Abstract Background. Physical therapists report inconsistent use of valid and reliable measures of walking post-stroke. Objective. To describe the methods physical therapists use to evaluate walking, reasons for selecting these methods, and the use of the evaluation results in clinical practice along the continuum of an organized system of stroke care. Methods. A qualitative descriptive study involving semi-structured telephone interviews of physical therapists in Ontario was conducted. A thematic analysis was performed. Results. Participants (n=28) used both standardized and non-standardized methods to assess walking. A hierarchy of factors influencing use of both methods was observed. Assessment results were commonly used for communication with other healthcare professionals or education of the patient. Conclusions. A variety of factors influence physical therapists to use standardized assessment tools. Future knowledge translation interventions should focus on these factors to improve the standardized assessment of walking post-stroke.

Sustainability is vital to the success of our cities and settlements. While communities are becoming increasingly conversant with sustainability concepts, uncertainty remains over how to translate these into planning practice. This practicum explores the role of sustainability checklists as one tool for planning and designing more sustainable communities. The inquiry examines the design, implementation and effectiveness of these tools and seeks to understand the motivation and context in which they are developed, the varying approaches and components of checklist tools, and the impact that they are having on planning and development practices. A review of twenty-four sustainability checklists from a selection of BC municipalities, an online survey and key informant interviews were used to inform this study. Nine key findings are identified suggesting that while checklists are helping to communicate sustainability objectives and are encouraging better development, they are not resulting in the large scale shifts to development patterns and urban systems that are required to achieve sustainable outcomes; therefore, checklists need to be integrated with other policies, regulations and tools in order to assist in achieving sustainable settlements.

Abstract Background. Physical therapists report inconsistent use of valid and reliable measures of walking post-stroke. Objective. To describe the methods physical therapists use to evaluate walking, reasons for selecting these methods, and the use of the evaluation results in clinical practice along the continuum of an organized system of stroke care. Methods. A qualitative descriptive study involving semi-structured telephone interviews of physical therapists in Ontario was conducted. A thematic analysis was performed. Results. Participants (n=28) used both standardized and non-standardized methods to assess walking. A hierarchy of factors influencing use of both methods was observed. Assessment results were commonly used for communication with other healthcare professionals or education of the patient. Conclusions. A variety of factors influence physical therapists to use standardized assessment tools. Future knowledge translation interventions should focus on these factors to improve the standardized assessment of walking post-stroke.

Sustainability is vital to the success of our cities and settlements. While communities are becoming increasingly conversant with sustainability concepts, uncertainty remains over how to translate these into planning practice. This practicum explores the role of sustainability checklists as one tool for planning and designing more sustainable communities. The inquiry examines the design, implementation and effectiveness of these tools and seeks to understand the motivation and context in which they are developed, the varying approaches and components of checklist tools, and the impact that they are having on planning and development practices. A review of twenty-four sustainability checklists from a selection of BC municipalities, an online survey and key informant interviews were used to inform this study. Nine key findings are identified suggesting that while checklists are helping to communicate sustainability objectives and are encouraging better development, they are not resulting in the large scale shifts to development patterns and urban systems that are required to achieve sustainable outcomes; therefore, checklists need to be integrated with other policies, regulations and tools in order to assist in achieving sustainable settlements.

