797 results for Doctoral, 2010

  • Teacher cognition about technology-mediated EFL instruction in the Thai tertiary context : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Second Language Teaching at Massey University

    Suwannasom, Thitirat (2010)

    Doctoral thesis
    Massey University

    Drawing on theories of teacher cognition and sociocultural frameworks, this study investigates Thai university English lecturers’ cognition about integrating Information and Communication Technology (ICT) in English language instruction and writing instruction in Thai tertiary contexts. A more specific goal is to investigate technology-using teachers’ personal principles and practices in their teaching contexts. The study was guided by the following research questions: What is the nature of Thai tertiary teacher cognition about the use of technology in EFL instruction? What is the nature of Thai tertiary teacher cognition about the use of technology in EFL writing instruction? How do Thai tertiary teachers perceive their practices and roles in relation to their technology-mediated EFL instruction in particular settings? In Thai tertiary education, what are the sociocultural aspects that shape teacher cognition and practice about technology-mediated EFL teaching? A teacher cognition questionnaire was designed and administered to 47 Thai EFL lecturers in seven public universities; semi-structured interviews and scenario-based tasks were conducted with seven lecturers; unstructured interviews and observations were carried out with three teachers who used technology in their classroom teaching in order to gain a better understanding of their situated perceptions about the use of technology in particular teaching and learning contexts. The results reveal that university EFL teachers’ views of technology are highly shaped by both their teaching environment and individual beliefs about English language learning. When teachers apply technology in their instruction, they also apply their personal principles or maxims that guide their practices. In addition, a number of sociocultural aspects emerged in teachers’ views about technology use in their EFL teaching contexts giving rise to theoretical implications about how teacher cognition is conceptualised. Some of the major implications for practice include: the need to encourage EFL teachers to reflect on their teaching principles relevant to their working contexts; the value of providing teachers with models of technology use in tertiary EFL teaching; and the maximisation of the use of available technology to support local practices. Implications for methodology include the use of multiple context-specific instruments and methods to elicit teachers’ underlying beliefs and perspectives about technology-mediated teaching.

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  • The development of a music therapy school consultation protocol for students with high or very high special education needs : a thesis presented in fulfilment of the requirement for the degree of Doctor of Philosophy in Music, New Zealand School of Music

    Rickson, Daphne Joan (2010)

    Doctoral thesis
    Massey University

    Music therapy school consultation is positioned to become a significant practice for music therapists. Historically, music therapy work with children who have special education needs in New Zealand has focused on those who attend special schools or units and, according to the published literature, seems to have taken place in clinic settings or withdrawal rooms. The current emphasis on inclusive education demands that music therapists consider other ways of working. Further, a paucity of music therapists and the geographic isolation of many students who attend their local schools suggest that the large majority of students who would benefit are unable to access music therapy services. The aims of the current study therefore were for a music therapist to empower members of special education teams to use music experiences which had been especially planned to assist children to meet individual developmental or academic goals, and to describe how the process was perceived, understood, used, and valued by participants. A further aim was to develop and trial a protocol for music therapists undertaking consultation work. Eight registered music therapists interviewed in stage one of the study, to aid the development of the initial protocol, had differing views and attitudes about consultation, and findings confirmed the need to clearly define the practice. The initial protocol was therefore fragile, based on limited understandings from sparse music therapy consultation literature and the author‟s previous experience of working with team members in isolated areas. In stage two, four consecutive case studies enabled the protocol to be trialled in the field and, using an action research approach, to be developed further. Accumulated learning outcomes led to the development of a music therapy school consultation protocol based on social learning theory which emphasises the interdependent relationships between the consultant‟s (music therapist), consultees‟ (identified team members), and clients‟ (students) behaviour, their internal personal factors, and environmental factors. The establishment of collaborative relationships, and an ecological assessment which is based on the theory that human development is influenced by environmental systems (Bronfenbrenner, 1989), are critical components of the protocol. Thus the music therapist spends a full week at each student‟s school. Findings demonstrate that interacting with team members as they went about their daily lives led to deeper understanding of their needs and in turn enabled pragmatic, accessible, and meaningful music activities and strategies to be successfully implemented. A „clinical‟ music therapy session remains an important part of the protocol, but findings suggest its primary significance is in highlighting students‟ strengths so that team members develop fresh understandings and increasingly positive views of students that enhance their mutual relationships. Team members became more motivated, energised, self reflective, and able to support as well as challenge their students‟ development. They were thus able to continue to use, develop and evaluate their use of music strategies, after the music therapist left the field. Music therapists are currently unprepared for the triadic relationships and the emphasis on adult empowerment that is fundamental to consultation. The findings therefore have significant implications for music therapy practice and training. These implications, including areas for future research, are discussed herein.

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  • Analysis of fungal inteins

    Bokor, Annika Anna Maria (2010)

    Doctoral thesis
    University of Otago

    xxvi, 298 leaves :col. ill ; 30 cm. Includes bibliographical references. University of Otago department: Biochemistry. "November 1, 2010"

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  • Rich and well, poor and sick? The relationship between income and self-rated health from the New Zealand household panel Survey of Family, Income and Employment (SoFIE)

    Imlach Gunasekara, Fiona Helen (2010)

    Doctoral thesis
    University of Otago

    Background This thesis investigates the relationship between income and health in New Zealand adults, using longitudinal data from the household panel Survey of Family, Income and Employment, 2002 to 2005. Evidence for a cross-sectional relationship between income and health is strong, but may be affected by confounding. Longitudinal data, with repeated measures on the same individuals, can be analysed to control for much of the confounding that biases cross-sectional analyses, giving a more accurate estimate of the causal impact of income on health. Methods and Results The outcome used was self-rated health (SRH), a five-level ordinal variable. The primary analytical method used was fixed effects regression modelling, which controls for time-invariant confounders, but applying this method to an ordinal outcome was challenging. Two fixed effects ordinal models were compared. These found that an increase in income of $10,000 increased the odds of better SRH by 0.6% (95% confidence interval -0.3% to 1.5%; ‘hybrid’ proportional odds model) to 0.9% (95% confidence interval -0.4% to 2.3%; amalgamated conditional logistic regression model). Random effects proportional odds models, which did not adequately control for bias from unmeasured time-invariant confounders, gave larger and statistically significant income estimates. Conclusions A modest (and statistically insignificant) association of changing income with changing SRH in New Zealand adults was found over the short-term, having controlled rigorously for confounding. The small size of the income estimate was consistent with results from other longitudinal studies. However, this thesis (and similar research) may have underestimated the putative causal association between income and health due to measurement error in income and changes in income over time. Likewise, SRH, as a general health measure, prone to ceiling effects and measurement error, may not be an ideal repeated measures outcome. Changes in SRH over time occur in response to changes in both mental and physical health and short term income changes may have different effects on mental and physical health outcomes. Long term income rather than short term income changes may be more relevant for health and time lags longer than one year between changes in income and effects on health were not accounted for.

