This work undertook the examination of the perceived barriers that exist to the management of occupational noise exposure in the workplace. Exposure to excessive levels of noise results in cumulative damage to the hearing mechanism of the ear and a subsequent hearing loss. This hearing loss is permanent and does not recover over time. Initially the conventional method of addressing or controlling noise exposure was through Hearing Conservation Programs and more recently through Occupational Noise Management Programs that take more of a risk management approach. However, the numbers of new hearing loss claims submitted through the various ???workcover??? and ???worksafe??? authorities in Australia continue to remain very high. Hearing loss claims rank within the top two in number of new claims each year. The research conducted shows that there are four main barriers perceived by individuals that work against the institution of effective preventive action. These four main barriers in order of priority are hearing protectors, information, culture and management, and are themselves each composed of several lesser factors. Each of the barriers was examined more closely in an attempt to better understand how they operate and the potential to discover how they may be overcome. To briefly summarise the main barriers: 1) Hearing protectors are uncomfortable, impede communication and are unpleasant to wear; 2) Individuals would like more information on noise reduction and for this information to be supplied by management; 3) workplace and management culture needs to be supportive of occupational health and safety in general and with the implementation of supportive preventive measures in particular; and 3) management needs to be seen to place importance on occupational health and safety in the workplace in general and the reduction of excessive noise in particular. By being aware of the barriers and operation the design of future more effective intervention or better noise management programs should be possible.

Australia is one of the driest continents in the world with changing climatic conditions continuing to put a strain on potable water sources. The use of water saving technologies such as greywater systems in residential properties is an important water conservation tool in order to reduce the consumption of the finite potable water resources in Australia. To this end, Master Builders Association Victoria with the assistance of RMIT University investigated the current barriers that builders face with regard to the installation of greywater systems in residential properties. Builders like other property and construction professionals have a part to play in promoting the use of sustainable technologies. The main aims of the project were to firstly find out or identify barriers that are inhibiting builders from installing greywater systems and secondly to identify and formulate strategies to reduce or eliminate the barriers identified. The main barriers for builders are; high cost, government regulations, lack of builder awareness or knowledge, and low client demand. The potential solutions for the reduction or elimination of the barriers identified as part of the research include; economic and reliable greywater systems, creation of a website with link on greywater systems and educating the general public.

Diabetes is a psychologically demanding disease with a major impact on a patient’s quality and quantity of life. The outcome of diabetes is highly dependent on the self-care activities of the person with diabetes. Depression is common among people with diabetes, complicating this self-management and thereby increasing the risk of developing diabetes-related complications. Despite depression’s specific relevance to diabetes and the serious impact it has on the disease, it is estimated that only one third of people with both diabetes and major depression are recognized and appropriately treated for both disorders. The aim of this thesis therefore was to investigate the interrelationship between depression and diabetes and evaluate methods of improving recognition rates and access treatment within a health care setting. Routine screening for depression using standardised depression screening instruments has been recommended for all adults in primary care to improve the low recognition rates of depression in this population. The aim of Study 1 was therefore to compare the effectiveness of four commonly used depression screening instruments (CES-D, HADS, DMI, SCAD) in identifying depression in a diabetes sample. This research was important as little previous research had investigated the efficacy of these depression screening measures within this specialist group and an evaluation of their comparative performance had not yet been conducted. 150 patients with diabetes receiving care at the endocrinology outpatient clinics of two major public hospitals in Brisbane, Australia completed a battery of questionnaires and were also involved in a structured clinical interview (CIDI-SF) to establish a criterion standard. Results indicated that three of the screening measures (CES-D, HADS, DMI-10) could be considered reliable predictors of depression in this sample. There was however evidence that the CES-D could be considered the preferred measure as it had the best ability to discriminate between depression and non-depression, it showed reasonable sensitivity, high specificity, and it was able to stand alone as a predictor of major depression with its predictive ability not improved with the inclusion of diabetes symptoms. Study two of this thesis investigated the demographic, medical, and psychosocial correlates of depression in patients with diabetes. This research was important as information about risk profiles can help improve rates of diagnosis and treatment and may provide a method by which screening can be more focused and cost effective. 1069 hospital outpatient patients with diabetes were asked to complete a battery of questionnaires to accomplish this aim. The results found that co-morbid depression in patients with diabetes was associated with type-1 diabetes, younger age, poor glycaemic control, insulin treatment, co-morbid medical illness, increased diabetes symptoms, lack of a partner, lower income, stressful life events, low social support, and poor quality of life. Of particular interest was the finding that the inclusion of psychosocial predictors reduced the predictive ability of many demographic and medical factors. Study three of this thesis investigated the impact of a depression screening and feedback procedure on a patient’s level of depression, glucose control, and quality of life. While routine screening for depression has recently been recommended for all patients with diabetes, no previous research had been conducted to evaluate the efficacy of this approach on treatment and patients outcomes. 164 patients with diabetes who were found to be depressed in study 2 were involved in a randomised controlled trial which compared patients who received feedback regarding their depression status with those patients who did not receive any feedback. The results found high rates of depression in this sample and suggested that screening for depression and providing feedback to patients regarding the outcomes of screening had beneficial effects on depression at six months but not on glycaemic control or quality of life. The final study in this thesis attempted to investigate the help seeking behaviours of patients following feedback and to identify barriers to seeking care. 82 participants who received feedback regarding their depression status in study 3 were contacted for a structured telephone interview. Results indicated that only 52.44% of depressed diabetes patients followed the recommended advice and sought help for their depression. Of the patients that did not seek help, several barriers to seeking care were reported. Overall, the results indicated that attitudes relating to the severity of the disorder and the need for treatment were more salient barriers for participants in this study than logistical issues, stigma, or current levels of depression.

