A needs assessment of public health professionals: supporting the implementation of Ontario 2010 revised elementary health and physical education curriculum

Based on the Comprehensive School Health framework, Ontario's Foundations for a Healthy School (2009) outlines an integrated approach to school health promotion. In this approach the school, community and partners (including public health) are fully engaged With a common goal of youth health. With the recent introductions of the Ontario Public Health Standards (2009) and the revised elementary health and physical education curriculum (2010), the timing for a greater integration of public health with schools is ideal. A needs assessment was conducted to identify the perceived support required by public health professionals to implement the mandates of both policy documents in Ontario. Data was collected for the needs assessment through facilitated discussions at a provincial roundtable event, regional focus groups and individual interviews with public health professionals representing Ontario's 36 public health units. Findings suggest that public health professionals perceive that they require increased resources, greater communication, a clear vision of public health and a suitable understanding of the professional cultures in which they are surrounded in order to effectively support schools. This study expands upon these four categories and the corresponding seventeen themes that were uncovered during the research process.

A Psychosocial Approach to Understanding Causality Assessment in Early Phase Oncology Clinical Trials: A Phenomenological Study

Research Question: What are the psychosocial factors that affect causality assessment in early phase oncology clinical trials? Methods: Thirty-two qualitative interviews were explicated with the aid of “Naturalistic Decision Making”. Data explication consisted of phenomenological reduction, delineating and clustering meaning units, forming themes, and creating a composite summary. Participants were members of the National Cancer Institute of Canada’s Clinical Trial Group Investigative New Drug committee. Results: The process of assigning causality is extremely subjective and full of uncertainty. Physicians had no formal training, nor a tool to assist them with this process. Physicians were apprehensive about their decisions and felt pressure from their patients, as well as the pharmaceutical companies sponsoring the trial. Conclusions: There are many problem areas when attributing causality, all of which have serious consequences, but clinicians used a variety of methods to cope with these problem areas.

Investigating Formative Assessment: Exploring the Impact on the Self-Efficacy and Motivation of Mathematics Students

This is a study of the implementation and impact of formative assessment strategies on the motivation and self-efficacy of secondary school mathematics students. An explanatory sequential mixed methods design was implemented where quantitative and qualitative data were collected and analyzed sequentially in 2 different phases. The first phase involved quantitative data from student questionnaires and the second phase involved qualitative data from individual student and teacher interviews. The findings of the study suggest that formative assessment is implemented in practice in diverse ways and is a process where the strategies are interconnected. Teachers experience difficulty in incorporating peer and self-assessment and perceive a need for exemplars. Key factors described as influencing implementation include teaching philosophies, interpretation of ministry documents, teachers’ experiences, leadership in administration and department, teacher collaboration, misconceptions of teachers, and student understanding of formative assessment. Findings suggest that overall, formative assessment positively impacts student motivation and self-efficacy, because feedback is provided which offers encouragement and recognition by highlighting the progress that has been made and what steps need to be taken to improve. However, students are impacted differently with some considerations including how students perceive mistakes and if they fear judgement. Additionally, the impact of formative assessment is influenced by the connection between self-efficacy and motivation, namely how well a student is doing is a source of both concepts.

Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in Hospital

[Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China

Working memory in Alzheimer’s disease and mild cognitive impairment (MCI) : assessment and intervention

