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Rurality has been frequently noted by researchers as pathways to understand human health in rural and remote areas. Current measures of rurality are mostly oriented to places, not individuals, and have not accounted for individual mobility, thus inappropriate for studying health and well-being at an individual level. This research proposed a new concept of individual-based rurality by integrating personal activity spaces. A feasible method was developed to quantify individuals’ rural experience using household travel surveys and geographic information systems (GIS). For illustration, the proposed method was applied to understand the well-being and social isolation among rural Latino immigrants, who had participated in a community-based participatory research (CBPR) study in North Florida, USA. The resulting individuals’ rurality indices were paired with their scores of well-being and social isolation to identify potential associations. The correlation analysis showed that the proposed rurality can be related to the social isolation, mental and physical well-being of individuals in different gender groups, and hence could be a suitable tool to investigate rural health issues.

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<p>Loneliness is widespread – 31 percent of New Zealanders reported being lonely a little, some, most, or all of the time in 2012, which equates to approximately 1.3 million New Zealanders. Loneliness is firstly an individual problem associated with corrosive health outcomes such as depression, and suicide. It is also a social problem because of the way social exclusion inhibits community wellbeing.  Loneliness is a reflection of both an objective condition and a subjective condition. The former reflects measures of the number and depth of social contact, and the later captures how people feel and judge their own level of loneliness. Typically, loneliness as a condition is ‘being alone and not liking it’.  The majority of research attention, both internationally, as well as in New Zealand, has been paid to loneliness among the old. What my thesis shows is that loneliness is not confined to a particular age group but widespread across all ages, and is in fact highest among the young and declines with age. Therefore, studies of loneliness are most appropriately based on population-wide surveys so that its prevalence across all age and socio-economic groups can be addressed. At the same time, particular attention now needs to be paid to the young. For this reason I apply statistical models of loneliness to two separate data sets: the 2012 New Zealand General Social Survey, and a sample of youth in Wellington, Taranaki and Auckland as provided by the 2006 Youth Connectedness Project.  My analysis of these two samples focuses on the relationship between objective measures of social connection and the subjective expression of loneliness itself. I show that while loneliness decreases with the level of social connection, it is also subject to considerable variation across a range of covariates. These include, most importantly, age, gender, socioeconomic status and health.  Connectivity also has a number of geographical properties which render this topic of interest to the human geographer. Among these are proximity – the readily availability of family and friends for regular face-to-face contact, as well as the ability to easily access and contribute to the local community. These are matters of geographic context which is addressed in several ways, including through a GIS analysis.  My primary finding has to do with the cumulative nature of connectedness. Over and above the separate effect of having a partner, local family, and friends, is the importance of their combined and cumulative effect in reducing loneliness, a feature which reinforces the importance of the concept of community.  I find that the young, females, migrants, the poor, and people in poor health are more likely to be lonely, particularly when these attributes combine. In terms of geographical context, residents of main urban areas, and in lower socioeconomic areas show a higher likelihood of being lonely in both datasets. However GIS results for the City of Wellington show that lonely youth show no evidence of spatially clustering in ways that would imply social exclusion in a geographic sense.  My analysis takes place against a backdrop of widespread concern about social connection in general, about the growing role of non-face-to-face communication among the young, about the dislocating effects of marital instability, and the supporting role of families both for the young and the old. None of my results dispel these concerns. What my results suggest is the need for a focused attention on the nature of social connections in particular contexts, and the way they evolve over time.</p>

<p>Loneliness is widespread – 31 percent of New Zealanders reported being lonely a little, some, most, or all of the time in 2012, which equates to approximately 1.3 million New Zealanders. Loneliness is firstly an individual problem associated with corrosive health outcomes such as depression, and suicide. It is also a social problem because of the way social exclusion inhibits community wellbeing.  Loneliness is a reflection of both an objective condition and a subjective condition. The former reflects measures of the number and depth of social contact, and the later captures how people feel and judge their own level of loneliness. Typically, loneliness as a condition is ‘being alone and not liking it’.  The majority of research attention, both internationally, as well as in New Zealand, has been paid to loneliness among the old. What my thesis shows is that loneliness is not confined to a particular age group but widespread across all ages, and is in fact highest among the young and declines with age. Therefore, studies of loneliness are most appropriately based on population-wide surveys so that its prevalence across all age and socio-economic groups can be addressed. At the same time, particular attention now needs to be paid to the young. For this reason I apply statistical models of loneliness to two separate data sets: the 2012 New Zealand General Social Survey, and a sample of youth in Wellington, Taranaki and Auckland as provided by the 2006 Youth Connectedness Project.  My analysis of these two samples focuses on the relationship between objective measures of social connection and the subjective expression of loneliness itself. I show that while loneliness decreases with the level of social connection, it is also subject to considerable variation across a range of covariates. These include, most importantly, age, gender, socioeconomic status and health.  Connectivity also has a number of geographical properties which render this topic of interest to the human geographer. Among these are proximity – the readily availability of family and friends for regular face-to-face contact, as well as the ability to easily access and contribute to the local community. These are matters of geographic context which is addressed in several ways, including through a GIS analysis.  My primary finding has to do with the cumulative nature of connectedness. Over and above the separate effect of having a partner, local family, and friends, is the importance of their combined and cumulative effect in reducing loneliness, a feature which reinforces the importance of the concept of community.  I find that the young, females, migrants, the poor, and people in poor health are more likely to be lonely, particularly when these attributes combine. In terms of geographical context, residents of main urban areas, and in lower socioeconomic areas show a higher likelihood of being lonely in both datasets. However GIS results for the City of Wellington show that lonely youth show no evidence of spatially clustering in ways that would imply social exclusion in a geographic sense.  My analysis takes place against a backdrop of widespread concern about social connection in general, about the growing role of non-face-to-face communication among the young, about the dislocating effects of marital instability, and the supporting role of families both for the young and the old. None of my results dispel these concerns. What my results suggest is the need for a focused attention on the nature of social connections in particular contexts, and the way they evolve over time.</p>

We aim to improve job workflow and satisfaction amongst clinic staff at an academic ophthalmology department. We analyzed survey data given over a 2-week period in July 2021. The participants were support staff (N = 18) from an academic ophthalmology department. Paper surveys were distributed to participants and returned anonymously for analysis. The survey contained 9 Likert-style categorical questions, 2 of which were free response options. A total of 22 participants attempted the survey, 18 of these (82%) were complete and included in analysis. About half of the staff were satisfied with the current workflow 10/18 (56%). Staff who were clinical care coordinators had the lowest average satisfaction (2/5 on a 5-point scale) and the nursing team had the highest average (4.75/5). The most exciting part of the job for staff was appreciation from coworkers 9/30 (30%) and from physicians 8/30 (27%). The most common staff suggestion for improving workflow was to train residents on forwarding and answering messages more effectively. This survey suggests that assigning patient message processing to the nursing staff can improve job satisfaction and workflow. The findings provide tips to physicians for optimizing communication, and staff experience, within their own ophthalmology clinics.