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  • The influence of skill and low back pain on peak and cumulative spine loads during wool harvesting

    Pal, Poonam (2010)

    Doctoral thesis
    University of Otago

    Sheep shearing is a physically demanding occupation, with high energy expenditure, spinal loads and risk of back injury. The cost of injury compensation and rehabilitation for this workforce is considerable. Although research shows the use of a commercially available trunk harness will significantly reduce spinal loads, there has been no investigation of worker skill on spinal loads and risk of injury. A higher skill level is accepted by the wool harvesting industry as improving quality of work and productivity. Others within the industry consider that increased skill lowers risk of injury by improving animal control and working in less demanding postures. Some research has shown a positive effect of skill within other occupations and tasks; such as a reduction in energy expenditure, spinal cumulative loads and asymmetric movements while others have shown no such effect. The aims of this research are to quantify lumbo-sacral cumulative and peak forces experienced by workers in the wool harvesting industry, and to determine how skill and a history of low back pain requiring clinical intervention (LBP-Clin) impact on these loads. Following ethical approval a total of 140 participants (80 shearers and 60 wool handlers) were recruited and surveyed during formal shearing and wool handling competitions in Southern New Zealand. Each subject was then video-taped while executing 3 to 5 consecutive trials (dependent on skill level and competition requirements) of their normal task cycle. These video clips were analysed by using posture binning and load analysis software (3D Match) that incorporated 3D kinematics, external hand forces and anthropometric data to calculate the peak and cumulative loads on the L4/L5 segment. Cumulative loads were then extrapolated to an 8-hour work day. Correlation analysis was performed to determine collinearity between e xplanatory (independent) variables. Univariate linear regression models were initially used to determine the individual influence of skill and LBP-Clin on cumulative and peak spinal forces while multivariate linear regression models were used to determine the combined influence of skill and LBP-Clin on cumulative and peak spinal forces. For shearers mean peak lumbo-sacral compression, joint anterior shear, joint anterior reaction shear, and extensor moments for shearers were 3828.7N, 230N, 458.3N, and 185.1Nm respectively. For wool handlers these peak lumbo-sacral loads were 3194.2 N, 189.2 N, 391.4 N and 165.1 Nm. Mean cumulative compression, force weighted compression, joint anterior shear, joint anterior reaction shear, and extensor moments for shearers were 82.6 MN.s, 84.8 MN.s, 5.4 MN.s, 11.8 MN.s and 4.2MNm.s while these mean cumulative scores were considerably less for wool handlers at 48.7 MN.s, 48.9 N.s, 2.53 MN.s, 5.7 MN.s and 0.023 Nm.s. Skill was associated with decreased peak catch and drag compressive force for junior, intermediate and senior shearers and also decreased cumulative extensor moments for junior and senior wool handlers. LBP-Clin was only associated with an increased peak extensor moment during the catch and drag for shearers while LBP-Clin had no significant influence on any peak or cumulative force for wool handlers. The interaction variable for skill and LBP-Clin also showed no significant influence on peak or cumulative forces for either shearers or wool handlers. Although this study demonstrates minimal influence for skill or LBP-Clin (or their interaction) on cumulative and peak cumulative and anterior shear forces, the prevalence of LBP-Clin within each skill level increases considerably (particularly for shearers). Interestingly increased skill is also strongly predictive of a considerable increase in productivity (or tally). Thus increased skill appears to be primarily beneficial in terms of increased wool production and task efficiency. Further research with a larger within-skill sample size and prospective design is needed to confirm these results. Other biomechanical factors such as body position within working postures, time spent in different postures, harvesting techniques, and non-sagittal postures and forces (medio- lateral shear and reaction forces) may also be linked to skill and LBP-Clin. Exploring the effect of these other biomechanical factors continues within the occupational biomechanics research team at the University of Otago. Similarly personal and psychosocial factors are recognised as being linked to injury and injury risk within the overlapping fields of ergonomics and occupational health. The part they play in injury risk within the wool harvesting occupations is unknown and is also under exploration. A recommendation for the wool harvesting industry is to continue with formal skill training as it does not appear to expose the worker to increased cumulative or peak spinal loading and it is strongly associated with productivity. However the marked increase in working lifetime prevalence of LBP-Clin in this physically demanding occupation is clearly a problem and it may be that exposure to such high compressive and shear forces (independent of skill) exceeds yet to be determined cumulative loading thresholds that lead to risk of low back injury. While postural demands and non-sagittal forces during traditional shearing also need to be investigated, development of alternative upright posture wool harvesting strategies is an industry identified direction for reduction of injury risk that is biomechanically sound and now under investigation.

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  • Who talks more? How the satisfaction - word of mouth relationship varies across services

    Lang, Bodo (2010)