L’objectif principal de cette thèse est d’examiner et d’intervenir auprès des déficits de la mémoire de travail (MdeT) à l’intérieur de deux populations cliniques : la maladie d’Alzheimer (MA) et le trouble cognitif léger (TCL). La thèse se compose de trois articles empiriques. Le but de la première expérimentation était d’examiner les déficits de MdeT dans le vieillissement normal, le TCL et la MA à l’aide de deux versions de l’empan complexe : l’empan de phrases et l’empan arithmétique. De plus, l’effet de «l’oubli» (forgetting) a été mesuré en manipulant la longueur de l’intervalle de rétention. Les résultats aux tâches d’empan complexe indiquent que la MdeT est déficitaire chez les individus atteints de TCL et encore plus chez les gens ayant la MA. Les données recueillies supportent également le rôle de l’oubli à l’intérieur de la MdeT. L’augmentation de l’intervalle de rétention exacerbait le déficit dans la MA et permettait de prédire un pronostic négatif dans le TCL. L’objectif de la deuxième étude était d’examiner la faisabilité d’un programme d’entraînement cognitif à l’ordinateur pour la composante de contrôle attentionnel à l’intérieur de la MdeT. Cette étude a été réalisée auprès de personnes âgées saines et de personnes âgées avec TCL. Les données de cette expérimentation ont révélé des effets positifs de l’entraînement pour les deux groupes de personnes. Toutefois, l’absence d’un groupe contrôle a limité l’interprétation des résultats. Sur la base de ces données, la troisième expérimentation visait à implémenter une étude randomisée à double-insu avec groupe contrôle d’un entraînement du contrôle attentionnel chez des personnes TCL avec atteinte exécutive. Ce protocole impliquait un paradigme de double-tâche composé d’une tâche de détection visuelle et d’une tâche de jugement alpha-arithmétique. Alors que le groupe contrôle pratiquait simplement la double-tâche sur six périodes d’une heure chacune, le groupe expérimental recevait un entraînement de type priorité variable dans lequel les participants devaient gérer leur contrôle attentionnel en variant la proportion de ressources attentionnelles allouée à chaque tâche. Les résultats montrent un effet significatif de l’intervention sur une des deux tâches impliquées (précision à la tâche de détection visuelle) ainsi qu’une tendance au transfert à une autre tâche d’attention divisée, mais peu d’effets de généralisation à d’autres tâches d’attention. En résumé, les données originales rapportées dans la présente thèse démontrent un déficit de la MdeT dans les maladies neurodégénératives liées à l’âge, avec un gradient entre le TCL et la MA. Elles suggèrent également une préservation de la plasticité des capacités attentionnelles chez les personnes à risque de développer une démence.

A Teacher’s Formative Assessment Perceptions and Practices in Oral Intermediate English Courses at the Université de Montréal

Au cours des dernières années, les pratiques de l’évaluation comme aide à l’apprentissage (c’est-à-dire l’auto-évaluation, l’évaluation par les pairs, la rétroaction) dans la salle de classe ont été de plus en plus considérées comme des éléments essentiels (Black & Wiliam, 1998; Harlen & Winter, 2004; van de Watering & van der Rijt, 2006). Cependant, dans le domaine de l’apprentissage d’une langue seconde la recherche sur ce sujet est plutôt limitée. En nous fondant sur les études de Colby-Kelly et Turner (2007) et de Lyster et Ranta (1997), nous avons mené une recherche exploratoire visant à combler ce besoin. L’objectif général était de comprendre comment l’évaluation formative se réalise dans deux cours d’anglais intermédiaire à l’Université de Montréal, et de comparer comment ces pratiques sont perçues et vécues par la professeure et ses étudiants. Trois questions de recherche étaient posées: 1. Quelle est la nature de l’évaluation formative dans une salle de classe d’anglais langue seconde? 2. Est-ce que les pratiques de la professeure reflètent ce qu’elle pense de l’évaluation formative? 3. Quels sont les correspondances et différences entre les croyances de la professeure et les perceptions de ses étudiants quant aux bénéfices de l’évaluation formative pour l’apprentissage de l’anglais langue seconde? La collecte de données comprend des observations en classe, des entrevues auprès de la professeure et des questionnaires pour les étudiants. Pour répondre à notre première question de recherche, nous avons analysé la rétroaction donnée par la professeure pendant une production orale réalisée par ses étudiants à partir de la typologie de feedback et de uptake de l’étude de Lyster et Ranta (1997). En ce qui a trait à la deuxième question de recherche, nous avons fait des entrevues avec la professeure en vue d’expliciter ses perceptions relativement à l’évaluation formative. À la fin du trimestre, nous avons comparé ses réponses avec sa pratique à partir des enregistrements vidéo produits en classe. Finalement, pour répondre à notre dernière question de recherche nous avons comparé les réponses données par la professeure aux entrevues avec les réponses des étudiants à un questionnaire adapté à partir de celui de Colby-Kelly et Turner. Finalement, nous présentons et discutons les résultats les plus significatifs obtenus dans cette étude qualitative Nous concluons cette thèse en proposant de avenues pour des recherches futures.

