WHO long form scoring, reliability, validity and norms for New Zealand : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington Campus, New Zealand

Background Self-reported health measures provide information about a wider range of health outcomes than objective measures of health status, such as mortality and hospitalisation rates. National health surveys play a role in monitoring population health. The New Zealand Health Monitor (NZHM) is the organised, co-ordinated and integrated survey programme of the Ministry of Health in New Zealand. The New Zealand Health Survey (NZHS) is one of the chief surveys of the NZHM. One of the categories of information collected in the NZHM is health outcomes, and within this there is the subcategory of health status. The International Classification of Functioning and Disability (ICF) provides the framework to describe the critical elements of non-fatal health outcomes captured by health status instruments. NZHM is to collect data on most if not all of these 21 ICF dimensions. The WHO Long Form was developed as the health module in the WHO Multi-country Survey Study. The WHO Long Form is made up of 20 health domains, some overlapping with the eight SF-36 domains. The WHO Long Form did not have a set scoring system for scales, unlike the SF-36 instrument. The SF-36 has been previously tested and validated in New Zealand in the 1996/97 NZHS. Methods The 2002/03 NZHS used a complex sample design. A total of 12,929 people responded to the survey, with 12,529 respondents being included in the CURF dataset available for research. The health status section of the 2002/03 NZHS measures health-related quality of life (HRQL) covered 16 health and health-related domains. The questions were derived from the SF-36 and the WHO Long Form questionnaire on health status. The health domains covered in the 2002/03 NZHS were general health, vision, hearing, digestion, breathing, pain, sleep, energy and vitality, understanding, communication, physical functioning, self-care. The health-related domains covered in the 2002/03 NZHS were mental health, role-physical and role-emotional (usual activities), and social functioning. There were five key aims specific to the current thesis. First, to group the WHO Long Form items in the 2002/03 NZHS into scales for each health domain and develop standard scoring protocols for each scale. Second, to test the reliability of the scales using standard psychometric tests for the total NZ population and for major population subgroups. Third, to test the validity of the scales using the standard psychometric tests for the total NZ population and for major population subgroups. Fourth, to construct norms for the WHO Long Form scales for the NZ population. And finally, to provide recommendations for the health status component of future NZ health surveys. Results In summary, this thesis developed a method for producing scale scores for domains of health not previously measured in New Zealand Health Surveys, providing greater coverage of domains from the ICF. There were virtually no missing data for all items and subgroups within the questions used to develop the scales. The scaling approach was consistent with that for the SF-36, allowing the new scales to be presented alongside the SF-36 scales. All scales for the total population and major population subgroups met the required criterion for satisfactory psychometric properties, with the exception of digestion and bodily excretions scale. For the digestion and bodily excretions scale, the Cronbach's alpha was lower than that required for between group comparisons. The composite physical functioning and social functioning scales performed no better than the existing SF-36 scales and were highly correlated with these scales. Conclusion Notwithstanding the limitations of this study, key findings of interest are that the new WHO Long Form questions can be used to form scales that cover physical functioning, social functioning, vision, hearing, digestion and bodily excretions, breathing, self-care, understanding, communication and sleep. The majority of the questions and scales work for the NZ population and subgroups. All but one of the scales, digestion and bodily excretions, have satisfactory psychometric properties for the total population and major subpopulation groups of interest. The respondent burden is an important consideration for the NZHS, thus it cannot be argued that enough is gained from adding questions to the physical functioning and Social Functioning domains, thus it would be recommended that the SF-36 scales are used to measure there two domains of health. The new WHO Long Form scales can now be presented alongside the SF-36 scales and used in future analyses looking at interrelationships between factors such as health risk and health status

Promoting green issues and sustainability in UK higher education libraries

Climate change affects us all. Individually and collectively, we must reduce our carbon footprint to protect the future of the planet. But how can higher education libraries contribute? In April of 2007, a request was made to SCONUL libraries – via LIS-SCONUL – for information on library green initiatives that they were taking forward. The responses highlighted that there is growing interest in the issue and that sustainability issues are beginning to be taken very seriously. This is partially driven by the greater awareness of the need to reduce carbon emissions throughout society. Specifically within higher education, it is also a result of encouragement by funding bodies, such as the Higher Education Funding Council for England (HEFCE) (see http://www.hefce. ac.uk/lgm/sustain/), through pressure from groups such as People and Planet and their ‘green league’ of higher education institutions (http:// peopleandplanet.org/gogreen/greenleague2007), and through rewards for excellence such as the Times Higher Education and Higher Education Academy Awards for an outstanding contribution by a higher education institution to sustainable development. Library staff are often active in wider institutional sustainability initiatives and can act as ‘champions’ for environmental issues and initiatives. Most of the libraries that responded to the request for information have aligned their green initiatives/ policies with those of their host organisation. Some libraries have participated in a wider institutional initiative to apply for the environmental management standard, ISO 14001. However, there are many specific ways that libraries can become more environmentally friendly and can make a difference

