L.I.F.E. Landscape: A Co-created Healing Environment for Vulnerable Maasai Youth

Thesis (Master's)--University of Washington, 2016-06

Trial of print and telephone delivered interventions to influence walking

Background. Both self-help print materials and telephone-assisted counseling have generally proved useful strategies to increase physical activity. This study examined their effectiveness in an intervention aimed specifically at promoting walking for specific purposes. Methods. Participants (n = 399) were randomly allocated to one of two 3-week intervention programs. The Print program comprised multiple mailing of brochures that emphasized walking within the local community environments. The Print plus Telephone program received the same brochures plus three telephone calls. Data collected via mailed self-completed surveys were analyzed by exploring outcomes related to walking for specific purposes. Results. There were no significant differences between the two programs in any of the walking measures. Both groups significantly increased time reported walking for exercise per week [Print: t(1,277) = -3.50, P < 0.001; Print plus telephone: t(1,106) = -2.44, P < 0.016]. Significantly, more participants in the Print plus Telephone group reported receiving and reading the materials (chi(2) = 20.11, P < 0.0001). Conclusions. The intervention programs were more successful at increasing walking for exercise than for any other purpose. The addition of brief telephone support was successful in focusing participants' attention on the print materials, but did not result in any additional increase in walking. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.

Suicide in developing countries (3) Prevention efforts

Until now, suicide prevention efforts have been limited in developing countries, although there are pockets of excellent achievement. Various universal, selective, and indicated interventions have been implemented, many of which target a different pattern of risk factors to those in developed countries. In the absence of sufficient mental health services, developing countries rely heavily on nongovemment organizations (NGOs) to provide crisis interventions for suicidal individuals, as well as proactive interventions aimed at raising community awareness and building resilience. Often these NGOs work within a social and public health framework, collaborating with others to provide nested suicide prevention programs that are responsive to local community needs. There is a clear need to develop appropriate, relevant and effective national suicide prevention plans in developing countries, since, to date, only Sri Lanka has done so. These plans should focus on a range of priority areas, specify the actions necessary to achieve positive change in these priority areas, consider the range of collaborators required to implement these actions, and structure their efforts at national, regional, and local levels. The plans should also promote the collection of accurate data on completed and attempted suicide, and should foster evaluation efforts.

Public opinion of a proposed wind farm situated close to a populated area in New Zealand: Results from a cross-sectional study

In accordance with New Zealand’s Resource Management Act 1991, in 2003, electricity generating company Genesis Energy made public its intention to apply for consent to build the Awhitu wind farm. Several community groups claiming to represent the majority opposed this application and in September 2004 consent was declined. The aim was to investigate the attitudes of local community members to the proposed wind farm. A survey was mailed to 500 Franklin residents, systematically selected from the local 2004/2005 telephone directory. Forty questionnaires were returned undelivered. Of the remaining 460, completed questionnaires were returned from 46% (211). Most, 70% (145), residents supported a wind farm being built in their area, with 17% (35) neutral, and only 13% (28) against the farm. There was no statistical difference in respondents’ attitudes between sex, age, or residential proximity to the farm. Respondents listed renewable resource (83%), suitability (78%), and environmental friendliness (76%) as main advantages. Visual unsightliness (24%) and noise pollution (21%) were listed as main perceived disadvantages. Contrary to the assertions of several lobby groups, the majority of local residents support the construction of the Awhitu wind farm. Scientifically robust methods are essential to measure appropriately community attitudes, particularly on contentious issues.

Website physical activity interventions: preferences of potential users

Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.

An analysis of returned medicines in primary care

Objective: The number of pharmaceutical items issued on prescription is continually rising and contributing to spiralling healthcare costs. Although there is some data highlighting the quantity, in terms of weight of medicines returned specifically to community pharmacies, little is known about the specific details of such returns or other destinations for wasted medications. This pilot study has been designed to investigate the types and amounts of medicines returned to both general practices (GPs) and associated local community pharmacies determining the reasons why these medicines have been returned. Method: The study was conducted in eight community pharmacies and five GP surgeries within East Birmingham over a 4-week period. Main outcome Measure: Reason for return and details of returned medication. Results: A total of 114 returns were made during the study: 24 (21.1) to GP surgeries and 90 (78.9) to community pharmacies. The total returns comprised 340 items, of which 42 (12.4) were returned to GPs and 298 (87.6) to pharmacies, with the mean number of items per return being 1.8 and 3.3, respectively. Half of the returns in the study were attributed to the doctor changing or stopping the medicine; 23.7 of returns were recorded as excess supplies or clearout often associated with patients' death and 3.5 of returns were related to adverse drug reactions. Cardiovascular drugs were most commonly returned, amounting to 28.5 of the total drugs returned during the study. Conclusions: The results from this pilot study indicate that unused medicines impose a significant financial burden on the National Health Service as well as a social burden on the United Kingdom population. Further studies are examining the precise nature of returned medicines and possible solutions to these issues. © Springer 2005.

