Digital Commons Network^™

Exploring Barriers, Facilitators, Preferences And Potential Disparities In Virtual Pelvic Physiotherapy - From The Perspective Of Physiotherapists: A Qualitative Descriptive Study., Sania Khalid

Electronic Thesis and Dissertation Repository

Virtual pelvic physiotherapy (VPP) has emerged as a valuable adjunct to in-person care. However, there is an inadequate understanding concerning barriers and facilitators associated with the uptake and delivery of VPP. Using qualitative descriptive methodology and semi structured interviews, this study explored the potential barriers, facilitators and preferences from the experiences of pelvic physiotherapists delivering virtual care. An overall positive experience with VPP was reported by providers. Facilitators included improved opportunities for collaboration and patient education, patient-centered care and positive perceptions of clients and providers regarding VPP. Barriers included inaccessibility to a private space and technology, connectivity challenges and clients’ …

Analyzing Sensory Gating Capacity In Misophonia, Facundo Federico Lodol

Electronic Thesis and Dissertation Repository

Misophonia is a pattern of aberrant sound perception that is defined by atypical emotional, neurophysiological, and behavioral reactivity to specific pattern-based trigger sounds (Brout et al., 2018). Those with misophonia exhibit increased arousal of the sympathetic nervous system, coupled with emotional distress, when in the presence of trigger sounds (Edelstein et al. 2013). We propose that individuals who experience this phenomenon may have difficulty filtering out irrelevant stimuli, such that repetitive and otherwise banal sounds cannot be ignored. Thus, the current study recorded responses to pairs of repeated stimuli from participants across the misophonic severity spectrum in order to gain …

Uncovering The Physical Activity Experiences Of Muslim Women Students At Western University, Mais Zuhair Awadallah

Electronic Thesis and Dissertation Repository

Purpose: This study will illuminate the experiences of young Muslim women studying at Western University regarding physical activity by exploring the intersectionality of sociocultural factors influencing their engagement with physical activity. Methods: Eleven participants were recruited using purposeful and snowball sampling. Individual, semi-structured, episodic interviews with the participants were conducted. Data was analyzed thematically using an abductive approach. NVivo software was used in the coding process. Critical Race Feminism and Orientalism were the theoretical frameworks used to frame interview guide and interpret research findings. Findings: It was found that religious teachings, ethnic background, and social support shape …

A Qualitative Study Exploring Patients' Perspectives On Pharmacological Management Of Osteoporosis Following Upper Extremity Fragility Fractures, Mahtab Jangi

Electronic Thesis and Dissertation Repository

Osteoporosis, a significant medical and socioeconomic threat, frequently results in fragility fractures in both men and women. This thesis delves into the various factors that impact how patients with osteoporosis adhere to their medication regimens, as well as the decision-making processes they go through after experiencing upper extremity fragility fractures. Employing qualitative interpretive description methodology, data were collected through semi-structured interviews with fourteen older adult patients at Hand and Upper Limb Centre, St. Joseph’s Hospital, through purposeful sampling. Thematic analysis of the transcripts revealed vital factors such as social support, personal health beliefs, side effect management, and treatment accessibility that …

Early Detection Of Oral Potentially Malignant Disorders, Xinru Li

Electronic Thesis and Dissertation Repository

Oral potentially malignant disorders (OPMDs) represent a diverse array of conditions with an elevated propensity for progressing into oral squamous cell carcinoma (OSCC). My study aims to enhance the early detection of OPMDs by investigating the expression levels of specific biomarkers, their correlation with disease severity, and the concordance between clinical and pathological diagnoses. Using nanoString gene expression analysis and immunohistochemical (IHC) staining, I identified significantly elevated levels of S100A7, Ki67, and Vimentin in OPMD tissues compared to normal controls, suggesting their potential as biomarkers for early detection and monitoring of disease progression. Conversely, E-cadherin showed reduced expression in OPMDs, …

Combining Repetitive Transcranial Magnetic Stimulation (Rtms) With Corticosteroid Joint Injections (Cji) For The Treatment Of Chronic Axial Pain (Cap): A Pilot Double-Blinded Randomized-Controlled Trial, Anike A. Alarape Ms

Electronic Thesis and Dissertation Repository

Chronic axial pain (CAP) is a debilitating condition impacting millions globally, with traditional treatments providing only short-term relief. This pilot study explored the primary outcomes of feasibility, tolerability, and safety, as well as the secondary outcomes of pain intensity, disability, quality of life, and patients’ perceived response to the combined intervention of repetitive transcranial magnetic stimulation (rTMS) and corticosteroid joint injections (CJI) as a novel approach to address CAP. Sixteen participants from St. Joseph’s Healthcare Pain Clinic were randomized (1:1) to receive 11 active or sham rTMS sessions over 12 weeks, with follow-up until week 24 or their next CJI, …

