BACKGROUND:Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM).METHODS:Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS), which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50) from healthy individuals (n = 50) in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI) in undergraduate college students (N = 458). The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale) in a different sample of undergraduate students (N = 62).RESULTS:Substudy (i) Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50 / controls r = 0.45). AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36 / controls r = 0.50). Controls (r = 0.64) had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33), which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii) In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40). Substudy (iii) AIOS scores were significantly correlated with positive affect (rAIOS24h = 0.56, rAIOS1month = 0.57) and positive states of mind (rAIOS24h = 0.42, rAIOS1month = 0.45), and inversely correlated with negative affect (rAIOS24h = -0.41, rAIOS1month = -0.59).CONCLUSIONS:The AIOS is able to distinguish relatively sicker from relatively healthier individuals / and correlates in expected directions with a measure of distress and indicators of positive and negative affect and positive states of mind. The AIOS offers a tool for CAM/IM research that extends beyond a disease emphasis.

The older lesbian, gay, and bisexual (LGB) population is often underrepresented in the current body of research and the needs of this population are not well understood. Most research with this population has focused on wealthy, gay men, creating a deficit in regard to our understanding of the lesbian and bisexual individuals in the population. The present study was designed to add to the body of research on same-sex attracted older adults, by assessing well-being and acceptance of sexual orientation within the population. This study filled gaps in our current understanding of this population and provided new data for the Gay Identity Questionnaire (GIQ) as well as normative data for this population on several measures of well-being. Additionally, it created an image of how older same-sex attracted adults view themselves and the needs that they perceive within their population. Same-sex attracted adults, age 50 and older, were recruited through an anonymous online survey (N = 327; Age M: 59 years old, SD = 6.96). Sexual identity development was assessed with the GIQ (Brady & Busse, 1994; Halpin & Allen, 2004), and psychological well-being was assessed via the Depression-Happiness Scale (Joseph & Lewis, 1993), Satisfaction with Life Scale (Pavot & Diener, 1993), UCLA Loneliness Scale (Russell, 1996), Rosenberg's Self Esteem Scale (Rosenberg, 1989), Interpersonal Support Evaluation List. Regression analysis showed that age was overall a significant predictor of all of the outcome measures, with higher age predicting better well-being scores. The GIQ was not a significant predictor in the final model. The implications of these results in regard to the usefulness of the GIQ as a research and clinical assessment tool are discussed, as well as suggestions for future research with this population. A descriptive analysis of results and participants comments is also provided, with an emphasis on different areas of need within the older LGB population.

The purpose of this thesis was to determine the feasibility of implementing an intervention tailored to overcome barriers to adherence to recommendations of critical care nutrition guidelines in the Intensive Care Unit (ICU). The thesis is comprised of four manuscripts. The first manuscript described the development of a 26 item questionnaire rating the importance of potential barriers as impediments to the provision of enteral nutrition (EN) in the ICU. Preliminary evaluation demonstrated acceptable face and content validity and internal reliability, but the test retest reliability and within group reliability were poor for some items. The second manuscript provided evidence to support the construct validity of the developed questionnaire by reporting the results of a multilevel multivariate regression analysis of cross-sectional data from 55 ICUs that demonstrated that a 10 point increase in the overall barrier score was associated with a statistically significant 3.5% (Standard Error (SE) 1.3) decrease in prescribed calories received from EN. The third manuscript provided data to inform whether the intervention should be tailored to site specific barriers by describing the barriers to enterally feeding critically ill patients identified by 138 nurses, and evaluating whether these barriers differed across the 5 participating sites. Statistically significant differences were found among ICUs for 4 out of the 22 potential barriers. The fourth manuscript described the results of a pretest posttest study involving 5 ICUs in North America and determined that all participating sites successfully developed the tailored intervention. A statistically significant 10% (Site range -4.3 to -26.0%) decrease in overall barriers score, and a non-significant 6% (Site range -1.5 to17.9%) change in prescribed calories received was observed following the intervention. However, there was variability in the degree of implementation achieved by each site. Taken together, the results of this thesis demonstrated that adopting a tailored approach to improving nutrition practice is feasible. However, the findings also resulted in revisions to the barriers questionnaire and modifications to the design of the tailored intervention. Thus, the next step is to formally test the hypothesis that a tailored intervention designed to address barriers to feeding critically ill patients will improve nutrition performance. / Thesis (Ph.D, Community Health & Epidemiology) -- Queen's University, 2013-04-28 21:37:54.695