A sociological analysis of four police consultative committees in Birmingham

Consultation between the police and the community was a recommendation of Lord Scarman in his report into the Brixton riots in 1981. By 1982 the West Midlands Police Authority had established local consultative committees on each police sub-division. This thesis is a study of four Police Consultative Committees in Birmingham, using qualitative methods of attendance at committee meetings and interviews with committee members. The research was carried out between 1990 and 1992 - ten years after formal consultation was established, and aimed to examine the relationship between the micro social processes of the committees and key sociological theoretical concepts. The analysis of the four committees contextualises them within the social and political parameters of urban policing in the late 1980s. Each committee is taken as a case study to highlight the following aspects of consultation:- relations between the police and black communities; membership, representation and accountability; responding to community conflict; crime prevention agencies and networks of social control. The findings are then generalised to the sociological theoretical concepts of hegemony, legitimation, community conflict and social control. The central proposition of this thesis is that, whilst these committees are not fulfilling the role Lord Scarman envisaged for them (of involving local community representatives in policing strategies and policies), they do have important policing and political roles. It is argued that they offer a platform from which senior police officers can engage local people into supporting policing objectives without actually involving them in determining those objectives. Furthermore, such committees have political symbolism in that they enable the government to be seen to be responding to the issues of accountability and relations between the police and black communities following the urban disorders, without actually devolving any statutory powers to the community.

Learning for life:educational provision at Cadbury, 1831-1981

Cadbury showed concern for the welfare of its labour force in a variety of ways and not least in the provision of educational and educative-recreational facilities. The firm regarded the education of employees as having a positive effect on the efficiency of the business at the same time as being of benefit to the individual, the local community and the nation. The life-long education of people was seen as essential for personal fulfilament, social improvement, economic competitiveness and the proper functioning of democratic procedures. The educational system built up at Cadbury, and the philosophy on which it was founded, acquired both a domestic and international reputation. Its main components were the day continuation education of juniors; the Bournville Works Evening Institute; vocational and non-vocational scholarships; emphasis on the primary importance of general education as a basis for life, work and technical training; stress on equality of educational opportunity for females; and leisure and sporting amenities which the firm felt to be educative in the sense that they contributed to personal psychological and physical development and social skills. The system was primarily shaped and constructed in the first three decades of the twentieth century and went into decline and eventual demise in the 1960's and 1970's as a result of economic pressures, social changes, enhanced state arrangements for education, shifts in Cadbury management thinking and the merger with Schweppes in 1969.

Evaluation of vulnerability factors for cyclones : the case of Patuakhali, Bangladesh

Tropical cyclones are considered as the most severe natural disasters in Bangladesh; they cause extensive damage, create losses in the country׳s economy, and affect social settings. The impact of natural disasters has been further intensified due to various vulnerability factors within the Bangladeshi community such as low income; shortages of food; lack of assets such as land and permanent housing; dense population, illiteracy. This study evaluates the vulnerability factors for cyclones in the community based in the Patuakhali region of south western Bangladesh. The bottom-up research approach was adopted for the study, whereby the local community was consulted for their viewpoints by using focus group interviews and semi-structured interviews. Different community groups and social categories including both men and women, from different age groups and livelihoods, participated in the study. The study revealed how the community׳s vulnerability to cyclones has been further aggravated by socio-economic factors such as social status, political influences and economic conditions. The majority of the community in Patuakhali has been “knowingly” vulnerable to cyclone disaster as a result of the lack of alternatives especially in terms of their livelihood patterns. The vulnerability of women, due to their lack of authority, domestic work, and fear of exposure within the society was also highlighted. The study revealed how vulnerability factors are interlinked with each other making them further difficult to manage. This calls for multi-faceted disaster risk reduction strategies that targets vulnerability factors deriving from different origins and root causes.