    Doctoral thesis
    University of Otago

    This thesis is about word of mouth (WOM), which is informal communication between consumers about a product or a service, with no party being formally rewarded. This thesis focuses on the relationship between customer satisfaction and WOM. Research has found support for three competing relationships: A positivity bias, where highly satisfied customers engage in more WOM than highly dissatisfied customers; a negativity bias, where highly dissatisfied customers engage in more WOM than highly satisfied customers; and lastly a symmetric relationship, where highly satisfied customers and highly dissatisfied customers engage in similar amounts of WOM. This thesis uses a taxonomy of service encounters to resolve these conflicting findings. The taxonomy is based on three variables: the duration of an encounter, the level of affect (emotional arousal) during the encounter, and the spatial proximity between staff and the customer during the encounter. The two extreme encounters in this taxonomy can be described as EAI (i.e. enduring, affectively charged and intimate distance) and BRD (i.e. brief, rational and public distance). This thesis proposes that the shape of the satisfaction – WOM relationship (positivity bias, negativity bias or symmetric) depends on the type of service encounter. Specifically, BRD encounters are predicted to result in a negativity bias, whereas EAI encounters are expected to exhibit a positivity bias. A mixed methods approach was used to investigate the satisfaction - WOM relationship. The qualitative phase consisted of semi-structured interviews and the data was analysed with a number of techniques. Results confirmed satisfaction as a key driver of WOM and also showed that the satisfaction – WOM relationship varied across different types of services. Importantly, a previously unconsidered variable, WOM's entertainment value, was discovered and shown to be highly associated with consumers’ WOM activity. During the quantitative phase a new measure of WOM intentions was developed and the measure showed high levels of validity and reliability. A Multiple Analysis of Variance (N = 281) supported the positivity bias for EAI encounters and the negativity bias for BRD encounters, thus reconciling the conflicting findings in the WOM literature. This can be considered as the major empirical contribution of this thesis. A Multiple Analysis of Covariance documented the strong impact of entertainment value on WOM activity, which confirms the importance of this construct in WOM research. Similar results were obtained in a second sample (N = 158). Results were explained using the self-serving bias (SSB), where consumers use positive WOM to enhance their self esteem and how other consumers perceive them, thereby engaging in a lot of WOM about highly satisfactory EAI encounters. Conversely, consumers attempt to reduce the potential self-threat of WOM, thus they talk less about highly dissatisfying EAI encounters. This thesis casts doubts over the widely-held misbelief that highly dissatisfied customers engage in more WOM than highly satisfied customers. Instead, this thesis suggests a more subtle relationship: In some categories (e.g. EAI services) highly satisfied customers will engage in more WOM, while in other categories (e.g. BRD services) highly dissatisfied customers are likely to engage in more WOM.

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  • The Making of New Zealanders: The evolution of national identity in the nineteenth century

    Palenski, Ronald Allan (2010)

    Doctoral thesis
    University of Otago

    This study examines the gradual development of New Zealand identity, the process during which immigrants in the nineteenth century began to think of themselves as New Zealanders rather than as transplanted Britons or immigrants from other overseas shores, including most particularly the other Australasian colonies. It contends that this process was made manifest earlier than has hitherto been postulated. Events held earlier as breakthroughs in a sense of national identity, such as the federation of Australia in 1901, the Boer War of 1899-1902, the rugby union team’s tour of the United Kingdom and France in 1905-06 and the Gallipoli campaign in 1915, were rather outward affirmations of the identity that had already taken shape. It studies some aspects of mid-nineteenth century New Zealand history that have rarely been remarked upon in the historiography, such as an early opposition to the fledgling country becoming a penal colony and to the introduction of a uniform time for the whole of the country. These are held to have been early markers of an evolving national identity. Others, such as the role of Māori, provided a unique dimension and led to a fused national identity between the indigenous and the recent arrivals. Māori in fact provided the lead in the sport that came to be regarded as “the national game,” rugby union. Landmark legislation, especially the world-first giving the franchise to women on a national basis, is also seen as having significant impact on the evolution of national identity. While some of the legislative change was also adopted elsewhere, it was an aggregation of the changes that made New Zealand distinctive and to be seen as a “social laboratory.” While the concept of national identity may have become passé among historians, and even be seen as being misleading and applying to a few rather than to the many, post-modern thinking cannot change what happened; it can only change interpretations of events of the past. This thesis is about the British and others who migrated to New Zealand from the 1840s, how they came to see themselves as New Zealanders and the various agencies that brought about that change. Whether that was right or wrong, or whether national identity is a devalued concept, is a debate for another time and another place. This is about the making of New Zealanders.

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  • eCommerce Website Evaluation framework: An Owner's Perspective

    Ghandour, Ahmad (2010)

    Doctoral thesis
    University of Otago

    In New Zealand, many businesses are investing in setting up their websites to sell goods and services as online trading becomes more popular. This action has caused disillusionment for some companies as it is difficult to clearly articulate the real benefits which could be derived from being online. This is may be due to the lack of an evaluation framework that enables owners to diagnose the performance of their eCommerce website. Current evaluative approaches presented in the literature are based on the users’ experience and fail to address the owner’s concerns. The research presented here is focussed on how to evaluate eCommerce websites based on the owner’s experience point of view. In order to be able to evaluate eCommerce websites, this study: (a) proposed a conceptual framework for eCommerce website evaluation, (b) developed measurement scales for the conceptual framework, (c) collected data based on owners’ perceptions (experience) with their websites, (d) tested the scale in businesses implementing eCommerce websites, and (e) investigated the relationship between the dimensions in the conceptual framework. The proposed research model is based on the current conceptualisation of Information Systems (IS) success models which suggest that success is a multidimensional construct. However, the customer experience is the dominant view taken in these success models. In the proposed model, and in order to address the concern of businesses setting up a website, evaluation is considered from the owner point of view. That is, a process model which links website offer to its payoffs through usage. Extra theoretical perspectives were necessary to account for the shift to the owner’s experience. Since the evaluation is based on the owner’s process understanding of creating a website, the owner satisfaction is included in the process as a contextual variance. This will enable factors in the evaluation model to be clearly linked in causal relationships that lead to owner satisfaction as an ultimate favourable result. Data was collected from 225 New Zealand businesses that have an eCommerce website through an online survey. The research model was tested using the two-step approach of Structural Equation Modeling (SEM) where the structural model and measurement model were separately analysed. A set of measurement models was used to determine indicators that capture each construct and a structural model was used to determine the relationships between concepts. Each measurement model was tested in isolation, then factors forming the endogenous variables, followed by factors forming the exogenous variables were each separately tested, and finally a collective network was determined and tested. The key findings of this research showed that there are four factors that explain the change of performance in the website. These factors are: website offer, usage, financial returns, and owner satisfaction. The study concluded that websites could be evaluated along those four factors the effectiveness of which could be monitored along their measurement scales. It is also premised on the same variable that these factors function in a serial manner and the ultimate measure of effectiveness is owner satisfaction. The study also concluded that these factors explain the success of a website; each factor is necessary but not sufficient on its own to explain the success of a website.