This thesis aimed to provide a second validation phase of a recently developed measure: the Parental Understanding of Neurodisability Questionnaire (PUN-Q) (Moran et al., submitted). The PUN-Q is a thirteen item self-report questionnaire measuring parents' understanding of their child's neurodisability. This thesis prospectively validated the PUN-Q over three time points, prior to and following a child's attendance at a Tier-Four paediatric diagnostic assessment, for queries regarding social communication. Four main aims were investigated: 1) to establish prospective Construct Validity by comparing the PUN-Q to two other parent-report measures (perceived self-efficacy and parenting stress); 2) to examine test-retest reliability of the PUN-Q by comparing two pre-assessment time points; 3) to examine whether the PUN-Q is sensitive measuring potential pre-and-post assessment changes to parental understanding; 4) to explore the relationship between the PUN-Q and child emotional, behavioural and social communication difficulties. These objectives were addressed using data collected from 37 parents, due to time constraints the study was underpowered at Times two and three (n=26, n=11, respectively); bootstrapping confidence intervals were therefore estimated for non-parametric data. Evidence was provided for Construct Validity at Time 1, but not at Time 3. Test-retest reliability was suggested for the PUN-Q between two non-intervention time points. Results suggested that the PUN-Q is responsive to changes over time, and that the clinic's diagnostic assessment is effective in enhancing parental understanding. The PUN-Q was not shown to be related to child-related outcomes. These preliminary results suggest that the PUN-Q is an important measure that can reliably and conveniently measure parental understanding of their child's neurodisability symptoms. This study suggests a role for parental understanding within a wider model of parenting stress and coping with disability. Further validation is needed to allow dissemination to the wider neurodisability service, and to less complex symptom presentations.

Objective: To assess the reliability of the Kids' Activity and Nutrition Questionnaire (KAN-Q) as part of a tiered process for developing Supplemental Nutrition Assistance Program-Education tools. Methods: The KAN-Q was administered at 2 time points to assess internal consistency using standardized values of Cronbach alpha and test-retest reliability using the intraclass correlation coefficient for continuous variables, Cohen's kappa (k) statistic for categorical variables, and the weighted k statistic for ordinal data. Results: Data were collected from 119 fourth graders. Cronbach a was adequate for behavior (.71) and knowledge (.72) scales and nutrition behavior (.78) and nutrition knowledge (.75) subscales. Test-retest reliability was generally acceptable, with intraclass correlation coefficients from 0.40 to 0.75 and k coefficients showing fair to substantial agreement (0.30 to 0.72). Conclusions and Implications: The KAN-Q is a practical and reliable questionnaire for school-based administration that aligns directly with Supplemental Nutrition Assistance Program-Education evaluation priorities.

Introduction : Lorsque l’on soupçonne la présence de moisissures dans une école, il peut être nécessaire de déterminer si la prévalence de symptômes et de maladies respiratoires dans cette école est élevée comparativement à une prévalence de référence normalement attendue. Cependant, aucune prévalence de référence n’est répertoriée en Estrie et il n’existe aucun outil optimal permettant de l’obtenir. Objectifs : La présente étude a pour objectif de proposer un tel outil en adaptant et bonifiant les questionnaires existants et d’en évaluer la validité de contenu et la fidélité test-retest. Elle vise aussi à estimer le taux et les biais des réponses des parents à un questionnaire disponible uniquement en ligne par rapport à l’ajout d’une option papier. Méthodologie : Certains éléments des outils existants recensés ont été conservés pour l’élaboration d’un nouveau questionnaire autoadministré à remplir par les parents au sujet de leur enfant. Pour la validation du contenu, chacune des questions et variables calculées à partir de celles-ci ont été révisées par un comité de cinq experts. Pour évaluer la fidélité test-retest, les parents d’enfants d’écoles primaires ont répondu au questionnaire à deux reprises à deux semaines d’intervalle. Pour chaque variable, l’accord était estimé par le coefficient kappa et des valeurs supérieures à 0,4 étaient recherchées. Pour évaluer les biais de réponse associés au format de questionnaire, les caractéristiques et les variables calculées à partir des réponses des parents répondant en ligne ont été comparées à celles des parents répondant au format papier. Résultats : La première ébauche du questionnaire comptait 31 questions. La version révisée après consultation des experts compte 34 questions générant 48 variables. Quatre-vingt-un parents ont rempli le questionnaire à deux reprises pour un taux de réponse de 24 %. Les coefficients kappa sont statistiquement différents de 0,4 pour la majorité des variables principales, dont la présence d’allergies (k=0,89; p<0,001), les symptômes nasaux (k=0,71; p=0,001) et l’indicateur d’humidité excessive (k=0,77; p<0,001). Le taux de réponse au questionnaire en ligne s’est avéré plus faible que celui avec l’ajout de la possibilité de répondre au questionnaire en format papier. Seule la variable niveau de scolarité des parents présentait une différence statistiquement significative (p=0,040) entre les deux versions de questionnaires. Conclusion : Cette étude montre que le questionnaire possède une bonne fidélité test-retest, mais lorsqu’il est disponible seulement en ligne, il obtient un taux de réponse trop faible et les répondants ne sont pas représentatifs de la population visée. D’autres études sont nécessaires pour documenter davantage sa validité, notamment sa capacité à identifier les écoles potentiellement problématiques.

