Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

published_or_final_version / Education / Master / Master of Education

No description available.

Denna empiriska undersökning bygger teori som stödjer det faktum att undervisning om hållbar utveckling bör leda till att utveckla elevernas förmåga att agera demokratiskt och ansvarsfullt. Detta agerande består både att kunna ta ställning i frågor som berör dem och deras framtid, och att kunna använda sin kunskap och sina förmågor för att handla i kommande situationer. Studiens syfte är att kartlägga skolungdomars uppfattningar gällande deras lärande och deras aktivism samt engagemang i miljö- och klimatfrågor. Undersökningen genomfördes genom att samla in skolungdomars uppfattningar via en enkät bestående av 5 öppna frågor. Svaren analyserades och kategoriserades i fenomenografiska beskrivningskategorier. Analysen visade att det fanns stor variation i elevers uppfattningar om deras lärande i samband med undervisning om hållbar utveckling. Resultaten visar att ett djuplärande som främjar förståelse uppfattas både som essentiellt och att undervisningen utvecklar dessa förmågor. Intressant var att både formellt och informellt lärande ansågs viktigt för skolungdomarnas lärande. Dessutom åskådliggjordes en problematik som bestod i att skolungdomars positiva uppfattningar om aktivism och engagemang inte speglades i uppfattningarna om skolungdomarnas egen roll.

Photoplethysmography (PPG) is a method to detect blood volume changes in every heartbeat. The peaks in the PPG signal corresponds to the electrical impulses sent by the heart. The duration between each heartbeat varies, and these variances are better known as heart rate variability (HRV). Thus, finding peaks correctly from PPG signals provides the opportunity to measure an accurate HRV. Additional research indicates that deep learning approaches can extract HRV from a PPG signal with significantly greater accuracy compared to other traditional methods. In this study, deep learning classifiers were built to detect peaks in a noise-contaminated PPG signal and to recognize the performed activity during the data recording. The dataset used in this study is provided by the PhysioBank database consisting of synchronized PPG-, acceleration- and gyro data. The models investigated in this study were limited toa one-layer LSTM network with six varying numbers of neurons and four different window sizes. The most accurate model for the peak classification was the model consisting of 256 neurons and a window size of 15 time steps, with a Matthews correlation coefficient (MCC) of 0.74. The model consisted of64 neurons and a window duration of 1.25 seconds resulted in the most accurate activity classification, with an MCC score of 0.63. Concludingly, more optimization of a deep learning approach could lead to promising accuracy on peak detection and thus an accurate measurement of HRV. The probable cause for the low accuracy of the activity classification problem is the limited data used in this study.

This study examined the influences of a variety of verbal and non-verbal strategies on the language acquisition of six fourth grade ESL students in a discipline-based art education classroom. The art teacher/researcher spoke only English, and the students spoke Spanish almost exclusively. The art instruction occurred during eighteen 30 minute sessions, over a period of five months. The program involved the whole language approach, collaborative/cooperative learning, and the study of art concepts through verbal and graphic symbol cue cards and images of art works. Data were amassed from transcripts of video recordings, student and teacher interviews, and reflective notes. This study showed highly successful results with student growth in language acquisition and comprehension of art concepts.

