This is the thesis (critical appraisal) component of a PhD by Published Works. The overall submission was a portfolio of ten published papers supported by a critical appraisal focusing on two key areas: an exploration of the roles that Health Information Professionals (HIPs) can play within evidence based practice (EBP) and an exploration of the effectiveness and impact of the traditional supportive role played by HIPs within EBP. The published papers are listed and referenced within this document but not contained within it. The majority are available elsewhere within the University of Salford Institutional Repository. Drawing on a model developed from the library literature, the thesis highlights a wide range of supportive and active roles that HIPs can potentially play within EBP. This model is informed and illuminated by the studies within the portfolio that demonstrate how the author has fulfilled a wide range of these roles in practice, and identified a new role within systematic reviews in health and social care. This demonstrates that HIPs can transfer their skills outside their traditional library and information practice domain, thus extending their role and offering a range of professional opportunities. Using a varied range of research methodologies, the thesis also explores the effectiveness and impact of the contribution made by HIPs when using traditional skills to support EBP. Two models are used to illustrate the outcomes to which HIPs contribute. These include improving search skills and providing evidence which can, over the longer term, contribute to policy making and patient care. At present the weight of the evidence presented to support these links is weak. Methodological issues and future research that needs to be addressed to improve the strength of the evidence base are therefore highlighted and discussed.

If there is one thing that policy makers at the World Health Organisation (WHO) and residents of the South African township of Langa are likely to agree on, it is that ‘just sitting’ is not good for you. The positions from which they approach this conclusion however differ profoundly. This research investigates different conceptualisations of physical activity, health, and wellbeing, and the implications of these differences for policy on the prevention of noncommunicable diseases (NCDs) in low and middle income countries, taking South Africa as a case study. With four out of five deaths from diseases such as diabetes, heart disease and stroke now occurring in low and middle income countries, prevention, of what have been termed ‘NCDs’, in these countries is rising rapidly up the global public health agenda. Physical activity is one of the four primary risk factors which have been identified as intervention targets, but there is an acknowledged paucity of research which helps us to understand how physical activity, and inactivity, are conceptualised in low and middle income country contexts. As a result the evidence base for design of physical activity policy interventions to address NCDs is also weak. The global discourse recognises the determinants of health as socially embedded, but struggles with what this means for policy on prevention. This study explores the detail of this social embeddedness by way of ethnographic research into wellbeing, health and physical activity carried out in a South African township, and juxtaposes this with conceptualisation of these same themes emerging from a review of academic and policy-oriented literature on the prevention of NCDs in low and middle income countries. The struggles of local research groups to reconcile the demands made on them from these very different worlds are explored, and strategies for addressing the specifics of NCD prevention without abstracting health from the broader context of the person or society are discussed. The research is theoretically informed by work on wellbeing in developing countries.

Having a sight impairment should not limit one’s opportunity to be socially included and obtain the many benefits of being in a green space. It is a challenge for landscape architects to ensure that every green space is sensibly planned and designed to provide benefits to all users, including the visually impaired. However, to date, little research has explored the extent to which this group of people use their local green space and how the attributes of green space help to maintain or increase their sense of emotional well-being, especially when their vision loss occurs later in life. This study has drawn on a sample of visually impaired people with central vision loss caused by late onset Age-related Macular Degeneration (AMD) from across Scotland to address this research gap. Subjects ranged from being partially sighted to severely sight impaired or blind. It employed a mixed method research strategy with a quantitative method as the main approach, supplemented by qualitative methods and triangulation. The study began with focus group discussions aimed at identifying those green space attributes that this group of people deemed important, as a basis for developing a choice-based conjoint (CBC) questionnaire survey. The survey data were analysed using conjoint analysis software (Sawtooth Software version 8.3) with a Hierarchical Bayesian (HB) method to evaluate the relative importance of green space attributes to the study participants. The purpose of this method was to demonstrate the different priorities placed by people with visual impairment on the physical, social, sensory and accessibility attributes of the green space. This work was followed by a series of walk-along and home interviews to gain an in-depth understanding of how the attributes that emerged as most important from the conjoint survey helped the participants to obtain a restoration of their emotional well-being through being in green spaces. The conjoint analysis results demonstrated that the relative importance of green space attributes differs by gender, visual condition and the emotional state caused by sight loss. The qualitative findings suggest that green space can act as a medium to promote emotional restoration by offering a compatible environment that motivates individuals to undertake the kind of outdoor physical and social activities that reduce social isolation. Taken together, the two most influential factors in relative importance and emotional restoration were individual affordance and social company. The value of this research lies in identifying the landscape design attributes that are of the greatest importance to people with AMD. Such findings could help policymakers and landscape architects to provide better design solutions to include this group of people. They may also prove valuable as part of a new approach to enable people to deal with the emotional issues surrounding their late-onset visual impairment.

