Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

The political history of South Africa, especially that of the apartheid years, has affected the structuring and functioning of business in the country profoundly. In general, White business is highly developed and formal, with access to financial and infrastructural support. Black business is often subsistence-based, informal and struggles for access to support mechanisms. These structural inequities have had a depressing impact on the economy that will continue if they are not resolved. Following the 1994 elections, policies and legislation have been introduced aimed at redressing structural imbalances. There is thus both a political and an economic imperative to bridge the gaps that have arisen between Black and White business. The study proposes Black/White joint ventures as a mechanism to this end. The history of Black/White relationships means that these enterprises are likely to face many problems. A model has been developed through the study for the formulation, structuring and operation of Black/White joint ventures that takes into account the factors that are likely to impact on these ventures and affect their success potential. The process of applying the model in practice is directed towards results that are not prejudiced by the background of the parties to the venture. The study expands the concept of joint ventures within the South African context to incorporate initiatives along a continuum ranging from extensions to employment to full joint ventures. Depending on its nature and objectives, a venture may be placed and remain at any stage along the continuum, or may progress along it. Case studies of Black/White joint ventures were investigated in depth and analysed in terms of the application of the model, in order to determine the relevance of the model. In all cases, the success or failure of the venture under scrutiny could be ascribed to the way in which the presence of various elements identified as being components of the model had been accommodated in practice within the venture. The use of the model when applied to formulating, structuring and operating a Black/White joint venture can contribute to its success potential. / Business Management / DBL

Hyatt, Jennifer Leigh. Women Chief Housing Officers at State Universities in the Northwest United States. Doctor of Education (Higher Education), December 2016, 89 pp., 1 table, 3 figures, 48 references, titles. This qualitative study explored the experiences of women chief housing officers (CHOs) at state universities within the northwest region of the United States. The study used narrative inquiry methodology with a thematic analysis approach to investigate how seven female CHOs experience and make meaning of their professional career progression and journey toward becoming and remaining a CHO. Five core themes emerged from the study: (a) understanding housing operations, (b) self-efficacy, (c) gender inequities, (d) relationships with staff, and (e) mentorship. The theme of gender identity suggests that gender does influence how these female CHOs make meaning of their professional experience. The overall results suggest that although the perception of many is that the field of student affairs is wide open to women, in some senior-level positions, such as CHO, gender inequity is prevalent. A factor that may contribute to this inequity is the privatization of housing which calls for a greater understanding of business and housing operations, areas dominated by males. An implication from this study is that an increase in the number of women in the CHO position may only occur when university housing personnel expand professional preparation for mid-level housing positions to include more business-related practices. The mid-level position could then be seen as a step toward desired CHO competencies and toward making the position of CHO more inclusive.

No description available.

Bakgrund: Kvinnor har rätt att välja var de vill föda barn. I Sverige sker majoriteten av alla förlossningar på sjukhus. De som föder hemma väljer det för att det är ett säkert alternativ samt för att vara i en bekant miljö och föda på sina egna villkor. Det finns idag varken nationella riktlinjer eller statlig finansiering för hemförlossningsverksamhet i Sverige, med enstaka undantag. Barnmorskors attityd till hemförlossning varierar internationellt. I de länder som har planerad hemförlossning integrerat i vårdvalet är barnmorskorna generellt positiva inställda. Motiv: I detta examensarbete undersöks hur barnmorskor som arbetat på förlossningsavdelning inom slutenvården ställer sig till planerad hemförlossning. De svenska studier som finns undersöker främst upplevelser hos barnmorskor som i privat regi redan arbetar med hemförlossning.  Syfte: Syftet med detta arbete är att undersöka barnmorskors inställning till planerad hemförlossning samt möjliga hinder för att bedriva sådan verksamhet. Metod: Semistrukturerade intervjuer genomfördes med 10 barnmorskor från fyra regioner i Sverige. Intervjuerna analyserades med tematisk analys. Resultat: Analysen resulterade i ett övergripande tema, ”Barnmorskors önskan att arbeta med kvinnor för kvinnor”, två huvudteman, ”Barnmorskor är positivt inställda till planerad hemförlossning” och ”Hinder för planerad hemförlossning”. Temana underbyggs av sju subteman. Konklusion: Förlegade patriarkala normer och hierarkier där läkarens ord väger tyngre än barnmorskans gör att barnmorskorna upplever att de inte har förutsättningar att arbeta så kvinnocentrerat och evidensbaserat som de önskar för att säkerställa god vård. Barnmorskorna i studien ansåg att det finns stora vinster med planerad hemförlossning för kvinnan och barnet men även för barnmorskan. Befintlig forskning styrker deras erfarenheter och många länder har implementerat rådande evidens i sin förlossningsvård och inkludera planerad hemförlossning i verksamheten.