Il y a quelques décennies, l’émergence du discours de la promotion de la santé infléchissait un nouveau tournant à la santé publique, orientant sa pratique vers l’action communautaire, participative et intersectorielle. Parallèlement, au Québec, la réforme du système de santé de 2004 réorganisait le niveau de gouverne locale à travers la création des centres de santé et de services sociaux (CSSS). Ceux-ci doivent articuler les secteurs des soins et de la santé publique à travers un continuum de services qui va de la promotion de la santé aux soins palliatifs. Ces changements ont des implications majeures pour les acteurs de la santé et de la santé publique, qui doivent composer avec de nouveaux rôles professionnels et de nouvelles stratégies d’action. Le développement professionnel est considéré comme un levier potentiel pour soutenir ces changements. En 2009, une équipe de la Direction de la santé publique de l’Agence de santé et des services sociaux de Montréal concevait un programme de développement professionnel appelé le Laboratoire de promotion de la santé. Ce programme mise sur une approche d’apprentissage de groupe pour permettre aux professionnels des CSSS de développer de nouvelles compétences, une pratique réflexive ainsi que de nouvelles pratiques de promotion de la santé. Basée sur une méthodologie générale qualitative et une approche d’évaluation collaborative, cette thèse utilise plusieurs stratégies d’investigation afin d’évaluer le Laboratoire de promotion de la santé sous trois angles, qui renvoient à sa conceptualisation, à son implantation et à ses effets. Plus spécifiquement, elle vise à : (1) examiner la plausibilité de la théorie d’intervention du programme; (2) décrire et comprendre les processus d’apprentissage d’équipe ainsi que les facteurs qui les influencent; et (3) explorer, du point de vue des participants, les effets réflexifs du Laboratoire. Afin de répondre à ces objectifs, la thèse mobilise diverses perspectives théoriques liées à l’apprentissage individuel, d’équipe et organisationnel. Les résultats des analyses démontrent que : (1) malgré quelques améliorations possibles, le modèle du programme est généralement bien conçu pour parvenir aux résultats visés; (2) l’implantation de ce modèle dans deux sites a donné lieu à des processus d’apprentissage d’équipe différents, bien que conditionnés par des facteurs communs liés aux participants, à l’équipe, au contexte organisationnel et à l’implantation du programme; (3) tel que visé, les participants des deux sites ont développé de la réflexivité vis-à-vis leur pratique et leur rôle professionnel – cette réflexivité adoptant une fonction formative ou critique en regard de l’expérience professionnelle. Ces résultats soulignent le potentiel que représente l’évaluation de la théorie d’intervention pour améliorer la conceptualisation d’un programme de développement professionnel, ainsi que l’intérêt et la pertinence d’évaluer les processus d’apprentissage au niveau de l’équipe dans le cadre d’une approche collective de développement professionnel. De plus, ils appuient l’importance de l’apprentissage réflexif pour l’amélioration des pratiques et l’engagement social des professionnels. En ce sens, ils proposent différentes avenues qui ont le potentiel de consolider les capacités de la main-d’œuvre de santé publique et d’influer conséquemment sur son efficacité à améliorer la santé des collectivités dans le prochain siècle. / The emergence of the health promotion discourse a few decades ago steered public health practice into a new direction, orienting it toward community-based, participatory, and intersectoral action. Meanwhile, in Quebec, the 2004 healthcare system reform restructured the local level through the creation of health and social services centres. The mandate of these new organizations is to integrate the public health and the healthcare sector across a continuum of services ranging from health promotion all the way to palliative care.All these changes have significant implications for healthcare and public health practitioners, who must come to terms with new professional roles and new intervention strategies. Professional development is considered to be a potential lever for action to support these changes. In 2009, a team from the Public Health Directorate of the Health and Social Services Agency of Montreal designed a professional development program called the Health Promotion Laboratory. This program builds on a team learning approach to enable participants to develop new competencies, a reflexive practice, and new health promotion practices within the organization. Based on a qualitative methodology and a collaborative evaluation approach, this doctoral thesis used several investigation strategies to evaluate three components of the Health Promotion Laboratory, i.e., the program’s conceptualization, implementation, and outcomes. More specifically, this thesis aims to: (1) examine the plausibility of the program’s intervention theory; (2) describe and understand the team learning processes involved in the program, as well as the factors influencing them; and (3) explore, from the participants’ perspective, the reflexivity outcomes of the program. In pursuing these objectives, this thesis adopts several theoretical perspectives related to adult learning, team learning, and organizational learning. The results show that: (1) while there is room for improvement, the program’s model is generally well designed to achieve the intended outcomes; (2) the model’s implementation in two sites resulted in different team learning processes, both of which depended on common factors related to the participants, the team, the organizational context, and the implementation of the program itself; and (3) as intended, participants from both sites developed reflexivity with regard to their practice and their professional roles, with this reflexivity taking on a formative and a critical function in terms of their professional experience. These results highlight the potential offered by the evaluation of a program’s intervention theory for improving the conceptualization of a professional development program. They also demonstrate the importance and relevance of assessing the learning process at a group level in the context of a collective professional development approach. Finally, the findings support the importance of reflexive learning for improving professional practice and fostering the social engagement of practitioners. Thus, they suggest different avenues having the potential to strengthen the capacities of the public health workforce and thereby to increase its effectiveness in improving the health of communities in the coming century.

