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Modulation Of The Cardiomyocyte Hypertrophic Responses To Endothelin-1 By Adipocytes, Suresh Chandra Bairwa

Electronic Thesis and Dissertation Repository

Leptin and adiponectin are the adipokines that are shown to exert pro-hypertrophic and anti-hypertrophic effects respectively, in cardiomyocytes. We sought to determine the direct interaction between the adipocytes and cardiomyocytes during endothelin-1 (ET-1)-induced cardiomyocyte hypertrophy and determine the role of leptin and adiponectin.

The adipose tissue conditioned medium (ACM) inhibited the ET-1-induced hypertrophy in a concentration-dependent manner and this anti-hypertrophic effect was more potent or reversed in the presence of leptin receptor antagonist (LRA; 0.1 nM) or adiponectin receptor-1 antibody (ARA; 100 ng/mL), respectively. ACM from heart failure rats induced by coronary artery ligation or obese rats did not mitigate …

An Examination Of Psychological Variables Influencing Perceptions Of The Self Among A Sample Of Female Exercise Initiates, Lisa Cooke

Electronic Thesis and Dissertation Repository

The general purpose of this dissertation was to explore the relationship among and within cognitive variables associated with exercise initiation and maintenance in a sample of female exercise initiates.

Manuscript 1 was structured to explore the changes to exercise identity among a population of female exercise initiates (N = 78) grouped into an imagery or control condition. Previous research has found that a strong exercise identity is associated with more frequent exercise (Strachan et al., 2009) and increases over time as a person continues to exercise (Cardinal & Cardinal, 1997). Participants were assessed multiple times (weeks 0, 5, 9, …

Motivational Interviewing Via Co-Active Life Coaching Intervention For Women Seeking A More Physically Active Lifestyle, Andrea M. Goddard

Electronic Thesis and Dissertation Repository

The purpose of this 12-week pre-post design pilot study was to assess the impact of Motivational Interviewing via Co-Active Life Coaching (MI-via-CALC) on exercise-specific self-efficacy, barrier-specific self-efficacy, self-esteem, and 12-week study duration engagement in physical activity (PA) for 25 women between the ages of 30 and 55 years. Participants were assessed quantitatively using the previously validated McAuley Exercise-Specific Self-Efficacy Scale (EXSE), McAuley Barrier-Specific Self-Efficacy Scale (BARSE), Rosenberg Self-Esteem Scale (RSES), and International Physical Activity Questionnaire (IPAQ-SF) at pre-, mid-, and post-intervention. Four one-way repeated measures ANOVAs were completed for each scale, and statistically significant differences in barrier-specific self-efficacy were detected …

Rural Heterosexual Female Adolescents' Decision-Making About Sexual Intercourse And Pregnancy In Ontario, Paulina Ezer

Electronic Thesis and Dissertation Repository

Rural areas in Ontario tend to have higher rates of adolescent pregnancy. A constructivist grounded theory methodology was used to gain an in-depth understanding of rural female adolescents’ decision-making process regarding sexual intercourse and their reproductive health, and how they view rural factors and circumstances influencing this process. The adolescent sexual decision-making process that emerged from the analysis involved prioritizing four influences that affect and are affected by the rural context: personal values and circumstances, family values and expectations, friends’ influences, and community influences. Findings will improve our understanding of how rural female adolescents make choices regarding their reproductive health. …

Investigating Cortical Changes In Cervical Spondylotic Myelopathy Using Functional Magnetic Resonance Imaging, Proton Magnetic Resonance Spectroscopy And Diffusion Tensor Imaging, Izabela Kowalczyk

Electronic Thesis and Dissertation Repository

Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in older adults. CSM can present abruptly with severe symptoms of neurological impairment or insidiously with a slow stepwise deterioration. There is no current imaging modality or biomarker that can help predict which patient will successfully respond to conservative versus surgical treatment. The goal of this thesis was to follow CSM patients longitudinally to assess how brain function, metabolism, and structure correlate to clinical outcomes in the context of recovering neurological function following surgery.

