The thesis set out to explore means of coping with change when in a state of isolation and basic parameters and references in life have been lost. Isolation may be a result of a change in environment, such as an interstate move to take up a new job,or changing from an office environment to home based work. It can result from relational changes such as marriage breakdown or from major life stage changes such as retirement. The first stage of the study involved the establishment of a collaborative group to explore issues that each member had experienced in coping with change. The second stage was an individual exploration of the author's own journey involving changes in work environments and interstate moves. The third stage was a consideration of literature that reflected and supported the thesis, of gathering information from relevant case studies conducted.Out of these stages came the hypothesis that people cope with change in isolation through a sense of belonging associated with several factors.Reflections on the research process and methodologies have been considered and implications arising out of the research are discussed. The thesis concludes with evocations of the impact of the research findings on others. / Master of Science (Hons)(Social Ecology)

Background: Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. It afflicts one million people and kills 750,000 annually. It is believed that both genetic and environmental factors contribute to the gastric carcinogenesis. However geographic variation and immigrant studies highlight the role of environmental factors. Objective: To evaluate the association of GC with the environmental factors of diet, helicobacter pylori (H. pylori) infection, lifestyle and occupation as well as family history in Iran. Methodology: A population based case-control study was conducted in the Northwest of Iran where one of the highest incidence rates of the world has been reported. Two hundred and seventeen cases of GC and 394 age and gender matched controls were recruited. Participants were interviewed using a structured questionnaire which elicited information on demographic characteristics, socioeconomic status, family and medical history, lifestyle (smoking, alcohol drinking and substance abuse) and occupation. Ten milliliters of each subject???s blood was collected for blood grouping and to investigate presence of IgG antibodies against H. pylori using an ELISA kit which had been locally validated for this study. Results: Diet and H. pylori infection were found to be the most important determinants of GC in this study. High intake of allium vegetables and fruit, especially citrus fruit, appears to play a protective role. In addition to the consumption of fruit and vegetables, consumption of fresh fish was also inversely associated with GC. On the other, hand consumption of red meat and dairy products were positively associated with the risk of GC. Other dietary practices were also found to be important factors in the etiology of GC. People who had a preference for higher salt intake and drinking strong and hot tea were at higher risk. Finally, H. pylori infection was found to increase the risk of GC. Conclusion: This study has provided important and original information about the etiology of gastric cancer particularly in the Iranian context. These findings could be used in planning preventive strategies for this malignancy, which is a major health problem in Iran.