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  • The effects of altering macronutrient composition on diabetes risk

    Te Morenga, Lisa Anne (2010)

    Doctoral thesis
    University of Otago

    The metabolic syndrome describes a cluster of risk factors for type 2 diabetes (T2DM). Nutritional approaches which favourably influence these factors might be expected to reduce the risk of T2DM. Two dietary intervention studies have been undertaken to examine the effects of macronutrient composition on clinical and metabolic determinants associated with the metabolic syndrome. Previous research suggests that moderately high-protein diets may be more appropriate than conventional low-fat, high-carbohydrate diets for individuals at high risk of T2DM. However in most such studies sources of dietary carbohydrate were not specified or may not have been appropriate. Thus in the first study two weight-loss diets – one moderately high in protein and the other high in fibre-rich, minimally-processed cereals and legumes – were compared to determine whether a relatively high-protein diet has the potential to confer greater benefit. Eighty-three overweight or obese women were randomised to either a moderately high-protein diet (HP) or to a high-fibre, relatively high-carbohydrate diet (HFib) for 8 weeks. Energy intakes were restricted. Participants on both diets lost weight (HP: -4.5kg; 95% confidence interval (CI):-5.4, -3.7kg and HFib: -3.3kg; 95% CI: -4.2, -2.4kg), reduced body fat and showed improvement in other markers of metabolic risk. However participants on HP lost more body weight (-1.3 kg; 95% CI: -2.5, -0.1kg) and total fat (-1.3kg; 95% CI: -2.4, -0.1). Diastolic blood pressure decreased more on HP than on HFib. Dietary approaches to reducing risk of T2DM typically emphasise fat and energy restriction, but for many achieving and maintaining weight loss is difficult. Diets that focus on substantially altering macronutrient distribution rather than energy restriction are promising alternatives. The second study examined the effects on body composition, insulin sensitivity and other metabolic risk factors, of dietary advice including moderate increases in protein and fibre, without specifying energy intake compared with standard dietary recommendations. Eighty-nine women at risk of T2DM were randomised to either a standard low-fat, highcarbohydrate diet (StdD) or to a relatively high-protein, high-fibre diet (HPHFib) for 10 weeks. Participants on the HPHFib diet lost more weight (1.3 kg; 95% CI 0.7, 1.9) and fat (1.0 kg; 95% CI 0.2, 1.8) than participants on StdD. Total and low-density-lipoprotein (LDL) cholesterol were also significantly lower after the HPHFib diet. In contrast insulin sensitivity was reduced on HPHFib (-17.8%; 95%CI -28.6%, -5.3%) compared with StdD after adjustment for weight loss. In conclusion a moderately high-protein, weight-reducing diet was associated with greater benefits when compared with an appropriate high-carbohydrate, high-fibre diet in high risk women, confirming the advantages of high-protein diets that have been observed by others. An ad-libitum diet high in both protein and fibre also improved body composition and markers of metabolic risk compared with standard dietary advice, although a decline in insulin sensitivity was observed. The consequences of the apparent impairment in insulin sensitivity are uncertain. Further research is needed to better understand the effect of macronutrient composition on insulin sensitivity.

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  • Assessing the effect of up-grading playgrounds on children’s physical activity

    Quigg, Robin (2010)

    Doctoral thesis
    University of Otago

    Playgrounds are facilities that may increase children’s physical activity. Territorial authorities provide playgrounds in public parks. The link between children’s needs for physical activity and subsequent provision of play equipment was acknowledged in the Dunedin City Council’s (DCC) 2006 Play Strategy. Implementation of the Strategy through planned up-grades in a spatially-defined area provided an opportunity to test whether children’s physical activity increased with improved play facilities. Two playgrounds were up-graded by the DCC in early 2008 providing the opportunity to conduct a natural experiment study known as LOCATE (Location of Children's Activity in Their Environment) set in Dunedin, New Zealand (NZ). The Location Of Children’s Activity in Their Environment Study (LOCATE) was a natural experiment, set in Dunedin, New Zealand (NZ). At baseline (October - December 2007), 184 children, aged five to ten years old, were recruited from participating schools in intervention and control communities with comparable demographic and spatial characteristics. There were 156 participants at follow-up (15% attrition). There were two phases: a baseline assessment and the follow-up assessment, with 12 months between each assessment. To obtain parents/guardians perceptions of their neighbourhood and other information associated with physical activity, a self-administered questionnaire was developed and tested for reliability in a pilot study. It was mailed to each participant’s home when they began each assessment phase. Participants’ heights and weights were measured, and age- and sex-standardised BMIs determined. Mean Total Daily Physical Activity (TDPA), measured by an Actigraph GT1M accelerometer, was matched with location data collected at one minute intervals using a GlobalSat DG-100 Global Positioning System Data Logger. A regression model was used to compare the log-transformed mean TDPA at follow-up, with baseline scores included as a covariate. All models controlled for repeated measures and clustering by schools by using random effects. Univariate screening was carried out using p<0.1 for inclusion in the model with a priori exploratory subgroup analyses by sex, age, and BMI performed by using interactions between these variables and the community. Non-linear associations were explored and fractional polynomial models were used where appropriate. There was evidence of statistically significant associations with mean TDPA at follow-up for participant age, sex and ethnicity; school day and usual mode of travel to school. Statistically significant interactions were found between sex and ethnicity; community and BMI z-score. Compared to the control community, participants in the intervention community did not have a statistically significantly different mean TDPA (p=0.456). Compared to baseline data, integrated location and physical activity follow-up data indicated a small, but statistically significant increase in median TDPA located at the two up-graded playgrounds in the intervention cohort (4,196 counts; Wilcoxon signed-rank test p=0.040). There was also evidence of statistically significant differences in the distance from home to the nearest up-graded playground, between those who visited following the playground up-grades, and those who did not. For each 100 metre increase in distance from the closest up-graded park, logistic regression indicated a 15.6% decrease in the odds of using that park (95% CI: 1.0, 28.0, p=0.037). These findings suggest that although playgrounds are promoted as facilities which support community physical activity, in NZ, they may have less influence than initially estimated. Nevertheless, playgrounds should be considered as one in a range of opportunities provided in communities for promoting physical activity amongst children.