Exploring The Lived Experiences Of Women With Chronic Obstructive Pulmonary Disease, Madeline M. Dougherty

Electronic Thesis and Dissertation Repository

Currently, there are many barriers to women seeking diagnosis and treatment for chronic obstructive pulmonary disease (COPD). These barriers include greater under-diagnosis and fewer medical consultations. Often thought of as a "male smoker's" disease, in the past decade there has been a sharp increase in the number of COPD cases in women. This research explored the lived experiences of women with COPD through diagnosis and treatment. This research used van Manen’s hermeneutic phenomenological methodology guided by a critical theory paradigm. The results highlighted the experiences of women with COPD, what women want from their care, and recommendations to better support …

Examining The Relationship Between Disability, Impairment, And Chronic Pain In Childhood Cerebral Palsy: A Scoping Review And Critical Analysis, Muning Zhang

Electronic Thesis and Dissertation Repository

Young people with cerebral palsy (CP) experience chronic pain at rates higher than their non-disabled peers. Despite this recognition, there have been no studies that have addressed how young people with CP’s experiences with chronic pain are represented and studied in the literature, and especially not through a critical disability studies lens. Foucault’s notion of discourse was used to guide critical analysis of studies. This scoping review was guided by the research question: “What is known about the relation between children’s experiences of chronic pain and cerebral palsy in the health and rehabilitation literature?”. Thirty-five studies were included in …

Eyes Open In The Dark, Brittany A. Forrest

Electronic Thesis and Dissertation Repository

An unusual dissertation that presents a science fiction autobiographical narrative, following a trial of trauma and identity dysphoria. Through a trans-queer biological female lens, the vulnerable tone of the author invites the reader into wording that describes matters they will care for on a human level. This study probes the question of what lives within the silence of our perceptions by appraising reverberations between interactions that coerce the human condition. Interrogating memory is inevitable when questioning how defense mechanisms interrelate and adapt to human needs. This study penetrates the complexities of perception fabrications, power dynamics, sensory perceptions, systemic moralities, and …

"The Whole World Opened Up, There's No Better Word For It Than Euphoria": Experience Of Embodiment In Trans*Feminine Individuals, Sara M. Stanley

Electronic Thesis and Dissertation Repository

The “experience of embodiment” is a construct that captures how an individual experiences the body in their socio-cultural context and has important implications for mental health and well-being. The construct was originally developed to explain the experiences of cis-gender girls and women, and has not been investigated in trans*feminine individuals. Grounded in social constructivism, and integrating the gender minority stress model and principles of intersectionality, the present study investigated trans*feminine experiences of embodiment. To expand our understanding of this construct, trans*feminine participants engaged in focus groups (n=28), a photo-elicitation task (n=25), and one-on-one semi-structured interviews (n=25). Using a combined inductive …

Psychometric Properties Of Patient-Reported Outcome Measures In Chronic Pain Conditions With Central Sensitization:- A Systematic Review, Mst Farjana Akhter

Electronic Thesis and Dissertation Repository

Objective: To identify available patient-reported outcome measures (PROMs) used to evaluate central sensitization (CS) manifestations in chronic pain conditions and evaluate the quality of psychometric properties of those instruments.

Methods: A comprehensive search was conducted across multiple databases. Methodological quality and psychometric properties were assessed and summarized using the COSMIN checklist and scoring manual.

Results: A total of fifty-eight studies addressing eight PROMs were identified. The Central Sensitization Inventory (CSI) received the highest overall ratings for most measurement properties among all the instruments, followed by the Pain Sensitivity Questionnaire and Fibromyalgia Survey Questionnaire. Based on pooled data, the test-retest reliability …

Elementary School Teachers’ Lived Experiences Of Teaching Nutrition: A Qualitative Study, Ashley P. Vito Ms

Electronic Thesis and Dissertation Repository

Early nutrition education is crucial for lifelong health and learning (Cusick et al., 2016). Elementary schools and teachers play a significant role in shaping children's understanding of nutrition (Cotton et al., 2020). Yet, there's limited research on teachers' experiences teaching nutrition to elementary students and how it affects their well-being. This qualitative study examines 13 Ontario-based teachers' experiences in delivering nutrition education. Interviews revealed themes such as teachers' perceptions of their role and secondly challenges and facilitators in teaching nutrition, including time constraints, resource scarcity, body image, and cultural differences. These findings offer insights into the complexities teachers face in …