Acute coronary syndrome (ACS), the acute manifestation of coronary heart disease (CHD), is the leading cardiovascular cause of mortality and morbidity globally, and represents one of the most common causes of acute medical admissions to Australian hospitals. Following medical and/or surgical management of ACS, lifestyle modification to reduce the underlying risk factors that contribute to the progression of the disease remains vital. Cardiac rehabilitation (CR) has been widely accepted as an intervention that can reduce mortality and modify risk factors for subsequent coronary events and cardiovascular disease. While the benefits of cardiac rehabilitation programs have been demonstrated, participation and adherence to these programs remain low for various reasons, particularly among patients whose treatment includes revascularisation with percutaneous coronary intervention. This method of revascularisation has become increasingly common due its immediate success, rapid procedural technique, short hospital stay and early return to work for patients of working age. The aim of this study was to develop and test the feasibility of an evidence-based health-related lifestyle management program for risk factor modification in patients with ACS undergoing percutaneous coronary intervention. Four distinct yet interrelated studies were undertaken as part of the Development and evaluation of a Health-related Lifestyle self-Management (HeLM) intervention for patients with ACS Project. Three of these studies informed the development of the HeLM intervention, which was based on the principles of chronic disease self-management and evidence-based practice that included best evidence from the literature, clinical expertise and patient preferences. The first study was a systematic review of the literature to identify the best available evidence of the effect of brief interventions for lifestyle modification in patients with CHD. Findings from the 17 trials included in the systematic review, although inconclusive suggest that brief structured interventions can have beneficial effects on risk factor modification and consequently on progression of CHD. The second study was a qualitative interview of CR coordinators to identify from their clinical expertise the influence of the Reducing Risk in Heart Disease guidelines on practice: the Implementation of the Cardiac Evidence-Based Reducing Risk in Heart Disease Guidelines (ICEBRG) study. Findings from this study indicated limited implementation of the guidelines due to various barriers relating to health services, CR programs, professional practice and the patient and their families. Despite these barriers, it was evident that CR coordinators were striving to overcome these odds and provide evidence-based care. The third study undertaken to identify patient preferences for CR was the Follow-up After percutaneous Coronary Treatment (FACT) Study. The findings indicated that although the majority of the participants had two or more risk factors, they lacked knowledge of the link between risk factors and CHD, and less than a third had attended CR. The main reasons for nonattendance included timing, distance to travel, length of program, work commitments and lack of motivation to attend the programs. Their suggestions for improvement included telephone follow-up and flexibility of the CR programs. This study also informed the development of a tool that can be used by clinicians to flag patients who are unlikely to attend traditional CR. Identification of these people will allow alternate strategies to reduce risk factors to be tailored to their needs. The findings from these three studies were used to develop the HeLM intervention. The final study was undertaken to assess the feasibility of the HeLM intervention that was based on evidence compared to standard treatment for promoting lifestyle modification. This study was undertaken in 51 participants who were followed up two weeks following the completion of the intervention. The findings demonstrated that patients found the information beneficial and were pleased to receive it in their homes. The telephone support was also extremely well received. The study enabled the program and the process for implementation to be refined and indicated that a large multicentre trial would be feasible. The HeLM may be a strategy that could reach patients who have thus far eluded traditional CR programs and support them to make the necessary lifestyle changes. It may also be an adjunct to traditional CR and have a synergistic effect in facilitating health-promoting behaviours in CHD patients. Studies of interventions for risk factor modification in participants with CHD require longer term follow-up to assess the effect of the intervention in the sustainability of behaviour modification. Further research is necessary to evaluate the long-term effects as well as the cost effectiveness of the intervention. / Doctor of Philosophy (PhD)

Over a quarter of children and two thirds of adults in Australia are overweight, with these estimates reflecting global trends. The literature review in Chapter 1 highlights that treatment of childhood overweight is an important part of the public health approach required to address the obesity epidemic. Energy moderation, behaviour modification and family support are the cornerstones of treatment of childhood overweight. However the evidence to guide best practice is limited, with a call being made for well designed studies to inform age-appropriate effective, long term child weight management. Studies are needed in a range of populations and to assess a range of health outcomes. This thesis tested the hypothesis that, pre-pubertal children whose parents participate in a parent-led, family-focused child weight management intervention comprising parent skills training and intensive lifestyle education will have adiposity, metabolic profiles and indicators of physical and psychosocial functioning after 12 months that are a) improved compared to children wait listed for intervention and b) no different to children whose parents participate in parenting skills training alone (without intensive lifestyle education). Methods of the randomised controlled trial undertaken with 111 overweight, pre-pubertal 6-9 year olds to test this hypothesis are detailed in Chapter 2. Parents were defined as the agents of change, responsible for attending intervention sessions and implementing family-focused lifestyle change to support child weight management. Two interventions, both utilising parenting skills training, but differing in the presence or absence of intensive lifestyle eduction were compared to a group waitlisted for intervention with a brief pamphlet. Program effectiveness was defined in terms of adiposity together with broader health and evaluation outcomes. Chapter 3 describes the study population, their flow through the study, the primary outcome BMI z score and waist circumference z score. With parenting plus intensive lifestyle education there was a 10% reduction in BMI z score over 12 months. However this was not statistically different to the 5% reduction observed with parenting alone or intervention waitlisting. There was a significant reduction in waist circumference between baseline and 12 months with parenting alone and parenting plus lifestyle education, but not waitlisting. There was a group, time and gender interaction, with boys receiving intervention having greater reductions in adiposity. In determining intervention effectiveness, growth, metabolic profile and psychosocial outcomes are presented in Chapter 4. While there were limited improvements in metabolic profile and body dissatisfaction, significant improvements were observed in parent-perceived HR-QOL relating to psychosocial and family functioning. Improvements were confined to the intervention groups, parenting plus lifestyle education more than parenting alone. Chapter 5 presents the study process and impact evaluation. Parents were satisfied with the program and reported that it provided the type of help they wanted. Personal, rather than program factors such as work and family commitments limited intervention attendance to 60%. Child health behaviours and parental weight status show positive change in all groups, but favour intervention. Chapter 6 highlights key findings, study strengths/limitations and areas for further research. In conclusion, a parent-led family-focused intervention utilising parenting skills training and healthy family lifestyle is a promising intervention for young overweight children.