Background: Healthcare workers are ranked among one of the top occupations for musculoskeletal disorder (MSD) injuries that affect the muscles, the bones, the nervous system and due to repetitive motion tasks (Centers for Disease Control and Prevention, 2017). Numerous high-risk patient handling tasks such as lifting, transferring, ambulating and repositioning of patients cause injuries that can be prevented when evidence-based solutions are used for safe patient handling and mobility (SPHM) tasks. Purpose: The purpose of this quality improvement project was to evaluate the knowledge and attitudes of orthopedic nurses regarding the use of SPHM algorithms as the standard of care when transferring patients. Theoretical Framework. Lewin’s Theory of Change Methods. A quasi-experimental pretest-post-test design was utilized in this evidenced-based practice project. Results. Descriptive statistics that evaluated pre and post questionnaires of the orthopedic nurses noted nurses displayed behavioral and attitudinal intent to use the SPHM algorithms as the standard of care to improve patient outcomes by decreasing falls. Although the behavioral beliefs and attitudes reflected acknowledgement of SPHM skills and knowledge, nursing did not improve in their documentation of SPH fall risk as two separate tools were required on each patient. Conclusions: SPHM evidenced-based standards do guide staff to critically examine how to safely transfer and mobilize a patient. Patient fall rates did decrease during educational sessions, prompting the need for on-going education of all staff on the unit that transfers patients. The findings from this quality project may encourage future practice approaches to use of the safe patient handling (SPH) fall risk assessment tool for all patients to prevent patient falls.

There has been a rising concern surrounding risk within society. This increasing concern has dominated almost all aspects of human life and more specifically the way in which citizens are governed. How risk is addressed in general has shifted significantly; given this, the criminal justice system has also seen an escalation in concerns surrounding risk. Subsequently, there has been a push towards evaluating said risks through the use of actuarial assessment tools. Research has shown that with the rising reliance on actuarial assessment tools came the decrease in practitioner’s ability to rely on their professional judgement when conducting their work. However, there has been a gap identified in the literature. This gap pertains to how practitioners, particularly, probation officers perceive the impact of these actuarial tools on their work. This study aims to analyse how probation officers, within the province of Ontario, view the impact of actuarial assessment tools on their work. This study is guided by the theory of governmentality, as coined by Michel Foucault. In order to explore the impact of actuarial assessment tools on the practice of probation, seven semi-structured interviews were conducted with former probation officers. The perceptions varied and participants did not provide a unique and monolithic response; rather, the voices of all participants were shared to create a larger picture of how actuarial assessment tools impact the work of practitioners in the practice of probation.