Chapter 1 of this thesis will provide a detailed literature review of the …

Navigating Life With Hiv: The Lived Experiences Of Youth Living With Hiv, Tamara M M Landry

Electronic Thesis and Dissertation Repository

Youth and young adults living with HIV, between the ages of 15 and 29 represent one-quarter of the new infection rates in Canada, but little is known about the safer sex practices, HIV disclosure processes and coping mechanisms used by this important but often neglected group to manage the every day realities of living with HIV. The primary objectives of this study were to gather qualitative data about the lived experiences of Canadian youth who are living with HIV and enhance our understanding of their experiences of becoming HIV-positive, navigating issues related to safer sex and HIV disclosure, and managing …

Gender Relations In Hospice Palliative Home Care For Clients With Cancer And Their Family Caregivers: A Critical Analysis, Nisha S. Sutherland

Electronic Thesis and Dissertation Repository

The purpose of this study was to critically examine gender relations in the sociopolitical context of hospice palliative home care for clients with cancer and their family caregivers. Using a critical feminist lens, I employed critical ethnography as a methodology to uncover taken-for-granted attitudes, beliefs, and practices that shape health and health care experiences within the culture of end-of-life at home. The study addressed the following research questions: (a) How do gender relations shape health and health care experiences within the socio-political context of hospice palliative home care for clients with cancer and their caregivers?; (b) How do gendered processes …

Understanding Women's Health Promotion In Rural Canadian Churches, Robyn Plunkett

Electronic Thesis and Dissertation Repository

Many rural health resources are linked to community churches, which are often well attended, especially by rural women. Thus, the rural church may be an effective health resource for rural Canadian women who have compromised access to health resources. Despite the significant role that the rural church plays in the life of rural communities, there is very limited research that addresses how the church acts or could act as a health resource for rural women. Furthermore, there is limited understanding of how the church as a place may influence health promotion in rural communities. This dissertation explores the relevance of …

Association Of Head And Cervical Injuries In Pediatric Occupants Involved In Motor Vehicle Collisions, Shayan Shekari

Electronic Thesis and Dissertation Repository

The leading cause of death for children in the age group of 1-14 years is accidental injury. Motor vehicle accidents make up 63% of all accidental injury deaths in this age category. Furthermore, traumatic brain injury causes the highest number of deaths among children involved in motor vehicle collisions. Although cervical spine injuries are less frequent, they do cause death in children. Using a retrospective database, the objective of this pilot study was to determine whether there was a relationship between head injuries and cervical spine injuries and if cervical spine injuries had a higher frequency in younger pediatric passengers. …

Quantitative Mri Correlates Of Hippocampal And Neocortical Pathology In Intractable Temporal Lobe Epilepsy, Maged Goubran

Electronic Thesis and Dissertation Repository

Intractable or drug-resistant epilepsy occurs in over 30% of epilepsy patients, with many of these patients undergoing surgical excision of the affected brain region to achieve seizure control. Advances in MRI have the potential to improve surgical treatment of epilepsy through improved identification and delineation of lesions. However, validation is currently needed to investigate histopathological correlates of these new imaging techniques. The purpose of this work is to investigate histopathological correlates of quantitative relaxometry and DTI from hippocampal and neocortical specimens of intractable TLE patients. To achieve this goal I developed and evaluated a pipeline for histology to in-vivo MRI …

Exploring Communication Apprehension And Its Relationship To Communication Attitude And Socio-Communicative Functioning In Children With Velopharyngeal Insufficiency, Agnieszka Dzioba

Electronic Thesis and Dissertation Repository

Myriad findings on children with velopharyngeal insufficiency (VPI) indicate the potential for this population of children to experience feelings of apprehension specific to communication and the potential for other psychological and social difficulties. The purpose of the present investigation was to explore the construct of communication apprehension (CA) and its potential relationship to social and communicative functioning in a diverse group of children with VPI. Potential linkages between CA and multiple socio-communicative constructs including attitude, speech satisfaction, speech and language skill, social competence, and speech severity were explored in a cohort of children with and without VPI, followed by an …

Body Mass Index Trajectories: The Effect Of Fetal Size And Early Life Modifiable Factors, Mathew Roy

Electronic Thesis and Dissertation Repository

Background: This study examined the relationship between small for gestational age (SGA) status at birth, a measure of fetal growth restriction, and childhood body mass index trajectories (BMI) using data from the National Longitudinal Survey of Children and Youth. Analytic Method: Using latent growth curve modeling, the growth trajectories of a cohort of small and appropriate for gestational age singletons were modeled from 2-10 years (N=1,273 at baseline). Results: SGA status had no effect on the growth trajectories of children after adjusting for prenatal and early life sociodemographic and maternal variables, and also early life modifiable factors. Moreover, the modifiable …