This study, in the main, focuses on the racial imbalances and inequities that characterised South African education between 1965 and 1992. A historical background of the South African educational system as well as an account on the apartheid ideology and its impact on education is presented. For the four principle racial groups in South Africa, namely, the Africans, Indians, Whites and Coloureds, a historicaleducational survey of the imbalances and inequities prevalent in pre-primary, school-based and post-secondary education in respect of access to education, financing of education, and human and physical resources is given. As a way forward, some recommendations for the redressing of the imbalances and inequities identified in this study are presented. / Educational Studies / M. Ed. (History of Education)

L’objectif de la présente thèse est de générer des connaissances sur les contributions possibles d’une formation continue à l’évolution des perspectives et pratiques des professionnels de la santé buccodentaire. Prônant une approche centrée sur le patient, la formation vise à sensibiliser les professionnels à la pauvreté et à encourager des pratiques qui se veulent inclusives et qui tiennent compte du contexte social des patients. L’évaluation de la formation s’inscrit dans le contexte d’une recherche-action participative de développement d’outils éducatifs et de transfert des connaissances sur la pauvreté. Cette recherche-action aspire à contribuer à la lutte contre les iniquités sociales de santé et d’accès aux soins au Québec; elle reflète une préoccupation pour une plus grande justice sociale ainsi qu’une prise de position pour une santé publique critique fondée sur une « science des solutions » (Potvin, 2013). Quatre articles scientifiques, ancrés dans une philosophie constructiviste et dans les concepts et principes de l’apprentissage transformationnel (Mezirow, 1991), constituent le cœur de cette thèse. Le premier article présente une revue critique de la littérature portant sur l’enseignement de l’approche de soins centrés sur le patient. Prenant appui sur le concept d’une « épistémologie partagée », des principes éducatifs porteurs d’une transformation de perspective à l’égard de la relation professionnel-patient ont été identifiés et analysés. Le deuxième article de thèse s’inscrit dans le cadre du développement participatif d’outils de formation sur la pauvreté et illustre le processus de co-construction d’un scénario de court-métrage social réaliste portant sur la pauvreté et l’accès aux soins. L’article décrit et apporte une réflexion, notamment sur la dimension de co-formation entre les différents acteurs des milieux académique, professionnel et citoyen qui ont constitué le collectif À l’écoute les uns des autres. Nous y découvrons la force du croisement des savoirs pour générer des prises de conscience sur soi et sur ses préjugés. Les outils développés par le collectif ont été intégrés à une formation continue axée sur la réflexion critique et l’apprentissage transformationnel, et conçue pour être livrée en cabinet dentaire privé. Les deux derniers articles de thèse présentent les résultats d’une étude de cas instrumentale évaluative centrée sur cette formation continue et visant donc à répondre à l’objectif premier de cette thèse. Le premier consiste en une analyse des transformations de perspectives et d’action au sein d’une équipe de 15 professionnels dentaires ayant participé à la formation continue sur une période de trois mois. L’article décrit, entre autres, une plus grande ouverture, chez certains participants, sur les causes structurelles de la pauvreté et une plus grande sensibilité au vécu au quotidien des personnes prestataires de l’aide sociale. L’article comprend également une exploration des effets paradoxaux dans l’apprentissage, notamment le renforcement, chez certains, de perceptions négatives à l’égard des personnes prestataires de l’aide sociale. Le quatrième article fait état de barrières idéologiques contraignant la transformation des pratiques professionnelles : 1) l’identification à l’idéologie du marché privé comme véhicule d’organisation des soins; 2) l’attachement au concept d’égalité dans les pratiques, au détriment de l’équité; 3) la prédominance du modèle biomédical, contraignant l’adoption de pratiques centrées sur la personne et 4) la catégorisation sociale des personnes prestataires de l’aide sociale. L’analyse des perceptions, mais aussi de l’expérience vécue de ces barrières démontre comment des facteurs systémiques et sociaux influent sur le rapport entre professionnel dentaire et personne prestataire de l’aide sociale. Les conséquences pour la recherche, l’éducation dentaire, le transfert des connaissances, ainsi que pour la régulation professionnelle