Teses / dissertações: "Public health Australia Evaluation"

1

McGuiness, Clare Frances. "Client perceptions : a useful measure of coordination of health care". View thesis entry in Australian Digital Theses Program, 2001. http://thesis.anu.edu.au/public/adt-ANU20020124.141250/index.html.

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Fleming, Brian James. "The social gradient in health : trends in C20th ideas, Australian Health Policy 1970-1998, and a health equity policy evaluation of Australian aged care planning /". Title page, abstract and table of contents only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phf5971.pdf.

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Wang, Wei Chun, e wwang@swin edu au. "A comparison of alternative estimation methods in confirmatory factor analyses of the general health questionnaire across four groups of Australian immigrants". Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051025.122616.

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This thesis examines the implications of using different correlation input matrices and estimation techniques in confirmatory factor analyses (CFAs) when analyzing ordinal, nonnormal data derived from responses of recently arrived Australian immigrants to the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 is one of the most widely used instruments for determining wellbeing in populations. The response format of the GHQ-12 comprises four ordinal categories and underlying distributions of data obtained invariably do not approximate univariate or multivariate normality. Owing to these data properties, consideration should be given to the application of appropriate statistical approaches for analyzing this type of data sets. This study also investigates the extent to which the GHQ-12 is invariant across gender and cultural groups. A three-dimensional measurement model for the GHQ-12 was initially examined for four groups of Australian immigrants who originated from Hong Kong (n = 201), Mainland China (n =213), former Yugoslavia (n = 259), and the United Kingdom (n = 428). A series of CFAs using either a Pearson�s product-moment or a polychoric correlation input matrix and employing either maximum likelihood (ML), weighted least squares (WLS) or diagonally weighted least squares (DWLS) estimation methods was conducted on the data. A comparison of the parameter estimates and goodness-of-fit statistics obtained for the different analyses provided support for using polychoric correlation input matrices and DWLS estimation in CFAs when analyzing ordinal, nonnormal data with smaller sample sizes. Invariance tests across gender and cultural groups were conducted on a second-order measurement model for the GHQ-12, culminating in significant differences between the two Asian and two European cohorts. The GHQ-12 was invariant for immigrants from Hong Kong and Mainland China, as well as for males and females from the United Kingdom. Partial invariance of the GHQ-12 was found for immigrants from Asia, the United Kingdom, and former Yugoslavia and for Asian males and females. Findings from the present study suggest that estimating models based on nonnormal ordinal responses using polychoric correlations with DWLS is more likely to result in a solution with higher parameter estimates and better indices of fit than other approaches. Further research should be conducted on real and simulated data to investigate the efficacy of WLS and DWLS estimation in CFAs when using polychoric correlations as the input data for varying categorical response formats, with a range of model and sample sizes.

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Polimeni, Anne-Maree, e Anne-Maree Polimeni@dhs vic gov au. "Narrative of women's hospital experiences the impact of powerlessness on personal identity". Swinburne University of Technology, 2004. http://adt.lib.swin.edu.au./public/adt-VSWT20050309.143640.

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Since women dominate the health care system as consumers, it is important to understand how women want to be treated by medical staff, and the factors that contribute to satisfactory hospital experiences. The present research comprised two separate but integrated studies exploring these issues. The first study adopted an atheoretical approach. Qualitative and quantitative methods were used to examine the importance of hospital experiences in the lives of women, and the role of power within those experiences. Closed answer items about hospital experiences were completed by 124 women who had had a hospital stay of at least one night. In addition, ten of the women provided open-ended oral and written comments about their hospital experiences, which were used as the basis of the qualitative data. The majority of the women were satisfied with their hospital stay, but a small group recalled experiences of powerlessness associated with the non-medical aspects of their treatment, such as behaviours on the part of health professionals that influenced participants� sense of control as hospital inpatients. The qualitative data reflected similar issues to the quantitative data and provided �process� information by demonstrating how health professionals� behaviour could contribute to patients� feelings of powerlessness. The results suggested that hospital experiences were a salient part of these women�s lives. The richness of the qualitative data suggested that qualitative methodology would be a productive way to further study this area. The second study was an extension of the first via in-depth interviews with 19 women who perceived their hospital experiences as life-altering. The interview content and the analysis were based on a narrative approach that used the theoretical framework of McAdams� (1993) Life Story Model of Identity. Using McAdams� methodology enabled the researcher to evaluate how women constructed meaning from their hospital experiences, and the main issues they faced. The life story interview also proved a useful way to explore issues of loss and self-growth in the face of traumatic hospital experiences. Transcripts of descriptions of positive and negative experiences were analysed according to McAdams� themes of agency (sense of power and control) and communion (relationships with others), and sequences of redemption and contamination. Redemption sequences involve the storyline moving from a bad, affectively negative life scene, to a good, affectively positive life scene. In a contamination sequence, the narrator describes a change from a good, affectively positive life scene, to a subsequently bad, affectively negative life scene (McAdams & Bowman, 2001). Participants also rated their experiences according to Hermans� (Hermans & Oles, 1999) list of affects. There was strong agreement between McAdams� coding of agency and communion and Hermans� agentic and communal indices: the women�s hospital stories strongly emphasised the negative or opposite of McAdams� agentic theme �Self Mastery through Control�, which indicated powerlessness, and Hermans� affects, which involved low self-enhancement. It may be useful for future studies to conceptualise McAdams� themes as bipolar by incorporating currently coded themes and their reverse; in particular, by expanding ideas of agency to incorporate powerlessness, as this theme was pervasive in women�s hospital experiences. The rating of affects added to the findings as this showed a latent dimension of communion manifested as isolation. The common agency and communion themes were apparent in the two distinct but related aspects of hospitalisation that affect patients� sense of control: the medical condition and the manner in which patients are treated by medical staff. The findings of the main study built on the pilot study by showing how ideas of control and powerlessness can inform better practice. For example, respectful, dignified and fair treatment by health professionals played a part in determining redemption sequences; women also indicated this was how they wanted to be treated. Due to the vulnerability of the �sick role�, disrespectful or offhand treatment by health professionals had particularly distressing effects evident in contamination sequences, such as negative changes to sense of self and attitudes toward the health care system. In some cases, such treatment led to participants� avoiding subsequent interactions with doctors and to sustained feelings of helplessness. The present thesis demonstrates that doctors, nurses and other health professionals need to allow time to attend to the affective as well as the medical aspects of the encounter. Health professionals need a good bedside manner, compassion, and communication skills, as these characteristics play a part in maintaining female patients� sense of self and their faith in and satisfaction with the health care system.

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Walton, Merrilyn. "A multifactorial study of medical mistakes involving interns and residents". Thesis, School of Public Health, 2004. http://hdl.handle.net/2123/9309.

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Kelman, Christopher William, e christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections". The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.

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With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation. ¶ Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system? ¶ The aims of the project were: · To examine the potential for using administrative data to generate outcome measures and surveillance indicators. · To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework. · To compare the Australian health-service data system with the current international state-of-the-art. · To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity. ¶ The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions. ¶ For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed. ¶ A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study. ¶ The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas. ¶ Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection. ¶ In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed. ¶ The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research. ¶ Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures. ¶ Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.

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Munns, Ailsa M. "Young families' utilisation, self-perceived requirements, and satisfaction with child health services in the City of Belmont, Western Australia". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/1426.

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The expectations of young families regarding care they would like to receive from community nurses working in the child health area is affected by the relationship between those expectations, utilisation and sociocultural factors such as family type, family composition and ethnicity. These factors influence family dynamics, needs, functioning and interactions with the wider community. A descriptive study with both quantitative and qualitative components was used to identify and analyse the self-identified requirements of young families utilising Child Health Services in the Belmont area, Western Australia, and their patterns of utilisation. Twenty five women who had a child or children under 5 years of age were interviewed. The study was guided by a conceptual framework provided by the Ottawa Charter (World Health Organisation-Health and Welfare Canada-Canadian Public Health Organisation, 1996). The three main themes that emerged from the data showed that the young families identified knowledge acquisition, reassurance of normal growth and development and accessibility as their key self-perceived requirements of Child Health Services. Family type, family composition and ethnicity were examined within the contexts of these themes, resulting in a greater understanding of the child health issues relating to all types of family groups. The challenge for the providers of Child Health Services is to provide culturally appropriate Child Health Services based on the principles of primary health care within an environment experiencing fiscal restraint The long term benefits to the families and the health care system are not easily evaluated but have important and wide ranging positive effects on the health and wellbeing of the community.