Exploring The Effect Of Combining Repetitive Transcranial Magnetic Stimulation With Functional Electrical Stimulation Cycling On Lower Extremity Function Following Incomplete Spinal Cord Injury, Fereshteh Ghahremani

Electronic Thesis and Dissertation Repository

Spinal cord injury (SCI) is a neurological condition that disrupts lower extremity function, limiting mobility and independence. This dissertation explores the feasibility, acceptability, and safety of combining repetitive transcranial magnetic stimulation (rTMS) with functional electrical stimulation (FES) cycling to improve lower extremity function following motor incomplete SCI (iSCI). This study is a case series pilot study in which participants with iSCI underwent a combined protocol of rTMS and FES cycling for six weeks. The results demonstrate the preliminary feasibility, participant acceptability, and safety of combining rTMS and FES cycling. While results varied between participants, one participant showed improvements in walking …

Enhancing Recovery: Investigating Outcome In Supercharged End-To-Side Anterior Interosseous Nerve To Ulnar Nerve Transfer, Tachit Jiravichitchai

Electronic Thesis and Dissertation Repository

Navigating the complexities of proximal ulnar nerve lesions presents a formidable challenge, prompting an urgent call for standardized outcome measures in the realm of supercharged end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, compounded by the intricacies of ulnar nerve transposition. This thorough thesis takes a dual-method approach, utilizing a rigorous Delphi study in addition to a scoping review methodology to clarify the complex terrain of SETS procedures.

The scoping review comprehensively delves into the outcomes and associated factors of SETS procedures, unraveling the intricate recovery trajectories while shedding light on the hurdles of standardization. Additionally, it incorporates …

Women's Mental Health During The Covid-19 Pandemic: A Mixed-Methods Sequential Explanatory Analysis Of The Role Of Sex, Gender, And Parenthood In The Experiences Of Depression And Anxiety, Hoda Seens

Electronic Thesis and Dissertation Repository

Research Questions

We examined the mental health experiences of women and gender-diverse people during the pandemic by answering three research questions. Q1. How did the levels of depressive and anxiety symptoms change during the pandemic by sex and gender? Q2. What individual and intersectional factors were related to experiencing the greatest levels of depressive and anxiety symptoms following the start of the pandemic? Q3. Why did some individuals experience more negative mental health outcomes?

Methods

This was a two-part mixed methods study. The first part was a quantitative study using an online survey; the second part was a qualitative explanatory …

Health Care And Social Predictors Of Gender Positivity And Gender Distress Among Transgender And Nonbinary People In Canada, Lux Li

Electronic Thesis and Dissertation Repository

Background: Transgender (trans) health care is focused on gender dysphoria and overlooks the diverse gender experiences of trans and nonbinary (TNB) individuals, especially gender positivity (also known as gender euphoria), a crucial aspect and resilience factor of trans well-being. Existing research on gender positivity is primarily qualitative, lacking quantitative assessment tools. This thesis provides quantitative insights by utilizing new assessment scales to evaluate gender positivity (GP) and gender distress (GD).

Methods: Data (n = 2316) were from Trans PULSE Canada, a 2019 cross-sectional community-based survey of TNB people aged 14+ in Canada. Social and bodily dimensions of gender …

Stress, Geographic And Sociodemographic Factors, And Oral Health Outcomes In Adolescents And Young Adults, Naima Abouseta

Electronic Thesis and Dissertation Repository

Oral health disparities are influenced by socioeconomic and demographic factors. Recent research suggests that stressors can contribute to these disparities. Adolescents and young adults are particularly vulnerable to these stressors, which can affect hypothalamic-pituitary-adrenal (HPA) axis reactivity. This thesis aimed to enhance understanding of the relationships among stress, geographic and sociodemographic factors, and oral health outcomes in adolescents and young adults. Additionally, salivary levels of mRNA encoding the glucocorticoid receptor (GR) were assessed and their relationship to stress and oral health outcomes investigated.