A detailed assessment of adverse perioperative outcomes of the elderly treated with radical cystectomy for bladder cancer

Objectifs: Les données provenant des centres de soins tertiaires suggèrent que le taux de mortalité péri-opératoire (MPO) après cystectomie notés pour les patients âgés (septuagénaires et octogénaires) n’excède pas celle des patients plus jeunes. Toutefois, les données provenant de la communauté démontrent un phénomène inverse. Spécifiquement, la MPO est plus élevés chez les ainés. Dans cette thèse nous allons présenter une réévaluation contemporaine du taux de MPO après cystectomie. Méthodes: Entre 1988 et 2006, 12722 cystectomies radicales pour le carcinome urothéliale de la vessie ont été enregistrées dans la banque de données SEER. Le taux de MPO a été évalué dans les analyses de régression logistique univariées et multivariées à 90 jours après cystectomie radicale. Les covariables incluaient: le sexe, l’ethnie, l’année de chirurgie, la région d’origine du patient ainsi que le grade et le stade de la tumeur. Résultats: Parmi tous les patients, 4480 étaient des septuagénaires (35.2%) et 1439 étaient des octogénaires (11.3%). Le taux de MPO à 90 jours était de 4% pour la cohorte entière vs. 2% pour les patients moins de 69 ans vs. 5.4% pour les septuagénaires vs. 9.2% pour les octogénaires. Dans les analyses de régression logistiques multivariées, les septuagénaires (OR=2.80; <0.001) et les octogénaires (OR=5.02; <0.001) avaient reçu un taux de MPO plus augmenté que les patients moins de 70 ans après une cystectomie radicale. Conclusion: Cette analyse épidémiologique basée sur les donnés le plus contemporaines démontre que l’âge avancée représente un facteur de risque pour un taux de MPO plus élevé.

Assessment of Tandem Mass Spectrometry and High Resolution Mass Spectrometry for the Analysis of Bupivacaine in Plasma

Triple quadrupole mass spectrometers coupled with high performance liquid chromatography are workhorses in quantitative bioanalyses. It provides substantial benefits including reproducibility, sensitivity and selectivity for trace analysis. Selected Reaction Monitoring allows targeted assay development but data sets generated contain very limited information. Data mining and analysis of non-targeted high-resolution mass spectrometry profiles of biological samples offer the opportunity to perform more exhaustive assessments, including quantitative and qualitative analysis. The objectives of this study was to test method precision and accuracy, statistically compare bupivacaine drug concentration in real study samples and verify if high resolution and accurate mass data collected in scan mode can actually permit retrospective data analysis, more specifically, extract metabolite related information. The precision and accuracy data presented using both instruments provided equivalent results. Overall, the accuracy was ranging from 106.2 to 113.2% and the precision observed was from 1.0 to 3.7%. Statistical comparisons using a linear regression between both methods reveal a coefficient of determination (R2) of 0.9996 and a slope of 1.02 demonstrating a very strong correlation between both methods. Individual sample comparison showed differences from -4.5% to 1.6% well within the accepted analytical error. Moreover, post acquisition extracted ion chromatograms at m/z 233.1648 ± 5 ppm (M-56) and m/z 305.2224 ± 5 ppm (M+16) revealed the presence of desbutyl-bupivacaine and three distinct hydroxylated bupivacaine metabolites. Post acquisition analysis allowed us to produce semiquantitative evaluations of the concentration-time profiles for bupicavaine metabolites.

Personalized 3D reconstruction of the rib cage for clinical assessment of trunk deformities

Scoliosis is a 3D deformity of the spine and rib cage. Extensive validation of 3D reconstruction methods of the spine from biplanar radiography has already been published. In this article, we propose a novel method to reconstruct the rib cage, using the same biplanar views as for the 3D reconstruction of the spine, to allow clinical assessment of whole trunk deformities. This technique uses a semi-automatic segmentation of the ribs in the postero-anterior X-ray view and an interactive segmentation of partial rib edges in the lateral view. The rib midlines are automatically extracted in 2D and reconstructed in 3D using the epipolar geometry. For the ribs not visible in the lateral view, the method predicts their 3D shape. The accuracy of the proposed method has been assessed using data obtained from a synthetic bone model as a gold standard and has also been evaluated using data of real patients with scoliotic deformities. Results show that the reconstructed ribs enable a reliable evaluation of the rib axial rotation, which will allow a 3D clinical assessment of the spine and rib cage deformities.

Multilevel Analysis of Trunk Surface Measurements for Noninvasive Assessment of Scoliosis Deformities.