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Cardona-Morrell, Magnolia. "Evaluation of a Community-wide Diabetes Prevention Program". Phd thesis, University of Sydney, 2011. http://hdl.handle.net/2123/8349.

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This thesis is an evaluation of the effectiveness of a community-wide diabetes prevention program conducted in three Divisions of General Practice in Sydney, Australia. The aims were to assess whether translation of diabetes prevention programs was feasible in real-life settings and whether results achieved were comparable with those of randomised trials on which this intervention was based. Its primary goals were to assess whether the lifestyle intervention could increase participation in moderate-to-vigorous physical activity to 210 minutes per week, reduce total fat and saturated fat consumption to 30% and 10% of total daily energy intake, increase fibre consumption to 15 g/1,000 kcal/day, and lead to 5% weight loss over one year. The background section covers the physiopathology of type 2 diabetes, its risk factors, and the available population screening tools to identify people at risk. The growing morbidity and mortality burden, the economic implications of this public health problem, and the importance and feasibility of preventing or delaying the onset by intervening in the precursor stages are then summarised. Evidence for preventability is examined through a literature review of lifestyle interventions in research settings comprising highly structured and closely monitored physical activity and dietary programs under controlled conditions. Examples of the effectiveness of translation of randomised controlled trials (RCTs) into less stringent programs in community settings such as workplaces, churches, indigenous communities and whole-of-country initiatives are presented. A systematic review and meta-analysis of effectiveness of the lifestyle approaches in routine clinical practice supplements the evidence for application of prevention principles in real-life settings. The main chapters of the thesis centre on process and impact evaluation of the semi-structured Sydney-based intervention, which recruited 1,250 participants from the mainstream Australian 29 public using general practitioner services in the study area, who were followed for 12 months. The intervention’s goals aligned with those of the Finnish Diabetes Prevention Program but with less stringent entry criteria and less intensive intervention components delivered by purpose-trained lifestyle officers. The Program included an initial individual assessment and coaching session, three subsequent group sessions in the following three months, then three follow-up coaching calls at three, six and nine months. A final assessment at one year, using the same objective and self-reported measures as in the initial assessment, captured changes in body weight, physical activity and dietary habits. The process evaluation showed that it is feasible and effective to use targeted screening to identify and recruit high-risk individuals into a free-of-charge program in the general practice setting, however a quarter of participants were lost to follow-up by one year. While minor variations in aspects of the Program were required to meet local need, Program fidelity in delivering components, and self-reported adherence to diet and physical activity was high. Using a before-after study design, the impact evaluation measured 1-year changes in key Program parameters in relation to baseline. These comprised: measured weight, waist circumference, BMI, and glycaemia measurements; and self-reported dietary intake and structured physical activity, using a 3-day food record and the Physical Activity Scale for the Elderly (PASE) questionnaire, respectively. The main findings at 12 months for the 586 completers as at December 2010 were: a mean weight loss of 2.1 kg; waist circumference reduction of 2.5 cm; no significant change in glycaemia; 3% reduction of fat and saturated fat intake; 16% increase in fibre intake; and mean increase in moderate-to-vigorous physical activity of 13.7 minutes/week. All these changes were smaller than those achieved by the RCTs in research settings, most likely due to the lower intensity and monitoring of the Sydney intervention. Weight loss and waist circumference reductions were similar for participants in 30 group session and those who received telephone-only coaching. Diabetes incidence was 1% at the end of the first year. An economic appraisal of the Program implementation completes the evaluation. A cost of A$400 per kg lost among people achieving the weight goal was estimated on Program completion, but the cost was double for the overall group that included non weight losers. The cost of achieving the physical activity goal and the dietary goals was not feasible or sustainable with resources available in routine clinical settings. The costs per outcome were similar for participants not attending group sessions, who received only telephone coaching. Hence it is worth exploring this less labour-intensive modality if a general practice based Program were to be delivered as routine preventive care. In sum, the evaluation of this community-wide diabetes prevention program showed that translation of diabetes prevention programs into routine practice, while feasible at less intensive levels than in RCTs, has a somewhat lower effect on diabetes risk reduction and it can still be a financial burden in clinical settings. However, given the potential for population-wide benefit, the effectiveness of alternative delivery modes, number and duration of program components and more targeted patient sub-groups should be investigated.
The Sydney Diabetes Prevention Program was funded by New South Wales Health as part of the Australian Better Health Initiative. Financial contribution and other in-kind support were provided by the Sydney South West Area Health Service and the Australian Diabetes Council -NSW.

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Esgin, Tuguy. "Evaluation of acceptance and efficiency of exercise for Indigenous Australians to benefit physiological, anthropometric and metabolic syndrome outcomes". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/2003.

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The proposed study will provide an increased understanding in a much-understudied area of how the Australian Indigenous community perceives physical activity and the beneficial effects for improving health outcomes. The PhD will be made up of three studies: 1) To design an exercise prescription that is culturally appropriate and specifically addresses the major Indigenous health issues around metabolic syndrome. The first will be a cross sectional study that surveys the motivators and barriers to physical activity within the Perth Noongar community. The results of this study will be used to enhance the intervention section of the PhD. It will provide a more accurate and the best means of ensuring not only a greater uptake, but also ways of developing positive lifelong physical activity habits. 2) Determining the amount of physical activity taking place within the Noongar community. Utilising the Global Physical Activity Questionnaire to measure the amount of physical activity and sedentary rates within the Indigenous community. 3) Evaluate the compliance and effectiveness of the developed intervention to inform future exercise therapy programmes for this population. The second study will be a randomised control trial looking at the physiological responses to a combination of aerobic and anabolic (resistance) exercise. The significance of this aspect of the PhD will be to capture and record physiological and quality of life measures some not previous recorded in the Indigenous community. This will inform policy relation to the most appropriate targets for eliciting successful behaviour change to improve health in Indigenous and non-Indigenous populations

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Davey, Peter J. "Municipal Public Health Planning and Implementation in Local Government in Queensland". Thesis, Griffith University, 2007. http://hdl.handle.net/10072/365756.