Les conseillers d’orientation (c.o.) en milieu scolaire ont plusieurs rôles à remplir auprès des élèves, entre autres la réponse aux demandes des élèves, le maintien de l’accès à une documentation pertinente et l’accompagnement dans une meilleure connaissance de soi et du monde du travail (Dupont, Gingras et Marceau, 2002a). Pour ce faire, plusieurs moyens sont à leur disposition, dont l’évaluation psychométrique (OCCOQ, 2013). Un concept qui pourrait utile de mesurer auprès des adolescents est la maturité vocationnelle (Jordaan et Heyde, 1979). Des instruments de mesure évaluant la maturité vocationnelle existent déjà, mais aucun d’entre eux ne semble convenir parfaitement à la réalité du Québec, emmenant la création d’un nouvel outil, le Questionnaire de maturité vocationnelle (QMV). L’objectif de ce mémoire est de vérifier les propriétés psychométriques de l’échelle affective du QMV. Les participants de l’étude sont 1 164 adolescents québécois âgés entre 14 et 18 ans (moyenne : 15,30 ans), provenant de 14 écoles secondaires. Pour ce qui est du niveau scolaire des participants, 511 (43,9 %) sont en 3e secondaire, 303 (26 %) sont en 4e secondaire et 350 (30,1 %) sont en 5e secondaire. Les résultats obtenus appuient la fidélité et la validité de l’instrument de mesure.

The master thesis presented deals with the  question of whether superiors in the engineering field in Germany should undergo managerial training to be better-suited managers than superiors without such training. This thesis looks into this question through a survey of a homogenous group of engineering professionals working in Germany. The survey strives to gain information from the engineering professionals regarding their opinions and experience as managers with and/or without managerial training and their capacity to fulfill their managerial duties. This problem resonates widely in the engineering world, yet it seems that not enough action is being taken towards educating personnel in elevated positions throughout a company’s hierarchy.

The promotion of an active lifestyle has become a priority in Western societies and school plays a dominant role. The primary objectives of this thesis were i) to examine the lifestyle and physical activity (PA) patterns of a sample of Greek children and ii) to examine the applicability of a school based intervention programme in promoting PA and sport participation. For the purposes of this study the Physical Activity and Lifestyle Questionnaire (PALQ) was developed and examined for its validity and reliability to assess habitual PA of Greek students. Afterwards, a need analysis was carried out in a) a cross sectional sample of 911 students from an urban area (11, 14 and 17 years olds, b) 103 elementary and secondary PE teachers, and c) 17 schools. The students answered the PALQ in order to depict a profile of their lifestyle and PA patterns. The teachers answered a questionnaire in order to evaluate their knowledge, attitudes and self-efficacy towards teaching health related exercise (HRE). A checklist has been used in order to establish the nature and extent of PA promotion in a sample of elementary and secondary schools. The results showed that: a) a large proportion of students adopted a sedentary lifestyle and were inadequately active to obtain health benefits, b) teachers' had limited ability in promoting effectively HR issues, and c) schools provided limited sport programmes and facilities. The overall finding of the need analysis justified the need for intervention and advocated the adoption of an ecological approach to promote PA Based on the Active School initiative (Almond & McGeorge, 1995), a school based intervention programme has been set up in order to a) promote students' participation in physical activity and sport and to enhance their knowledge on health related (HR) issues, b) increase teachers' knowledge and effectiveness on teaching HR exercise. The decisions about the intervention contents and priorities were based on the findings of the need analysis taking into consideration the cost and the resources. The intervention strategy and the implementation process focused on: a) the teachers' training, b) the creation and the provision of the necessary resources (PE curriculum, a handbook and a CD-Rom for the teachers and two books for the students), c) the creation of a positive and enjoyable learning PE environment, and d) the co-operation between school and out of school health and sport alliances. The intervention programme was applied in 9 elementary and 5 secondary schools for a period of six months and involved 15 PE teachers. A quasi-experimental design with a control group was applied (experimental group N1=699 and control group N2=213). A number of different parameters were estimated at the beginning, during and at the end of the program. The intervention process was monitored on a weekly basis by the author and the school teachers. The effectiveness of the intervention was evaluated in terms of: a) students' behaviour, fitness, self-efficacy, intrinsic motivation, intentions, and attitudes related to PA, b) teachers' knowledge, attitudes and self-efficacy on teaching HR issues, and c) the broader impact of the programme on the school ethos. The intervention implementation and effectiveness was also assessed by an external evaluator. The overall purpose of the intervention was to examine the applicability of promoting PA throughout school environment by creating an innovative and realistic framework for school physical education lesson. The findings of this thesis were very encouraging. Significant differences have been observed in most of the evaluated variables both, for students (fitness, attitudes, self-efficacy, PA level), for teachers (knowledge) and schools' ethos. However, this pioneer study revealed a number of key considerations and issues in designing intervention programmes to promote PA throughout schools in urban areas.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.