abstract: Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults. / Dissertation/Thesis / Ph.D. Nursing and Healthcare Innovation 2012

Research indicates that tobacco cessation rates are at least doubled when smokers receive assistance from a clinician; receiving tobacco cessation advice from multiple types of clinicians increases quit rates even further.¹ To address a decades-long deficiency in the tobacco cessation training of health professionals in general, a shared curriculum, Rx for Change: Clinician-Assisted Tobacco Cessation, was developed in 1999 as a collaboration of the schools of pharmacy in California.^2,3 Between 2003 and 2005, pharmacy faculty members (n=191) participated in national train-the-trainer workshops designed to equip faculty with the necessary knowledge and skills to implement the Rx for Change curriculum at their academic institutions.⁴ <div><br></div><div> The studies that comprise this dissertation are a logical extension of this national initiative, applying a mixed-methods approach to: (a) evaluate the long-term impact of training pharmacy faculty using the Rx for Change program, (b) delineate recommendations for developing and disseminating shared curricula for health-care programs, and (c) evaluate utilization of the Rx for Change website, which hosts faculty resources and curricular files for download. In combination, these (along with a previously-conducted qualitative study) provide a comprehensive “view” of the long-term impact of this unique shared curriculum. </div><div><br></div><div>Results from the three studies provided evidence for: (1) reach to the majority of pharmacy institutions, (2) a high level of adoption of the Rx for Change in health professional schools, (3) a positive impact on faculty trainees’ careers and their level of confidence for teaching, precepting clinical students, and assisting tobacco users, (4) implementation of the Rx for Change curriculum with a variety of teaching methodologies, and (5) continuity of use within the core curriculum of pharmacy institutions. Seven key factors were found to have contributed to the success of the Rx for Change program, and thus the following are recommended for future shared curriculum developers: (1) appeal to attendees, (2) relate content to clinical practice, (3) deliver live training (in-person), (4) develop high quality materials delivered by experts, (5) meet accreditation standards, (6) provide support for teaching, and (7) demonstrate effectiveness. Data from the website analysis provided evidence for interprofessional reach of the Rx for Change website to educators, learners, and professionals.<br></div>

While weight loss programs over the past 30 years have proven to be effective in producing initial weight-loss, long-term weight maintenance has remained an elusive goal. Given the serious negative health consequences associated with obesity, new approaches to weight management are warranted. The purpose of this study was to evaluate the efficacy of a maintenance-oriented weight management program in producing changes in weight, body composition, fitness, blood lipids, physical activity, and strength following completion of the treatment program and at 3-month follow-up. Fifty overweight and obese men (n = 18) and women (n = 32), ages 27-55 (M = 40.52) who had low cardiorespiratory fitness (M = 20.87 ml/kg/min) and high total cholesterol (M = 223.36) were randomly assigned to one of three treatment conditions: 1] Behavioral Choice Treatment (BCT) with a theory-based maintenance-oriented program, moderate calorie goals, and the New Healthy Pyramid for nutrition recommendations; 2] a traditional exercise and nutrition education program (USDA) using the current Dietary Guidelines for Americans with the Food Guide Pyramid; and 3] a wait-list control group that was transitioned into BCT without the maintenance-oriented program (WLC/BCT w/o maintenance). All groups (during treatment) received a center-based strength and aerobic program utilizing short-duration, but prescriptive protocols aimed at increasing fitness and strength. Assessments were completed at baseline, 16 weeks, 28 weeks, and 40 weeks (WLC/BCT w/o maintenance only). Participants in BCT and USDA experienced significant health changes compared to WLC who experienced minimal weight gain and decreased fitness across the 4-month waiting period. Results comparing BCT, BCT w/o maintenance, and USDA revealed that participants in all treatment conditions significantly improved aerobic fitness, strength, and physical activity during treatment (p's < .05). Participants in the BCT groups experienced significant decreases in weight, total % body fat, waist and hip circumferences, BMI, and LDL-C (p's < .05), while participants in USDA did not. At 3-month follow-up, while participants in both BCT groups continued to make improvements on multiple health outcomes, only participants in BCT with maintenance group were able to maintain their fitness gains (p < .001). In addition, BCT with maintenance group showed a trend toward continued weight loss, maintenance of physical activity, and increased strength. Taken together, the data indicate that any BCT offers greater health outcomes compared to a more traditional educationally based program both at post-treatment and follow-up. Importantly, BCT with maintenance offered additional benefits including continued weight loss, continued decreased intra-abdominal fat, maintenance of fitness, physical activity, and strength compared to BCT w/o maintenance. In conclusion, given the limited scope of small center-based trials, future studies need to examine the effectiveness of this program in a more community-based setting where there is potential for greater public health impact. / Ph. D.

