The Influence of Plantar Cutaneous Stimulation on a Functional Test of Gait in Parkinson’s Disease

Although possible deficits in proprioception have been implicated as a cause of gait impairments in individuals with Parkinson’s disease (PD), little research has been done to investigate improving this possible deficit as a method to influence mobility. The overall purpose of the current thesis was to investigate the influence of increased plantar stimulation on stability and gait impairments. This study also investigated the contribution of attention to locomotion in PD. The two studies comprising this thesis addressed the possible influence of the ribbed insoles in the initial response of PD participants as well as the long-term use of the insole. The first study focused on developing a task to assess the influence of the facilitatory insoles on gait for individuals with PD compared to healthy control participants. For the purpose of evaluating the facilitatory insoles in a functionally relevant task participants performed a modified “Timed Up and Go” task with an additional secondary motor task. The secondary task of carrying a tray with glasses demonstrated that attention plays a large role in the production and maintenance of gait as gait deficits became more pronounced. However, the facilitatory insoles also influenced gait parameters which demonstrated that the possible deficits in proprioception contribute to the gait impairments in PD. The initial response to the insoles, in the first study, did not improve gait parameters, which suggests that PD participants may need more time to adjust to the increased plantar stimulation. The second study investigated the influence of the facilitatory insoles when they are worn for a longer period of time. Participants wore either the facilitatory insoles or blank insoles while completing the PD Sensory Attention Focussed Exercise (PD SAFEx) rehabilitation program. Results demonstrated that when the facilitatory insoles are worn long-term, they can benefit the turning and straight-line walking in individuals with PD. PD participants became more confident in their ability to turn as they exerted less control over their centre of mass. Participants also displayed a decreased base of support and time spent in double limb support without negatively affecting lateral stability. These improvements suggest that the facilitatory insoles, when worn long-term, allow for a more normalized pattern of gait for individuals with PD. The TUG task used in this thesis proved to be a good measure to evaluate changes in stability and gait parameters in PD participants. Long-term use of the facilitatory insoles demonstrated improvements in stability and gait deficits during difficult aspects of gait such as turning. This suggests that the facilitatory insoles would be a simple and effective intervention to use, however further investigation should occur to ensure that the improvements will continue when facilitatory insoles are used on a daily basis. As well, investigation into the long-term use of other types of cutaneous stimulation such as vibratory insoles would be beneficial for the PD population

Are you readieee? Taking the "eek" out of participating in fully online communities: Exploring Readiness using the Fully Online Learning Community (FOLC) Model

This workshop will provide an overview of the theoretical underpinnings and description of the FOLC model and its component parts. Through small group activities, participants will examine and discuss propositional definitions for the FOLC components. Participants will complete the FOLCS online self-assessment instrument and discuss their experience with a focus on improving the FOLCS for global use. In addition, participants will examine the application of the FOLCS for use with their students as a component of determining readiness to moving into fully online learning environments. The workshop will conclude with an explanation of the global educational learning observatory (GELO) and its associated tool set will be shared and participants will be invited to join into this global research network

Parameterized Complexity of Streaming Diameter and Connectivity Problems

We initiate the investigation of the parameterized complexity of Diameter and Connectivity in the streaming paradigm. On the positive end, we show that knowing a vertex cover of size k allows for algorithms in the Adjacency List (AL) streaming model whose number of passes is constant and memory is O(logn) for any fixed k. Underlying these algorithms is a method to execute a breadth-first search in O(k) passes and O(klogn) bits of memory. On the negative end, we show that many other parameters lead to lower bounds in the AL model, where Ω(n/p) bits of memory is needed for any p-pass algorithm even for constant parameter values. In particular, this holds for graphs with a known modulator (deletion set) of constant size to a graph that has no induced subgraph isomorphic to a fixed graph H, for most H. For some cases, we can also show one-pass, Ω(nlogn) bits of memory lower bounds. We also prove a much stronger Ω(n2/p) lower bound for Diameter on bipartite graphs. Finally, using the insights we developed into streaming parameterized graph exploration algorithms, we show a new streaming kernelization algorithm for computing a vertex cover of size k. This yields a kernel of 2k vertices (with O(k2) edges) produced as a stream in poly(k) passes and only O(klogn) bits of memory

GELO and GreX: A framework and dashboard to investigate technology competency and culture

Participation in 4th Industrial Revolution society is increasingly dependent upon competencies related to the use of digital technologies for a wide variety of purposes. A person’s competence in the use of digital technologies has implications for a wide variety of contexts and situations, including learning in physical as well as virtual spaces, career choices and employability, digital citizenship, cultural orientations and values, and even democracy (Erstad, 2010). This workshop will provide an overview of the Global Educational Learning Observatory (GELO) project and invite participants to experience a variety of self-assessment tools accessed through the customizable dashboard, the Global Readiness Explorer (GREx). The GELO project attempts to provide a framework for an international network of institutions utilizing data-driven evidence to inform evolving best practices for online and mobile learning. To achieve this, the project (i) assembles a nucleus of formal educational institutions, (ii) constructs the necessary tools to extend research on formal learning models, and (iii) reaches into the workplace as well as other more public spaces to integrate with informal learning settings. The primary source of data derives from a customizable dashboard, the Global Readiness Explorer (GREx), and the tools that can be implemented within it. These tools are designed to give individuals, organizations, and institutions the means to construct complex profiles that can be used to identify gaps in competency attainment and development. Through small group activities, participants will examine and discuss the various tool suites in the GREx including the digital learning competency profiler (DCP); the fully online learning community survey instrument (FOLCS); the Personal Cultural Orientation Scale (PCOS) and others. In this workshop, participants will choose a self-assessment instrument to participate in and then discuss their experience with a focus on improving the GREx tool suite for global use. In addition, participants will examine the GREx for use with their students as a component of determining readiness for moving into fully online learning environments. The workshop will conclude with an explanation of the global educational learning observatory (GELO), and participants will be invited to join this global research network