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Assessment tools were developed to address the need for a low cost, rapid method of quantifying the quality of agricultural best management practices (BMPs). Best management practices are either cost-shared, where some or all of the capital costs of the practice were subsidized with federal, state, or local funds, or non cost-shared, where the cost of the practice and its upkeep is paid for by the landowner or farm operator. Cost-share practices are required to comply with state standards, while non cost-share practices are not subject to any standards. For this study, BMP quality is defined as the adherence to design, site selection, implementation, and maintenance criteria relating to water quality as specified by state and federal agencies promoting BMP implementation. The two objectives of this research were: 1. develop a set of assessment tools to quantify the quality of agricultural best management practices in a rapid low-cost manner, and 2. test the tools and determine if differences in quality exist between cost-share and non cost-share BMPs in the James River Basin of Virginia. Assessment tools were developed for sixteen practices: alternative water systems, stream fencing, streambank stabilization, grass filter strips, wooded buffers, permanent vegetative cover on critically eroding areas, permanent vegetative cover on erodible cropland, reforestation of erodible crop and pasture land, animal waste storage facilities, grazing land protection systems, loafing lot management systems, late winter split application of nitrogen on small grains, protective cover for specialty crops, sidedress application of nitrogen on corn, small grain cover crops-fertilized and harvested, and small grain cover crops for nutrient management. Assessment tools were developed using both Virginia BMP standards and expert knowledge. Virginia Department of Recreation and Conservation (DCR) and Virginia and national Natural Resource Conservation Service (NRCS) BMP standards were collected and sorted into the four quality component categories; design, site selection, implementation, and maintenance. Standards that pertained directly to a BMPs' potential to protect water quality were translated into question format. Multiple-choice or yes/no questions were used as often as possible to avoid potential bias and for ease of processing. Assessment tool development involved an iterative process that included input from a research team (university-based researchers) and an expert team (public and private sector professionals and practitioners responsible for BMP design and assessment). One hundred and fifty-five cost-shared BMPs and 150 non cost-shared BMPs were assessed on 128 independent farms in the James River Basin of Virginia over a period of four months. The assessment tools were loaded onto a personal digital assistant (PDA), which facilitated data collection and eliminated the need for data transcription. Data collected on the PDA were uploaded periodically to a computer database. A digital camera was used to develop a photographic record of the assessed BMPs. Best management practice quality scores were based on five-point scale, with one being the lowest quality score and five as the highest. Statistical analyses conducted on both the overall quality scores and the quality component scores, indicate that there is not a strong significant difference (p = 0.05) in quality between the cost-shared and non cost-shared BMPs assessed for this study. Statistically significant differences between cost-share and non cost-share practices did, however, exist. For the filter/buffer strips practices (grass filter strips and wooded buffers), the implementation quality component cost-share mean (3.35) and the non cost-share mean (3.88) were statistically different at the 0.05 level (p-value = 0.026). One other statistically significant difference was found. For stream fencing, the overall quality cost-share mean was 4.68 while the non cost-share mean was 4.20; the means are statistically different at the 0.05 level (p-value = 0.043). Statistical analyses were performed to determine if age of practice, farm size, or Soil and Water Conservation District (SWCD) had effects on the BMP quality. No statistically significant differences (p = 0.05) were found relating to the age of an assessed BMP or farm size. One SWCD, the Robert E. Lee district, had a statistically significant difference in the design quality component means; cost-share mean = 4.21, non cost-share mean = 2.94 with a p-value of 0.048. The statistically significant differences that were detected do not establish a clear trend; it appears that for the BMPs assessed here the qualities of cost-share and non cost-share practices are roughly equal. The fact that cost-share practices and non cost-share practices do appear to be roughly equal may be the result of education and outreach programs sponsored by Virginia's SWCDs and Virginia Cooperative Extension. Non cost-share practices may be of equal quality to cost-share practices because those implementing BMPs without the benefit of cost-share may have a greater stake (both financial and personal) in those practices performing well. If no statistically significant difference in quality exists between cost-share and non cost-share practices, then non cost-share practices should be treated equally when accounting for BMPs in NPS pollution in watershed management and computer modeling. Currently, only cost-share practices are included in computer models, in part because these are the only practices tracked by the existing BMP establishment infrastructure. Estimating the numbers and distribution of non cost-share practices and incorporating them into NPS water quality modeling efforts will more accurately reflect the steps agricultural producers have and are taking to decrease the amount of NPS pollution reaching water bodies. Additionally, policy regarding NPS pollution and BMPs should reflect the apparent equal qualities of cost-share and non cost-share practices. The assessment tools developed as a part of this study can potentially be applied to determine the quality of BMPs on basin or state-wide scales to give policy makers a better understanding of the practices and populations that the policies are created for. Moreover, BMP quality scores have the potential to be used as a surrogate measure for BMP performance. Further research recommendations include correlating BMP quality scores with BMP performance, wider scale testing of the tools, continued revision of the tools, and using the assessment tool scores to diagnose BMP quality problems. / Master of Science

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Master of Science / Clinical Sciences / Daniel U. Thomson / Consumer interest in production agriculture has prompted the beef industry to develop tools to increase accountability of producers for animal management practices. The Beef Quality Assurance Feedyard Assessment, developed by veterinarians, animal scientists, and production specialists, was used to objectively evaluate key areas of beef cattle production such as animal handling, antimicrobial residue avoidance, and cattle comfort in 56 Kansas feedyards. During the assessment, management protocols were reviewed, facilities and pens were inspected, and cattle handling practices were observed. Of the 56 feedyards, 19 maintained complete and current Best Management Practices documentation for all management protocols required by the assessment. During assessment of cattle handling practices, 78.6% of feedyards met requirements for an Acceptable score for all measured criteria. An electric prod was used on only 4.0% of cattle during processing. In addition, 83.0% of feedyards scored Acceptable for stocking rate, feed bunk, water tank, and mud score standards.