this population is often very low. No in-depth study has been undertaken to explore the determinants of exercise participation for this group and no studies have examined the benefits of habitual physical activity on the health status and quality of life of CF adults. As well, the current methods to quantify physical activity are problematic. The series of studies, involving CF adults, in this thesis was therefore undertaken in order to examine the physiological rationale for the use of exercise as an airway clearance technique, to understand the decision making process to engage in exercise, to determine if health status and quality of life were affected by exercise participation, and to establish the accuracy of a recently-developed objective measure of physical activity. The study in Chapter 2 provided some physiological rationale for choosing treadmill exercise to aid airway clearance in CF. The main findings were that a single bout of moderate intensity exercise increased the subjective ease of expectoration, most likely due to the increased ventilation with exercise, and that sputum viscoelasticity was favourably decreased immediately following treadmill exercise compared to cycle exercise and control. The studies in Chapters 3 and 4 identified the main beliefs regarding exercise for CF adults and highlighted that the main predictors of exercise intention and participation for this group were aspects of perceived and actual control to exercise, namely self-efficacy or confidence to exercise, feeling healthy, receiving encouragement to exercise, and rating exercise as a high priority treatment. Positive ratings of these aspects of control either increased exercise participation directly, indirectly by increasing intention, or strengthened the conversion of exercise intention to participation. Strategies aimed at targeting these aspects of control are therefore likely to be effective in increasing exercise participation for CF adults. The study in Chapter 5 demonstrated that CF adults, who reportedly performed at least 90 minutes of moderate to strenuous exercise per week, had significantly higher quality of life and fewer days in hospital over the following year than their peers, who exercised less. The difference in hospitalisation between the CF adults, who reportedly exercised more than 90 minutes per week and those who did not, was independent of baseline lung function, and the females who reportedly performed less than 90 minutes of exercise per week had three times as many days in hospital than their high-activity peers. The study in Chapter 6 showed that the SenseWear Pro3 Armband activity monitor provided a reasonable estimate of energy expenditure and step count. Also, its accuracy was not affected by diagnosis with CF, despite the potential for the high salt content in the sweat to interfere with the device’s physiological sensors placed on the skin. Overall, this series of studies adds to the growing evidence of the physical and psychological benefits from exercise participation for CF adults, as well as providing some empirical evidence upon which to base strategies to improve exercise participation for this group and support for an objective measure of physical activity.

