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

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

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

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

Kiste Trui, Amersfoortse Keientrekkers en de Peelkabouters van Horst. Het claimen van volksverhalen door gemeenten en de rol van identiteit.

Dit onderzoek richt zich op het claimen van volksverhalen in de provincies Utrecht en Limburg. Het toe-eigenen van verhalen komt veelal tot uitdrukking door bijvoorbeeld het plaatsen van beelden in relatie tot het verhaal, het verkopen van souvenirs en het verbinden van de naam van de legende of sage aan horecagelegenheden. Er wordt hier ingegaan op de rol die (lokale en regionale) identiteit kan spelen bij het claimen van dit immateriele erfgoed. Ook wordt er kort aandacht besteed aan toerisme in dit verband

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

Developing Learning Communities in Fully Online Spaces: Positioning the Fully Online Learning Community Model

The Fully Online Learning Community (FOLC), developed at the University of Ontario Institute of Technology (UOIT), is a social-constructivist model, addressing a paradigm shift in employment skills, and supporting key elements of transformational learning. Adopting a Problem-based Learning (PBL) approach to activity design, FOLC has served as basis for both undergraduate and graduate, fully online degree programs for almost a decade. In this time, it has demonstrated its ability to facilitate richly collaborative, socially cohesive, and constructively critical, learning communities supported by a flexible array of synchronous and asynchronous digital affordances. FOLC represents a “divergent fork” of the Community of Inquiry (CoI) design to foreground the synergistic dynamics of social and cognitive presence, the role of professional educators as co- learners, the community-oriented nature of knowledge construction, the mediating role of digital competence and open technologies in fully online learning, and the transformational potential of democratized communication and assessment practices. Having positioned FOLC conceptually, a developing research agenda, aimed at grounding the FOLC on a broader body of empirical data, is presented. The underlying argument is that rich, transformative learning communities can be established in fully online programs, and these communities can have a significant democratizing effect on participants and the broader social context

Items and dimensions for the construction of a multidimensional computerized adaptive test to measure fatigue in patients with rheumatoid arthritis

Objectives Development of an item pool to construct a future computerized adaptive test (CAT) for fatigue in rheumatoid arthritis (RA). The item pool was based on the patients' perspective and examined for face and content validity previously. This study assessed the fit of the items with seven predefined dimensions and examined the item pool's dimensionality structure in statistical terms. Study Design and Setting A total of 551 patients with RA participated in this study. Several steps were conducted to come from an explorative item pool to a psychometrically sound item bank. The item response theory (IRT) analysis using the generalized partial credit model was conducted for each of the seven predefined dimensions. Poorly fitting items were removed. Finally, the best possible multidimensional IRT (MIRT) model for the data was identified. Results In IRT analysis, 49 items showed insufficient item characteristics. Items with a discriminative ability below 0.60 and/or model misfit effect sizes greater than 0.10 were removed. Factor analysis on the 196 remaining items revealed three dimensions, namely severity, impact, and variability of fatigue. The dimensions were further confirmed in MIRT model analysis. Conclusion This study provided an initially calibrated item bank and showed which dimensions and items can be used for the development of a multidimensional CAT for fatigue in R

Examining Student and Educator use of Digital Technology in an Online World

Over the past thirty years, institutions of higher learning across the world have increasingly embraced digital technology for teaching and learning. Many institutions have begun to offer mobile, hybrid, and online courses and programs for enhanced relevance and accessibility. Universities and colleges employ digital technology through learning management systems for maintaining and processing educational information/records, offering blended/hybrid learning using asynchronous online student/instructor interaction and collaboration, and web conferencing software for synchronous and asynchronous virtual classroom functionality. Thus, it is critical for us to gain a better understanding the nature of these technological changes and the factors affecting the online realities of 21st Century teaching and learning. The study reported here involved students and instructors at the University of Ontario Institute of Technology (UOIT) in Oshawa, Canada using the General Technology Competency and Use (GTCU) Survey, in which they assessed the purpose and frequency for which they used a variety of digital technologies, and the confidence they had in using various digital technologies. Preliminary results indicated high scores in both confidence and frequency of use for computers/laptops and smartphones, and low scores for frequency of use and confidence with newer technologies, such as “wearables” and the “Internet of Things”