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The furious pace of global urbanisation has serious impacts on the long-term sustainability and health of the local communities in which we live. The debate about relationships between population size, environmental management and human well-being must now encompass the fundamental concept of sustainability (Rees, 1992; WCED, 1990; McMichael, 2002; Hancock, 1996). Increasingly, the local municipal level is the most influential setting in which to change our relationship with the environment (Chu, 1994; Chu et al., 2000). In the 1980s, the World Health Organisation (WHO) met this global challenge by advocating healthy public policy and laying foundations for its global Healthy Cities Movement. Significant support developed in the early nineties for participatory health planning action in local government: over 2000 cities world-wide developed municipal public health plans (MPH Plans). The Healthy Cities Movement through regional networks of cities and towns encouraged government partnerships with non-government agencies and industry, to anticipate and mitigate urbanisation’s negative impacts. In Queensland eighteen local governments have developed and implemented MPH Plans using a seven-step process (Chapman and Davey, 1997; WHO (1997b) to improve local planning for health and address the social determinants of health through agency collaboration. There is however limited understanding and evidence of the success factors for the effective implementation of MPH Plans. Studies of the evaluation of Municipal Public Health Planning (MPHP) approaches have focused predominately on the evaluation of the process of planning, without conducting comprehensive evaluation of its implementation. The organisational barriers that contribute to ineffective health-planning implementation have not been well researched and documented. Here lies the gap in the research: MPHP requires thorough qualitative assessment, not only of the planning process, but also the implementation impacts. This research explores the achievements, barriers and success factors associated with MPHP implementation in local government organisations by developing a process and impact evaluation framework and applying it to two MPHP projects in Queensland: one, local planning in an expanding tourist city of over 400,000 people; the second, a regional approach involving two provincial cities with a combined population of 100,000 residents. The research examines the degree of collaboration resulting from health planning and assesses if the aims of the MPH Plans have been met. MPHP is both a health promotion tool and a strategic business planning process applied in local communities: this research seeks to understand more about organisational strategic management issues that act as barriers to planning or impact on the success of planning outcomes. This study design uses qualitative methods with a triangulation approach to analyse and understand the complexities of MPH Plan implementation. Grounded theory provides a methodology for interpreting meanings and discovering themes from the comprehensive process and impact evaluation consisting of preliminary cases studies, key informant interviews, using specific process and impact indicator questions and an analysis of MPHP models compared to other CPHP models and legislative frameworks. The impacts of the intervention are discussed and relate to the implementation effects of MPHP on individuals and organisations including council, government and non-government agencies and on the community. Achievements and barriers associated with MPHP are identified and discussed. Three main factors emerged. Firstly, MPHP had significantly increased the degree of intersectoral collaboration between the agency project partners, with particular success in clarifying the role of agencies in the management and delivery of public health services. The principles of successful partnerships need to be further articulated in local government settings to successfully implement MPHP. Secondly, positive political and organisational support was found to be a critical factor in the success of the planning implementation. Thirdly, and most importantly, the aims of the MPHP had not been substantially met due to a lack of financial and human resources. The study concluded that, although MPHP has strengths and weaknesses compared to other CPHP models, its features most suit local government. Success factors recommended for effective MPHP include formalising collaboration and partnerships and improved agency organisational governance in planning; building individual and organisational capacity to strengthen strategic planning; integrating the many layers of regulatory planning in local government and other agencies; sustaining planning structures and processes through regulation and commitment to investment in implementation stages of MPHP. The study’s major recommendation is that, for MPHP local government should facilitate a three-dimensional platform approach: healthy governance – long-term vision, recognising the many layers of planning, supported by state legislation and local industry and with awareness of legislative planning frameworks; a platform mechanism – sustaining agency networking, hosting the stakeholder forum, supporting the advisory committee, enhancing communication; and strategy implementation – in the context of an improved understanding of organisational behaviour, local government and agencies must action priority strategies, formalising agency partners responsibility, articulating desired outcomes, monitoring progress and evaluation. This recommended Platform Approach to MPHP provides an effective model for managing and implementing future MPH Plans, allocating resources three ways: to build people’s capacity to engage in planning mechanisms, to build organisational capacity to manage planning outcomes and to build more effective Healthy Cities planning approaches. The MPHP evaluation framework developed in this thesis could be used to evaluate other MPHP projects in local governments both in Australia and internationally.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Centre for Environment and Population Health
Faculty of Environmental Sciences
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Wallace, Ruth. "Supporting Nutrition for Australian Childcare (SNAC): The development, implementation and evaluation of an online nutrition education intervention". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2016. https://ro.ecu.edu.au/theses/1771.

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The provision of a nutritious diet in a child’s early years can have an immense effect on their future health and wellbeing. Due to the increasing number of children attending child care, this setting is strategically placed for teaching children important food literacy skills and establishing positive eating habits, which remain through to adulthood. However, food served in child care facilities is often not of the best nutritional quality (Zuercher, Grace, & Kranz, 2011) and there is lack of positive role modelling among staff. Both of these factors pose obstacles to a health-promoting environment for the children who attend. The nutritional needs of young children are well known. This research sought to identify the child care specific nutrition education resources currently available, and to understand the broader needs of Australian child care staff that would enable them to provide a healthy eating environment. The findings of this research phase informed the design and development of a website to increase child care staff nutrition knowledge and confidence in providing a healthy eating environment, facilitating ongoing continuous improvement in their professional development. Discussion boards to promote a sense of community and provide ‘information wrapped in support’ were a key website feature. Qualitative interviews were conducted with child care facility staff and key industry stakeholders. Although positive attitudes towards promoting healthy eating were demonstrated, data revealed that recommended nutrition resources were not well known or utilised by the childcare sector and staff reported a lack of confidence and workplace support. Guided by the Spiral Technology Action Research model (H. Skinner, Maley, & Norman, 2006), a health promotion project management tool, these findings informed the development of the website, “Supporting Nutrition in Australian Childcare” (SNAC), containing a range of resources, recipes, discussion boards and links. Use of the website, staff nutrition knowledge, attitudes, confidence and sense of community were evaluated using a qualitative, netnographic approach, through conversation threads, interviews and observations. Quantitative data collection methods including pre- and post-intervention surveys and web analytics were utilised to triangulate these findings. Despite the “netnographic slog”, that is, the persistence and continued attempts to recruit educators and encourage them to engage with the website, findings suggest that the SNAC website was well utilised and valued by more than 1200 SNAC members, attracting over 90,000 page views and 600 posts/comments. Educators valued the ‘information wrapped in support’ offered by the website, and a sense of community developed, particularly around shared emotional connection. Educators reported positive attitudes and high self-efficacy towards providing a healthy eating environment. However, evaluation results demonstrated disparity between reported knowledge and behaviours, such as high self-efficacy, and those observed, such as poor quality menu plans. This research has shown the need for changes in public health policy to reprioritise a healthy eating environment in Australian childcare facilities; changes that foreground optimal nutrition in the early years as vital for future health and wellbeing. However, given that high-level policy change is often difficult and time consuming, the demonstrated disparity between reported and observed knowledge and behaviours highlights the need for shorter term strategies that address the support so badly needed, to ensure the long-term sustainability of these changes.

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Porter, Mark Robert. "An analysis of treatment retention and attrition in an Australian therapeutic community for substance abuse treatment". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/568.

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Research undertaken in the last three decades has consistently reported that the length of time spent in inpatient and outpatient alcohol and other drug (AOD) treatment programs predicts treatment success (De Leon, Melnick, Kressel, & Jainchill, 1994; Hubbard, Craddock, & Anderson, 2003; Simpson, Joe, Fletcher, Hubbard, & Anglin, 1999). However, treatment attrition rates are high and present a major problem for improving treatment outcomes. Various factors that have been reportedly associated with increased AOD treatment attrition rates include being female, younger clients, clients using methamphetamines, and clients with elevated psychopathology scores. The aim of this thesis is to improve understanding of various factors reported in the research literature to influence AOD treatment retention, including client psychopathology, age, gender and primary drug of abuse. The research was conducted in two phases. Phase one involved an analysis of archival data of clients admitted to a single Australian therapeutic community (TC) program over a 6-year period (2000-2005).The second stage involved a focus group comprised of nine Australian and New Zealand therapeutic community managers and senior clinicians who discussed the findings from the first phase of the study and provided feedback on these findings. The focus group also discussed barriers and solutions to incorporating these findings in TC treatment services. The results from the first phase indicated that elevated anxiety and depression scores at entry to treatment were strong predictors of client retention at 8 weeks, and retention at 14 weeks was predicted by high self-esteem scores at entry. Clients receiving medication (primarily anti-depressant medication) were more likely retained at 14 weeks. Older clients (24 – 29 years, and 30 – 50 years) were significantly more likely to drop out of treatment by the 14 week stage compared with the younger client group (17 – 24 years). The second stage revealed general agreement with the findings, provided support for the efficacy of TC treatment for clients with comorbid mental health problems, highlighted challenges and benefits of working with mental health services, and suggested other factors influencing treatment retention. The first stage findings contribute to the understanding of TC treatment retention factors with an Australian population, but do not support previous findings that female clients, younger clients, clients with elevated anxiety or depression scores, or clients with methamphetamine abuse problems are more likely to drop out of TC treatment. This study involved the collection of a large client database from a single TC over six years, including the longitudinal collection of client psychometric data at various stages throughout treatment. This study makes an important contribution to the understanding of various client factors and their respective influence on client retention and attrition within an Australian therapeutic community. The study has relevance for residential substance abuse treatment services in many countries, but has special relevance within Australia where few studies focusing on TC retention have been undertaken. There have been even less studies focusing on TC retention that have included longitudinal psychometric data collected from a client population primarily comprised of young methamphetamine-users.

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Emmelin, Maria. "Self-rated health in public health evaluation". Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-226.

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Wright, Trudy, e n/a. "Primary health care : the health care system and nurse education in Australia, 1985-1990". University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061110.171759.

