Thesis (M.P.A.)--Kutztown University, 1996. / Source: Masters Abstracts International, Volume: 45-06, page: 2937. Abstract precedes thesis as [3] preliminary leaves. Typescript. Includes bibliographical references (leaves [3]).

Thesis (M.A.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains v, 68 p. Includes abstract. Includes bibliographical references (p. 49-68).

Thesis (Psy. D.)--Wheaton College Graduate School, 2002. / Abstract. Includes bibliographical references (leaves 86-89).

Thesis (M.A.)--York University, 2001. Graduate Programme in Geography. / Typescript. Includes bibliographical references (leaves 109-129). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ66394.

<p>According to the United Nations, more than half a billion people (about 650 million) worldwide are disabled. Disability can have a vast impact on both the individual and the family. Rehabilitation is therefore a fundamental need for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it is important to seek clients&rsquo / perspectives of the rehabilitation services and to incorporate these perspectives into the planning and delivery of rehabilitation services. In areas where rehabilitation services are available in South Africa, minimal research has been done to explore the clients&rsquo / experiences regarding provision of these services. The aim of this study&nbsp / therefore was to explore the persons with physical disabilities&rsquo / experiences of the rehabilitation services they received at community health centres (CHCs) in the Cape Town Metro Health&nbsp / District. Data was collected using a mixed methods design in the form of a sequential exploratory strategy. Qualitative data collection was done using in-depth interviews and this was followed&nbsp / by administration of an interview questionnaire. The questionnaire was developed using results from the in-depth interviews together with information from literature. Ten persons with physical&nbsp / isabilities, who had received rehabilitation services at participated in the in-depth interviews and 95 responded to the interview questionnaire. The interviews were tape-recorded and&nbsp / transcribed verbatim and they were analysed using predetermined themes. The SPSS version 16.0 was used to analyse the quantitative data which was presented in frequencies, medians, quartiles and percentages. The results&nbsp / of the study revealed that the participants experienced problems with getting transport to travel to the community health centres and getting adequate information from the service providers,&nbsp / &nbsp / particularly information regarding disability and support services available for them. Experiences regarding participants&rsquo / involvement in their rehabilitation were generally positive. Generally, the&nbsp / participants reported positive experiences regarding their interaction with service providers and family support and involvement and this study recommends the staff to maintain their standards&nbsp / &nbsp / regarding these two dimensions of rehabilitation. However most of the participants were not concerned about whether the service providers gave them an opportunity to express their preferences or not. The results indicate the need to improve transport services for persons with physical disabilities and to give them more information regarding support services. The service providers&nbsp / should also give the clients more opportunities to get involved in their rehabilitation and educate them about the benefits of them getting involved.</p>

This thesis is based on a journey towards developing team working within a primary healthcare setting which enabled the NHS agenda for primary care service delivery to keep pace with the government modernisation agenda. (Department of Health, 1997). Initially the focus was on the development of an integrated nursing team which enabled all disciplines of nurses to work towards a patient focussed healthcare service, but it soon became evident that all staff involved in delivering the primary healthcare service were essential to the process and developments of the enquiry if the objective was to be achieved. An action enquiry approach based on collaborative and participative action research (Carr and Kemmis, 1986; Lincoln and Guba, 1989; Cayer, 1997) was discussed and was the prime method of enabling changes to occur in the healthcare practice. This is represented by the interrelated four main cycles of enquiry that have emerged from the data, and discussed in this thesis. Key to the success of the developments was an understanding of team working and leadership as it applied within a healthcare setting and also the underlying dynamics, which are evident when different professional groups from different traditions and knowledge base work together. (Schon, 1983) This was explored within the context of a systems approach to organisational development and through reflective dialogue along the principles advocated for creating a learning organisation. (Senge, 1990) This thesis will demonstrate how confidence developed in myself and the practitioners, especially those from marginalised groups, and how the wider healthcare system made an impact on the developments within the practice. The area of leadership will be discussed from multiple perspectives and recognition that as a concept all stakeholders had a poor understanding of leadership. The key finding from this study identifies the need for a holistic approach to manage and sustain change, and indeed everyday productive working relationships. This especially identifies the importance of giving attention to the preparation of future healthcare workers, the appropriateness of organisational structures in which services are delivered and support structures available to those in team leadership positions.