Move More Mommy: A Web-Based Physical Activity Intervention For Postnatal Women (Pilot Study), Sarah Gray

Electronic Thesis and Dissertation Repository

Despite the many benefits of physical activity, postnatal women are not currently meeting Health Canada Guidelines of 150 minutes per week of moderate-vigorous physical activity. This study, Move More Mommy, used a mixed methods design to test the feasibility and acceptability of a web-based intervention combined with a group mediated cognitive behavioural approach, and it’s effectiveness to increase physical activity, self-efficacy, and group cohesion among postnatal women. Participants received an 8-week intervention delivered through 8 group exercise classes and a purpose built website. From baseline to post-intervention, participants significantly increased self-reported physical activity levels and group cohesion. Objectively measured physical …

Exploring Health Care Access For Gay, Bisexual, And Other Men Who Have Sex With Men Living In Middlesex County, Ontario, Todd A. Coleman

Electronic Thesis and Dissertation Repository

Published research suggests gay, bisexual, and other men who have sex with men (GB-MSM) present in health care with additional, distinct psychosocial and sexual health concerns compared to heterosexual men, emphasizing the importance of access to health care for these groups.

This exploratory thesis used data from the online survey (n=202) of the Health in Middlesex Men Matters (HiMMM) Project – a community-based study examining health care access for GB-MSM living in Middlesex County, Ontario. For each manuscript, blockwise modified Poisson regression models were fit sequentially with predisposing, enabling, and need variables, as theorized by the Behavioral Model of Health …

Older Woman Workers: Met And Unmet Needs For Health And Wellbeing In The Workplace, Gillian Gorfine

Electronic Thesis and Dissertation Repository

Older women workers report experiencing occupational injustices however the literature focuses on barriers faced rather than understanding the needs-based strategies empowering women as they age at work. This study engaged women aged 55 and older in a participatory action research project defining and examining strategies for older women workers’ health and wellbeing. In Phase 1, a key informant advisory group (N = 4) defined the problem and guided the design of an open answer survey conducted with 72 older women in work. Three categories emerged informing the fundamental, instrumental, and contextual needs of older women workers. Meeting fundamental needs may …

Integrating Spirituality And Medical Education: What Students And Teachers Have To Say - A Qualitative Study, Sharon N. Hatcher

Electronic Thesis and Dissertation Repository

Aims

This thesis explored the perceptions of medical students and teachers with regards to spirituality, its role in health care, and its integration into medical education.

Methods

Two studies were conducted using qualitative descriptive thematic analysis: the first using focus groups with students; and the second depth interviews with teachers. Both studies were carried out in Francophone Canada.

Findings

Teachers spoke of a concept of spirituality evolving as a journey, while students reported sudden turning-points. Both regarded spirituality as important to patient care. Students were struggling with their future physician role and their commitment to rationality, whereas …

Psychometric Evaluation Of Self-Report Pain And Disability Measures For Elbow Disorders, Joshua Vincent

Electronic Thesis and Dissertation Repository

Elbow disorders are one of the commonest musculoskeletal problems with a prevalence of 9% in men and 8.1% in women. Patient centered care is the goal of current healthcare delivery models; but optimizing treatment outcome and clinical research is hampered by a lack of outcome measures. Since pain and disability resulting from elbow disorders are experienced differently across individuals, they are best captured by patient reported outcome measures (PROM).

PROMs like the Patient-rated Elbow Evaluation (PREE); American Shoulder and Elbow surgeons – Elbow form (pASES-e) have been developed for use in elbow disorders, but important questions remain about their measurement …

The Expression And Potential Significance Of Human Kallikreins 6, 7, 8, 10, 13, And 14 In The Epithelium Of Selected Odontogenic Cysts And Tumors Of Variably Aggressive Biological Behaviour, Rebecca Woodford

Electronic Thesis and Dissertation Repository

ABSTRACT

This study analyzed the immunohistochemical staining, localization and relative concentrations of human kallikreins (KLKs) 6,7,8,10,13,14 to determine if there is a predilection for odontogenic epithelium and if differential staining could predict biological behavior of selected odontogenic lesions.