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Primary health care as a model for the provision of health services was introduced by the World Health Organization In the mid 1970s. Initially viewed as a means of health promotion and advancement of wellness in developing countries., it was soon to be adopted by industrialised countries to assist in relieving the demand on acute care services. This was to be achieved through education of the community towards good health practices and the preparation of nurses to practice in the community, outside of the acute care environment Australian nurses were slow to respond to this philosophy of health care and this study has sought to examine why this is so. It has been found that there are a multitude of reasons for the lack of action In the decade or more following the Declaration of Alma Ata and the major Issues have been identified and elaborated. Some of the major reports of the time that were associated with and had some Influence on health care and nurse education have been examined to identify recommendations and how much they support the ethos of primary health care. These include the Sax committee report of 1978 and a submission by the Department of Employment and Industrial Relations In 1987. As part of the investigation, nursing curricula from around Australia in the mid 1980s have been examined to determine the degree of the primary health care content according to guidelines recommended by the World Health Organization. It was found that generally at that time, there was a deficit In the preparation of undergraduate students of nursing for practice In the area of primary health care when the world, including industrialised nations, was making moves towards this model of health care delivery. Factors Influencing the slow response of nursing have been examined and finally recommendations for further studies have been put forward.

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Sinclair, Andrew. "The primary health care experiences of gay men in Australia". Connect to this title online, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20060713.084655/.

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Sinclair, Andrew James, e n/a. "The primary health care experiences of gay men in Australia". Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.

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The present research, consisting of two studies, was designed to examine the primary health care experiences of gay men in Australia and assess doctors? attitudes and training with regard to gay men and their health care. In the first study, 195 gay men were surveyed regarding their health issues and their primary health care experiences. The most important health concerns of gay men were stress and depression followed by HIV/AIDS, body image disorder and other sexually transmissible infections. Including those participants who were unsure, approximately one-half reported experiencing homophobia and almost one?quarter reported experiencing discrimination in the provision of health care. Despite this, respondents were generally satisfied with their primary health care, although respondents felt that all GPs should receive additional undergraduate medical education regarding gay men?s health. In the second study, 25 doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their knowledge of gay men?s health and their comfort working with gay men. Non-gay specialist GPs were less comfortable treating gay men, reported poorer communication and were more homophobic than their gay specialist counterparts. Further, doctors perceived their medical education regarding gay men?s health has been inadequate. Together, the results of the two current studies suggest that disclosure of sexuality is an important issue for both gay men and doctors, and has the potential to impact on the quality of health care that gay men receive. In order to improve the level of disclosure, the pervasiveness of homophobia and discrimination in primary health care must be reduced. Finally, the results indicate that medical education must be updated to reflect current knowledge regarding the health issues of gay men. Failure to address these issues will condemn gay men to continued health inequality.

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Hughes, Roger, e n/a. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia". Griffith University. School of Health Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.120233.

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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.

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Hughes, Roger. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia". Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366114.

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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
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Ramanathan, Vijayasarathi, Virginia Furner, Sarangapany Jeganathan, Katerina Lagios, Melissa Kang e Eva Jackson. "Accessibility and Acceptability of Public Sexual Health Clinics for Adult Clients in New South Wales, Australia". Thesis, Masters in Medicine (STD/HIV) The University of Sydney, 2006. http://hdl.handle.net/2123/3573.

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The objectives of this study were to examine the accessibility of public sexual health clinics (SHCs), identify the service preferences of clients and assess whether the services delivered by public SHCs were acceptable (suitable) to users’ expectations. Participants were adult clients attending public SHCs in 4 different geographical regions of New South Wales (NSW). A self completed anonymous questionnaire survey was employed in this study and the data was collected over a two week period per clinic. The overall participation rate was 89%. Three hundred and two clients participated of which 68.2% and 31.8% were males and females respectively. Geographical proximity to residence or work was the single most common reason cited to choose a particular clinic by all clients. The main source of information about public SHCs for young and middle aged clients was their personal contacts, whereas for older individuals it was health professional’s referral. Of the total sample, nearly 59% vs. 32% of clients used private and public transport to get to the clinic. About 80% of private transport users of the city and suburban clinics had indicated some difficulty with parking facilities. For more than two thirds of clients, the time taken to get to the clinic was less than 30 minutes. Overall, more clients preferred an appointment (56%) compared to a walk-in (32%) system. Nearly 65% of all clients preferred to attend the clinic during the weekdays and about 11% preferred weekends. Of those clients who had a preference for a time to attend a clinic, 83.3% attended clinic in their preferred time. Overall, more than one third (39%) of all clients preferred a same gender health care worker (HCW) whereas 13% of clients did not prefer a same gender HCW. Among clients who had a clear preference, more than 90% of all females and nearly 80% of overseas born males preferred a same gender HCW. More females (81%) than males (59%) were actually able to have a consultation with a HCW of their preferred gender. The majority (79%) of clients preferred to consult the same doctor in the follow up visits and only a few clients (5%) preferred a separate male and female waiting room. The vast majority (97%) of clients had no difficulty with language during consultation. About 93% of clients had rated the services delivered by public SHCs to be either excellent or good. The public SHCs were found to be accessible and acceptable to the clients who currently utilise them. Designated parking spaces for the city and suburban clinic users and providing an option for female and overseas born male clients to select a HCW of their preferred gender need to be considered. Further research is required to examine accessibility and acceptability aspects of public SHCs for the potential clients who either currently use other services or do not access any form of services.

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Cullerton, Katherine B. "An exploration of the factors influencing public health nutrition policymaking in Australia". Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/109095/1/Katherine_Cullerton_Thesis.pdf.

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This thesis was an exploration of the factors that influence nutrition policymaking in Australia which resulted in strategies that could be used by poorly-resourced health organisations to gain traction in public health nutrition policymaking. Insight into these strategies was gained through a social network analysis exploring the power of interest groups and their influence on nutrition policy in Australia and in-depth interviews with these key influencers.

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Kelly, Susan. "Public relations and accountability : the emergence of a profession". Thesis, Queensland University of Technology, 1996. https://eprints.qut.edu.au/36286/1/36286_Kelly_1996.pdf.

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One of the major issues confronting public relations practitioners over the past decade has been how to measure the performance of theμ- activities in order to meet the increasing accountability expectations of senior management. However, the literature over this time has focussed on issues relating to the use of evaluation to demonstrate accountability and there has been very little research into the actual experiences of practitioners in endeavouring to meet these accountability expectations. This research adds to the body of knowledge by considering how Australian public relations practitioners address these issues by posing the question: How do public relations practitioners account for themselves within the corporate environment? Case study methodology was used to address this research question. Nine public relations managers from a range of state-based, national and international organisations located in Queensland, New South Wales and Victoria were selected. A survey was used to interview the managers to ascertain their perspective on issues relating seven research questions covering: • role and influence of public relations practitioners within organisations; • activities undertaken by public relations practitioners; • benefits from demonstrate accountability; • program planning; • evaluation; • conveying performance; and • communication models. The data was analysed using pattern-matching, matrices and cross-case analysis. The results of the research indicate that accountability and evaluation are current issues of concern to Australian public relations practitioners. The ability to demonstrate accountability is seen to have ramifications for both practitioners and the profession in terms of professional status, what is actually encompassed by public relations practice and resource levels. Additionally, this study highlighted that practitioners view evaluation and accountability from a highly politicised perspective which has implications for future research in this area. This study has provided in-depth qualitative data which contributes to the professional literature on evaluation and accountability.

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Watts, Christina. "Tobacco industry interference in supply-side policies in Australia". Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/24682.

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Tobacco smoking rates in Australia are at a historic low, largely due to decades of tobacco control policy reforms aimed at reducing consumer demand for tobacco products. However, while some conditions have been placed on the sale of tobacco, such measures are not explicitly aimed at reducing the supply of tobacco products by restricting their sale. Tobacco therefore remains one of the most widely available consumer goods on the market in Australia, which contributes to a perception that tobacco is a normal part of everyday life. The widespread retail availability of tobacco in Australia undermines smokers quit attempts and increase impulse purchases, which ultimately increases tobacco consumption. Regulating the supply of tobacco in Australia is an essential next step to achieving future reductions in smoking prevalence. However at present, the lack of regulation on the “supply-side” of tobacco control presents opportunities for the tobacco industry to exploit loopholes, undermine tobacco control policies and exert its power and influence. Tobacco companies and tobacco retailers both play a unique and interrelated role in the sale of tobacco in Australia and it is critical that research exploring supply-side tobacco control policies investigates the motivations and activities of both tobacco companies and retailers, and how they work together. This is particularly paramount in light of the tobacco industry’s increasing attempts to reframe its corporate image alongside efforts to undermine and influence the public health policy landscape. This body of work will establish an understanding of attitudes, beliefs and experiences of retailers in regards to selling tobacco and uncover the ways in which tobacco companies manage relationships with retailers to covertly market their products to maximise profitability. It will also investigate the tobacco industry’s tactics to interfere with and influence policy through a corporate social responsibility agenda and explore the implications of this on tobacco retail reform in the future.