This research began a journey towards improved maturity around data quality management in New Zealand health care, where total data quality management is 'business as usual" institutionalised into the daily practices of all those who work in health care. The increasingly information intensive nature of health care demands a proactive and strategic approach to data quality to ensure the right information is available to the right person at the right time in the right format, all in consideration of the rights of the patient to have his/her health data protected and used in an ethical way. The work extends and tests principles to establish good practice and overcome practical barriers. This thesis explores the issues that define and control data quality in the national health data collections and the mechanisms and frameworks that can be developed to achieve and sustain good data quality. The research is interpretive, studying meaning within a social setting. The research provides the structure for learning and potential change through the utilisation of action research. Grounded theory provides the structure for the analysis of qualitative data through inductive coding and constant comparison in the analysis phase of the action research iterative cycle. Participatory observation provided considerable rich data as the researcher was a member of staff within the organisation. Data were also collected at workshops, focus groups, structured meetings and interviews. The development of a Data Quality Evaluation Framework and a national Data quality Improvement Strategy provides clear direction for a holistic and 'whole of health sector' way of viewing data quality, with the ability for organisations to develop and implement local innovations through locally developed strategies and data quality improvement programmes. The researcher utilised the theory of appreciative enquiry (Fry, 2002) to positively encourage change, and to encourage the utilisation of existing organisational knowledge. Simple rules, such as the TDQM process and the data quality dimensions guided the change, leaving room for innovation. The theory of 'complex systems of adjustment' (Champagne, 2002; Stacey, 1993) can be instilled in the organisation to encourage change through the constant interaction of people throughout the organisation.

This research was undertaken approximately 20 months after the introduction of alcohol brand advertising on New Zealand television, which resulted in a fourfold increase in televised alcohol advertising and a 42% increase in overall alcohol advertising. The primary aim of the research was to examine the nature of the relationships between young people's responses to televised alcohol advertising and drinking-related behaviours. The research was based on two surveys, one with l0 to 17 year olds and one with 18 to 29 year olds. The l0 to 17 survey involved 500 randomly selected face-to-face interviews in New Zealand's three largest urban areas. The 18 to 29 survey involved 1012 interviews. Respondents were randomly selected from throughout New Zealand and interviewed using a computer-assisted telephone interviewing (CATI) system. Both surveys asked about responses to specific alcohol advertisements, which were ones these age groups had been more exposed to. One of the two key response measures identified how frequently they recalled having seen the advertisement; this was labelled recalled exposure. Positive response to the advertising was measured by liking of the advertisement. Structural equation modelling (SEM) was used for the analyses, but this was preceded by correlation and regression analyses. On the basis of factor analyses that preceded the structural equation modelling, most of the modelling was based on the responses to the three beer advertisements in each study. 10 to 17 year old survey: The findings from the structural equation modelling were consistent with the hypothesis that positive responses to beer advertising (as measured by liking) were contributing to an increase in expected frequency of future drinking. The data were also consistent with the beer advertising contributing to an increased frequency of current drinking, although the relationship was just under the 0.05 level of significance. There was some limited evidence that recalled exposure may be associated with the drinking status of 10 to 13 year olds but, because of the small number of drinkers in this age group, this result needs to be interpreted with caution. The regression analyses indicated that recalled exposure was a predictor of 10 to 17 year olds' perceptions of how often their age/gender group drank and how accepting their friends were of drinking and occasional drunkenness. Other survey responses were also indicative of an influence of alcohol advertising on young people. Alcohol advertising was an important source of information about drinking, particularly for the 10 to 13 year old males. Almost half of these younger males accepted the portrayals in alcohol advertising as realistic and almost two thirds of them felt that alcohol advertising does encourage teenagers to drink. 18 to 29 year old survey: This study provided support for the hypothesis that more positive responses to televised beer advertisements resulted in larger quantities of alcohol being consumed on typical drinking occasions by 18 to 29 year old New Zealanders. It did not provide support for the hypothesis that drinking larger quantities of alcohol led to more positive responses to beer advertisements. The model showed that positive responses to beer advertisements had both a direct influence on quantity and an indirect influence, via its influence on positive beliefs. This study also provided support for the hypothesis that more positive responses to beer advertising were associated with increased alcohol-related problems. As with the 10 to 17 year olds, recalled exposure was related to perceptions of peer influence and behaviour. It was a significant predictor for female perceptions of peer quantities consumed and male and female perceptions relating to peer approval of drunkenness. The regression analyses also identified that recalled exposure was a predictor of males saying they were drinking more than the year before, however a SEM that specified reciprocal paths between these two variables found neither path to be significant. Discussion and implications This research has identified the importance of examining positive responses to alcohol advertisements. This acknowledges the active recipient of advertising who responds positively to advertising that offers valued outcomes. It also emphasises the importance of considering emotional/affective responses to advertising. However, the study also indicates that the weight of advertising is important, as reflected in the cognitive measure of recalled exposure. This appears to be having most influence on perceptions of what is normative behaviour. The results of the SEMs must be viewed as tentative, given the exploratory nature of the analyses and the limitations of cross-sectional surveys. However, as for all the previous studies, relationships have been identified between measures relating to alcohol advertising and those relating to alcohol consumption. While it is not possible to make definitive statements about directions of influence between these variables, these studies have all provided data that are consistent with the theory-based hypothesis that alcohol advertising does have an influence on alcohol consumption by young people.