This research provides an analysis of the disparate notions and ideas, to form an overview of the possible trends in residential property for the Victorian coastal areas of the Surf Coast and the Bellarine Peninsula. It examines the interaction of the consumers, space producers and infrastructure providers as they are influenced by the three key determinants of the market, the demographic factors, economic conditions and statutory factors. While examining the patterns of urban development on coastal Victoria over the next 20 years, the research also investigates the validity of myths that have emerged concerning the Sea Change experience, the investment market in coastal areas and the adequacy of the relevant infrastructure. The qualitative data used in this research comes from both primary and secondary sources. The primary qualitative and quantitative data was developed on the basis of the responses to a mail out questionnaire to residents from seven towns on the Bellarine Peninsula and the Surf Coast and from a number of interviews with local property experts from these areas. The secondary qualitative and quantitative data came from the results of various government surveys, demographers, the press and the census. The main thrust of this research is to answer the question

Work-life balance is a concept that has attracted attention for several years. It is relevant as people attempt to apportion time to different demands they face from both work and life. The multiplicity of demands that individuals have can increase this challenge as people strive to incorporate many more activities into lives. The focus of current literature regarding work-life balance tends to focus on how employees can be provided with opportunities by their organisations for achieving this elusive balance. Research has been conducted into various strategies that organisations have implemented to facilitate their employees’ lifestyle options. Furthermore, studies have examined the role of organisational initiatives and staff retention. However, many of the organisations providing these opportunities for employees have substantial resources, thereby enabling the provision of these initiatives. Previous empirical research has examined work-life balance in depth. However, there are aspects that call for further attention. In particular, the management of this concept within small business requires further research. Australia has a large number of small businesses, which comprise a large proportion of the labour force and contribute significantly the national economy. The broad category of small business includes different business models, and two of these models are the independent and the franchised business. The success of these models has been demonstrated by their rapid growth in the Australian economy. As one of the reasons most commonly cited for entering into a small business is to regain the control over one’s life and work-life balance, the purpose of this research is to investigate work-life balance from the perspective of small business owners. Examination of different research issues considering the perception of work-life balance, the impact of control, of owning a small business, and the choice of business model on work-life balance is undertaken. The research considers how small business owners perceive the concept of work-life balance, and whether it is regarded as important to them. This research seeks to understand how work-life balance is viewed differently for small business owners. The concept of control requires examination to clarify how control and work-life balance relate to each other. Due to the popularity of franchising in the small business sector, a comparison of the concept of work-life balance by both franchised and independent small business owners is warranted...

<p>Under det senaste decenniet har kvinnor gjort ett utträde på arbetsmarknaden. De har gått från att vara hemmafruar till yrkesarbetande. Närmare 1,2 miljoner kvinnor var hemmafruar i Sverige på 1960-talet, idag är de endast 48 000. Jag ville ta reda på vad det innebär att var hemmafru idag för hemmafruarna själva. Jag har utgått från min frågeställning; Vad innebär det att vara hemmafru idag? Hur ser de på förväntningarna som riktas mot dem? Vad finns det för mål och motiv för dessa kvinnor att bli hemmafruar? Hur upplever de sin position som hemmafruar? Jag har genomfört mitt arbete utifrån Grundad teori då jag ville få fatt i vad det innebär för dagens hemmafruar själva utan att utgå från någon bestämd teori. För att få fram detta har jag intervjuat fem kvinnor. Resultatet visade att dagens hemmafru är en kvinna som under en fas i livet har valt att stanna hemma från arbetslivet för att ta hand om sina barn, ett val som de haft ekonomisk möjlighet att välja i kombination med att de upplever att det dem gör har ett värde samt att det är meningsfullt. De har valt en livsföring utifrån det som har ett värde för dem. <strong></strong></p>

Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

Bakgrund: Anledningen till att människor söker sig till sjukvården beror ofta på deras hälsobeteende. De behöver göra en förändring, men vad är det som får människor att göra förändringar? Syfte: Syftet med studien var att beskriva på vilka sätt motiverande samtal (MI) varit en användbar metod för att främja livsstilsförändringar. Metod: Studien utfördes som en allmän litteraturstudie. Åtta empiriska studier ingick. Sammankopplingar gjordes med tre teorier som MI bygger på Bems självuppfattningsteori, Roger´s teori om "non-directive counselling" samt "The transteoreticial model of behavior change". Resultat: Sjuksköterskans användbarhet bestod i att använda sig av MI:s tekniker genom att lyssna aktivt, ställa öppna frågor samt att uppmuntra patienten till ett eget ansvar. Begränsningar ur sjuksköterskans perspektiv var svårigheter med nytt tänkande. Utvidgad utbildning och handledning i MI var viktigt vid implementeringen i verksamheterna. De studier som ingick visade i de flesta fall inte att MI som metod skulle vara effektivare än annan typ av rådgivning. Slutsats: I MI samtalet är det viktigt att sätta patienten i fokus, att hjälpa patienten att hitta motivationen samt självförtroende att genomföra förändringar. Vid implementeringen av MI är det viktigt med utbildning och handledning samt att praktik och teori går hand i hand. / Background: The reason of people visiting health care centers often depends on their health behavior. They often need to make a change. The aim of the study: The aim of the study was to describe in which way motivational interviewing has been successful to make lifestyle changes. Method: The study was carried out as a literature review. Associations were made with three of the theories which motivational interviewing is based upon: Bem’s "Self perception theory", Roger’s "Non-directive counseling theory" and "The transtheoretical model of behavior change". Result: The nurse made use of the MI techniques by actively listening, asking open questions and encouraging the patients to take their own responsibility. The limitations, from the nurse’s point of view were problems with the new way of thinking. Extended training and coaching in MI were important for the implementation activities. The studies included showed in most cases that MI as a method wasn´t more effective than any other type of counseling. Conclusion: In MI it´s crucial to put the focus on the patient, to help the patient find the motivation and confidence to make changes. For the implementation of MI it is important to include education, practice and coaching sessions.

Under det senaste decenniet har kvinnor gjort ett utträde på arbetsmarknaden. De har gått från att vara hemmafruar till yrkesarbetande. Närmare 1,2 miljoner kvinnor var hemmafruar i Sverige på 1960-talet, idag är de endast 48 000. Jag ville ta reda på vad det innebär att var hemmafru idag för hemmafruarna själva. Jag har utgått från min frågeställning; Vad innebär det att vara hemmafru idag? Hur ser de på förväntningarna som riktas mot dem? Vad finns det för mål och motiv för dessa kvinnor att bli hemmafruar? Hur upplever de sin position som hemmafruar? Jag har genomfört mitt arbete utifrån Grundad teori då jag ville få fatt i vad det innebär för dagens hemmafruar själva utan att utgå från någon bestämd teori. För att få fram detta har jag intervjuat fem kvinnor. Resultatet visade att dagens hemmafru är en kvinna som under en fas i livet har valt att stanna hemma från arbetslivet för att ta hand om sina barn, ett val som de haft ekonomisk möjlighet att välja i kombination med att de upplever att det dem gör har ett värde samt att det är meningsfullt. De har valt en livsföring utifrån det som har ett värde för dem.