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  • Health seeking and health related behaviour for type 2 diabetes mellitus among adults in an urban community in Tanzania

    Nguma, Lucy Kinavi (2010)

    Doctoral thesis
    University of Otago

    Early in the 20th century, diabetes mellitus was considered to be a rare medical condition in African countries, and mostly in sub-Saharan Africa. Over the past 30 or 40 years however, the situation has changed. Diabetes is now regarded as a major public health problem throughout Africa particularly among urban communities. The disease is little understood in the general population and is often poorly detected. Previous research, for example, shows about 50 percent of people with type 2 diabetes mellitus in Tanzania are unaware of their condition and more than 80 percent diabetes cases are undiagnosed. This thesis aims to explore factors influencing health-seeking and health related behaviour among adult patients with type 2 diabetes mellitus in an urban community in Tanzania. It seeks to answer the following key question: What are the key factors influencing health seeking and health related behaviour and care management for type 2 diabetes mellitus? Data collection was carried out from March to June 2007 in two diabetes clinics in Dar es Salaam, the commercial capital city of Tanzania. The main study population consisted of patients aged 35 years and above who had been diagnosed with the disease more than one year before the time of the current study. In-depth interviews were carried out with 20 frequent and 10 infrequent clinic attendees, their 14 caregivers, and seven health care workers; while key informant interviews were carried out with six key national health officials. Furthermore, eight focus group discussions were carried out with people with diabetes and selected community members. Multiple influences on health-seeking behaviour were identified, many of which affected clinic attendance, adherence to treatment programmes, and outcomes. These influences included poor accessibility to diabetes drugs and other services at the clinics, lack of financial resources for transport to the clinic and purchasing of drugs, overcrowded and inadequate public transport, lay beliefs and models of disease causation and treatment which accentuate the role of traditional healers, and poor organisation of the clinics leading to long queues and waiting times. The findings suggest that improving the delivery of care to people with diabetes will require action to address a range of structural, financial, cultural, and administrative issues. These might include improving the distribution and accessibility of essential diabetes drugs, as well as the accessibility and affordability of health care services, patient and public education, involvement of traditional healers, better provision of public transport and more patient-centred organisation of care in public health clinics. The findings have significant policy implications. First, the government needs to decentralise the current diabetes services from regional and district facilities to primary health care centres and existing dispensaries, along with procuring adequate drugs, equipment and health care providers to enhance access to services. Second, the government should develop mechanisms for working with traditional health practitioners as a strategy to enhance early referral of people with diabetes by these practitioners to biomedical care facilities to improve the rates of early diagnosis and management of this disease. Finally, the government needs to acknowledge the growing threat of NCDs such as diabetes and develop national prevention and control strategies including general public education about the disease.

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  • Constructions of Nature and Tensions in the Outdoors

    Reis, Arianne Carvalhedo (2010)

    Doctoral thesis
    University of Otago

    This dissertation explores aspects of hunting and tramping experiences in the southernmost region of New Zealand, Stewart Island/Rakiura. The focus is on the complexities of hunting, and how tramping, particularly as performed by international tourists, impinges on these complexities. My primary goal is to provide a more nuanced understanding of hunting in modern society, using the particular case of hunting on Stewart Island/Rakiura to provoke new thoughts on the diverse possibilities that this practice provides for hunters who sensually engage with other elements of Nature. This more nuanced understanding involves the discussion of constructions of Nature in modern Western societies, and how the philosophical underpinnings of these constructions help shape experiences and performances in the outdoors, particularly those of hunting. Secondly, through the understanding of hunting as performances situated in space and place, I discuss how other contemporary practices, equally taking place in natural environments, may influence the embodied narratives of hunters, creating tensions that may, occasionally, turn into conflict situations. I use tourism experiences of tramping in New Zealand, particularly on Stewart Island, to illustrate my arguments. To achieve my aims I examine the historical processes that relate to hunting in New Zealand and the social norms and values associated with this activity over time. Tramping in this country is examined as a tourism product that is sold to, and performed by, international visitors. Also, I explore how the commodification of the tramping experience impacts on the local routine of hunting as recreation. In doing so, I relate New Zealand hunting and tramping, the latter as performed by tourists, to broader social issues and discuss the meanings attached to their practices in relation to philosophies of environment present in contemporary society. These philosophies are central to the combined understanding of both practices, their connections and disparities, and the relationships with the natural environment and with nonhuman animals that they provoke. In order to be able to develop the literature on ‘uses’ of Nature and wildlife, integrating debates from philosophy and the animal studies field to conversations in the tourism and leisure studies field, the present study moves towards a more emergent approach to research, embracing a qualitative methodology where both humans and nonhuman animals are understood as being part of a intertwined web of complex relations performed in an ‘out of doors’ context. A critical reflexive narrative approach was selected as better suited to facilitate metaphorical conversations between the different social actors. Hunters, trampers, and the researcher all bring to this project contributions promising a better understanding of human/nature relations, as well as a more emotionally engaged and embodied relationship with the research act. These exchanges challenge common assumptions associated with recreation conflict and the so-called consumptive uses of wildlife in recreation and tourism studies, thus opening a new window for sociocultural studies of human/nature relationships.

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  • CFD Simulation of Wind Flow over Vegetated Coastal Sand Dunes

    Pattanapol, Wichai (2010)

    Doctoral thesis
    University of Otago

    This research applies Computational Fluid Dynamics (CFD) to modelling flow over a vegetated foredune in the coastal zones. Morphological changes resulting from wind flow and sedimentation have direct impacts on plant and animal species, and people living nearby. Information on natural processes such as foredune formation have remained poorly understood owing to the complex interaction of a range of biogeomorphic factors. CFD can be employed in order to investigate complex flows over a coastal foredune. Extending CFD to modelling flow over a vegetated foredune is challenging as the combined natural processes need to be modelled. This thesis aims to test the efficacy of CFD in accurately predicting i) wind flow over a vegetated complex foredune, ii) associated sand transport and iii) to determine whether CFD can be employed for use to predict complex flows in real circumstances. In two-dimensional computations, the RANS-based turbulence models were optimised with the wall functions to model a wall bounded flow with a vegetation cover. The turubence model: the renormalisation group (RNG), the realisable κ — є model as well as the SST κ — ω model were optimised with the wall functions (the standard, the non-equilibrium and the enhanced wall function). The optimised models were then applied to model flow over a ve-getation cover in 2D. The effects of vegetation cover was modelled by using two approaches: i) using the roughness parameter (κѕ) in the wall function; and ii) adding the source/sink terms into the momentum equation for flow (to account for plant drag). The models for sand transport were investigated and the Volume of Fluid (VOF) model was selected, modified and verified with field data from the literature. The verified models for turbulence, vegetation covers and and transport were then used in three dimensional simulations. A more complex turbulence model the detached eddy simulation (DES) model was tested in addition to the RNG model in three dimensional computations. The DES model performed better than the RNG model in predicitng 3D flow, and was used with the source/sink term models (for vegetation cover), and the VOF model (for sand transport) to model the 3D-flow over a vegetated foredune at Mason Bay, Stewart Island, New Zealand. In 2D, the combination of the RNG and the non-equilibrium wall function returned the most accurate predictions particularly for the streamwise mean velocity. Modelling vegetation cover with the source/sink term in the momen¬tum equation returned more accurate predictions than by using the roughness parameter in the wall function particularly in the canopy regions. The modi¬fied VOF model predicted realistic sand bed profiles but under-predicted the velocity magnitude near the surface. In 3D, the model combination of the DES, the source/sink term model, and the VOF model successfully predicted the pattern of sand transport over the foredune at Mason Bay. The results given by CFD simulations provided new information on natural processes. The simulation results in this research showed that sand trapped on a flat vegetated surface has a certain pattern. More sand is trapped at the front and rear side of the vegetation covered surface area, which agree with wind tunnel data collected at Oregon State Univerisity. In real circumstances, at the foredune system at Mason Bay, the pattern of sand distributed on the foredune between two cases; with- and without grass cover, are only different in terms of magnitude. The distribution patterns of sand on the foredune's surface between the two cases are similar. The maximum height of foredunes can be predicted by looking at the wind speed in vegetation cover layers at the foredune crest. If the wind speed is below a threshold velocity for sand transport, more sand can be trapped by the vegetation, resulting in an increase in dune height. The pattern of sand deposition on a foredune can also be predicted by determining the surface shear velocity, the higher shear velocity the less sand trapped on the surface. CFD simulations even without the models for sand transportation can be used to predict the maximum foredune height when the topographic and wind data are available. In conclusion, CFD can be an effective tool for modelling complex flows in coastal zones, as long as numerical errors, and modifying assumptions are clearly recognised. Accuracy of the predictions can be improved, and possible solutions were provided in this research.