Development and psychometric tests of the Chinese-version low vision quality of life questionnaire

Background/Aims: To develop and assess the psychometric validity of a Chinese language Vision Health related quality-of-life (VRQoL) measurement instrument for the Chinese visually impaired. Methods: The Low Vision Quality of Life Questionnaire (LVQOL) was translated and adapted into the Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The CLVQOL was completed by 100 randomly selected people with low vision (primary group) and 100 people with normal vision (control group). Ninety-four participants from the primary group completed the CLVQOL a second time 2 weeks later (test-retest group). The internal consistency reliability, test-retest reliability, item-internal consistency, item-discrimination validity, construct validity and discriminatory power of the CLVQOL were calculated. Results: The review committee agreed that the CLVQOL replicated the meaning of the LVQOL and was sensitive to cultural differences. The Cronbach's α coefficient and the split-half coefficient for the four scales and total CLVQOL scales were 0.75-0.97. The test-retest reliability as estimated by the intraclass correlations coefficient was 0.69-0.95. Item-internal consistency was >0.4 and item-discrimination validity was generally <0.40. The Varimax rotation factor analysis of the CLVQOL identified four principal factors. the quality-of-life rating of four subscales and the total score of the CLVQOL of the primary group were lower than those of the Control group, both in hospital-based subjects and community-based subjects. Conclusion: The CLVQOL Chinese is a culturally specific vision-related quality-of-life measure instrument. It satisfies conventional psychometric criteria, discriminates visually healthy populations from low vision patients and may be valuable in screening the local community as well as for use in clinical practice or research. © Springer 2005.

Evaluation of vulnerability factors for cyclones:the case of Patuakhali, Bangladesh

Tropical cyclones are considered as the most severe natural disasters in Bangladesh; they cause extensive damage, create losses in the country[U+05F3]s economy, and affect social settings. The impact of natural disasters has been further intensified due to various vulnerability factors within the Bangladeshi community such as low income; shortages of food; lack of assets such as land and permanent housing; dense population, illiteracy. This study evaluates the vulnerability factors for cyclones in the community based in the Patuakhali region of south western Bangladesh. The bottom-up research approach was adopted for the study, whereby the local community was consulted for their viewpoints by using focus group interviews and semi-structured interviews. Different community groups and social categories including both men and women, from different age groups and livelihoods, participated in the study. The study revealed how the community[U+05F3]s vulnerability to cyclones has been further aggravated by socio-economic factors such as social status, political influences and economic conditions. The majority of the community in Patuakhali has been "knowingly" vulnerable to cyclone disaster as a result of the lack of alternatives especially in terms of their livelihood patterns. The vulnerability of women, due to their lack of authority, domestic work, and fear of exposure within the society was also highlighted. The study revealed how vulnerability factors are interlinked with each other making them further difficult to manage. This calls for multi-faceted disaster risk reduction strategies that targets vulnerability factors deriving from different origins and root causes. © 2014 Elsevier Ltd.

SME resilience to extreme weather events:important initiatives for informing policy making in the area

Enhancing the resilience of local communities to weather extremes has gained significant interest over the years, amidst the increased intensity and frequency of such events. The fact that such weather extremes are forecast to further increase in number and severity in future has added extra weight to the importance of the issue. As a local community consists of a number of community groups such as households, businesses and policy makers, the actions of different community groups in combination will determine the resilience of the community as a whole. An important role has to be played by Small and Medium-sized Enterprises (SMEs); which is an integral segment of a local community in the UK, in this regard. While it is recognised that they are vital to the economy of a country and determines the prosperity of communities, they are increasingly vulnerable to effects of extreme weather. This paper discusses some of the exploratory studies conducted in the UK on SMEs and their ability to cope with extreme weather events, specifically flooding. Although a reasonable level of awareness of the risk was observed among the SMEs, this has not always resulted in increased preparedness even if they are located in areas at risk of flooding. The attitude and the motivation to change differed widely between SMEs. The paper presents schemas by which the SMEs can identify their vulnerability better so that they can be populated among a community of SMEs, which can be taken forward to inform policy making in this area. Therefore the main contribution the paper makes to the body of knowledge in the area is a novel way to communicate to SMEs on improving resilience against extreme weather, which will inform some of the policy making initiatives in the UK.