This study sought to (a) investigate the effect of Van Hiele theory-based instruction on Grade 11 students’ geometric proofs learning achievement, (b) explore students’ views on their geometry learning experiences, and (c) develop a framework for better teaching and learning of Grade 11 Euclidean geometry theorems and non-routine geometric proofs. The study is based on Van Hiele’s theory of geometric thinking. The research involved a convenience sample of 186 Grade 11 students from four matched secondary schools in the Capricorn district of Limpopo province, South Africa. The study employed a sequential explanatory mixed-methods design, which combined quantitative and qualitative data collection methods. In the quantitative phase, a non-equivalent groups quasi-experiment was conducted. A Geometry Proof Test was used to assess students’ geometric proof construction abilities before and after the teaching experiment. Data analysis using non-parametric analysis of covariance revealed that students from the experimental group of schools performed significantly better than their counterparts from control group schools. In the qualitative phase, data were collected using focus group discussions and students’ diary records. Results revealed that the experimental group students had positive views on their geometry learning experiences, whereas students from the control group of schools expressed negative views towards the teaching of Euclidean geometry and geometric proofs in their mathematics classes. Based on the quantitative and qualitative data findings, it was concluded that in addition to organizing instruction according to the Van Hiele theory, teachers should listen to students’ voices and adjust their pedagogical practices to meet the expectations of a diverse group of students in the mathematics class. A framework for better teaching and learning of Grade 11 Euclidean geometry theorems and non-routine geometric proofs was thus developed, integrating students’ views and Van Hiele theory-based instruction. The study recommends that teachers should adopt the modified Van Hiele theory-based framework to enhance students’ mastery of non-routine geometric proofs in secondary schools.

Many researchers in planning have demonstrated the connection between land-use planning and transport planning. Mainly to describe how urban development can reduce emissions and congestion in cities. That public transport can be used as a tool in urban development is not as researched but is a general idea among planners and researchers. The theoretical approach of Transit-Oriented development has developed the idea of how urban development and transport planning can cooperate in an integrated planning process. This study has evaluated a tramway project conducted in Norrköping during the years 2006-2011 that extended tramway line 2 from Jura through Hageby to Navestad to deepen the knowledge about how public transport and urban development correspond. Transit-Oriented development has been used to evaluate the planning process preceding the tramway extension through a theory-based evaluation. This study uses a project logic to describe the planning strategies of the municipality in the planning process. Quantitative indicators have been used to map the outcome of the planning strategies. The study demonstrates that the planning process integrated the aims of urban development into the planning process of the tramway. Aims of a denser city, a city with mixed land use and active businesses in all parts of the city were included in the tramway project. The evaluation shows that the area along the extended tramway line has become denser with more varied land use and increased population density. The number of jobs in the area has increased mainly because of more jobs within the public sector. The number of jobs within the private sector has decreased in the area.

No description available.