et les politiques de santé buccodentaire, sont examinées à partir de cette perspective. / This thesis aims to generate knowledge on how a continuing education course might contribute to the evolution of oral health professionals’ perspectives and practices. Promoting patient centered care, the course aims to sensitize professionals to poverty issues and to encourage socially inclusive practices that take into account the social context of patients. The course evaluation is nested within a participatory action research project aimed at developing educational and knowledge transfer tools to sensitize oral health professionals to poverty issues and Our research strives to contribute to the fight against social inequities in health and in access to care in Québec; it is grounded in our intent for greater social justice and reflects our belief in the importance of a critical public health founded on a « science of solutions » (Potvin, 2013). Four scientific articles, grounded in constructivism and in the concepts and principles of transformative learning theory (Mezirow, 1991), constitute the heart of this thesis. The first presents a critical review of the literature on health professional education for patient-centered care. We focus on the concept of shared epistemology as a foundation for patient-centered care and determine and analyse the educational principles allowing for its development in students and practitioners. Our second article, located within the participatory developmental process, delves into the co-construction of a social realist screenplay portraying poverty and issues of access to dental care. The article examines and reflects on the participatory processes, in particular the co-learning that took place among the partners involved in writing the screenplay and in producing the educational tools on poverty. We discover the potency of shared knowledge among professionals, citizens, educators and academics for enhancing reflection on bias and perspective taking. The educational tools developed have been integrated into an onsite credited continuing education course on poverty and oral health, privileging critical reflection, founded on transformative learning theory, and integrating dimensions of person-centered care. The results of an instrumental case study among the 15 members of a dental team having participated in the course constitute the last two articles of the thesis. The first describes and analyzes the new meanings and actions among course participants, emphasizing shifts in thinking about the causes of poverty, about life on welfare, about certain patient behaviors and about the participants themselves. New actions refer to changes made in verbal and non-verbal communication and appointment giving policy. The article also examines unanticipated and paradoxical effects of learning, such as the reinforcement of certain beliefs. The final thesis article presents the case study results in terms of the participants’ experience of their workplace ideologies and how these constitute obstacles or objections to learning or to making practice or policy changes. These ideologies include 1) identification with a for-profit and private market oral health care system; 2) “equal treatment”, a belief constraining concern for equity and the recognition of discriminatory practices; 3) a predominantly biomedical orientation to care; and 4) stereotypical categorization of publically insured patients into « deserving » vs. « non-deserving » poor. This knowledge contributes to our understanding of systemic influences on professionals’ practices and interactions with patients living on welfare. We discuss implications for research, dental education and knowledge translation, as well as in terms of oral health policy and oral health professional regulation.

This study examined the schooling experiences of eleven graduates from the rural south of Egypt with primary community schools in Assiut. The study used individual interviews and focus groups to examine how community school graduates understood their experiences. The community schools were found to have removed previous obstacles of distance and cost. The quality of education that the students received allowed them to flourish in education rather than falter, and that was largely influenced by the quality of their relationship with their teachers. The students learned academic skills, as well as attitudes and dispositions that serve as cultural capital. They have more opportunities than before, yet also face significant challenges as they transition to the public system. The model of community schooling is also facing significant challenges as differences with the public schooling systems are exerting tension on the community school model to converge.