Bristen på sjuksköterskor är ett växande problem över hela världen. Bristen på respekt och en dålig lön får många att välja en annan yrkesväg. Men trots alarmerande uppgifter angående bristen på personal samt dåliga arbetsförhållanden fortsätter många att utbilda sig till sjuksköterskor. Vad är det då som gör att arbetet som sjuksköterska lockar och varför stannar de kvar inom yrket; dessa övergripande frågeställningarna gav upphov till uppsatsen. Syftet med studien är därför att beskriva faktorer i det dagliga vårdarbetet som bidrar till att sjuksköterskor upplever yrkestillfredsställelse. En litteraturöversikt med både kvalitativa och kvantitativa artiklar har använts. Resultatet redovisas under huvudtemat När yrket ger mening, präglas av kollegial gemenskap och är i samklang med livet i övrigt – då stannar vi kvar. Detta huvudtema har fyra teman; Meningsfullhet, Lagarbete, Autonomi och Livsharmoni. Slutsatsen är att det mest värdefulla inom yrkesutövningen är det patientnära arbetet då sjuksköterskan får använda sin fulla potential och professionella expertis inom det vårdvetenskapliga området. Även samspelet med patienten anses som värdefullt och givande. Är vården väl utförd skapar det tillfredställelse hos patienten vilket bidrar till en känsla av bekräftelse hos sjuksköterskan. Något som även anses som viktigt är det kollegiala samarbetet mellan sjuksköterskor eftersom detta skapar trygghet och arbetsglädje. De faktorer som lyfts fram som viktiga är samma oavsett land, kultur och etnicitet. Sjuksköterskor strävar efter samma mål oberoende av om vården utförs i ett rikt eller fattigt land.

This study describes the results of a cross-sectional survey conducted in Mambwe district in the Eastern Province in Zambia. It uses a One Health approach to assess the impact of veterinary, medical, environmental and social determinants on animal and human health and wellbeing. One Health is defined as a holistic and interdisciplinary approach that describes the complexities between people, animals, the environment and their health. Human wellbeing is defined in this thesis as 'a condition in which all members of society are able to determine and meet their needs and have a large range of choices to meet their potential' (Prescott-Allen, 2001). As a first step, eight focus group discussions with the inhabitants followed by key informant interviews with stakeholders in the area were conducted to give a primary impression and narrow down the problems in relation to animal and human health of the area in general. Following this, a randomized selection of 210 households was visited and in each household blood samples were taken from all humans and all animals belonging to five animal species, namely cattle, goats, sheep, pigs and dogs. A third of the households did not keep any of the animal species chosen for sampling, but their inclusion was important for the social analysis. In all of these 210 households a wellbeing questionnaire was administered and, for every human and animal sampled, a health questionnaire. The study area falls within the tsetse-infested region of Zambia. It has a high wildlife density reflecting the proximity of several national parks and is historically endemic for both human and animal African trypanosomiasis (HAT&AAT). Therefore humans and animals were tested for trypanosomiasis using internal transcribed spacer (ITS) polymerase chain reaction (PCR). Since it is important as a differential diagnosis, malaria was tested for by a rapid diagnostic test in the field from human blood. Sera from mature individuals from all animal species except pigs were tested in a field laboratory for brucellosis using the Rose Bengal test. Additionally, cattle and dogs were tested for five genera of tick-borne infections (TBI) including Anaplasma, Ehrlichia, Theileria, Babesia and Rickettsia using reverse line blot (RLB) in the laboratory at the University of Edinburgh (UoE). The blood samples for PCR and RLB analysis at UoE were stored on WhatmanTM FTA cards. A total of 1012 human samples were tested for HAT and none found positive. 1005 (seven people had been tested positive or treated against malaria shortly before the sampling) people tested for malaria showed an overall prevalence of 15% (95% CI 13.2-17.7). None of the 734 Rose Bengal tests showed up positive for brucellosis. The prevalence of AAT in 1275 samples tested was much lower compared to former samplings; in cattle 22% (95% CI 18-27.2), in goats 7% (95% CI 4.5-9.2), in pigs 6% (95% CI 3.2-9.4), in dogs 9% (95% CI 5.2-13.6) and no samples were found positive in sheep. The prevalence of TBIs is much more complex with many multiple infections. A total of 340 cattle and 195 dogs were tested. In cattle the number of samples positive for any microorganism was as follows; 92% (95% CI 88- 94.2). Overall there were fewer positive samples from dogs with 25% of animals infected (95% CI 19.2-31.8). The wellbeing and health questionnaires were designed to help to identify possible risk factors for the above-mentioned diseases and signs, such as fever, diarrhoea and seizures, indicative for several other diseases. The results of these surveys might also help to identify potential reasons for a lower or higher prevalence of trypanosomiasis and malaria found than expected from previous studies. Additionally, information on personal happiness, attitudes towards veterinary and medical services, medical treatments received, education, women's reproductive history, drug abuse, people's perceptions of changes in environment and agriculture, demography, poverty and migration were collected via the questionnaires alongside information on livestock demographics and fertility. One of the main conclusions is that both medical and veterinary health care systems suffer from a number of shortcomings. The distance to appropriate treatment and care facilities is far and the necessary drugs are often unavailable. Also, both the knowledge and technology for diagnosing selected diseases is not in place. This study suggests that neurocysticercosis (NCC) plays an important role in this area due to the high number of seizures reported in people, in whom treatment for epilepsy was unsuccessful. Samples taken from a few pigs indicated the presence of Taenia solium, the causal agent of NCC. Furthermore, many of the TBIs are of zoonotic nature and further investigations must be made to begin to assess the burden of these diseases in humans and animals. Environmental changes such as degradation of the vegetation are likely to have an influence on the prevalence of studied diseases and this aspect is being investigated further in other studies. Due to the nature of a cross-sectional study, only limited conclusions can be drawn on the causal relationships of disease prevalence, but the social analysis conducted in this study confirmed the interactions of selected factors related to health and wealth unique for this study area.