Study Design. Reliability study. Objectives. To assess between-acquisition reliability of new multilevel trunk cross sections measurements, in order to define what is a real change when comparing 2 trunk surface acquisitions of a same patient, before and after surgery or throughout the clinical monitoring. Summary of Background Data. Several cross-sectional surface measurements have been proposed in the literature for noninvasive assessment of trunk deformity in patients with adolescent idiopathic scoliosis (AIS). However, only the maximum values along the trunk are evaluated and used for monitoring progression and assessing treatment outcome. Methods. Back surface rotation (BSR), trunk rotation (TR), and coronal and sagittal trunk deviation are computed on 300 cross sections of the trunk. Each set of 300 measures is represented as a single functional data, using a set of basis functions. To evaluate between-acquisition variability at all trunk levels, a test-retest reliability study is conducted on 35 patients with AIS. A functional correlation analysis is also carried out to evaluate any redundancy between the measurements. Results. Each set of 300 measures was successfully described using only 10 basis functions. The test-retest reliability of the functional measurements is good to very good all over the trunk, except above the shoulders level. The typical errors of measurement are between 1.20° and 2.2° for the rotational measures and between 2 and 6 mm for deviation measures. There is a very strong correlation between BSR and TR all over the trunk, a moderate correlation between coronal trunk deviation and both BSR and TR, and no correlation between sagittal trunk deviation and any other measurement. Conclusion. This novel representation of trunk surface measurements allows for a global assessment of trunk surface deformity. Multilevel trunk measurements provide a broader perspective of the trunk deformity and allow a reliable multilevel monitoring during clinical follow-up of patients with AIS and a reliable assessment of the esthetic outcome after surgery.

Noninvasive Clinical Assessment of Trunk Deformities Associated With Scoliosis

Besides the spinal deformity, scoliosis modifies notably the general appearance of the trunk resulting in trunk rotation, imbalance, and asymmetries that constitutes patients' major concern. Existing classifications of scoliosis, based on the type of spinal curve as depicted on radiographs, are currently used to guide treatment strategies. Unfortunately, even though a perfect correction of the spinal curve is achieved, some trunk deformities remain, making patients dissatisfied with the treatment received. The purpose of this study is to identify possible shape patterns of trunk surface deformity associated with scoliosis. First, trunk surface is represented by a multivariate functional trunk shape descriptor based on 3-D clinical measurements computed on cross sections of the trunk. Then, the classical formulation of hierarchical clustering is adapted to the case of multivariate functional data and applied to a set of 236 trunk surface 3-D reconstructions. The highest internal validity is obtained when considering 11 clusters that explain up to 65% of the variance in our dataset. Our clustering result shows a concordance with the radiographic classification of spinal curves in 68% of the cases. As opposed to radiographic evaluation, the trunk descriptor is 3-D and its functional nature offers a compact and elegant description of not only the type, but also the severity and extent of the trunk surface deformity along the trunk length. In future work, new management strategies based on the resulting trunk shape patterns could be thought of in order to improve the esthetic outcome after treatment, and thus patients satisfaction.

Consequence modelling,vulnerability assessment and fuzzy fault tree analysis of hazardous storages in an industrial area

The hazards associated with major accident hazard (MAH) industries are fire, explosion and toxic gas releases. Of these, toxic gas release is the worst as it has the potential to cause extensive fatalities. Qualitative and quantitative hazard analyses are essential for the identitication and quantification of the hazards associated with chemical industries. This research work presents the results of a consequence analysis carried out to assess the damage potential of the hazardous material storages in an industrial area of central Kerala, India. A survey carried out in the major accident hazard (MAH) units in the industrial belt revealed that the major hazardous chemicals stored by the various industrial units are ammonia, chlorine, benzene, naphtha, cyclohexane, cyclohexanone and LPG. The damage potential of the above chemicals is assessed using consequence modelling. Modelling of pool fires for naphtha, cyclohexane, cyclohexanone, benzene and ammonia are carried out using TNO model. Vapor cloud explosion (VCE) modelling of LPG, cyclohexane and benzene are carried out using TNT equivalent model. Boiling liquid expanding vapor explosion (BLEVE) modelling of LPG is also carried out. Dispersion modelling of toxic chemicals like chlorine, ammonia and benzene is carried out using the ALOHA air quality model. Threat zones for different hazardous storages are estimated based on the consequence modelling. The distance covered by the threat zone was found to be maximum for chlorine release from a chlor-alkali industry located in the area. The results of consequence modelling are useful for the estimation of individual risk and societal risk in the above industrial area.Vulnerability assessment is carried out using probit functions for toxic, thermal and pressure loads. Individual and societal risks are also estimated at different locations. Mapping of threat zones due to different incident outcome cases from different MAH industries is done with the help of Are GIS.Fault Tree Analysis (FTA) is an established technique for hazard evaluation. This technique has the advantage of being both qualitative and quantitative, if the probabilities and frequencies of the basic events are known. However it is often difficult to estimate precisely the failure probability of the components due to insufficient data or vague characteristics of the basic event. It has been reported that availability of the failure probability data pertaining to local conditions is surprisingly limited in India. This thesis outlines the generation of failure probability values of the basic events that lead to the release of chlorine from the storage and filling facility of a major chlor-alkali industry located in the area using expert elicitation and proven fuzzy logic. Sensitivity analysis has been done to evaluate the percentage contribution of each basic event that could lead to chlorine release. Two dimensional fuzzy fault tree analysis (TDFFTA) has been proposed for balancing the hesitation factor invo1ved in expert elicitation .