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Walker, Sandra, e n/a. "Prostate cancer support groups an evaluation". Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20060905.085536.

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The population of Australia is increasing in age, consequently the incidence of cancer diagnoses is rising. This rise will have a dramatic impact on hospitals with much of the disease burden extending to psychological support for cancer care. At present few men diagnosed with cancer seek support. This study sought to explore men's perceptions of support and prostate cancer support groups. The benefits of support groups for men with prostate cancer have been well documented in international studies. In Australia however, relatively few men diagnosed with prostate cancer join such groups and few studies have examined the factors that influence membership and attendance. This study investigated the experiences of a sample of 181 Australian men diagnosed with prostate cancer, 80 of whom were members of support groups and 107 who were not. The participants were recruited from prostate cancer support groups and an outpatient department of a major cancer hospital, in Melbourne, Australia. The two groups were compared on a range of factors, including disease characteristics, illness perceptions and views of prostate cancer support groups. Further, members of support groups rated a number of objectives to determine the effectiveness of the groups. The majority of members recommended prostate cancer support groups to other men with prostate cancer (92%), however of the non-members of prostate cancer support groups, almost half (48%) had never heard of them. Factors that discriminated between support group members and non-members were emotional perceptions of the illness, symptom reports and illness coherence, with support group members reporting higher scores on these variables. Length of diagnosis and age were also factors that discriminated between the groups with support group members younger and diagnosed longer than non-members. There were no differences between the groups on personal control, both groups reported high perceptions of control over the disease. Members reported more benefits and less costs associated with prostate cancer support groups than non-members. Benefits included information, support, sharing experiences, and supporting other men with the disease. Costs included negative discussions, other men dying, and the distance required to travel to the groups. Both members and non-members reported distance to travel to the groups as a major barrier to attendance. The majority of members had heard of the groups through friends and, for non-members who had heard of the groups, through hospital staff. General practitioners were one of the least likely sources of information about prostate cancer support groups reported by members. Prostate cancer support group members reported high levels of satisfaction with the groups on a range of objectives outlined by the Cancer Council of Victoria. Making friends and accessing community assistance exceeded men's expectations of attendance, however men reported a desire for more information and communication. A need for more funding, advertising, and recognition of prostate cancer support groups by medical staff was also reported. Many men with prostate cancer are unaware of support groups, however a number of benefits were noted by both members and non-members. Greater recognition of prostate cancer support groups by medical staff may provide men with prostate cancer an opportunity to access those benefits. Health service providers should consider the important role prostate cancer support groups play in the recovery of men from prostate cancer and consider ways of dispelling myths men may hold regarding the notion of support.

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White, Jasmin. "Oral health problems of elderly women in Australia : an holistic approach". Thesis, The University of Sydney, 1996. http://hdl.handle.net/2123/4630.

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Johar, Meliyanni Economics Australian School of Business UNSW. "Three essays on econometric evaluation of public health interventions". Awarded By:University of New South Wales. Economics, 2009. http://handle.unsw.edu.au/1959.4/43400.

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This dissertation consists of three independent essays evaluating the impact of public health interventions in two countries, Indonesia and Australia. The first two essays concern the national pro-poor health card program in Indonesia, which fully subsidises health care purchases by its recipients. In quantifying the impact of the program, the combination of propensity score matching and difference-in-differences techniques is used to address bias due to non-random assignment. Covariates to match include both variables affecting demand and eligibility and variables measuring local health care supply. Using data from the single, nationally-representative longitudinal study of Indonesian households, the program is found to have limited impact. The second essay evaluates the program??s impact on supply variables. In the absence of a wage revision or additional staff, the program lowers the incentives for health workers to maintain their public position. This is particularly true for those workers providing outpatient care as patients can not be controlled by waiting lists. The analysis finds some evidence of reduced number of full-time doctors in areas where the distribution of health cards were most extensive. The final essay uses Australian data to investigate changes in women??s preferences for cervical screening following a screening promotion campaign and a vaccination program. Discrete choice experiments were used to elicit preferences, and results from experiments conducted prior and after the interventions were compared. Several additional comparison groups were created based on spatial variations and by variation induced by randomisation. The study finds that the interventions have minor impact on how women valued various screening attributes. However, there was a general reduction in the willingness to screen, which was unexpected given the awareness campaign. Through simulation, it is shown that an effective way to increase the screening rate is through encouraging a more active role of the provider.

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Davidson, Nicholas E. "Defining the role of Public Health in Disaster Recovery: An Evaluation of State Public Health Planning Efforts". Monterey California. Naval Postgraduate School, 2013. http://hdl.handle.net/10945/32809.

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CHDS State/Local
There is very little to direct public health planning for long-term disaster recovery. This research surveyed plans from nine hurricane-prone states to determine the extent to which those plans comply with recently published standards from the Centers for Disease Control (CDC) in 2011. An abstraction form was devised to score each plan and to document novel or innovative components within each plan. Results indicate poor compliance with the CDC standards; 79 percent of the assessments of individual preparedness components resulted in a score of zero (on a scale of zero to four). Particularly notable was a lack of planning for continuity of operations and the insufficient plans for advising residents and partner agencies as to the plans and locations for providing services after a disaster. A complicating factor was the general lack of acceptance, by public health, of the fact that public health recovery should be focused on restoring community services instead of simply restoring operations of public health agencies. This research identifies smart practices that can be adopted by public health agencies in an attempt to ensure a robust level of recovery preparedness.

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Madzokere, Eugene T. "The Current Status, Evolution and Spread of Arboviruses Circulating in Australia". Thesis, Griffith University, 2022. http://hdl.handle.net/10072/417227.