abstract: New teachers quit the profession at high levels, particularly in rural and urban schools. These high rates of turnover create staffing issues, particularly in high-needs areas like math and special education. High levels of stress and dissatisfaction with the profession have been cited as common reasons teachers exit the profession within the first few years. However, positive interventions from the field of positive psychology as well as mindfulness have been used in the workplace and have been found to support increasing wellbeing as well as reducing stress. This study defines workplace wellbeing as a construct of positive emotions, engagement, positive relationships, meaning/purpose, achievement and health within the workplace. In this mixed methods quasi-experimental study, 26 new teachers within a large suburban schools were sorted into experimental (n=13) and a control (n=13) groups. The experimental group was provided with a mindfulness training (in-person or virtually) as well as was asked to journal twice a week about three things that went well during the week, why those things went well, and what impact that had on students. The experimental group was invited to share their journals with their Teacher Induction and Support Program (TISP) coach in-person during their weekly confidential meetings. The control group was asked to write down any three things that occurred over the week (positive, negative, or neutral) and was also invited to share this with their TISP coach. Participants completed journals for the months of November, December, and January. All participants took a workplace wellbeing survey (developed by Peggy Kern and used with permission of Dr. Kern) at October, December, March and June. Additionally, five participants from the control group and five participants from the control group were interviewed about their experiences as new teachers and their experiences using the interventions. Participants in the control group experienced decreases in their workplace wellbeing throughout the year whereas participants in the control group experiences steady or increases to their workplace wellbeing, particularly in the areas of positive emotions, relationships, meaning, and self-efficacy. Participants in the experimental group also reported mindfulness practices increased their confidence and promoted positive emotional regulation that supported a positive classroom, despite challenging student behaviors. While this study uses a small sample size, these findings were confirmed in qualitative data, quantitative data, and are consistent with findings in related literature. While the findings are consistent with findings in related studies utilizing positive interventions and mindfulness within the workplace, these findings run counter to studies on the emotional experiences of teachers which assert that teacher’s (particularly new teachers) experience high levels of negative emotions and stress, particularly during the middle of the year. The findings from this dissertation suggest positive interventions and mindfulness may bolster new teacher’s workplace wellbeing and self-efficacy during the first year. / Dissertation/Thesis / Doctoral Dissertation Educational Leadership and Policy Studies 2018

Abstract available in the American Journal of Pharmaceutical Education.

The quality of the physical workspace environment has been widely debated in research and corporate communities. Inadequate workspace conditions have been associated with elevated levels of work-related stress, productivity, and job satisfaction. However, scholarly literature offers very little on the relationship between workspace and office placement, and workforce productivity and wellbeing. The purpose of this non-experimental quantitative study was to examine the impact of customized workspace and strategic office placement on work related stress, productivity, and job satisfaction. Optimal distinctiveness theory and cognitive-motivational-relational theory provided the theoretical framework for this study. Nine research questions in this study were designed to identify any statistically significant difference in any of the three dependent variables(work-related stress, productivity, job satisfaction) in relation to workspace design and office placement. The Work Stress Scale, Individual Work Performance Questionnaire, and the Brief Index of Affective Job Satisfaction served as data collection instruments. Data were collected from a convenience sample of 131 male and female full-time employees from 5 different organizations nationwide. With a 2x2 causal-comparative research design, a multivariate analysis of variance was conducted, which showed statistically significant difference on work-related stress and job satisfaction in relation to workspace design with no statistically significant difference for the remaining seven research questions. This study offers significant insight into best practices for ensuring the highest quality of workspace environment to enable optimal employee performance along with improved overall wellbeing.

