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

On the compactification of bounded edge Morse flow trees

Let $L\subset J^1(M)$ be a closed Legendrian submanifold of the 1-jet space of a closed Riemannian manifold $(M,g)$ and consider the moduli space $\mathcal{L}(L,N)$ of Morse flow trees in $L$ with at most $N$ edges. We construct a compactification of $\mathcal{L}(L,N)$, by considering the moduli space $\overline{\mathcal{L}}(L,N)$ of broken flow trees in $L$ with at most $N$ edges, provided that $L$ has simple front singularities and satisfies Ekholm's preliminary transversality condition. In particular, we show that a sequence of Morse flow trees $T_n$, with a uniform edge bound, always has a subsequence that converges to some broken flow tree $\mathcal{T}$.Comment: 36 pages, 7 figures. Various changes. Added definition of true (broken) flow trees. Dealt with phenomenon of removable vertices and ghost edges. Comments appreciate

Participation¿why bother?: The views of Black and Minority Ethnic mental health service users on participation in the NHS in Bradford. Report of a community research process undertaken by the International Centre for Participation Studies, University of Bradford and Sharing Voices (Bradford).

YesThe International Centre for Participation Studies and Sharing Voices Bradford (for information on these organisations, see Appendices 3 and 4) maintain that participation is an important part of a healthy democracy, with benefits for all. However, participation can be anything from empowering to tokenistic, and must be critically examined if we are to understand how to use it effectively. This paper considers the contribution of participation to improved service delivery in the health service. For beneficiaries, participation can be about ownership and responsibility for the services we use, as well as rights and the chance to express what we want from them. For service providers, participation is widely recognised as an effective way of tailoring services to the needs of the different communities they serve. The NHS and other service providers have made great strides in developing mechanisms for participation by service users. However, these do not always reach all sections of the community. Many individuals feel sceptical about getting involved, unconvinced that their contribution could make a real difference. Through the Participation ¿ Why Bother? workshops, we set out to explore these feelings, to reflect on perceived barriers and identify changes that might help overcome them. The aim was not to look at the substance of service delivery issues, but to try and work out how the process of involving people in decision-making in the NHS could be improved, to make it easier for voices from Black and Minority Ethnic (BME) communities to be heard.Bradford District Care Trust; South and West PCT; City tPC

A Case Study of How Principals Create Collaborative Environments

This study examines the perceptions of principals and their respective teachers regarding the principals’ abilities to create a collaborative environment at the elementary level. Isolation of teachers has been a historical practice in most American schools and contributed to a lack of growth among practitioners. Increasing collaboration and ending isolation is one way to improve our country’s educational system for students and teachers. The methodology applied in this study employed a qualitative multiple case study design which provided an in-depth perspective of three elementary school principals and staff respective staff. The major findings of the data collected from interviews, focus groups and observations revealed leaders who possess abilities and support systems including: (a) servant oriented moral compass, (b) developing and maintaining professional relationships, (c) support roles, (d) structured periodic collaborative time, and (e) comprehensive communication are most able to create a collaborative environment. This study yielded important results which could be utilized to further research which would provide valuable insight for practitioners regarding how effective principals’ creation of collaborative teams were at ending teacher isolation

THE RELATIONSHIPS BETWEEN THE PROCESS OF ACCULTURATION OF TEACHERS AND BELIEFS ABOUT STUDENT LEARNING

One of the most challenging aspects of being a school leader is the struggle to get the school staff to embark on school improvement initiatives. The culture of the school can be a powerful driver in or a resister to our ability to move a school forward to increase student learning. New teachers struggle to understand the culture of the school along with the unwritten norms, values, and customs. As they observe the school culture, beginning teachers try to understand their individual power and role in the school culture. A teachers belief in students can help students enhance their chances of education success in the classroom and beyond. Many new teachers enter the profession with this intent. However, disenfranchised veteran teachers can negatively impact their beliefs and convey a school culture that harmfully changes the beliefs of the new teachers. This study answers two research questions: How are new teachers\u27 beliefs shaped by interactions with a range of veteran colleagues and school leaders? In addition, what impact does this dynamic have on school culture? Face-to-face interviews of the new teachers at the site, a questionnaire for new and veteran teachers, an electronic diary entry, a veteran teacher interview, and an interview with the principal were utilized to collect data for this study. The study finds that the new teachers\u27 beliefs were influenced by their colleagues and by their principal. This influence by their colleagues and by their principal once they entered the profession was both positive and negative, depending on the interactions the teachers had with colleagues. Although formal settings, such as department meetings, staff meetings, and professional learning communities provided time for interaction with a range of colleagues, the informal settings were the spaces in which colleagues had more impact on new teachers\u27 beliefs. Of further interest, the study finds not all of the teachers believed their students were capable of learning, thus having an effect on the overall culture of the school.\u2