In the first study, the association between neighborhood-level socioeconomic status and dental care outcomes was explored in …

Period Poverty And Menstrual Perceptions Among Unhoused Menstruators In An Urban Center In Southern Ontario, Kristina D N Fernando

Electronic Thesis and Dissertation Repository

The purpose of this study is to uncover, describe and examine period poverty among unhoused menstruators accessing an urban shelter in Southern Ontario. Situated in a postmodern feminist lens and explored through thematic analysis, I employ participant observations and semi-structured interviews with shelter residents (n=13) and shelter staff (n=3) to conduct an exploratory case study at Dahlia Women and Family Shelter. The study findings suggest that menstruators at Dahlia experience period poverty and undergo significant challenges to their menstrual hygiene management. Menstrual perceptions were also found to vary based on the menstrual education that menstruators received …

Experience Of Community Physicians Who Provide Medical Assistance In Dying: A Qualitative Analysis, Rimpy Cheema

Electronic Thesis and Dissertation Repository

Aims: Since decriminalization in 2016, medical assistance in dying (MAiD) has transformed the landscape of end-of-life care in Canada. This study explored the experiences of community family physicians who provide MAiD.

Methods: Using a qualitative study design and phenomenological approach, semi-structured interviews were conducted of twelve physician providers in Southwestern Ontario. The transcripts were coded and inductively analyzed for overarching themes.

Findings: At the individual level, providers felt a profound sense of purpose. At the local level, participants reflected on the practical challenges encountered. At the system level, participants described the critical role of organizational support structures and the effects …

Exploring The Quality Performance Of Ethno-Specific And Mainstream Not-For-Profit Long-Term Care Homes In Ontario, Lanei Amein

Electronic Thesis and Dissertation Repository

The purpose of this retrospective study was to determine how ethno-specific not-for-profit long-term care (LTC) homes in Ontario perform in comparison to mainstream not-for-profit LTC homes using nine RAI-MDS 2.0 quality indicators. Publicly available data from three sources: the Canadian Institute for Health Information "Your Health System: In Depth" database from the Continuing Care Reporting System, data on Ontario ethno-specific not-for-profit LTC homes from the Home and Community Care Support Services, and data on home and ownership records from the Ministry of Long-Term Care “Public Reporting” website, between 2017-2022, were retrieved and analyzed. Descriptive analysis suggests that for all quality …

Older Adolescent Perspectives On The Use Of Research Within Online Communities, Ahrrabie Thirunavukkarasu

Electronic Thesis and Dissertation Repository

This study explores the attitudes of older adolescents (aged 16 to 19) regarding researchers collecting personal information from Social Networking Sites (SNSs) through passive observation to support Non-Suicidal Self-Injury (NSSI) research. The aim of this study is to add to the ongoing discourse in the scientific community, by providing a unique perspective on how researchers can uphold ethical conduct throughout their research process. This study adopts a mixed-methods approach and incorporates a Qualtrics^XM survey and online focus groups (FGs). The findings reveal that participants have reservations toward passive, hidden observational researchers. Despite their concerns, participants support researchers using their …

Examining Fragility Of Health Systems In Afghanistan: Development And Application Of A Theoretical Framework For Fragile Health Systems, Faiza Rab

Electronic Thesis and Dissertation Repository

Globally, health systems face destabilization amidst conflicts and natural disasters, adversely affecting populations' well-being. Understanding domains of health system fragility remains a gap in literature, hampering effective mitigation. In protracted conflict, Afghanistan's health system offers a crucial case for studying health system fragility. This research aimed to bridge gaps in comprehending health system fragility, with research questions:

1. What is the conceptual understanding of the fragility of health systems and its relationship with resilience, and how can it be applied in Afghanistan?

2. Did the introduction of female health workers to support Maternal, Neonatal, and Child Health service delivery by …

The Together Study: Exploring The Relationship Between Ontario Undergraduate University Students’ Levels Of Resilience And Their Experiences Of Diversity And Inclusion, Manvir Ahluwalia

Electronic Thesis and Dissertation Repository

This study’s primary purpose was to assess, quantitatively, the relationship between Ontario undergraduates’ levels of resilience and experiences of diversity and inclusion, and to identify demographic factors most associated with these outcomes. The secondary purpose was to explore, qualitatively, students’ experiences of diversity and inclusion and their perspectives on how these experiences influenced their resilience. Demographic questions, three scales, and (focus group and individual) interviews were used. Undergraduates (n = 276) from 19 Ontario universities completed the survey. Pearson’s correlation revealed a positive relationship between resilience and experiences of diversity and feelings of inclusion. Demographics indicative of equity-deserving group …

Voice: Exploring The Experiences Of University Students Who Have Experienced Gender-Based Violence, Rabani Nagra

Electronic Thesis and Dissertation Repository

Introduction: The occurrence and severity of gender-based violence (GBV) on Canadian higher education campuses has been a concern for decades. In September 2021, there were multiple reports of GBV at several Canadian universities with Western University being an exceptional case. The goal of this study was to explore: (1) the experiences of students who have experienced GBV during their enrollment at Western University; (2) the impact of GBV on students’ academics; and (3) student knowledge and experience with GBV resources.