Le travail de recherche présenté ici prend place dans le département de l’Allier, en Auvergne. Au travers de deux dispositifs – le premier vise à réduire les inégalités sociales de santé d’un territoire, le second à impliquer les membres des établissements scolaires dans une réflexion sur la promotion de la santé – nous cherchons à déterminer les relations qu’il peut y avoir entre les conceptions et les pratiques déclarées de collégiens avec les conceptions et les pratiques déclarées de professionnels d’un territoire sur les questions de santé et de bien-être des adolescents. Pour explorer ce sujet, nous nous appuyons sur deux recueils de données. Le premier est constitué de 49 entretiens semi-directifs et concerne les conceptions et pratiques déclarées de professionnels par rapport aux questions de santé et de bien-être des adolescents. Le second, basé sur 1170 questionnaires renseignés par des collégiens, porte sur les conceptions que les adolescents ont de leur santé et de leur bien-être ainsi que sur leurs pratiques relatives à ces questions. L’étude des systèmes de conceptions de divers professionnels en lien avec les conceptions et pratiques d’adolescents nous permettent de penser que la formation des professionnels sur les questions de santé, d’éducation à la santé et de promotion de la santé devraient permettre aux différents acteurs de mieux appréhender la complexité de leur public concernant les questions de santé et de bien-être, de mieux prendre en compte les différentes dimensions de la santé en favorisant le développement des compétences psychosociales et l’empowerment de leur public ainsi que la qualité des interactions entre pairs. De même, les questions concernant la prise en compte par les professionnels de l’environnement, notamment familial, des adolescents devraient être approfondies. / This research work takes place in the Department of Allier in Auvergne in Central France. Through two projects - the first aims to reduce social inequalities in health of a territory, the second aims to involve schools in a reflection on the health promotion - we are trying to determine the relationships there may be between the conceptions and declared practices of middle school students with the conceptions and the practices of professionals of a territory on issues of health and well-being of adolescents. To explore this topic, we rely on two collections of data. The first consists of 49 semi-structured interviews with respect to conceptions and practices of professionals with regard to questions of health and well-being of adolescents. The second, based on 1170 questionnaires filled in by school boys and girls, deals with conceptions and declared practices that adolescents have on their health and their well-being. The review of systems of conceptions of various professionals in relation to the concepts and practices of adolescents allow us to think that the training of professionals on the issues of health, health education and health promotion should enable stakeholders to better understand the complexity of their public about health and well-being issues; better take account of the different dimensions of health by promoting the development of life-skills and the empowerment of the adolescents and the quality of peer relationships. Then, issues concerning how does stakeholders take into account environment of adolescents, including family, should be improved.

Little is known about how employees in New Zealand companies view their organisation’s involvement in community-based initiatives that attempt to address areas of social needs. Understanding what people and organisations think from their frame of reference (Taylor & Bodgan, 1998) on ways of contributing to enhance community wellbeing is of high importance within a nation growing in diversity, and where everyone needs to fully participate in building a harmonious society (Ministry of Social Development, 2005; Swanson, 2002). Despite abundant extant research and many models already developed, frameworks in this area are fragmented. A case study approach has been adopted using one New Zealand Company to test a preliminary framework, Stakeholders and Organisational Enablers Relationship (SOER) Model, that analyses “the nature of relationships in terms of processes and outcomes for the business and its stakeholders” (Jones & Wicks, 1999, p. 207). From investigating the company’s community involvement from the employees’ perspective, results indicate that this particular company is engaging with the community, supporting and empowering employees to participate in the company’s community programme and thereby making a difference in the community by giving to the community. However, in general terms, solving recurring social, economic, political and psychological issues that influence social wellbeing requires cooperation between public, private, and voluntary sectors of the community (New Zealand Ministry of Economic Development, New Zealand Ministry of Social Development, New Zealand Dept of Labour, & New Zealand Dept of Statistics, 2003; Roberts & King, 1989; Steane, 1999). While the results from the case company reported in this study demonstrate that community engagement is being taken seriously by exemplary private sector companies, generalisation of these findings would require further cross-sectional research across industries and organisations from all sectors: private, public and voluntary.