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  • Effect of bile salts on drug delivery to the brain

    Yang, Lin (2010)

    Doctoral thesis
    University of Otago

    Bile salts are endogenous surfactants which have been extensively studied as permeability enhancers to increase drug transport across various biological barriers such as the intestine, skin and buccal mucosa. However, only a few studies of the blood brain barrier (BBB) have been carried out. Previous animal studies have shown that 12-monoketocholate (MKC), a semisynthetic bile salt, enhanced brain uptake of quinine and increased the activity of morphine and pentobarbital in rat, which was speculated to be due to modulation of BBB permeability. Drug delivery to brain is largely prevented by the BBB with its densely packed lipid bilayers, tight junctions, efflux transporters and minimal endocytotic activity. The aim of this thesis was to study bile salts as permeability enhancers and to investigate the mechanism by which bile salts potentially enhance BBB permeability. MKC and three natural bile salts, cholate (C), deoxycholate (DC) and taurocholate (TC) were compared for their effects on the biophysical properties and transport characteristics of four different membrane models. From simple to complex, these were phospholipid monolayers, phospholipid bilayers (liposomes)), RBE4 cells (an immortalized rat brain capillary endothelial cell) and the whole animal (rat). The RBE4 cell line was used as a more complex bilayer model with some similarities to in vivo brain endothelium. In the phospholipid monolayer study using the Langmuir Blodgett trough, bile salts varied in their ability to penetrate into the monolayers in the order DC > TC > C> MKC. The penetration was dependent on the concentration of bile salt and on the surface pressure of the monolayer. Moreover, once bile salts inserted into the phospholipid monolayer, they increased membrane compressibility. In the phospholipid bilayer study, various techniques were used to study the effect of bile salts on their biophysical properties. Using electrophoresis and fluorescence polarisation spectroscopy, it was found that bile salts increased membrane surface negative charge and increased membrane fluidity. These effects subsequently modulated drug/membrane binding and membrane permeability. Capillary electrophoresis-frontal analysis showed that bile salts increased membrane binding of cationic compounds in a liposome/buffer system. Release studies using carboxyfluorescein as a model drug showed that, on initial exposure to bile salts, membrane permeability markedly increased but then stabilised. It is suggested that the initial insertion of the bile salt into the outer leaflet disrupts the membrane but then the membrane restabilises as the bile salt distributes approximately evenly between the inner and outer leaflets of the lipid bilayer. Although the lipid bilayer becomes relatively less permeable once the distribution of bile salt reaches equilibrium in both leaflets, the incorporation of bile salt in the bilayer still makes the membrane more permeable than a bilayer without bile salt as shown by a dithionite permeability study. In initial studies in RBE4 cells, cytotoxicity of bile salts was assessed using hemolysis, LDH and MTS assays. It was found that cytotoxicity of bile salts correlated with their lipophilicity with the exception of TC which was non-toxic. It is suggested that this is because TC is actively effluxed from RBE4 cells. In studies of drug transport via the transcellular pathway, rhodamine 123 (R123) was used as a model compound. It was found that C, DC and TC enhanced the uptake of R123 by increasing passive diffusion, probably as a result of their effect on cell membrane fluidity. DC showed a more significant effect on passive diffusion than other bile salts as it requires much lower concentration to increase R123 uptake significantly (ANOVA, α=0.05). Both uptake and efflux studies showed MKC inhibited efflux of R123 by P-glycoprotein (P-gp). Mechanistic modelling suggested that MKC decreased maximum efflux rate rather than the dissociation constant of P-gp-mediated efflux. In studies of drug transport via the paracellular pathway, it was shown that the tightness of the cell monolayers was increased by using astrocyte-conditioned medium. Relatively high concentrations of bile salts (2-5 mM) were required to increase permeabilities of sucrose and morphine-6-glucuronide (M6G). The former is a marker of paracellular transport and the latter is a very hydrophilic model drug. The effect of MKC on the pharmacodynamics and pharmacokinetics of M6G was studied in rat. The results show that MKC at a subcutaneous dose of 20 mg/kg significantly (ANOVA, α=0.05) enhanced analgesic activity of M6G in the hotplate test and increased M6G concentration in both brain and blood. Due to the decrease in plasma clearance of M6G in the presence of MKC, the blood concentrations of M6G in the treatment group (AUC = 8741±310 h•ng/ml) was much higher (no overlap of two 95% confidence intervals) than in the control group (AUC = 5561±142 h•ng/ml). As a result, the presence of MKC decreased the brain/plasma area under the curve (AUC) ratio. This may due to the active efflux transport of M6G in the in vivo BBB. In conclusion, the results of this research suggest bile salts increase membrane permeability by modulating some biophysical properties of membranes such as surface charge and fluidity. MKC inhibits P-gp efflux and may be useful to enhance the BBB permeability of P-gp substrates. In future, the effects of MKC on the BBB permeability of a P-gp substrate should be studied using microdialysis at a steady state blood level of the model drug.