Il y a quelques décennies, l’émergence du discours de la promotion de la santé infléchissait un nouveau tournant à la santé publique, orientant sa pratique vers l’action communautaire, participative et intersectorielle. Parallèlement, au Québec, la réforme du système de santé de 2004 réorganisait le niveau de gouverne locale à travers la création des centres de santé et de services sociaux (CSSS). Ceux-ci doivent articuler les secteurs des soins et de la santé publique à travers un continuum de services qui va de la promotion de la santé aux soins palliatifs. Ces changements ont des implications majeures pour les acteurs de la santé et de la santé publique, qui doivent composer avec de nouveaux rôles professionnels et de nouvelles stratégies d’action. Le développement professionnel est considéré comme un levier potentiel pour soutenir ces changements. En 2009, une équipe de la Direction de la santé publique de l’Agence de santé et des services sociaux de Montréal concevait un programme de développement professionnel appelé le Laboratoire de promotion de la santé. Ce programme mise sur une approche d’apprentissage de groupe pour permettre aux professionnels des CSSS de développer de nouvelles compétences, une pratique réflexive ainsi que de nouvelles pratiques de promotion de la santé. Basée sur une méthodologie générale qualitative et une approche d’évaluation collaborative, cette thèse utilise plusieurs stratégies d’investigation afin d’évaluer le Laboratoire de promotion de la santé sous trois angles, qui renvoient à sa conceptualisation, à son implantation et à ses effets. Plus spécifiquement, elle vise à : (1) examiner la plausibilité de la théorie d’intervention du programme; (2) décrire et comprendre les processus d’apprentissage d’équipe ainsi que les facteurs qui les influencent; et (3) explorer, du point de vue des participants, les effets réflexifs du Laboratoire. Afin de répondre à ces objectifs, la thèse mobilise diverses perspectives théoriques liées à l’apprentissage individuel, d’équipe et organisationnel. Les résultats des analyses démontrent que : (1) malgré quelques améliorations possibles, le modèle du programme est généralement bien conçu pour parvenir aux résultats visés; (2) l’implantation de ce modèle dans deux sites a donné lieu à des processus d’apprentissage d’équipe différents, bien que conditionnés par des facteurs communs liés aux participants, à l’équipe, au contexte organisationnel et à l’implantation du programme; (3) tel que visé, les participants des deux sites ont développé de la réflexivité vis-à-vis leur pratique et leur rôle professionnel – cette réflexivité adoptant une fonction formative ou critique en regard de l’expérience professionnelle. Ces résultats soulignent le potentiel que représente l’évaluation de la théorie d’intervention pour améliorer la conceptualisation d’un programme de développement professionnel, ainsi que l’intérêt et la pertinence d’évaluer les processus d’apprentissage au niveau de l’équipe dans le cadre d’une approche collective de développement professionnel. De plus, ils appuient l’importance de l’apprentissage réflexif pour l’amélioration des pratiques et l’engagement social des professionnels. En ce sens, ils proposent différentes avenues qui ont le potentiel de consolider les capacités de la main-d’œuvre de santé publique et d’influer conséquemment sur son efficacité à améliorer la santé des collectivités dans le prochain siècle. / The emergence of the health promotion discourse a few decades ago steered public health practice into a new direction, orienting it toward community-based, participatory, and intersectoral action. Meanwhile, in Quebec, the 2004 healthcare system reform restructured the local level through the creation of health and social services centres. The mandate of these new organizations is to integrate the public health and the healthcare sector across a continuum of services ranging from health promotion all the way to palliative care.All these changes have significant implications for healthcare and public health practitioners, who must come to terms with new professional roles and new intervention strategies. Professional development is considered to be a potential lever for action to support these changes. In 2009, a team from the Public Health Directorate of the Health and Social Services Agency of Montreal designed a professional development program called the Health Promotion Laboratory. This program builds on a team learning approach to enable participants to develop new competencies, a reflexive practice, and new health promotion practices within the organization. Based on a qualitative methodology and a collaborative evaluation approach, this doctoral thesis used several investigation strategies to evaluate three components of the Health Promotion Laboratory, i.e., the program’s conceptualization, implementation, and outcomes. More specifically, this thesis aims to: (1) examine the plausibility of the program’s intervention theory; (2) describe and understand the team learning processes involved in the program, as well as the factors influencing them; and (3) explore, from the participants’ perspective, the reflexivity outcomes of the program. In pursuing these objectives, this thesis adopts several theoretical perspectives related to adult learning, team learning, and organizational learning. The results show that: (1) while there is room for improvement, the program’s model is generally well designed to achieve the intended outcomes; (2) the model’s implementation in two sites resulted in different team learning processes, both of which depended on common factors related to the participants, the team, the organizational context, and the implementation of the program itself; and (3) as intended, participants from both sites developed reflexivity with regard to their practice and their professional roles, with this reflexivity taking on a formative and a critical function in terms of their professional experience. These results highlight the potential offered by the evaluation of a program’s intervention theory for improving the conceptualization of a professional development program. They also demonstrate the importance and relevance of assessing the learning process at a group level in the context of a collective professional development approach. Finally, the findings support the importance of reflexive learning for improving professional practice and fostering the social engagement of practitioners. Thus, they suggest different avenues having the potential to strengthen the capacities of the public health workforce and thereby to increase its effectiveness in improving the health of communities in the coming century.