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Arboviruses circulating in Australia are of clinical importance as they cause painful, often chronic musculoskeletal arthritic or fatal dengue disease. They include Ross River virus (RRV), Barmah Forest virus (BFV), chikungunya virus (CHIKV) and dengue virus (DENV). This dissertation assessed the seroprevalence, diversity, evolution, spread and strategies for controlling infection caused by these arboviruses. The overall aim of research presented in this dissertation was to improve public health responses such as nationwide surveillance, diagnosis, and infection control. Research undertaken in chapter 2 achieved this through systematic review and statistical synthesis of human seroprevalence data for RRV, BFV and DENV. I have shown that many factors influence the reporting of human seroprevalences for these three arboviruses. Among these factors is the choice of assay method, timeframe, and sampling strategy. I have also presented findings showing that the spatiotemporal range and median seroprevalences reported for DENV and RRV are wider and higher than those for BFV. This indicates that the risk of exposure to DENV and RRV is significantly higher and extends overseas, however this risk relates to the distribution of the transmitting vectors. My analysis highlighted that DENV presents the highest risk of exposure but its incidence in Australia is declining due to successful implementation of Wolbachia-DENV control programs which have restricted the distribution of Aedes aegypti. Most serosurveys reviewed reported a positive association between age and seroprevalence, and increasing seroprevalence with gender. However, studies reporting gender-seroprevalence data did not do statistical analysis to show the significance of outcomes. This dissertation therefore recommends streamlining, standardization and statistical synthesis of serosurveys data to better quantify risk of exposure, identify risk factors, at-risk groups/populations, associations between seroprevalence and risk factors and at-risk groups/populations. In chapter 3, I characterised the phylogenetic relationship among 193 RRV near whole genomes sourced from multiple hosts, nationwide and the Pacific, in-between 1959-2018. Eight-six of these genomes were generated in this dissertation. My assessment revealed that the four RRV genotypes display high levels of intra-genomic diversity, as I was able to characterise the virus into eight additional sublineages within genotypes G1 (n = 2), G3 (n = 5) and G4 (n = 1). This characterisation brings the total number of known RRV sublineages to 13. Only three of these sublineages (G3D, G4A and G4B) contain viruses that have circulated in Australia within the last decade. The last sampling of genotype 1 and 2 (G1 and G2) viruses was in 1976 and 1995 from Queensland and Western Australia. These viruses may no longer be in circulation within Australia. Sublineages G4A and G4B the most dominant circulating variants of RRV in recent times but they are spatially restricted to Eastern and Western Australia. My phylogenetic analysis suggests that a human traveller likely introduced RRV into the PICTs from northern rather than eastern Australia causing the explosive 1979-80 epidemic. This hypothesis builds upon the one postulated by authors of previous studies who used genomic datasets for RRV isolates sampled from a few locations and not nationwide as I did. Future studies are required to determine differences between RRV sublineages, factors driving lineage replacement, and understand the role of positively selected codon site to RRV evolution. For chapter 4, I studied the evolution, dissemination and phylogenetic relation between 87 BFV near whole genomes sourced nationwide and from Papua New Guinea from three hosts; humans, mosquitoes and a macropod, during 1974-2018. Fifty-four of these genomes were generated in this dissertation and were sampled throughout Australia. Despite the addition of these new genomes to the BFV phylogeny, results obtained indicate that BFV still consists of three genotypes with most new genomes generated from isolates sampled from northern, eastern, and Western Australia grouping in genotype G3. This dissertation reconstructed the most plausible and statistically supported dissemination pathways for BFV and identified the PNG as the most likely source of the virus. The impacts of nucleotide variation within repeat sequence elements and positive selection with the nsP1 Mtase-Gtase domain on virus replication and host range need to be investigated further. For Chapter 4 and 5, I showed that BFV and RRV have a synonymous codon usage bias toward A or C at the 3rd codon position; an abundance of CA and UG, and suppression of CG and UA dinucleotides; display coincidental and antagonistic synonymous codon usage bias with their respective mosquito and vertebrate hosts. In chapter 7, I also showed that amino acid coevolution and compositional biases are prevalent within protein coding regions belonging to RRV and BFV. I found translational selection to be the most influential evolutionary force driving RRV codon usage patterns (chapter 5). Mutational pressure was a close second. I also identified host motifs associated with RRV and BFV coevolving sites. Altogether these results indicate that many factors drive RRV and BFV evolution, among them virus and host related influences. Investigation of the clinical relevance of these findings (chapters 4, 5, and 7) is required. In chapters 6 of this dissertation, I identified five drugs [Anidulafungin (an antifungal), Fondaparinux (an anticoagulant), Rifabutin (an antibiotic), Deslanoside (a cardiac glycoside), and Temsirolimus (an antineoplastic agent)] that bind with high affinity, potency and efficiency to the RRV, BFV and CHIKV capsid. Their role as capsid inhibitors and potential treatments for RRV, BFV and CHIKV infection needs validating through functional and preclinical studies. In chapter 8, I proposed a strategy for generating integrated species distribution modelling frameworks to improve prediction of mosquito-vector habitat shifts in the future. Such modelling frameworks do not currently exist and so their generation and evaluation as an additional component to existing vector and arbovirus surveillance initiatives in Australia is required. This dissertation has addressed its research aims and hypothesis. It has demonstrated that robust nationwide surveillance, review and synthesis of seroprevalence, genomic, host, and environmental data for RRV, BFV and DENV enhances the understanding and management of arbovirus epidemics, virus characterisation and discovery, and infection control in Australia. This research has also shown that some of the factors driving alphavirus evolution, can be exploited for vaccine development. In addition, this dissertation has also presented five approved medicines with potential for repurposing as anti-alphaviral treatments. More broadly, this dissertation has generated new strategies and concepts for improving arbovirus surveillance and infection control in Australia.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Glycomics
Griffith Health
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28

Stewart, Anthony Paul. "[Epidemiology : reports and papers]". Master's thesis, Canberra, ACT : The Australian National University, 1993. http://hdl.handle.net/1885/142697.

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Barnett, Elizabeth. "Physical Activity and Enjoyment: Measurement, Evaluation, and Theory". Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27201740.

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Childhood engagement in physical activity improves health and contributes to the sustainment of physical activity in adulthood. My dissertation research broadens scholarship by disentangling the effects of sports- vs. non-sports-focused summer camps on children’s physical activity and identifying modifiable activity characteristics contributing to physical activity enjoyment, an important predictor of physical activity sustainment. My work also challenges current discourse by presenting the analytical argument for bringing enjoyment research to the forefront of public health. In Chapter 1, I hypothesize that children attending a sports camp spend more time in moderate-to-vigorous physical activity (MVPA) compared to children attending general day camps. Multivariable linear regression models estimated differences in percent of accelerometer-monitored time spent in MVPA. Children in the sports camp spent significantly more time in MVPA compared to children in a non-sports-oriented camp. This is the first study of its kind to use real data to document physical activity differences between sports and non-sports camps. In Chapter 2, I investigate whether children in a sports camp experience higher enjoyment when the activity 1) is competitive, 2) has an active line or no line, 3) involves active coaches, 4) poses challenge, or 5) requires skill. Enjoyment scores were higher for competitive vs. non-competitive activities and those with higher perceived challenge and skill. Integrating challenging, competitive, and skill-building activities into sports camps is relatively simple, yet may have broad effects on children’s physical activity behavior. Chapter 3 presents rationales for bringing enjoyment to the forefront of public health dialogue and action to increase physical activity in children. I outline five challenges that have limited physical activity enjoyment research and offer strategies for addressing them. While other fields have linked physical activity enjoyment with physical activity maintenance, the public health field rarely measures or incorporates enjoyment in epidemiologic, intervention, or theory research. Increasing physical activity in childhood should be prioritized in public health. The findings and lessons from these chapters not only contribute new scientific evidence, but also have the potential to inform policies and programs that improve children’s relationship with and experiences of physical activity during childhood and across the life course.

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Taylor, Stuart James. "Community health indicators for Ontario public health units, an evaluation of the Ontario Community Health Profile". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0002/MQ46613.pdf.

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Rajeev, Deepthi. "Development and evaluation of new strategies to enhance public health reporting". Thesis, The University of Utah, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3594716.

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Public health reporting is an important source of information for public health investigation and surveillance, which are necessary for the prevention and control of disease. There are two important problems with the current public health reporting process in the United States: (a) the reporting specifications are unstructured and are communicated with reporting facilities using nonstandard public health department Web sites and (b) most reporting facilities transmit reports to public health entities using manual and paper-based processes. Our research focuses on the development and evaluation of new strategies to improve the public health reporting process by addressing these problems.

To improve the communication of public health reporting specifications by public health authorities, we: (a) examined the business process of a laboratory complying with the reporting requirements, (b) evaluated public health department Websites to understand the problems faced by reporting facilities while accessing the reporting specifications, (c) identified the content requirements of a knowledge management system for public health reporting specifications, (d) designed the representation of the public health reporting specifications, and (e) evaluated the content and design using a prototype web-based query system for public health reporting specifications.

To improve the transmission of case reports from healthcare facilities to public health entities, we: (a) described public health workflow associated with the management of case reports, (b) identified the content of a case report to meet the needs of public health authorities, (c) modeled the case report using Health Level Seven (HL7) v2.5.1, and (d) evaluated the electronic case reports by comparing the timeliness, completeness of information content, and the completeness of the electronic reporting process with the paper-based reporting processes.

We demonstrated a model for public health reporting specifications using a prototype web-based query system. The evaluation conducted with users from laboratories, healthcare facilities, and public health entities showed that the proposed model met most of the users' needs and requirements. We also identified variation in the reporting specifications, some of which could be standardized to improve reporting compliance.