Characterisation of untreated and treated biodegradable wastes

As part of a Defra sponsored project (WRT220), approximately 40 biodegradable wastes were characterised according to biodegradability (DR4 and BM100), total PTE content, C:N ratio and biochemical composition. Two leaching tests were employed; upflow percolation test and a one step LS10 test; eluates were analysed for TOC, pH, electrical conductivity, PTEs and a range of cations and anions. This paper contains a limited set of data for a selection of untreated and treated waste types representing four waste treatment processes (composting, MBT, MHT, anaerobic digestion). The DR4 and BM100 tests were found to be appropriate for a wide range of waste types but where possible they should be used in conjunction with other related tests. Longer-term MBT composting processes appeared to produce compost material with reduced ammonium concentrations and extractability of some PTEs. Carbon content (carbon analyzer - LECO) could be estimated as C = LOI/1.9 which is a routine operation. N LECO values were approximately 12% greater than the equivalent N Kjeldahl values

A laboratory study of the use of lime stabilisation on contaminated and uncontaminated clays

This study presents the results of experimental research carried out to investigate the effects of lime treatment on naturally deposited kaolinite clay, containing quartz, and a contaminated clay, containing calcium sulfide and heavy metals, known as galligu. The efficacy of lime stabilisation may be evaluated using unconfined compressive strength (U CS) tests which were carried out for different lime contents (0%, 5% and 10% of the sample mass) and various curing times (7, 28 and 90 days). Chemical and mineralogical changes of the two clays were established using X - R ay diffraction (XRD) and X - Ray flu orescence (XRF) in order to establish their effect on the geotechnical properties of the stabilised materials. Lime stabilised clay demonstrated improved geotechnical characteristics including a drop in moisture content (the ratio of the mass of water to the mass of solids in soil), increase in bulk density (the weight of the soil in a given volume, in this case 1m 3 ) and decrease in air voids (pockets of air between aggregate particles in the soil). However the net geotechnical improvements in the natural clay were demonstrably less than the galligu, principally in terms of strength. Galligu as recovered has a high moisture content and the alkaline conditions were able to supply sufficient moisture and the optimum chemical environment for effective cation exchanges and pozzolanic reactions. For the natural clay the lime addition caused an increase in the optimum moisture needed for effective compaction, which was higher than the natural moisture content of the clay

Different Executive Functions Support Different Kinds of Cognitive Flexibility: Evidence From 2-, 3-, and 4-Year-Olds

Improvements in cognitive flexibility during the preschool years have been linked to developments in both working memory and inhibitory control, though the precise contribution of each remains unclear. In the current study, one hundred and twenty 2-, 3-, and 4-year-olds completed two rule-switching tasks. In one version, children switched rules in the presence of conflicting information, and in the other version, children switched rules in the presence of distracting information. Switching in the presence of conflict improved rapidly between the ages of 3 and 3.5 years, and was associated with better working memory. Conversely, switching in the presence of distraction developed significantly between the ages of 2 and 3 years, and was associated with better inhibitory control

Application of DR4 and BM100 Biodegradability tests to treated and untreated organic wastes

The aerobic DR4 and anaerobic BM100 biodegradability tests are currently applied in England and Wales for monitoring the reduction in biological municipal waste (BMW) achieved by mechanical biological treatment (MBT) plants (Environment Agency 2005). The protocol is applied only when outputs are landfilled and is based on estimating the reduction in potential biogas production between the MBT input, municipal solid waste (MSW), and all of the landfilled outputs, using the BM100 test. As this is a long term 100 day test the more rapid 4 day DR4 test may also be applied as this has been shown to correlate with the BM100 test. We have now applied the DR4 and BM100 tests to 132 organic waste samples including untreated and treated BMW and specific organic wastes. The results indicate that the correlation between the DR4 and BM100 tests has proved valid for mixed MSW derived BMW wastes. However when both tests are applied to specific organic wastes such as turkey feathers, cardboard packaging waste and pizza food wastes the correlation between the tests is less strong. It is concluded that the use of the DR4 and BM100 test correlation is valid for its designed application (monitoring MBT processes treating MSW derived mixed BMW), but that caution should be exercised when applying both tests to specific single component organic wastes

Energy consumption and capacity utilization of galvanizing furnaces

An explicit equation leading to a method for improving furnace efficiency is presented. This equation is dimensionless and can be applied to furnaces of any size and fuel type for the purposes of comparison. The implications for current furnace design are discussed. Currently the technique most commonly used to reduce energy consumption in galvanizing furnaces is to increase burner turndown. This is shown by the analysis presented here actually to worsen the thermal efficiency of the furnace, particularly at low levels of capacity utilization. Galvanizing furnaces are different to many furnaces used within industry, as a quantity of material (in this case zinc) is kept molten within the furnace at all times, even outside production periods. The dimensionless analysis can, however, be applied to furnaces with the same operational function as a galvanizing furnace, such as some furnaces utilized within the glass industry. © IMechE 2004