Service quality and reliability assessment of mobile communication infrastructure

The service quality of any sector has two major aspects namely technical and functional. Technical quality can be attained by maintaining technical specification as decided by the organization. Functional quality refers to the manner which service is delivered to customer which can be assessed by the customer feed backs. A field survey was conducted based on the management tool SERVQUAL, by designing 28 constructs under 7 dimensions of service quality. Stratified sampling techniques were used to get 336 valid responses and the gap scores of expectations and perceptions are analyzed using statistical techniques to identify the weakest dimension. To assess the technical aspects of availability six months live outage data of base transceiver were collected. The statistical and exploratory techniques were used to model the network performance. The failure patterns have been modeled in competing risk models and probability distribution of service outage and restorations were parameterized. Since the availability of network is a function of the reliability and maintainability of the network elements, any service provider who wishes to keep up their service level agreements on availability should be aware of the variability of these elements and its effects on interactions. The availability variations were studied by designing a discrete time event simulation model with probabilistic input parameters. The probabilistic distribution parameters arrived from live data analysis was used to design experiments to define the availability domain of the network under consideration. The availability domain can be used as a reference for planning and implementing maintenance activities. A new metric is proposed which incorporates a consistency index along with key service parameters that can be used to compare the performance of different service providers. The developed tool can be used for reliability analysis of mobile communication systems and assumes greater significance in the wake of mobile portability facility. It is also possible to have a relative measure of the effectiveness of different service providers.

Qualitative air flow modelling and analysis of data centre air conditioning as multiple jet array

This work identifies the importance of plenum pressure on the performance of the data centre. The present methodology followed in the industry considers the pressure drop across the tile as a dependant variable, but it is shown in this work that this is the only one independent variable that is responsible for the entire flow dynamics in the data centre, and any design or assessment procedure must consider the pressure difference across the tile as the primary independent variable. This concept is further explained by the studies on the effect of dampers on the flow characteristics. The dampers have found to introduce an additional pressure drop there by reducing the effective pressure drop across the tile. The effect of damper is to change the flow both in quantitative and qualitative aspects. But the effect of damper on the flow in the quantitative aspect is only considered while using the damper as an aid for capacity control. Results from the present study suggest that the use of dampers must be avoided in data centre and well designed tiles which give required flow rates must be used in the appropriate locations. In the present study the effect of hot air recirculation is studied with suitable assumptions. It identifies that, the pressure drop across the tile is a dominant parameter which governs the recirculation. The rack suction pressure of the hardware along with the pressure drop across the tile determines the point of recirculation in the cold aisle. The positioning of hardware in the racks play an important role in controlling the recirculation point. The present study is thus helpful in the design of data centre air flow, based on the theory of jets. The air flow can be modelled both quantitatively and qualitatively based on the results.

An agroclimatic assessment of the crop growth potential of south india

Usually, under rainfed conditions the growing period exists in the humid months. Hence, for agricultural planning knowledge about the variabilities of the duration of the humid seasons are very much needed. The crucial problem affecting agriculture is the persistency in receiving a specific amount of rainfall during a short period. Agricultural operations and decision making are highly dependent on the probability of receiving given amounts of rainfall; such periods should match the water requirements of different phenological phases of the crops. While prolonged dry periods during sensitive phases are detrimental to their growth and lower the yields, excess of rainfall causes soil erosion and loss of soil nutrients. These factors point to the importance of evaluation of wet and dry spells. In this study the weekly rainfall data have been analysed to estimate the probability of wet and dry periods at all selected stations of each agroclimatic zone and the crop growth potentials of the growing seasons have been analysed. The thesis consists of six Chapters.