We found that all KLKs studied were present in the epithelium of all lesions examined. However, there were significant differences in location of intra-epithelial staining and staining scores between the lesions. There was no significant, unexplainable difference in staining between odontogenic cysts and the control cyst indicating no specific role in odontogenic cystogenesis. However, the odontogenic neoplasms showed statistically significant increased expression …

The Experiences Of Black Men Living With Hypertension In Ontario, Canada: A Critical Narrative Study, Rob Haile

Electronic Thesis and Dissertation Repository

To date, most Black hypertension literature centers on the risk factors predictive of hypertension, and the treatment of this condition within this population. The purpose of this critical narrative inquiry is to better understand how Black men make sense of their hypertension diagnosis, and how they negotiate this condition into their everyday lives. Eight individual in-depth interviews were utilized to elicit stories from four Black men living in Ontario, Canada. Additionally, a critical stance was used in this study to illuminate how racism and power dynamics embedded within social, historical, and political contexts affected participants’ experiences of living with hypertension. …

Body Image And Quality Of Life: An Exploration Among Individuals With Head And Neck Cancer, Melissa M. Nash

Electronic Thesis and Dissertation Repository

Background: One of the most distressing aspects of head and neck cancer (HNC) is the potential for physical disfigurement. Such changes may impact one’s body image (BI) with a secondary potential to impact long-term functioning; hence, changes in perceived BI may be seen as a critical component that influences post-treatment quality of life (QOL).

Methods: Forty participants completed 4 validated questionnaires during regular clinical follow-up visits.

Results: Perception of BI image does influence perception of QOL following HNC treatment(s), yet perceptions are highly individualized. Gender related differences are notable on BI questionnaire scores.

Conclusions: Data suggest that efforts to …

Inter-Relationships Of Functional Status In Children With Cerebral Palsy: An Extension, Emily Dyszuk

Electronic Thesis and Dissertation Repository

The primary aim of this study was to establish functional profiles for children with cerebral palsy (CP), by determining the relationships between three classification systems (the Gross Motor Function Classification System, the Manual Ability Classification System, and the Communication Function Classification System). The secondary aim of this study was to investigate the number and impact of health conditions in the most prevalent clusters. Data were analyzed on 222 children with CP with an average age of 6.1 years, from several locations across North America. A total of 56 out of 125 possible combinations were recorded; four most prevalent cell combinations …

Maternal Employment During Infancy And Toddlerhood: Mechanisms For Associations With Childhood Overweight/Obesity In Canada, Nathalie Victoria Metzer

Electronic Thesis and Dissertation Repository

Background: Childhood overweight and obesity is a major public health issue, with approximately 1 in 3 children classified as overweight or obese in Canada. Research suggests that maternal employment during childhood may be associated with later overweight and obesity risk, but it is not known whether employment during infancy and toddlerhood has a similar effect on weight status. Mechanisms such as reduced breastfeeding and use of informal child care have been proposed in the literature but not been formally tested among infants and toddlers. It is important to identify possible mechanisms that could explain the association with overweight and obesity …

Access To The Local Aids Service Organization Among African, Caribbean And Other Black Residents Of Middlesex-London, Ontario, Canada, Soraya Blot

Electronic Thesis and Dissertation Repository

The migration of people from HIV-endemic countries has altered the demographics of the HIV epidemic in high-income countries. In Canada, most people from HIV-endemic countries are of African descent. While they are an established priority group for HIV-related services, they can face access difficulties. This study uses quantitative data from the Black, African and Caribbean Canadian Health Study to evaluate AIDS service organization access in Middlesex-London, Ontario, using the Andersen-Gelberg model for vulnerable populations and an overarching intersectionality framework. In bivariate analysis, older age, having a primary care provider, less inappropriate fear of contagion and less time in Canada were …

A Health Promotion Perspective On Transitioning Into Retirement, Catherine P. Gelinas

Electronic Thesis and Dissertation Repository

The transitional stages towards retirement of those with chronic disorder(s) often present a diversity of additional challenges and people look at the measurement of their anticipated quality of life as a meaningful way of determining this successful adjustment. The overall objective of this research study was to understand transition into retirement considering the impact of comorbidity and associated socio-demographic factors have on the (physical and mental) health status. Quantitative data analysis of people (aged 50-65) with chronic upper extremity musculoskeletal disorders was used to inform health impacts in the group transitioning towards retirement; or who have selected or required early …

Learner Anxiety And Professional Practice Self-Efficacy In Nursing Education, Joanna Pierazzo