<p><strong>Title</strong><em>: Barriers to the implementation of E-learning system with focus on organizational culture</em></p><p><strong>Introduction: </strong>Nowadays, Information Technology has become a necessity for businesses not only to gain competitive advantage but also to survive. Strategic use of new educational technologies can enhance learning and teaching process. In order to stay viable in this intense competitive environment, providers of education and trainings have developed efficient and effective learning environment, called E-learning. However with the success there also exist barriers containing the cultural aspects of the organizations throughout the implementation process. <strong> </strong></p><p><strong>Purpose: </strong>The purpose of this research is to describe and analyze critical factors which may affect the implementation of E-learning system with a special focus on organizational culture.</p><p><strong> </strong></p><p><strong>Research Question: </strong>What are the critical barriers of implementing E-learning system and what is the role of organizational culture in successful implementation of E-learning system?<strong></strong></p><p><strong>Research design: </strong><strong> </strong>This research is based on a qualitative approach and based on secondary data collection method. The required literature has been obtained by searching Mälardalen University’s library. Furthermore, authors have used online library (ebrary) as well as other libraries’ databases such as Elin, Emerald, Eric and EBSCO. Reference books from university library were also used in the course of the research. The data has been extracted from articles which are title base keywords search criteria were used for searching articles. Our research is exploratory and based on the Interactive model which consists of three activities which are data reduction, data display, and conclusion. Research analysis emphasizes more on comparing various authors’ view to analyze and describe the critical barriers and role of organizational culture to successfully employ E-learning system in organizations.</p><p><strong> </strong><strong>Target audience:</strong> This research provides a general guidance to the readers and organizations interested in E-learning initiative and for those who have already implemented E-learning.<strong></strong></p><p><strong> </strong><strong>Conclusion: </strong>This research elicited and examined a number of various points of views about the barriers of implementing E-learning system in organizations. Within organization, bridging education is challenging if the organizational culture is unwilling to accept an E-learning initiative. Finally it was suggested that by behavioral change and by motivating the employees can new vitality and momentum can be brought for implementation success. Organization should underpin their implementation strategy of E-learning system proactively to reap the maximum benefits.</p><p> </p>