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  • Factors mediating successful oral vaccination with lipid-encapsulated Mycobacterium bovis BCG

    Czepluch, Wenzel (2010)

    Doctoral thesis
    University of Otago

    During the course of this thesis factors mediating successful oral vaccination with lipidencapsulated Mycobacterium bovis BCG were examined. Mice were fed 2x10E07 CFU BCG encapsulated into a lipid matrix to prevent destruction by the gastrointestinal tract and to allow passage through the gut epithelia. In order to trace the vaccine following oral vaccination, mice were sacrificed at various time points ranging from 6 hours to 8 weeks post vaccination, and macerated lymphatic and non-lymphatic organs plated on solid agar. Initially, BCG was distributed widely in lymphatic and non-lymphatic organs, however, BCG was cleared quickly from most organs and formed small populations of less than 500 CFU/mouse in the mesenteric and cervical lymph nodes, as well as the Peyer’s patches 8 weeks post vaccination. Immuno-histochemistry and confocal microscopy, showed that BCG was absent from the follicles, but instead resided in the T cell containing intra-follicular areas. Very rarely BCG was associated with small CD11b+ cells that did not resemble typical macrophages and lacked peroxidase activity. Instead the majority of BCG could be found forming extracellular groups of 1-4 rods. This was confirmed using cell sorting of leukocytes isolated from alimentary tract lymphatics of orally vaccinated mice and only showed a minority of BCG to be associated with CD11c+ cells. Therefore, BCG is absent from typical antigen presenting cells, but instead might reside in CD11c+CD11b+ myeloid DC. Additionally, Ziehl-Neelsen staining revealed groups of intracellular coccoid forms of BCG. These were located toward the subcapsular space of draining lymph nodes where they were associated with sub-capsular macrophages. Interestingly, cocci proved to be non-platable using solid agar but instead required resuscitation in liquid media and therefore might resemble a form of dormancy. The presence of extracellular rods and intracellular cocci in on-professional antigen presenting cells might highlight the importance of secreted factors as an antigen source promoting successful activation of the immune system. Following oral vaccination, IFN-γ producing cells almost exclusively resided in the spleen. In order to characterize these cells, splenocytes of orally vaccinated mice were isolated 6 weeks post vaccination on the basis of surface marker expression using fluorescence activated cell sorting (FACS). Antigen-specific release of IFN-γ was monitored using ELISA and ELISpot assays and IFN-γ producing T cells were characterized as T effector memory cells expressing CD44, but not CD62L and lacked the expression of mucosal homing markers such as CD103 or α4β7. In addition, Lincoplex assays revealed the production of IL-17 by splenocytes. These did not express CD4+ but rather the γδ T cell eceptor. Together these results show that antigen reservoirs of BCG present in the draining lymphatics contain small numbers of typical filamentous BCG. A larger population of coccoid forms leaves open the possibility that coccoid forms are a major source of antigen for the stimulation of T cells. Although typical CD11c+ APC isolated from the lymphatic tissue of immunized mice did not appear capable of stimulating, T cells responses were nevertheless effectively induced by oral vaccination and shown to be IFN-γ producing TEM residing in the spleen but lacking expression of mucosal homing markers.

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  • Pervasive Personal Information Spaces

    Krishnan, Aparna (2010)

    Doctoral thesis
    University of Waikato

    Each user’s electronic information-interaction uniquely matches their information behaviour, activities and work context. In the ubiquitous computing environment, this information-interaction and the underlying personal information is distributed across multiple personal devices. This thesis investigates the idea of Pervasive Personal Information Spaces for improving ubiquitous personal information-interaction. Pervasive Personal Information Spaces integrate information distributed across multiple personal devices to support anytime-anywhere access to an individual’s information. This information is then visualised through context-based, flexible views that are personalised through user activities, diverse annotations and spontaneous information associations. The Spaces model embodies the characteristics of Pervasive Personal Information Spaces, which emphasise integration of the user’s information space, automation and communication, and flexible views. The model forms the basis for InfoMesh, an example implementation developed for desktops, laptops and PDAs. The design of the system was supported by a tool developed during the research called activity snaps that captures realistic user activity information for aiding the design and evaluation of interactive systems. User evaluation of InfoMesh elicited a positive response from participants for the ideas underlying Pervasive Personal Information Spaces, especially for carrying out work naturally and visualising, interpreting and retrieving information according to personalised contexts, associations and annotations. The user studies supported the research hypothesis, revealing that context-based flexible views may indeed provide better contextual, ubiquitous access and visualisation of information than current-day systems.

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  • Investigation and Modelling of Fetal Sheep Maturation

    Xu, Yanyang (2010)

    Doctoral thesis
    University of Waikato

    In this thesis, I study the maturational changes of the fetal sheep ECoG (electrocorticogram) in its third-trimester of gestation (95-140 days of gestation), investigate three continuum models for electrical behaviour of the cortex, and tune the parameters in one of these models to generate the discontinuous EEG waves in the immature cortex. Visual inspection of the ECoG time-series shows that the third-trimester of fetal sheep is comprised of two stages: early third-trimester characterised by bursting activity separated by silent intervals, and late third-trimester with well-defined SWS (slow wave sleep) and REM (rapid eye movement) sleep states. For the late third-trimester, the results of power, correlation time, and SVD (singular value decomposition) entropy analysis demonstrate that the sleep state change is a cortical phase transition—with SWS-to-REM transition being a first-order transition, and REM-to-SWS second-order. Further analyses by correlation time, SVD entropy, and spectral edge frequency display that the differentiation of the two distinct SWS and REM sleep states occurs at about 125 dGA (day gestational age). Spectral analysis divides the third-trimester into four stages in terms of the frequency and amplitude variations of the major resonances. Spindle-like resonances only occur in the first stage. A power surge is observed immediately prior to the emergence of the two sleep states. Most significant changes of the spectrum occur during the fourth stage for both SWS (in amplitude) and REM (in frequency) sleep states. For the modelling of the immature cortex, different theoretical descriptions of cortical behaviour are investigated, including the ccf (cortical column field) model of J. J. Wright, and the Waikato cortical model. For the ccf model at centimetric scale, the time-series, fluctuation power, power law relation, gamma oscillation, phase relation between excitatory and inhibitory elements, power spectral density, and spatial Fourier spectrum are quantified from numerical simulations. From these simulations, I determined that the physiologically sophisticated ccf model is too large and unwieldy for easy tuning to match the electrical response of the immature cortex. The Waikato near-far fast-soma model is constructed by incorporating the back-propagation effect of the action potential into the Waikato fast-soma model, state equations are listed and stability prediction are performed by varying the gap junction diffusion strength, subcortical drive, and the rate constants of the near- and far-dendritic tree. In the end, I selected the classic and simpler Waikato slow-soma mean-field model to use for my immature cortex simulations. Model parameters are customised based on the physiology of the immature cortex, including GABA (an inhibitory neurotransmitter in adult) excitatory effect, number of synaptic connections, and rate constants of the IPSPs (inhibitory postsynaptic potential). After hyperpolarising the neuron resting voltage sufficiently to cause the immature inhibitory neuron to act as an excitatory agent, I alter the rate constant of the IPSP, and study the stability of the immature cortex. The bursting activity and quiet states of the discontinuous EEG are simulated and the gap junction diffusion effect in the immature cortex is also examined. For a rate constant of 18.6 s-1, slow oscillations in the quiet states are generated, and for rate constant of 25 s-1, a possible cortical network oscillation emerges. As far as I know, this is the first time that the GABA excitatory effect has been integrated into a mean-field cortical model and the discontinuous EEG wave successfully simulated in a qualitative way.