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine the affective component of learner engagement (Linnenbrink & Printrich, 2003); more specifically students’ perceptions of learner anxiety and self-efficacy for professional practice in clinical nursing education. This study identified the factors in clinical learning contexts that contribute to learner anxiety, the differences among these factors in real and simulated learning contexts, and finally, the teaching and learning strategies that minimize learner anxiety and positively enhance self-efficacy for professional nursing practice. A convenience sample of 186 students from three university nursing programs in Ontarioparticipated in a two-phased mixed methods study, reflecting a response …

The Clinic Narrative: A Multiple Case Study Of Integrated Knowledge Translation And Equity-Oriented Primary Health Care, Christine A. Garinger

Electronic Thesis and Dissertation Repository

Understanding how PHC organizations implement changes to achieve equity-oriented care will add to the knowledge base regarding primary care renewal. Implementation science or knowledge translation (KT) has emerged, with the goal of enhancing evidence-based practice by implementing strategies of knowledge mobilization. Questions in this qualitative multiple case study were: 1) How does a new knowledge product, a ‘clinic narrative’, co-created by the researchers and the clinic leads, influence practices in the clinic specific to equity-oriented care?, 2) What facilitates or constrains the use of the narrative? and, 3) What are the novel uses of the narrative for organizational goals? The …

Investigation Of Β-Catenin-Mediated Regulation Of Igfbp-6 And The Roles Of Igfbp-6 And Igf-Ii In Dupuytren's Disease, Christina N. Raykha

Electronic Thesis and Dissertation Repository

Dupuytren’s Disease (DD) is a benign and heritable connective tissue fibrosis that affects the palmar fascia and typically results in permanent finger contracture(s). Similar to other fibroses, DD is characterized by increased fibroblast proliferation, myofibroblast differentiation and excess collagen deposition. Currently, there are no truly effective treatment options for connective tissue fibroses.

Increased levels of β-catenin, an intracellular trans-regulator of gene transcription, have been previously reported in DD. Genes that are associated with, and therefore potentially transcriptionally regulated by, β-catenin during DD development were identified in this thesis. One of these gene targets, IGFBP6, was shown to consistently be …

The Inter-Relationship Between Core Language Skills And Social Competence In Preschool Children, Clarissa Lau

Electronic Thesis and Dissertation Repository

Language skills provide preschoolers with the foundational skills needed to socially interact, but little is known about the relationship between specific language skills and broad constructs of social competence. Sixteen preschoolers between 3-5 years with varying language abilities were recruited. Descriptive and correlational analyses were conducted to examine the relationships between speech, syntax, semantics, coherence, and literacy skills and social cooperation, social independence and social interaction. The main finding of this study showed that literacy skills as measured by the Numbers, Letters and Words subtest (K-SEALS) and word knowledge and retrieval as measured by the Semantics subscale ( …

The Association Between Heavy Episodic Drinking And Alcohol-Related Unsafe Sex Among Canadian Undergraduate Student Drinkers, Shirley Solomon

Electronic Thesis and Dissertation Repository

Young adults who engage in risky sexual behaviours are placing themselves at risk for serious health problems. This study assessed the extent of alcohol-related unsafe sex among Canadian undergraduate students and examined the association between unsafe sex and heavy episodic drinking as well as drinking motives, drinking locations, age when they first drank alcohol, and illicit drug use. Data were obtained from the 2004 Canadian Campus Survey (N = 4,437). Logistic regression and modified Poisson regression was used to examine associations with unsafe sex. The proportion of students reporting having had unsafe sex was estimated to be at 7.37%. Heavy …

Experiences Of Biphobia, Anxiety, And Posttraumatic Stress Symptoms Among Ontarian Bisexuals: A Cross-Sectional View Of Potential Moderators, Melissa A. Macleod

Electronic Thesis and Dissertation Repository

The literature largely shows that bisexuals are at greater risk for poor mental health compared to heterosexual, gay, and lesbian people. This increased risk has been linked to the 'double' discrimination (e.g. biphobia) that bisexuals face from both the heterosexual and gay communities. This study used previously collected data (n=405) to examine the relationship between biphobia from these sources and two mental health outcomes: anxiety and posttraumatic stress (PTSD) symptoms. Community identification and involvement, positive bisexual identity, and volunteerism/advocacy/activism were tested as moderators. Confirmatory factor analysis showed that the measure used for PTSD symptoms (PCL-C) did not perform well in …