We implemented HL7 v2.5.1 case reports from Intermountain Healthcare hospitals to the Utah Department of Health. The electronic reports transmitted from the Intermountain hospitals were more timely (median delay: 2 days) than the paper reports sent from other clinical facilities (median delay: 3.5 days) but less timely than the paper reports from Intermountain laboratories (median: 1 day). However, the evaluation of the completeness of data elements needed for public health triage prior to investigation showed that electronic case reports from Intermountain hospitals included more complete information than paper reports from Intermountain laboratories. Even though the paper reports from Intermountain laboratories were more timely, the incomplete reports may delay investigation. There are informatics opportunities and public health needs to improve both electronic laboratory reporting and electronic case reporting.

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Capezio, Alessandra. "Does performance pay? : an economic and structural analysis of CEO cash reward and firm performance in Australian public companies". Phd thesis, Faculty of Economics and Business, Discipline of Work and Organisational Studies, 2008. http://hdl.handle.net/2123/8916.

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Chedid, Rebecca. "Prenatal Health Is Public Health: Best Practices for Prenatal Health Program Design, Implementation and Evaluation". Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37303.

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Prenatal health programs and public health promotion provide strategies to mitigate modifiable risks to pregnancy. Women marginalized by race/ethnicity, disability, sexual identity, socioeconomic status, immigration, Francophone and Indigenous status experience barriers to prenatal service access. Multijurisdictional program evaluations were conducted to review prenatal health promotion, design, implementation and evaluation strategies for Canadian government-hosted websites, prenatal e-classes and international prenatal guidance documents. Gaps were noted in prenatal content targeted to non-Anglophone, immigrant, Indigenous and disabled women and LGBTQ communities. I recommend that prenatal program best practices consist of evidence-based, theoretical foundations which recognize the diverse interacting determinants of health across the lifespan. Intersectoral collaborations and integration of public health into primary care facilitates delivery of accessible, inclusive, woman-centred services. These best practices are anticipated to help harmonize prenatal programs across communities, which optimize maternal-child health and children’s long-term health outcomes.

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Norrie, Philip Anthony. "Wine and health through the ages with special reference to Australia /". View thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20060420.102152/index.html.

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Thesis (PhD.)-- University of Western Sydney, School of Social Ecology and Lifelong Learning, 2005.
"A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy, School of Social Ecology and Lifelong Learning, University of Western Sydney." Includes bibliographical references and index.

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Selikane, Mapaseka. "Evaluation of the 1988 user-fee policy in Lesotho". Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/9348.

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Bibliography: leaves 99-104.
This report provides a comprehensive evaluation of the factors underlying the evolution, design and implementation of the 1988 fee policy in Lesotho. The chief aim of the study was to conduct a critical appraisal of this policy, focusing on the key factors that might have constrained or facilitated the process. The performance of the policy was assessed in terms of financial sustainability in the health sector as well as promotion of equitable access for economically marginalized groups.

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Walker, Agnes Emilia, e Agnes Walker@anu edu au. "Modelling the links between socioeconomic status and health in Australia: a dynamic microsimulation approach". The Australian National University. National Centre for Epidemiology and Population Health, 2005. http://thesis.anu.edu.au./public/adt-ANU20060127.120857.

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This thesis concerns the modelling of individuals health over the life course, within the framework set by the now substantial international literature on the relationship between socioeconomic status and health. The focus is on people with long term illnesses and related disabilities, on inequalities in health by socioeconomic status (SES) and on the impact of health on employment.¶ The main tool of analysis is a dynamic microsimulation model of the Australian population which tracks the demographic, socioeconomic and financial characteristics of individuals and their families over the life course. Its original form, developed at the National Centre for Socioeconomic Modelling, University of Canberra, is based on a one per cent representative sample of the Australian population (around 150,000 individuals), with a series of life course events simulated for individuals and their families up to 2050 - such as births, deaths, migration, taxes, education, labour force participation, earned income, wealth accumulation and government transfers. The model is written in the C programming language and was initially used on a UNIX system. The dramatic increases in the speed and memory size of PCs over the past five years has led to a PC version now being available.¶ Despite their relatively short existence and long development phases, dynamic microsimulation models are now used in many developed countries for example, the USA, UK, Canada, France, Sweden, Norway and Italy. In recognition of their ability to analyse distributional and financial issues in considerably greater depth than what is possible with traditional methods, their use by government for policy analysis is rapidly increasing.¶ In this thesis two new modules were added to the original Australian dynamic microsimulation model namely: a Health_SES module and a Health State Transitions module. The former makes the study of health inequalities across socioeconomic groups possible. The latter provides a link between health status and the ability of individuals to carry out every day activities as the severity of their ill-health increases with age. A major advantage of adding these new modules to an existing main model is that it allows much more comprehensive studies over the life courses of individuals than the alternative would allow that is the building of two stand-alone models developed exclusively for health-SES and health state transition types of applications.¶ The main data sources used to construct the two new modules were an extract from the Australian Institute of Health and Welfares Mortality database covering the 1995-97 period, and the Australian Bureau of Statistics 1998 survey of Disability, Ageing and Carers. The analysis of the mortality data was handled using EXCEL, and that of the much larger Disability survey unit record dataset - over 40,000 individuals and 100s of variables using the SAS programming language.¶ While most of the methodologies used in constructing the new modules are in line with what became the norm for dynamic microsimulation model development, the thesis contains several innovations. The main ones are: a quantitative assessment of the suitability of different types of SES indicators for studies of health inequalities; the modelling of the progression of peoples health from illness-free status to mild and severe disability; the development of a methodology for estimating health state transition probabilities from cross-sectional data (in the absence of longitudinal data); and the linking of health status to individuals ability to stay in the labour force.¶ As with most models, there are a number of limitations. These are discussed in the thesis, together with areas of possible future improvements.¶ The thesis also presents two novel and topical though at this stage illustrative applications of the enhanced dynamic microsimulation model. The first simulates the impact of a narrowing in health inequalities in Australia as health is lifted nationally to the level currently enjoyed by the most affluent 20% of the population. The findings are that, if such a policy change were implemented, close to half a million fewer Australians would be disabled, around 180,000 life years would be saved, health care costs would be around A$1 billion lower per year and the government could save close to A$700 million on the Disability Support Pension.¶ The second application quantifies the likely impacts of longer working lives in future, which may arise from changes such as: more favourable labour market conditions; government incentives to remain in the labour force longer (eg the lifting of the pension age); and general improvements in health. This application estimates the probability that Australians aged 65-70 would work more than 15 hours per week, had such changes eventuated. The decision to retire is modelled as a function of each individuals own health, socioeconomic status, age, sex and family composition. The impacts are simulated in a world in which current patterns of health by age, sex and SES remain unchanged over time the Base case; and a world replicating the narrower health inequalities scenario of the first application. Under the Base case an additional 450,000 persons aged 65-70 years were estimated to remain in the workforce - with the related earnings totalling up to $20 billion in 1998 ($35 billion in 2018) and savings by government on the age pension of around $2 billion ($4 billion in 2018). Under the narrower health inequalities scenario the numbers working, their earnings and the related savings on the age pension were estimated to be around 7% higher. Much of the original research carried out for this thesis has appeared, or is yet to appear, in refereed publications.¶

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Schrage, Andrea Michelle. "Kansans move into health: a program evaluation". Thesis, Kansas State University, 2010. http://hdl.handle.net/2097/7003.

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Master of Public Health
Public Health Interdepartmental Program
Tandalayo Kidd
Heart disease, cancer, stroke, and diabetes are the leading causes of death in the United States. In addition, the prevalence of obesity has significantly increased since the 1970s. In Kansas, 37% of adults are overweight and 24% are obese. These chronic diseases and conditions tend to be prevented by and/or managed with both adequate physical activity and a healthy diet rich in fruits, vegetables, and whole grains. In Kansas 48.5% of adults meet the current recommendations for physical activity set by the American Heart Association, while 20% of adults consume the recommended amounts of fruits and vegetables. Public health officials need to work together to encourage Kansas adults to increase their participation in physical activity and consumption of fruits and vegetables to help prevent future health problems or manage current chronic diseases. To help address these health issues in Kansas, Kansas State University Research and Extension developed the 8-week Kansans Move into Health nutrition and physical activity program, building its framework around the Theory of Planned Behavior (TPB). Using TPB, participants address attitudes and perceived norms as well as perform specific behaviors associated with healthy eating and physical activity. The purpose of this study was to evaluate the effectiveness of condensing the 8-week nutrition and physical activity program into four one-hour classes using a pre- and post-survey. Nineteen participants from the Johnson County community signed up to participate with 63% (n=12) completing the program. Results indicated that participants changed their belief that nutritious foods are more expensive (p≤0.05). Furthermore, participants gained knowledge in how to prepare healthy snacks that are quick and easy. All other measures did not change (n=19; p>0.05). Future research evaluating longer program interventions could better assess attitudes and perceived norms associated with healthy behaviors and determine whether the increase in knowledge leads to behavior change.