Introduction: Motorcyclists in New Zealand suffer a disproportionate number of road traffic crashes. In 1995, 2% of all registered vehicles in NZ were motorcycles, but 9% of reported injuries and 13% of all fatalities were in motorcycle riders. Generally there is a lack of good evidence about many postulated risk factors, with previous studies reporting inconsistent findings. Aim: To identify the role of age, gender, experience, training and alcohol consumption as risk factors for moderate to fatal injury resulting from a motorcycle crash. These factors were chosen because they are the subject of current policy debate in New Zealand. Methods: A population-based case-control study was conducted in the Auckland region over a three year period from Feb 1993. The study base was defined as motorcycles being ridden on non-residential public roads of the Auckland region over a three year period between the 15th of February 1993 and the 14th of February 1996 between 6am and midnight. A case was defined as a motorcycle crash occurring within the study base in which either or both the motorcycle driver or pillion passenger met the injury criteria: were admitted to a public hospital within Auckland; were treated in the Public Hospital Emergency Department in the region with an Injury Severity Score of 5 or greater; or died as a result of a motorcycle crash. The aim was to identify all cases using comprehensive case finding procedures included surveillance of emergency departments, the Coroner's office and injury crashes reported to the Police. Controls, or the sample of the study base, were identified from roadside surveys which were conducted at random times from 150 random sites chosen from non-residential roads. Each road was sampled in proportion to its total length. This produced a random sample of motorcycle riding from the study base. If possible, the motorcyclist was stopped at the survey site. If this was not possible, they were identified by following up their registration plate number. Interviewer-administered questionnaires were used, either face-to-face or by telephone, to obtain exposure data. Objective alcohol data were also obtained from blood and breathalyser tests. Results: Information was obtained on 477 cases and 1518 controls, with interviews completed for 94.5% of case drivers and 81.2% of control drivers. Motorcyclists aged 25 years and over had the lowest risk of moderate to fatal injury from a motorcycle crash when compared to drivers aged from 15 to 19 years (adjusted RR=0.45, 95%Cl=0.33-0.62); the risk for 20 to 24 year olds was intermediate (adjusted RR=0.72, 95%Cl=0.52-1.00). There was insufficient evidence from this study to assess whether there was a changing pattern of risk for motorcycle riders aged over 50 years. The population attributable risk for 15 to 16 year olds in this study was only 0.72%. There was no evidence of an association between gender and risk, indicating that most motorcycle injuries occur in males because most motorcycle riding is done by males. Motorcyclists with more than five years of regular on-road motorcycle riding experience were associated with some increased risk compared to those with less than two years (adjusted RR=1.57, 95%Cl=0.96-2.58), particularly among the 20 to 24 year age group. Motorcyclists who had ridden their motorcycle 10,000 kilometres or more had a lower risk compared to those who had ridden less than 1000 kilometres (adjusted RR=0.52, 95%Cl=0.35-0.79). There was no clear effect observed for other measures of experience including off-road motorcycle riding, other motor vehicle driving and familiarity with the road. There was some evidence that motorcyclists who had attended motorcycle training were at lower risk (adjusted RR=0.74, 95%Cl=0.49-1.14), but the precision of this estimate was poor. There was less clear evidence of an association with recent non-motorcycle training and risk. Motorcyclists who reported having consumed alcohol within 12 hours were at higher risk (adjusted RR=1.53, 95%Cl=1.05-2.23) with a population attributable risk of 11%. Discussion: The methods used in this study to identify and sample the study base by obtaining a random sample of motorcycle riding are likely to have provided a valid estimate of the risks associated with the exposures measured. However some limitations of the study design include the general reliance on self-reported measures of exposures, the lack of data collected on other motor vehicles on the road and the poor quality of data available on alcohol and other environmental factors. This study has identified the following groups of motorcyclists to be at increased risk of moderate to fatal injury: riders aged less than 20 years, riders with more than five years of riding, riders who have not undertaken a motorcycle training course, riders who have ridden less than 1000 kilometres on their current motorcycle and those who have recently consumed any alcohol. Given these results, combined with the information obtained from the systematic literature review, the provisions of the Graduated Drivers Licensing System should be reviewed. This should include consideration of basing restrictions for riding primarily on the age rather than the experience of the motorcyclist and the completion of specific motorcycle training courses only, rather than a training course for any motor vehicle. Further research should consider some of the shortcomings of this study that have been outlined above and also consider methods of increasing the proportion of female riders and older riders in research. The limited evidence of benefit from motorcycle training courses, while encouraging, indicates that further investigation of their benefit in controlled trials is required.

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