<p>Electricity accounts for much of the primary energy used in China, and more thanthree-quarter of the total electricity is generated by coal combustion. Coal burningcombined with flue gas cleaning system generates large quantity of coal combustionproducts (CCPs), which has caused significant environmental and economic burden tothe economy, ecology and society. Of great importance are thus different applicationswhich contribute to the increased use of CCPs. This thesis looks at an overview ofCCPs production and utilization all around the world and investigates current CCPsapplications as well as potential technically sound and economically justifiedtechnologies. Results of this thesis show that CCPs utilization rate in differentcountries varies widely from 13% to 97%. Worldwide, a significant proportion ofCCPs from the main producers, e.g. China, the United States and India, is still beingdisposed off, resulting in a low-level of overall utilization of these products. It isevident that the amount of CCPs produced substantially exceeds consumptionsbecause of various existing obstacles and limitations. In order to formulate effectiveapproaches, identifying challenges to increased use of CCPs is of great weight. The aimof this thesis is to analyze current and potential utilizations of CCPs and morespecifically address factors that inhibit or promote the use of CCPs from coal-firedpower plants in China.</p><p>Savings of natural resources, energy, emissions of pollutants, GHG emissions anduseful land were found as the major incentives for CCPs utilization. In China, a ban ofsolid clay bricks was also found to be a very powerful measure to stimulate thedevelopment of other by-product based wall materials while saving useful land andprotecting the environment. However, this strong support from the government hasnot been fully implemented, which seriously hampered CCPs uses. Results presentedin this thesis also show that high transportation cost of low unit-value CCPs,competition from available natural materials and spatial variation in supply-demandposes three of the most important barriers to the increased use of CCPs in China.Industrial organizations with assistances from the government have shown to be offundamental importance for formulating approaches to take in overcoming thebarriers.</p><p>This thesis emphasized that transforming laboratory- and pilot-scale technologies intocommercial productivity is of the highest priority for increased use of CCPs. Aconceptual model of CCPs Eco-Industry Park (EIP) as a potential effective solutionwas proposed. Mutual economic and environmental benefits can be achieved throughthe collaboration between different industries in the CCPs EIP. And other feasiblerecommendations of initiatives from both the government and industries were alsodiscussed.</p>

Objective: A significant number of children suffer from life-limiting illnesses, with many dying each year in the U.S. Services, beyond standard medical care, aimed at increasing overall quality of life for children with life-limiting illnesses, are greatly needed within and outside of our hospitals. Palliative care is conceptualized as treatment provided to relieve symptoms and improve quality of life. Despite the empirically supported benefits of providing pediatric palliative care, only a small percentage of pediatric patients actually receive these services. Thus, there is a great need for the development and provision of these services. The first aim of the current study was to compare results from Holtz Children’s Hospital (HCH) at the University of Miami with those from Lucile Packard Children's Hospital (LPCH) at Stanford University, where a survey assessing pediatric healthcare providers’ palliative care needs was originally developed. The second aim was the modification and further development of the measure, including an evaluation its psychometric properties. The third aim was to identify the educational and training needs of healthcare providers in providing pediatric palliative care. The fourth aim was to evaluate whether completing the survey improved awareness of a palliative care team. Method: Two hundred and twenty five healthcare providers at HCH completed the Survey on Pediatric Palliative Care for Healthcare Providers (SPPCHP). Participants were diverse with regards to ethnicity/race and profession. Results: Healthcare providers at both hospitals reported feeling inexperienced in similar aspects of delivering palliative care and desired further training and support. The SPPCHP demonstrated strong internal consistency and good construct validity, evidenced in factor analyses. Pediatric healthcare providers at HCH reported only feeling “somewhat” experienced in all aspects of pediatric palliative care and rated families’ inability to accept terminal diagnosis as the top barrier to providing this care; half of healthcare providers reported not receiving adequate support. Although referrals did not increase six months after study completion, awareness at the hospital was improved. Conclusions: Clinical implications include the need for systematic training and support in palliative care for a range of pediatric professionals, with an emphasis on addressing key barriers to care. Given the similarity of the findings at HCH and LPCH, these results appear generalizable to a variety of children’s hospitals.