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Wong, Yee-sheung Olga. "Use, misuse and abuse of statistics an evaluation of the quality of public health reporting in Hong Kong /". Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B33828052.

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Marshall, Shawn Calder. "Evaluation of restricted driver licensing for medical impairments in Saskatchewan". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ57137.pdf.

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Moucheraud, Corrina. "Evaluation of Strategies and Outcomes in Maternal and Child Health". Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:16121157.

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Maternal and child mortality, particularly during the neonatal period, are among the most challenging global health issues of this era. This burden disproportionately affects the poorest populations, across and within countries. And although many of these deaths would be avertable, improvements in most countries have been slow. This dissertation explores three main research questions: (1) what is the effect of maternal health on infant outcomes?; (2) what survival gains could be attained through improved interventions, across the continuum of care?; and (3) how do health system characteristics affect the potential impact and cost-effectiveness of such interventions? The first paper uses decision modeling to evaluate how increased use of family planning and of improved intrapartum care could reduce maternal deaths in Nepal—as well as the cost-effectiveness of doing so, and of accompanying interventions to achieve these targets. The second paper estimates the potential impact of administering interventions from the Safe Childbirth Checklist at health facilities in India, and how “real world” implementation might see different results due to health system characteristics. Lastly, the third paper examines child survival outcomes following a maternal death in Ethiopia, using a long-term household-level longitudinal dataset. Together, these papers aim to provide new insights on approaches to reducing the high level of mortality among women and children.
Global Health and Population

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Schwaller, Denise E. "Stürzen und Public Health : Evaluation des PatientInnenklientels der Sturzklinik Basel /". Oberkulm, 2007. http://www.public-health-edu.ch/new/Abstracts/SD_09.01.08.pdf.

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Duldig, Paul. "The extent of private health insurance coverage in Australia : public problem or private choice? /". Title page, contents and introduction only, 1985. http://web4.library.adelaide.edu.au/theses/09EC/09ecd881.pdf.

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Chalmers, Jane. "The oral health of older adults with dementia". Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.

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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.

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Cogil, Christine. "Implementing evidence-based oral health guidelines| An evaluation of health care provider behavior change". Thesis, New Mexico State University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3663311.

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Primary care providers have not customarily provided oral assessments or offered anticipatory guidance about oral health care; dentists manage that task. Myths and access-to-care issues often result in limited or no dental care during pregnancy. Improving the oral health of pregnant women has a positive correlation with fewer dental caries in their children. Currently, evidence-based practice (EBP) oral health guidelines exist for pregnant women and children. While health care providers (HCPs) want to implement best practices, they find practice change challenging.

This project utilizes a planned change theory to guide the implementation of oral health guidelines with a methodical approach. Retrospective and prospective chart audits evaluate HCP behavior change. The chart audits reveal HCPs change behaviors after a practice intervention with a Primary Care Oral Assessment Tool (PCOAT), and again after introduction of EBP guidelines. Some changes in provider behavior were statistically and clinically significant.

Keywords: pregnancy, pregnant, prenatal, antenatal, dental care, oral health, and practice guidelines

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Przezdziecka, Krystyna. "Profile of Australian dentistry". Thesis, The University of Sydney, 1995. http://hdl.handle.net/2123/4687.

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Perez, Alicia Carmen Marlena. "Program Evaluation of the Employee Health and Wellbeing Program". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7568.

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Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive analysis was applied towards interpreting the organizational structure, and identifying all contributions to employee wellness. Inferential analysis was applied to identify correlations between survey results. The findings of the evaluation were mixed. The organizational structure of the program complied with CDC wellness program guidelines; of the 97 service departments surveyed, results revealed an 83.51% improvement in engagement, disengagement, satisfaction, best places to work, and customer satisfaction. The Pathway to Excellence survey results revealed a supportive organizational structure for a culture of wellness. The program contribution analysis showed that the health system provided accessible wellness and health promotion opportunities. Positive social change may result from this evaluation as the program is reinforced and the focus on employee wellness, health promotion, and disease prevention services are continued. As a result, the lives of employees, their families, and communities might be improved.

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Radon, Katja. "Evaluation of an internet-based online-questionnaire administered to young adults". Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29467.

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The objective of this thesis was to assess the acceptance of an online-questionnaire in a survey of young adults in southern Germany. The online-questionnaire was implemented in a study of respiratory diseases. Each of 280 subjects, aged 18 to 20 years, was assigned randomly to one of two groups who responded using (1) a paper-based questionnaire and (2) an otherwise identical questionnaire that was to be completed on the Internet. This group also received a copy of the printed questionnaire. Only eight subjects made use of the online-questionnaire, and the remainder of the respondents used the paper-based instrument. The major reason given for not using the online-questionnaire was that subjects considered it too time-consuming (39.7%). Additionally, 27.0% of the subjects did not have access to the Internet at home. In conclusion, the acceptance of an Internet-based questionnaire by adolescents with an Internet coverage of about 60% may still be low.

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Tamim, Hala. "Development and evaluation of on-site triage algorithm for trauma patients". Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=35633.

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Introduction. Trauma triage protocols are important because they identify, at the injury scene, patients with major injuries requiring transfer to a Level I trauma center, from those with non-major injuries who could be treated at Levels II and III trauma centers. The Pre-hospital Index (PHI) is a physiological injury severity measure which may be used as a trauma triage tool.
Purpose. The purpose of the present study was to: (1) prospectively evaluate the predictive ability of the PHI in identifying trauma patients with major versus non-major injuries, and (2) develop a trauma triage scale which incorporates, along with the PHI, a subset of the variables age, body region injured, mechanism of injury, comorbidity, and time between 911 call and departure of the ambulance from the injury site, so as to improve the predictive ability of the PHI-based triage instrument.
Methods. This study was based on 1,291 trauma patients treated in Montreal between April 1993 and December 1996. A patient was considered to have major injuries if the patient died within seven days since hospital admission, had an intensive care unit admission within seven days, or major surgery performed within four days. Three hypothetical trauma triage protocols were developed using logistic regression analysis; where the model that describes the data best was selected according to Bayes factor approximation. In detecting major versus non-major injuries, sensitivities, specificities, positive and negative predictive values were calculated for all the cutoff points of the PHI and the triage protocols. Also, areas under the Receiver Operating Characteristic (ROC) curves were calculated and compared for these instruments.
Results. The trauma triage protocol which included the variables age, body region injured, mechanism of injury, comorbidity, and PHI produced the best combination of sensitivity and specificity; of 0.95, and 0.24, respectively. This algorithm underwent a significant improvement over the PHI (area under the ROC curve: 0.76 versus 0.66, p < 0.05).
Conclusion. An improvement in the predictive ability of the PHI-based triage instrument was introduced after the addition of the variables age, body region injured, mechanism of injury, and co-morbidity.

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Walker, Agnes Emilia. "Modelling the links between socioeconomic status and health in Australia : a dynamic microsimulation approach /". View thesis entry in Australian Digital Theses Program, 2005. http://thesis.anu.edu.au/public/adt-ANU20060127.120857/index.html.

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Jadambaa, Amarzaya. "Bullying in Australia: Prevalence, health outcomes, cost outcomes, and economic evaluation of bullying prevention". Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/206147/1/Amarzaya_Jadambaa_Thesis.pdf.

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Bullying among children and adolescents is a major public health problem. The negative consequences of bullying are not limited to health problems, nor to experiences in childhood and adolescence, and can persist into adulthood. This research found that one in seven Australian children experienced bullying victimisation; bullying victimisation contributes a significant proportion of the burden of disease; a substantial annual cost to Australian society results from bullying; and further investment in bullying prevention is an efficient use of scarce healthcare resources. This thesis makes an important contribution to the field of bullying and the vital role of bullying intervention programmes.

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