Methods: This cross-sectional, qualitative study used an interpretive description framework and dialogue maps, underpinned by intersectionality. Seventeen undergraduate students were …

Sociodemographic Determinants Of Potentially Avoidable Hospitalizations Due To Ambulatory Care Sensitive Conditions Among Hospitalized Patients In The United States, Munira Kashem

Electronic Thesis and Dissertation Repository

Social determinants of health play a crucial role in explaining the variation of potentially avoidable hospitalizations (PAH) due to Ambulatory Care Sensitive Conditions (ACSCs). Utilizing data from the National Inpatient Sample from 2018 to 2020 in the United States, this study conducted retrospective cohort analyses to explore the relationships between sociodemographic factors, specifically income, race, geography, age, and sex and PAH. Our approach used multilevel logistic regression models to adjust for potential confounders and account for clustering of admissions within hospitals. Of the 17,629,891 hospital admissions examined in this study, 1,868,609 (10.6%) were attributable to ACSCs. Our results indicate that …

Validation Of A Virtual Auditory Space, And Its Use To Investigate How Pitch And Spatial Cues Contribute To Perceptual Segregation Of Auditory Streams, Nima Zargarnezhad

Electronic Thesis and Dissertation Repository

The human auditory system can decompose complex sound mixtures into distinct perceptual auditory objects through a process (or processes) known as Auditory Scene Analysis. Pitch and spatial cues are among the sound attributes known to influence sequential streaming (Plack 2018). In this project, the fidelity of a virtual acoustic space (the Audio Dome) in reproducing precisely located sound sources with a 9^th-order ambisonics algorithm was validated. The estimated horizontal Minimum Audible Angles aligned with previously reported values (Mills 1958) homogeneously across the space, and a robust low-frequency presentation was identified. Then, the Audio Dome was utilized to test …

Regulation Of Health Ai Chatbots In Ontario, Mingi Chu

Electronic Thesis and Dissertation Repository

Artificial Intelligence (AI) has made remarkable strides in healthcare, from revolutionizing medical imaging, patient support, research insight, and health education. However, a recent shift from query-based to interactive and regenerative AI presents a question of properly facilitating its development. Upon close inspection, regulations and policy adaptations lag behind the rapidly advancing field of medical AI which raises concerns over governance and societal implications. This paper explains some of the technical and ethical considerations surrounding the use of health AI applications with chatbots as a specific example. It evaluates the existing policies and regulations in Ontario, Canada, that govern the production …

The Population-Centered Medical Model: A Theory Of Practice For Public Health And Preventive Medicine, Sudit Ranade

Electronic Thesis and Dissertation Repository

Introduction

Public health physicians occupy a unique place in the fields of both medicine and public health. Trained in each field, and often holding positions of authority in public health systems, public health physicians are sometimes challenged to identify their roles in either field of practice. Public health physicians work to achieve population health, but there has been limited theoretical development in this field of practice.

Objectives

The objective of this research was to develop an empirical theory of practice for public health physicians.

Methods

A literature review of current practice models applicable to public health physicians was performed. A …

Sex And Gender Differences In Arthritis Health Information, Tania Al-Jilawi

Electronic Thesis and Dissertation Repository

Arthritis is a common disorder that may result in pain and inflammation, making it challenging to move or continue being active. Arthritis comes in a variety of forms. The two studies of this thesis aimed to identify the influence of intersectionality, especially sex and gender, in arthritis. The first study, a structured review, evaluated the inclusion of sex/gender and intersectional identities in patient resources of three arthritis societies: the Canadian Arthritis Society, the American Arthritis Foundation, and the National Rheumatoid Arthritis Society. The appraisal tool, the Sex/Gender and Intersectional Considerations in Patient/Consumer Health Information Appraisal Tool was used to evaluate …

Lbnp Reduces Cerebral Perfusion But Does Not Impact Executive Function, James Van Riesen

Electronic Thesis and Dissertation Repository

A growing body of literature has demonstrated that a single bout of aerobic exercise and/or hypercapnic manipulations increase cerebral blood flow (CBF) and are linked to a transient (i.e.,min) post-intervention executive function (EF) benefit. However, there are no direct studies examining whether a transient decrease in CBF elicits a post-intervention EF decrement. Accordingly, my thesis employed 10-min single bout manipulations of -30 mmHg and -50 mmHg lower-body negative pressure (LBNP) to determine whether a transient reduction in CBF impacts EF. LBNP was applied as it renders sub-atmospheric pressure to the lower limbs and redistributes blood from the upper to lower …