Evolving Strategies for Online Learning in Graduate Courses in Education

Internet-based learning is becoming more commonplace in post-secondary settings in canada and internationally, though, often, instructors struggle to develop effective programming for their students. In this article, we present three cases in which instructors critically reflect on their experiences designing and implementing online learning environments for various courses in the graduate programs in education at the university of ontario institute of technology (uoit) in oshawa, canada. The first case focuses on an instructor’s efforts to develop courses involving problem-based learning (pbl) on the basis of a faculty-developed conceptual framework. In the second case, an instructor describes how her experiences as a graduate student influenced her efforts to create community-centred online courses at uoit. In the third case, an instructor and his students reflect on the implementation of a major course assignment involving student-facilitated small group discussions. These cases provide insights regarding theory-informed graduate course development; consideration of meaningful past experiences in graduate course development; and strengths and weaknesses of hybrid online learning systems

The Hidden Reserve of Nurses in The Netherlands:A Spatial Analysis

Worldwide, nurse shortages constitute a problem, including in the Netherlands. Every region in the country has a shortage of all types of nurses. At the same time, there are large hidden reserves: persons who have been trained as a nurse but do not work in the healthcare sector. The size of the hidden reserve exceeds the shortage of nurses. Until now, the literature has not paid much attention to spatial aspects of the nursing shortage problem. In this paper, we analyze the size of the hidden reserves and how they are distributed over the country, across large and smaller cities, and across different nurse categories. We find that especially densely populated areas have relatively small shares of trained nurses as well as large hidden reserves relative to their population. These areas are also facing the largest nurse shortages. As nurse labor markets are local, policies that are more focused on local situations are necessary to activate these hidden reserves.</p

Translation and validation of the Dutch version of the Effective Consumer Scale (EC-17)

PURPOSE: The Effective Consumer Scale (EC-17) measures the skills of musculoskeletal patients in managing their own healthcare. The objectives of this study were to translate the EC-17 into Dutch and to further evaluate its psychometric properties. METHODS: The EC-17 was translated and cognitively pretested following cross-cultural adaptation guidelines. Two hundred and thirty-eight outpatients (52 % response rate) with osteoarthritis or fibromyalgia completed the EC-17 along with other validated measures. Three weeks later, 101 patients completed the EC-17 again. RESULTS: Confirmatory factor analysis supported the unidimensional structure of the scale. The items adequately fit the Rasch model and only one item demonstrated differential item functioning. Person reliability was high (0.92), but item difficulty levels tended to cluster around the middle of the scale, and measurement precision was highest for moderate and lower levels of skills. The scale demonstrated adequate test-retest reliability (ICC = 0.71), and correlations with other measures were largely as expected. CONCLUSION: The results supported the validity and reliability of the Dutch version of the EC-17, but suggest that the scale is best targeted at patients with relatively low levels of skills. Future studies should further examine its sensitivity to change in a clinical trial specifically aimed at improving effective consumer skills

Community Building in Online PBL Courses: Instigating Criticality

As post secondary institutions continue to endeavor to address changing stakeholder expectations and policy directions, new curriculum models that allow for choice and learner flexibility are required. One approach that shows promise in this area is online problem-based learning (PBL). This paper discusses a case-study of the implementation of a problem-based learning pedagogical framework that fosters the development of meaningful teacher-learner; learner-learner, and learner-content relationships (vanOostveen & Desjardins, 2013) in an online Bachelor’s program in adult education and digital technology. Within this context, the attributes and affordances of a program design model on facilitating online community are examined

Nurses' self-regulated learning in clinical wards:Important insights for nurse educators from a multi-method research study

Central in nurse education curricula stands the preparation of future nurses to work in quickly evolving, dynamic, clinical wards. Learning in the flow of work plays a pivotal role in initial nurse education, but also during continuous professional development. To drive their ongoing development, nurses need competency in self-regulation of learning (SRL). Despite the importance of SRL in the clinical workplace for all (future) healthcare professionals, research on self-regulated workplace learning (SRwpL) of nurses and future nurses in clinical wards is underdeveloped. This study aims to enhance the conceptual understanding of SRwpL strategies and practices in clinical nursing wards and to offer insights for designing effective educational interventions supporting the facilitation and development of (future) nurses' SRwpL in the clinical ward. A multi-actor, multi-method perspective was adopted to qualitatively investigate SRwpL strategies nurses engaged in. Nurses were observed and interviewed, but also professionals responsible for ongoing development in clinical wards (the ward's head nurses and learning counselors) were interviewed. The data collection took place before the COVID pandemic. Results reveal self-regulatory strategies conditional for SRwpL in addition to strategies initiating, progressing, and evaluating the learning process. Head nurses and learning counselors report a lack of these conditional strategies and little variation, and sporadic engagement in all other self-regulatory strategies. To enhance (future) nurses' SRwpL, we suggest that clinical supervisors from educational institutions could exert a lasting influence by not only educating student nurses, but also fostering further professional development of counselors and head nurses to scaffold the SRwpL processes of future nurses in clinical wards.</p