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The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.
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Background: Measurement of what knowledge is taken-up and how that information is used to inform practice and policies can provide an understanding about the effectiveness of knowledge uptake and utilization processes. In 2007, the Knowledge Uptake and Utilization Tool (KUUT) was developed to evaluate the implementation of knowledge into practice. The KUUT has been used by numerous large health organizations despite limited validity evidence and a narrow understanding about how the tool is used in practice and interpreted by users. As such, the overall purpose of this protocol is to redevelop the KUUT and gather validity evidence to examine and support its use in various health-related organizations. This protocol paper outlines a validation and redevelopment procedure for the KUUT using the unitary view of validity. Methods: The protocol outlined in this article proceeds through four phases, starting with redeveloping the tool, then evaluating validity evidence based on: test content, response processes and internal structure. The initial phase gathers information to redevelop the tool, and evaluates item content and response format. The second phase evaluates response process validity evidence by examining how a variety of users interact with the tool. In the third phase, the tool will be pilot tested with knowledge users and, in the final phase, psychometric properties of the tool will be examined and a final scoring structure will be determined. A knowledge translation plan described herein outlines where the final tool will be housed and how the information about the tool will be disseminated. Discussion: This protocol outlines a procedure to gather different sources of validity evidence for the KUUT. By addressing limitations in the original KUUT, such as complexities with scoring, a redeveloped KUUT supporting validity evidence will enhance the ability of health-related organizations to effectively use this tool for its intended purpose.
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Background: Despite high quality evidence supporting multiple physical and cognitive benefits of community-based exercise for people after stroke, there is little understanding on how to facilitate uptake of these research findings to real-world programs. A common barrier is a lack of standardised training for community fitness instructors, which hampers the ability to train more instructors to deliver the program as it was designed. Scaling up program delivery, while maintaining program fidelity, is complex. The objective of this research is to explore novel use of the Template for Intervention Description and Replication (TIDier) framework to evaluate and support implementation fidelity of a community exercise program. Methods: We embedded intervention fidelity evaluation into an inaugural training program for fitness instructors who were to deliver the Fitness and Mobility Exercise Program for stroke, which has established efficacy. The training program consisted of a face-to-face workshop followed by 3 worksite ‘audit and feedback coaching cycles’ provided over 3 iterations of the 12-week program offered over 1 year. A modified TIDIER checklist (with 2 additional criteria) was used within the training workshop to clarify the key ‘active ingredients’ that were required for program fidelity, and secondly as a basis for the audit and feedback process enabling the quantitative measurement of fidelity. Data were collected from audits of observed classes and from a survey provided by fitness instructors who implemented the program. Results: We demonstrated the feasibility of the TIDier checklist to capture 14 essential items for implementation evaluation of a complex exercise intervention for people with chronic health conditions over 3 iterations of the program. Based on the audit tool, program fidelity was high and improved over time. Three content areas for workplace coaching (intensity monitoring, space, and educational tips) were identified from the audit tool and were addressed. Conclusion: Training of staff to deliver exercises to high need populations utilising workshops and workplace coaching that used the TIDier framework for training, onsite audit and feedback resulted in a high level of fidelity to the program principles. A novel checklist based on the TIDier framework was useful for embedding implementation fidelity in complex community-based interventions.
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kritische berichte - Zeitschrift für Kunst- und Kulturwissenschaften, Bd. 41 Nr. 2 (2013): kritische berichte
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Mathematical models used in epidemiology provides a comprehensive understanding of disease transmission channels and they provide recommendations for methods of control. This thesis uses different mathematical models (direct and indirect transmission models) to understand and analyze different infectious diseases dynamics and possible prevention and/or elimination strategies. As a first step in this research, an age of infection model with heterogeneous mixing and indirect transmission was considered. The simplest form of SIRP epidemic model was introduced and served as a basis for other models. Most mathematical results in this chapter were based on the basic reproduction number and the final size relation. The epidemic model was further extended to incorporate the effect of diffusion using a coupled PDE-ODE system. We proposed a novel approach to modelling air-transmitted diseases using a reduced ODE system, and showed how the reduced ODE system approximates the coupled PDE-ODE system. A deterministic compartmental model of the co-interaction of HIV and infectious syphilis transmission among gay, bisexual and other men who have sex with men (gbMSM) was developed and used to examine the impact of syphilis infection on the HIV epidemic, and vice versa. Analytical expressions for the reproduction number and necessary conditions under which disease-free and endemic equilibria are asymptotically stable were established. Numerical simulations were performed and used to support the analytical results. Finally, the co-interaction model was modified to assess the impact of combining different HIV and syphilis interventions on HIV incidence, HIV prevalence, syphilis incidence and all-cause mortality among gbMSM in British Columbia from 2019 to 2028. Plausible strategies for the elimination of both diseases were evaluated. According to our model predictions and based on the World Health Organization (WHO) threshold for disease elimination as a public health concern, we suggested the most effective strategies to eliminate the HIV and syphilis epidemics over a 10-year intervention period. The results of the research suggest diverse ways in which infectious diseases can be modelled, and possible ways to improve the health of individuals and reduce the overall disease burden, ultimately resulting in improved epidemic control.
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The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.
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International Quarterly for Asian Studies, Vol 50 No 3-4 (2019): Urban Poetics and Politics in Asia, Part I
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What does the ideal housing type look like? A 2015 online survey of individuals living in the Loire-Atlantique Département in France provided 1,134 interviews, which we analyze using a mixed-effect probit model. We look at the probability of living in the ideal housing type related to 28 variables of dwelling and respondent characteristics, density perception, district perception, type of municipality, and proximity to education, healthcare and food facilities. The issue is important because certain housing types yield greater land consumption and longer trips. Local governments support infill developments with higher built-up density levels to conserve land and support walking, cycling, and transit. We find that the probability of living in the ideal housing type has no relationship to density perception. What matters is a positive district perception and proximity to healthcare. Well-designed infill development with higher built-up density levels can succeed, associating a higher probability of living in the ideal housing type with suitable urban forms given the physical constraints of territories, in a sustainable development framework.
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