The purpose of this research was to determine whether changes in the presentation format of items in a computer display could be used to alter the impact of specific cognitive biases, and to add to the knowledge needed to construct theory-based guidelines for output design. The problem motivating this study is twofold. The first part of the problem is the sub-optimal decision making caused by the use of heuristics and their associated cognitive biases. The second part of the problem is the lack of a theoretical basis to guide the design of information presentation formats to counter the effects of such biases. An availability model of the impact of changes in presentation format on biases and heuristics was constructed based on the findings of a literature review. A six-part laboratory experiment was conducted utilizing a sample of 205 student subjects from the college of business. The independent variable was presentation format which was manipulated by altering the visual salience or visual recency of items of information in a visual computer display. The dependent variables included recall, perceived importance, and the subjects' responses to three judgment tasks. The results clearly demonstrate that changes in presentation format can be used to alter the impact of cognitive biases on human decision making. The results also provide support for the availability model, with the exception of the proposed influence of learning style. Learning style was found to have no significant impact on decision making whether alone or in combination with changes in presentation format. The results of this investigation demonstrate that by using our knowledge of cognitive processes (e.g., the visual salience effect, the visual recency effect, and the availability heuristic), presentation formats can be altered in order to moderate the effects of certain biases and heuristics in human decision making. An understanding of these results may be useful in improving DSS design.

Submitted by maria oliveira (maria.oliveira@utp.br) on 2018-05-08T14:22:26Z No. of bitstreams: 1 EDUCACAO NO SISTEMA PRISIONAL.pdf: 2438729 bytes, checksum: 18b36ef3109681c6059d0ef324b21fc1 (MD5) / Made available in DSpace on 2018-05-08T14:22:26Z (GMT). No. of bitstreams: 1 EDUCACAO NO SISTEMA PRISIONAL.pdf: 2438729 bytes, checksum: 18b36ef3109681c6059d0ef324b21fc1 (MD5) Previous issue date: 2017-04-18 / Outlines a panorama about the Brazilian prisional system and comes with analyses of people deprived of their liberty in Brazil and mostly in the Paraná state. Seeks to understand the vicissitudes between the legislation and how occurs the public politics implementation. It is a research of documentary nature. The analysis of how the public education politics for people deprived of their liberty is expressed on the legislation, figure as the general objective of this research. And, as the specifics objectives: Proposes a list the relevant legislation to the education in the prisional system, analyze the data contained in the Brazilian National Penitentiary Department report of 2014 and analyse the prisional education trajectory in the Paraná state projects and programs developed created for this specific public. It was used as theorical referential the authors Adorno, (1991), Leme, (2007), Onofre, (2007), Mirabete, (2007) and Julião, (2011), who dedicate themselves to studying the possibility of the education development process in prisons. Among others who have contributed to a better understanding of the study of the objects in question, as methodological resource if opted for theory based on data that has enabled, through the analysis of the data available publicly, a better understanding of the panorama of education and public policies for educational persons deprived of liberty, as are planned and if they are really effective. he results of this research brings an important warning about the need for consolidation of education within the prison system that passes by the necessity of recognition of the dignity of the human person, respect for the rights acquired by the people deprived of their liberty to exercise citizenship and the need of public policies that guarantee the development of the education of youth and adults in the Brazilian prison system. / Traça um panorama sobre o sistema prisional brasileiro e traz análises das políticas públicas educacionais para pessoas privadas de liberdade no Brasil e, principalmente, no estado do Paraná. O problema reside em compreender as vicissitudes entre a legislação e a implementação das políticas públicas educacionais para pessoas privadas de liberdade. Trata-se de uma pesquisa de natureza documental. A análise de como as políticas públicas educacionais para pessoas privadas de liberdade expressam-se na legislação figura como objetivo geral desta pesquisa. Como objetivos específicos, propõe-se investigar a legislação pertinente à educação no sistema prisional, analisar os dados constantes no relatório do Departamento Penitenciário Nacional do ano de 2014 e analisar a trajetória da educação prisional no estado do Paraná nos projetos e programas desenvolvidos para o público em questão. Utilizaram-se, como referencial teórico, os autores Adorno (1991), Leme (2007), Onofre (2007), Mirabete (2007) e Julião (2011), que se dedicam a estudar a possibilidade do desenvolvimento de processos educacionais em prisões, entre outros que contribuíram para melhor compreensão do objeto de estudo. Como recurso metodológico, optou-se pela teoria fundamentada nos dados, que possibilitou, mediante a análise dos dados disponibilizados publicamente, a melhor compreensão do panorama da educação e das políticas públicas educacionais para pessoas privadas de liberdade, como são planejadas e se são realmente efetivadas. Os resultados desta pesquisa trazem um importante alerta sobre a necessidade da consolidação da educação no sistema prisional, que passa pela urgência do reconhecimento da dignidade da pessoa humana, pelo respeito aos direitos adquiridos pelas pessoas privadas de liberdade a exercer a cidadania e pela necessidade da efetivação de políticas públicas que garantam o desenvolvimento da educação de jovens e adultos no sistema prisional brasileiro.