Sufficient physical activity, a key prerequisite for health, is lacking in many teenagers. Limited knowledge, however, exists about who, when, why, and if New Zealand teenagers are getting their daily dose of health-related physical activity. At conception of this thesis, available information was predominantly survey-derived with no New Zealand data and few international studies that had assessed adolescent physical activity levels objectively. Data were collected from three projects. Convenience sampling was used across all projects to recruit students from low-decile high schools located in the Auckland region. For Project 1, 236 Year 9 to Year 13 students each wore a pedometer for five days (three weekdays and two weekend days) and reported their mode of transportation to and from school. To explore ethnic and sex-specific perceptions of physical activity among youth (i.e., barriers, benefits, potential physical activity enhancing strategies), Project 2 involved nine focus group discussions with 44 Year 9 and Year 10 students who identified as Māori or European. Project 3 was a large cross-sectional study of 3,451 high school students (Years 9 - 13) from seven low-decile schools. Through this project the following self-reported data were collected: demographics, physical activity levels during four school-day physical activity opportunities (i.e., active travel, lunchtime physical activity, recess physical activity, after-school physical activity), sedentary behaviour (i.e., school-day television (TV) watching), level of perceived encouragement to be active, and the presence of home policies regarding TV use. Analyses revealed low physical activity participation and high TV use behaviours. Pedometer data showed that only 14.5% of participants achieved a conservative criterion of 10,000 steps daily. Also, daily steps varied by age group (junior students: 11,079 ± 330; senior students: 9,422 ± 334), sex (males: 10,849 ± 381; females: 9,652 ± 289), time of week (weekday: 12,259 ± 287; weekend day: 8,241 ± 329), and transportation mode to/from school (walkers: 13,308 ± 483; car transit users: 10,986 ± 435). Low school-day physical activity levels emerged, especially during school hours (i.e., during recess and lunchtime). Based on dichotomised grouping (less active versus more active), the proportion of students in the ‘more active’ group during morning recess and lunchtime, after school, and as part of active travel to/from school were 26%, 32.4%, 56.3%, 58.1% respectively. Only 11.1% of participants were in the ‘more active’ group across all four physical activity opportunities. The focus group data revealed primarily social benefits of physical activity (e.g., meeting new people, fun). Barriers were mainly environment-related and included lack of peer support, low accessibility to and availability of physical activity opportunities, alternative sedentary activities, structure of physical education classes (females only), and distance between home and school (in terms of active transportation). Potential strategies to increase physical activity reflected the articulated barriers and benefits (e.g., increase peer support, parents to turn off the TV, organised activities at school, restructure physical education classes to allow student involvement in the decision-making process of class content). No ethnic and few sex differences in perceptions were found. Focusing on the verbalised importance of social support from the focus groups, Project 3 data showed that the strength of association between perceived encouragement from different support sources (i.e., parents, older siblings/cousins, peers, school) and physical activity participation varied by the physical activity opportunity examined. In particular, multivariate logistical regression showed reduced odds of being in the ‘more active’ group was associated with low parental encouragement (Juniors, OR: 0.47, 95% CI: 0.38-0.58; Seniors, OR: 0.41, 95% CI: 0.29-0.60) and low peer encouragement (Juniors, OR: 0.61, 95% CI: 0.51-0.74; Seniors, OR: 0.49, 95% CI: 0.35-0.69) for after-school physical activity, low peer encouragement (Juniors, OR: 0.39, 95% CI: 0.32-0.48; Seniors, OR: 0.41, 95% CI: 0.29-0.57) for lunchtime activity, and low peer encouragement (Juniors, OR: 0.78, 95% CI: 0.66-0.92) for active transportation (junior students only). No significant difference in physical activity was found between students who received high encouragement from two parents than students who reported high encouragement from their sole parent in a single parent family. Concentrating on the after-school period, Project 3 data were analysed to examined the relevance of the displacement hypothesis during this school-day period. The association between parental strategies (i.e., encouragement to be active and having TV limits) and youth after-school activity behaviours (i.e., hours spent viewing TV, physical activity participation) was also examined. Support for the displacement hypothesis emerged. In particular, compared to students who watched less than one hour of TV, those who watched greater than four hours of TV were half as likely to be in the more active group for after-school physical activity participation (adjusted OR: 0.51; 95% CI: 0.40-0.65). Comparing activity profile groups (i.e., based on combined TV use and after-school activity levels), compared to the participants in the ‘low TV/active’ group, participants in the other three activity groups (e.g., ‘high TV/low active’) were at least 1.28 times more likely to have parents that executed only one parental strategy and up to 4.77 times more likely to have parents that did not carry out either strategy. Substantive opportunities exist for youth to be active every day, and in different contexts and environments, yet a large proportion of young people are not maximising these opportunities to be active. If the health issue of inactivity is to be tackled in a comprehensive and efficient manner, a multi-strategy, multi-environment, coordinated approach among local authorities, government agencies, schools, families, and neighbourhoods is required to address the noted policy, physical, and social-related associates of an active lifestyle for youth. Future effort, whether in the form of strategy development, intervention work, or research, needs to be founded upon ecological theory, where both individual and a range of familial, social, and physical environmental factors (and there potential interactions) are considered. Lastly, equal research attention should be directed at improved physical activity levels, and just as importantly, reducing time youth spend in a sedentary state.

People I Know is a conceptual visual arts project which involves collecting and archiving information with the intention of extending the notion of portraiture and identity beyond the frame of the body. The collection is a body of collaged material that is a substitute for the body of the sitter, characterizing them. My practice methodology is a combination of collage and collection which allows for a wide field of research and an interdisciplinary approach. These works could be considered case studies of people I know; in object, text, and sculpture; brought together in installation.

Thèses (Ph.D.)--Université de Sherbrooke (Canada), 2000. / Titre de l'écran-titre (visionné le 20 juin 2006). Publié aussi en version papier.

Introduction: Interprofessional Learning (IPL) is an approach that teaches students from different disciplines to share their professional knowledge in order to gain a more complex understanding of the situation at hand. According to WHO, interprofessional learning strengthens communication and the collaborative practice which in turn improves health outcomes for patients. Insufficient interprofessional communication due to inexperience with interprofessional teamwork can affect patients’ safety. Aim: To compare differences in nursing- and medical students readiness for interprofessional learning in Vietnam and if they believe that IPL could affect the quality of communication with patients. Method: A quantitative study was conducted, with a descriptive approach where the population consisted of nursing- and medical students at University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam. The data was collected through a structured questionnaire called Readiness for Interprofessional Learning Scale (RIPLS). Mann Whitney U-test was used for statistical analyzes. Results: A statistical significant difference, between the two professions, was found in four out of nineteen questions. Therefore we could not see a difference in readiness between the two professions. Regarding the students’ perception on IPL and communication, we could not see a statistical difference, the two groups had similar views on the topic.   Conclusion: We could only find a few questions that reflected an actual difference (p &lt; 0.05) in opinion between the two professions.