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  • Beyond certification: The maintenance of ISO 9000 in Malaysian service organisations

    Ab Wahid, Roslina (2010)

    Doctoral thesis
    University of Waikato

    This research is an in-depth study of the quality management systems of two Malaysian "government-linked companies" (GLCs) classified as being in the service industry. Both are mature holders of ISO 9000 certification and the research focuses on how they have gone about maintaining and improving their quality management system (QMS), the extent to which they have succeeded, and what management and employees of the companies feel have been critical success factors and problems to be overcome. A case study approach is used for this study. The study has been comprehensive in its data collection with 30 individual face-to-face interviews with top management, middle management, lower management in charge of operations and quality, the management representative responsible for the implementation of ISO 9000 in the case companies being conducted, 300 questionnaires being distributed to employees of both companies, and a thorough review of ISO 9000 and other quality documents carried out. The results of the study showed that the two companies maintain their ISO 9000 based on the requirements of the standard. However, to support the technical requirements and in order to maintain the quality system more effectively and strive for excellence, the study highlights the need for integrating the human resource aspects of quality management into the quality system. Critical success factors of ISO 9000 maintenance identified are top management commitment, employee involvement, recognition and reward, teamwork, continuous improvement, and quality culture. The main problems associated with maintaining ISO 9000 faced by the companies are lack of cooperation and commitment from people, lack of knowledge and training, lack of communication, and lack of awareness and understanding on ISO 9000. Measures outlined to overcome the problems include closer interaction between people, training of management and employee on ISO 9000 and related subjects, skill and competency, and better communication. The study has identified lessons to be drawn by similar companies facing similar challenges and those striving for excellence. It has provided insights into the improvements and changes brought by the continued maintenance of the ISO 9000 after certification. It has also added to the knowledge on aspects of organisational development for service companies and casting new light on various theories put forward in the quality management literature. Further, the development of a framework for effective ISO 9000 maintenance in service organisations will enable it to be tested and compared with other industry frameworks in future studies.

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  • Exploring Knowledge Transfer and Knowledge Building at Offshore Technical Support Centers

    Chen, Jihong (2010)

    Doctoral thesis
    University of Waikato

    This is an exploratory investigation into knowledge transfer and knowledge building processes observed at offshore Technical Support Centers (TSCs) in China. Utilizing a multiple case study approach, the study examines how knowledge was transferred from the US-based support center to the China-based offshore support center, and how individuals and the organization built and expanded knowledge in a dynamic changing business context. The field cases were three Technical Support Centers in China. Three models were developed from the qualitative analysis of the field data to explain how knowledge is transferred and built in offshore TSCs. The knowledge transfer type adoption model identifies the relationships amongst the levels of knowledge (novice, advanced beginner, competency, and proficiency), the types of knowledge and the knowledge transfer approaches (structured transfer stages, unstructured copy, unstructured adaptation, and unstructured fusion). The basic individual tacit knowledge building model shows that tacit knowledge is acquired and built through two continuous knowledge building loops, an explicit learning loop and an implicit learning loop. The organizational knowledge building model demonstrates the interaction amongst knowledge flow, absorptive capacity, knowledge stock and knowledge intermediary in offshore knowledge transfer and building within the three levels (individual, group and organization levels) of the SECI spiral (socialization, externalization, combination and internalization). The three models provide new insights into the knowledge transfer process for different levels of knowledge acquisition, individual tacit knowledge building processes and organizational knowledge building processes in an offshore outsourcing business context. By applying these models to appropriate field situations, both practitioners and academics may be able to gain a deeper understanding of knowledge transfer approaches, be able to better guide new employees’ expertise and confidence building through controlled and monitored experiential learning process, and be able to improve understanding of how knowledge is built and evolves within organizations.

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  • Realistic electronic books

    Liesaputra, Veronica (2010)

    Doctoral thesis
    University of Waikato

    People like books. They are convenient and can be accessed easily and enjoyably. In contrast, many view the experience of accessing and exploring electronic documents as dull, cumbersome and disorientating. This thesis claims that modelling digital documents as physical books can significantly improve reading performance. To investigate this claim, a realistic electronic book model was developed and evaluated. In this model, a range of properties associated with physical books---analogue page turning, bookmarks and annotations---are emulated. Advantage is also taken of the digital environment by supporting hyperlinks, multimedia, full-text search over terms and synonyms, automatically cross referencing documents with an online encyclopaedia, and producing a back-of-the-book index. The main technical challenge of simulating physical books is finding a suitable technique for page turning that is sufficiently realistic, yet lightweight, responsive, scalable and accessible. Several techniques were surveyed, implemented and evaluated. The chosen technique allows realistic books to be presented in the Adobe Flash Player, the most widely used browser plug-in on the Web. A series of usability studies were conducted to compare reading performance while performing various tasks with HTML, PDF, physical books, and simulated books. They revealed that participants not only preferred the new interface, but completed the tasks more efficiently, without any loss in accuracy.

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