Latinas are at risk for not engaging in optimal exercise and are at greater risk than other ethnic groups for being overweight and suffering deleterious health consequences. The current study’s researcher utilizes pedometers, exercise logs, surveys, and participatory photography to determine exercise motivators and barriers to exercise among Latinas. The specific aims of the presented research were to identify predictors of exercise, to investigate the relationship between motivation types, self-determination and acculturation among Latinas, and employ participatory photography methodology to better understand Latina’s exercise motivators and barriers. The methodology included both quantitative and qualitative methods. Exercise motivation types (Amotivation, Extrinsic, Intrinsic) using the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), an exercise log and pedometer step counts were collected from 169 Latinas. Acculturation and demographic variables including income, education, and number of children were also collected. Each Latina met with the researcher to complete the BREQ-2, receive her exercise log and pedometers and to return her exercise logs. A sub-sample of 19 Latinas responded to semi-structured questions about exercise and photographed their exercise motivators and barriers. Results showed that the more acculturated to American culture, the fewer steps on average per day were recorded by participants. Demographic variables were not significant predictors of exercise. Motivation type was not found to predict exercise (recorded steps per day). The Intrinsic regulation subscale, ‘I value the benefits of exercise,’ of the BREQ-2 had the highest mean score (m = 3.28, SD = .83). Participants in the qualitative phase of the study defined exercise as physical activities done for the purpose of exercising involving a set of physical and emotional effects. Exercise motivators identified through qualitative semi-structured interviews were classified as either Extrinsic or Intrinsic with the most frequently commented on being the Extrinsic category. Exercise barriers that emerged from the data were classified into a) competing obligations, b) personal limitations, c) environmental limitations, and d) competing diversions. Cultural aspects influencing Latinas’ exercise also emerged from the data classified into the following categories: a) job stress, b) changing family roles, c) fast food availability, and d) transportation. The findings of this study suggest avenues for interventions that are family-centered and culturally-tailored based on education of what constitutes exercise. Exercise motivation is a complex issue for Latinas, and future researchers need to examine the mechanisms of becoming more Americanized that may adversely affect Latinas’ activity levels. The concept and measurement of Identified regulation may need to be revised before its further use among Latinas in addressing the significant health disparity attributable to sub-optimal exercise.

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">Despite wide acceptance of Voluntary Counselling and Testing (VCT) as a crucial entry point for the prevention, treatment, care and support of HIV-infected persons / the prevalence of testing in Ethiopia remains very low. A review of the literature identifies the set of factors that influence HIV testing of individuals to include socio-economic and demographic factors, knowledge of HIV/AIDS, risk perception, fear of stigma, social capital and the perceived benefit of VCT. By drawing assumptions based on the known literature, this mini-thesis explores the relationship between VCT usage and the above factors in order to explain the status of HIV testing in Moher and Aklil district, Gurage Zone, Ethiopia. The study hopes to address the dearth of material on VCT and contribute to it in a non-clinical and rural context.</p> </font></font></p>

<p>In countries like Zambia where HIV prevalence (14.3% in the age group 15-49 years) is one of the highest in sub-Saharan Africa, HIV testing is an important strategy to combat the HIV/AIDS epidemic, because it is a critical step towards HIV/AIDS care, treatment and support. Despite decades of HIV/AIDS information and education campaigns, only 10% of Zambians know their HIV status. This study aimed to describe the uptake of voluntary counseling and testing and factors associated with uptake at Ngungu Mini - hospital in Ngungu Township, Zambia. Methodology: A descriptive, cross-sectional survey was conducted among 100 adult clients accessing health care at Ngungu mini - hospital during the second week of January 2009. Participants were asked to fill in a questionnaire on VCT, knowledge, attitudes towards HIV testing, and factors that promote/hinder HIV testing. Data was captured with Excel and basic descriptive analysis done using SPSS version 16.0 and Epi Info Version 3.3.1.</p>

Innovation is, in most cases, a necessity for firms in today’s changingmarket place. It has the potential to offer firms numerous advantages,including increased profit and growth. However, innovationis no easy process and there are many barriers and impedimentsto innovation that needs to be overcome in order to efficiently innovate.A study conducted by Vinnova (2007) showed that 18% ofSMEs consider a shortage of qualified personnel as a high barrier toinnovation. How are competence barriers to innovation experienced by smallenterprises in the selected sample? Do competence barriers to innovationvary depending on different firm characteristics and in thatcase how? Which consequences do small enterprises encounter as aresult of facing competence barriers to innovation? Are small enterprisesthat face high competence barriers to innovation more likelyto encounter consequences? The purpose of this research report is to investigate competencebarriers to innovation within small enterprises and the consequencesthese barriers might result in. Competence barriers to innovation are considered moderate in thissample. The highest barrier was shortage of qualified personnel necessaryfor innovation. In general, small enterprises that experienceda higher level of competition also faced higher competence barriersto innovation. The most frequently reported consequences fromfacing competence barriers to innovation were; inability to acceptcertain jobs or contracts, decreased profitability and difficulty in expandingthe business. Small enterprises which face higher competencebarriers to innovation are more likely to encounter consequences.