The influence of socio-cultural environments on the performance of nascent entrepreneurs:an instrumental variable approach

The importance of informal institutions and in particular culture for entrepreneurship is a subject of ongoing interest. Past research has mostly concentrated on cross-national comparisons, cultural values, and the direct effects of culture on entrepreneurial behavior, but in the main found inconsistent results. The present research adds a fresh perspective to this research stream by turning attention to community-level culture and cultural norms. We hypothesize indirect effects of cultural norms on venture emergence. Specifically that community-level cultural norms (performance-based culture and socially-supportive institutional norms) impact important supply-side variables (entrepreneurial self-efficacy and entrepreneurial motivation) which in turn influence nascent entrepreneurs’ success in creating operational ventures (venture emergence). We test our predictions on a unique longitudinal data set (PSED II) tracking nascent entrepreneurs venture creation efforts over a 5 year time span and find evidence supporting them. Our research contributes to a more fine-grained understanding of how culture, in particular perceptions of community cultural norms, influences venture emergence. This research highlights the embeddedness of entrepreneurial behavior and its immediate antecedent beliefs in the local, community context.

Genomic variation of HIV-1 and its effects on drug resistance and molecular epidemiology analyses

In the first part of this study human immunodeficiency virus type 1 (HIV-1) proviral DNA sequences derived from 201 clones of the C2-V3 env region and the first exon of the tat gene were obtained from six MV-1 infected heterosexual couples. These molecular data were used to confirm the epidemiological relationships. The ability of the molecular data to draw such conclusions was also tested with multiple phylogenetic analyses. The tat region was much more useful in establishing epidemiological relationships than the commonly used C2-V3.^ Subsequently, using nucleotide sequences from the first exon of the Tat gene, we tested the hypothesis that a Florida dentist (a common source) infected five of his patients in the course of dental procedures, against the null hypothesis that the dentist and each individual of the dental group independently acquired the virus within the local community. Multiple phylogenetic analyses demonstrated that the sequences of the five patients were significantly more related to each other than to sequences of the controls. Our results using Tat sequences, combined with envelope sequence data, strongly support a common phylogenetic epidemiological relationship among these five patients.^ A third study is presented, which deals with the effects of genomic variations in drug resistance. HIV-1 reverse transcriptase (RT) mutations were detected in DNA from peripheral blood mononuclear cells from 11 of 12 HIV-infected children after 11-20 months of zidovudine monotherapy. The codon 41/215 mutant combination was associated with general decline in health status. Patients developing the codon 70 mutation tended to have a better health status. ^

The influence of HOPE VI public housing on public schools

In the United States, public school enrollment is typically organized by neighborhood boundaries. This dissertation examines whether the federally funded HOPE VI program influenced performance in neighborhood public schools. In effect since 1992, HOPE VI has sought to revitalize distressed public housing using the New Urbanism model of mixed income communities. There are 165 such HOPE VI projects nationwide. Despite nearly two decades of the program's implementation, the literature on its connection to public school performance is thin. My dissertation aims to narrow this research gap. There are three principal research questions: (1) Following HOPE VI, was there a change in socioeconomic status (SES) in the neighborhood public school? The hypothesis is that low SES (measured as the proportion of students qualifying for the Free and Reduced Lunch Program) would reduce. (2) Following HOPE VI, did the performance of neighborhood public schools change? The hypothesis is that the school performance, measured by the proportion of 5th grade students proficient in state wide math and reading tests, would increase. (3) What factors relate to the performance of public schools in HOPE VI communities? The focus is on non-school, neighborhood factors that influence the public school performance. For answering the first two questions, I used t-tests and regression models to test the hypotheses. The analysis shows that there is no statistically significant change in SES following HOPE VI. However, there are statistically significant increases in performance for reading and math proficiency. The results are interesting in indicating that HOPE VI neighborhood improvement may have some relationship with improving school performance. To answer the third question, I conducted a case study analysis of two HOPE VI neighborhood public schools, one which improved significantly (in Philadelphia) and one which declined the most (in Washington DC). The analysis revealed three insights into neighborhood factors for improved school performance: (i) a strong local community organization; (ii) local community's commitment (including the middle income families) to send children to the public school; and (iii) ties between housing and education officials to implement the federal housing program. In essence, the study reveals how housing policy is de facto education policy.