Maintaining independence is a primary reason that many older drivers continue to drive. Safety, however, is a growing concern for all older drivers. Numerous studies have noted that many older drivers lack an awareness of their driving abilities and driving safety issues for older adults. Identifying the awareness level of older drivers from a theoretical standpoint is important. The current educational interventions for older drivers show promising results and suggest that educational programs can impact older driver knowledge, self-reported awareness, and behaviours. However, rarely have older drivers with cognitive deficits been included. This research study fills a gap in the current literature regarding the utility of a theoretically-based intervention program to increase older driver awareness, improve attitudes towards driving, and increase behaviours around older driver safety. The purpose of this research study was to develop, pilot, and examine the effectiveness of a novel, theoretically based, in-class education program entitled “Safety Awareness for Elderly Drivers” (SAFE) for older drivers both with and without cognitive impairment. The SAFE education program was based on five relevant models/theories: 1) Driving as an Everyday Competence, 2) Hierarchical Awareness Theory, 3) Toglia & Kirk’s Awareness Model, 4) Theory of Planned Behaviour, and 5) Transtheoretical Model. A convenience sample of 47 current older drivers aged 70 years or older currently contemplating changing their driving behaviours and their passengers were recruited and randomly assigned. Participants in the intervention group received the group education session, while those in the treatment as usual control group received a copy of the Insurance Board of British Columbia’s “Roadsense for Driver’s” handbook. We measured general knowledge, awareness of individual driving abilities, attitudes, intention to change driving behaviours, driving behaviours, and readiness to change before, immediately after the intervention (intervention group only), and at 2-month follow-up. Results indicated that the “Safety Awareness for Elderly Drivers” education program was well received by older drivers. The education program demonstrated immediate impacts, such as increased knowledge of older driver safety issues (general level awareness), increased individual awareness, and some changes in attitude and intentions toward changing driving behaviours. Older drivers with mild cognitive impairment showed similar benefits from the education program. However, the program did not appear to be more effective than the review of a drivers handbook available though ICBC in follow-up, with most follow-up measures being similar to baseline. Implications of this research and further research suggestions for older drivers are discussed.

En France, la question du tabagisme des jeunes demeure un défi majeur pour la santé publique. Si l'influence des pairs peut encourager l'usage du tabac, on constate que l'éducation par les pairs a aussi un potentiel bénéfique pour changer le comportement tabagique des adolescents. En outre, il a été démontré que la Théorie du comportement planifié (TCP) donnait la meilleure prédiction des intentions et du comportement dans plusieurs domaines de la santé. Cependant, la TCP est peu utilisée pour développer des interventions contre le tabac. Dans le programme de P2P, des lycéens professionnels volontaires ont conçu et réalisé leur propre intervention basée sur la TCP (avec l'aide d'éducateurs formés), visant à réduire le tabagisme de leurs camarades. Notre objectif était de mesurer l'impact de la première année de P2P sur une population particulièrement exposée de lycéens professionnels. L'hypothèse principale est que P2P évite l’augmentation de la prévalence du tabagisme quotidien au cours de l'année dans le groupe d'intervention comparativement au groupe de contrôle. / In France, the issue of youth smoking remains a major challenge for public health. If peer pressure may encourage smoking, the peer education also has a positive potential to change smoking behavior of adolescents. In addition, it was demonstrated that the theory of planned behavior (TPB) gave the best prediction of intentions and behaviors in many domains of health. However, the TPB is usually not used to develop interventions against tobacco. In the P2P program, voluntary professional school students have designed and built their own TPB-based intervention (with the help of trained educators), aimed at reducing smoking peers. Our goal was to measure the impact of one year of P2P on a population particularly vulnerable professional students. The main hypothesis is that P2P avoids the increasing of daily smoking during the year in the intervention group compared to the control group