A series of educational reforms implemented in recent years had a considerable impact on secondary schools. From principals to teachers; from the school sector to the educational system, all parties had to effect fundamental changes. Facing this new educational era, many scholars suggested schools should have organizational learning so as to have continuous improvement and to pursue excellence. / Based on the findings from the quantitative and qualitative studies, some implications could be drawn. First, teachers should be encouraged to attend more workshops and seminars so as to familiarize themselves with the curriculum reforms. Secondly, schools should utilize the central database to store all the teaching materials for teachers' reference and collaborative lesson preparation should be organized so as to facilitate the co-operation among teachers in order to enhance teaching effectiveness. Of course, schools also should know that all the organizational learning obstacles would together form the unique schools atmosphere while these determine whether the schools can have effective organizational learning. Therefore, the schools should have deep understanding of the atmosphere and then make proper improvement accordingly. Thirdly, the Education Bureau should put in more resources to help the language and liberal studies teachers. Training courses for vice-principals should be strengthened so as to enhance their capabilities to assist principals in leading the teaching staff and carrying out the educational reforms in the school. / However, according to various studies, there was low level of organizational learning process and organizational learning outcome in the majority of primary and secondary schools. From this, we learn that there must be some obstacles for schools to practice organizational learning. Furthermore, the capability of teachers, the main staff of schools, to learn effectively is often the key factor affecting the success or failure of schools. Unfortunately, according to some studies and some reports concerning teachers' stress, it is found that in facing series of educational reforms, teachers were facing tremendous work pressure. Many teachers are unable to meet the new requirements of the educational environment. Some chose to retire early or even to leave the educational sector. Therefore, a study on the obstacles to organizational learning in schools becomes a must. / The findings in the qualitative study showed that organizational learning obstacles varied among teachers of different subjects. Language and Liberal Studies teachers were having the most problems. Besides, as some of the educational reforms were still in their initial stage, not many teachers were involved and hence the problems of having organizational learning were still not serious and explicit. Other than that, teachers regarded the policies launched by the Education Bureau were too fast and too extensive in scale, the schools did not have the capabilities to make school-based modifications. / The findings in the quantitative study showed that the problem of having organizational learning obstacles in Hong Kong secondary schools was not serious. Among all the seven factors concerning organizational learning obstacles, the main one was in the factor of communicating problems. Besides, a major finding of the study indicated that the obstacles at the school level were more serious than those at the personal level. From this, one could learn that teachers regarded support from the school organizational structure, school culture and the principals still have room for improvement while they did not think: that they had great problems with their cognitive abilities and confidence. Only that they did have difficulty in handling the ever-mounting work-load. Other than that, it was found that all the factors concerning the organizational learning obstacles were significantly correlated. / This study was conducted both quantitatively and qualitatively. First, by reviewing the literature, one could have a deeper understanding of the situation secondary schools were facing. Based on the above information, a study tool for the organizational learning obstacles was developed. Through this tool, the existing situation of Hong Kong secondary school in organizational learning was examined. Then, according to the questionnaire data, schools were divided into three groups: high, middle and low in the degree of learning obstacles. One school from each group was chosen to have the qualitative study. Through the interviews with frontline teachers, more data were collected and this could not only help to improve the research tool, but also to gain a better understanding of the situation of the teachers in having organizational learning and the underlying causes of these obstacles. / 蔡愛玲. / Advisers: Sun Keung Pang; Kwan Choi Tse. / Source: Dissertation Abstracts International, Volume: 73-02, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (p. 360-379). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Cai Ailing.