Digital Commons Network^™

Urologist Burnout: Frequency, Causes, And Potential Solutions To An Unspoken Entity, Julie Franc-Guimond, Brian Mcneil, Steven M. Schlossberg, Amanda C. North, Alp Sener

Anatomy and Cell Biology Publications

Physician burnout has been linked to decreased job performance, increased medical errors, interpersonal conflicts, and depression. Recent multispecialty studies suggest that urologists have higher rates (up to 63.6%) of burnout compared to physicians in other specialties; however, these reports were limited by low sample sizes.1 We aimed to evaluate the prevalence of urologist burnout, verify risk factors, and recommend preventative measures and solutions for colleagues at risk or suffering from burnout. Urologist burnout is a true entity that transcends level of training and nationality. Its roots appear to be deep-seated in our tireless efforts to strive for excellence in care …

Multiple-Modality Exercise And Mind-Motor Training To Improve Mobility In Older Adults: A Randomized Controlled Trial, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Michael A. Gregory, John Bocti, Robert Petrella

Lifestyle Research Team

Objective:

To investigate the effects of multiple-modality exercise with or without additional mind-motor training on mobility outcomes in older adults with subjective cognitive complaints.

Methods:

This was a 24-week randomized controlled trial with a 28-week no-contact follow-up. Community-dwelling older adults underwent a thrice -weekly, Multiple-Modality exercise and Mind-Motor (M4) training or Multiple-Modality (M2) exercise with an active control intervention (balance, range of motion and breathing exercises). Study outcomes included differences between groups at 24 weeks and after the no-contact follow-up (i.e., 52 weeks) in usual and dual-task (DT, i.e., serial sevens [S7] and phonemic verbal fluency [VF] tasks) gait velocity, …

Medical Sciences 4300: London-Middlesex Suicide Prevention Council, Harshith Bhaskar, Adnan Husein, Ramin Javaheri-Poya, Sabrina Jetly, Christopher Nguyen, Serena Tejpar

Community Engaged Learning Final Projects

Suicide is an issue that affects people of all backgrounds, and takes the lives of many individuals every year. The London-Middlesex Suicide Prevention Council (LMSPC), an organization established in 1990, seeks to provide suicide prevention training to members of the community. They seek to engage community members in prevention and intervention by recognizing warning signs that may exist among the London-Middlesex region. The three main programs that strive to deliver these skills are ASIST, ASK, and safeTALK, each with a slightly different focus. LMSPC’s current goal is to increase access to these services through external grants and potential partnerships. Our …

Liver X Receptor And Retinoid X Receptor In Cartilage Development And Homeostasis, Man-Ger Sun

Electronic Thesis and Dissertation Repository

Osteoarthritis (OA) is a heterogeneous and multifactorial degenerative disease characterized by cartilage degradation in the joint. Available treatment options target symptoms but do not address the underlying issue of joint tissue degeneration. A better understanding of the molecular mechanisms maintaining cartilage health is essential for developing novel therapeutic strategies. Previous studies have shown the nuclear receptor Liver X Receptor (LXR) to possess protective roles against cartilage breakdown in OA, however the underlying mechanisms behind this process remain unknown. Since LXR regulates transcription by forming obligate heterodimers with another nuclear receptor, the Retinoid X Receptor (RXR), I hypothesized that LXR and …

Rural Ontario Youth And Mental Wellness, Brad Ross

Electronic Thesis and Dissertation Repository

Currently, there is a significant lack of knowledge regarding rural Ontario youth and their mental wellness. This study addresses the following research questions: 1) How do rural youth maintain mental wellness? and 2) What factors facilitate or hinder the mental wellness of rural youth from their perspective? Eight rural participants, four male and four female, aged 16-23 provided data via one on one interviews. It was found that many rural youth have adapted to utilize their rural environment, social support, and intrapersonal techniques to maintain their mental wellness. Furthermore, four main themes act as both facilitators and hindrances to their …

Higher And Lower Order Factor Analyses Of The Temperament In Middle Childhood Questionnaire., Yuliya Kotelnikova, Thomas M Olino, Daniel N Klein, Sarah V M Mackrell, Elizabeth P Hayden

Brain and Mind Institute Researchers' Publications

The Temperament in Middle Childhood Questionnaire (TMCQ) is a widely used parent-report measure of temperament. However, neither its lower nor higher order structures has been tested via a bottom-up, empirically based approach. We conducted higher and lower order exploratory factor analyses (EFAs) of the TMCQ in a large ( N = 654) sample of 9-year-olds. Item-level EFAs identified 92 items as suitable (i.e., with loadings ≥.40) for constructing lower order factors, only half of which resembled a TMCQ scale posited by the measure's authors. Higher order EFAs of the lower order factors showed that a three-factor structure (Impulsivity/Negative Affectivity, Negative …

Non-Pathological Bilious Vomiting Complicating Therapeutic Hypothermia For Hypoxic Ischaemic Encephalopathy In Neonates: A Retrospective Cohort Study, Julie Hukui, Sarah Jones, Kevin Coughlin, Simon Levin, Jennifer Ruth Foster

Paediatrics Publications

Objective Therapeutic hypothermia (TH) for moderate-to-severe neonatal hypoxic ischaemic encephalopathy (HIE) is generally described as safe. We performed this study to determine the incidence of bilious vomiting or bilious drainage (BVD) attributable to TH in this population. Design A single-centre, retrospective cohort study. Setting Neonatal and paediatric intensive care units (NICU and PICU) of a single tertiary care centre. Patients All newborns with HIE who met criteria for TH between 2009 and 2014. Interventions Cases were matched 1:1 for unit of care (NICU vs PICU), gestational age, gender, and Sarnat score with historic controls who did not receive TH. Groups …

Hockey Fans In Training: A Pilot Pragmatic 1 Randomized Controlled Trial, Robert Petrella, Dawn P. Gill, Guangyong Zou, Ashleigh De Cruz, Brendan Riggin, Cassandra Bartol, Karen Danylchuk, Kate Hunt, Sally Wyke, Cindy M. Gray, Christopher Bunn, Merrick Zwarenstein

Lifestyle Research Team

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.

Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of …

Hockey Fans In Training: A Pilot Pragmatic 1 Randomized Controlled Trial, Robert Petrella, Dawn P. Gill, Guangyong Zou, Ashleigh De Cruz, Brendan Riggin, Cassandra Bartol, Karen Danylchuk, Kate Hunt, Sally Wyke, Cindy M. Gray, Christopher Bunn, Merrick Zwarenstein

Lifestyle Research Team

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.

Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of …

Determination Of Knee Cartilage Volume And Surface Area In Beagle Dogs: A Pilot Study, Aad Dhollander, Amanda Malone, James Price, Alan Getgood

Bone and Joint Institute

© 2017, The Author(s). Background: The objective of this study was to determine the cartilage volume and surface area of male and female Beagle dog knees using 3D (3 dimensional) reconstructed MRI images. Methods: Six Beagle Dogs (Canis familiaris) (3 males and 3 females) of 10-18 months old and weighing between 7.2 and 17.1 kg underwent a MRI evaluation of both knees. The data acquired allowed a 3D reconstruction of the knee and measurement of the cartilage volume and surface area. Results: Mean knee cartilage volume (averaged over the right and left knees) of animals between 7.2 and 17.1 kg …

Optimization Of The Hockey Fans In Training (Hockey Fit) Weight Loss And Healthy Lifestyle Program For Male Hockey Fans, Wendy Blunt, Dawn P. Gill, Shannon Sibbald, Brendan Riggin, Roseanne Pulford, Ryan Scott, Karen Danylchuk, Cindy M. Gray, Sally Wyke, Christopher Bunn, Robert Petrella

Lifestyle Research Team

BACKGROUND:

The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits.

METHODS:

Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting …

Aesthetic Outcome Of Maxillomandibular Advancement Surgery For The Treatment Of Obstructive Sleep Apnea, Jennifer Curran

Electronic Thesis and Dissertation Repository

Introduction:

Obstructive sleep apnea (OSA) is a common sleep disorder in which complete or partial airway obstruction causes disruptive sleep and excessive daytime sleepiness. Highly successful treatment outcomes for OSA utilizing maxillomandibular advancement (MMA) surgery have been reported. However, due to the large degree of surgical advancement that is performed, concerns may exist regarding the final aesthetic result.

Objectives:

To evaluate facial profile changes in patients treated for OSA with MMA surgery utilizing panels of oral and maxillofacial surgeons (OMFS), orthodontists (ORTHO) and laypeople (LAY).

Methods:

This was a retrospective cohort analysis. Pre- and post-treatment silhouettes of patients who underwent …

Design And Evaluation Of Neurosurgical Training Simulator, Trinette L. Wright

Electronic Thesis and Dissertation Repository

Surgical simulators are becoming more important in surgical training. Consumer smartphone technology has improved to allow deployment of VR applications and are now being targeted for medical training simulators. A surgical simulator has been designed using a smartphone, Google cardboard 3D glasses, and the Leap Motion (LM) hand controller. Two expert and 16 novice users were tasked with completing the same pointing tasks using both the LM and the medical simulator NeuroTouch. The novice users had an accuracy of 0.2717 bits (SD 0.3899) and the experts had an accuracy of 0.0925 bits (SD 0.1210) while using the NeuroTouch. Novices and …

Determining The Impact Of A New Physiotherapist-Led Primary Care Model For Back Pain: Protocol For A Pilot Cluster Randomized Controlled Trial, Jordan Miller, David Barber, Catherine Donnelly, Simon French, Michael Green, Jonathan Hill, Joy Macdermid, Jacquelyn Marsh, Kathleen Norman, Julie Richardson, Monica Taljaard, Timothy Wideman, Lynn Cooper, Colleen Mcphee

Bone and Joint Institute

© 2017 The Author(s). Background: Back pain is a leading contributor to disability, healthcare costs, and lost work. Family physicians are the most common first point of contact in the healthcare system for people with back pain, but physiotherapists (PTs) may be able to support the primary care team through evidence-based primary care. A cluster randomized trial is needed to determine the clinical, health system, and societal impact of a primary care model that integrates physiotherapists at the first visit for people with back pain. Prior to conducting a future fully powered cluster randomized trial, we need to demonstrate feasibility …

Nursing Practice During A Mission In Nepal: Ethics And Leadership, Lorena M. Bonilla

Electronic Thesis and Dissertation Repository

The ability of nurses to reflect or critically examine the impact of professional standards of practice, legal guidelines, and ethical frameworks that influence and guide their practice is essential to help patients achieve quality of life and wellness. Regardless of the location and setting where nursing takes place, contextual factors such as the benefits and potential harm resulting from the care provided, availability of resources, the nurse’s scope of practice, and evidence-based practice guidelines, all affect a nurse’s ability to practice in a safe, ethical, competent, caring, and compassionate manner.

Using an exploratory case study to investigate nurses’ (n=9) view …

E-Visits For Early Post-Operative Visits Following Orthopaedic Surgery Can They Add Efficiency Without Sacrificing Effectiveness, William G. Jeffery

Electronic Thesis and Dissertation Repository

We asked 217 sport surgery and 135 total knee arthroplasty (TKA) patients to complete a questionnaire (e-Visit) before attending their two and six-week post-operative appointment. Our primary objective was to use the questions asked of patients prior to their appointment to develop a model that could be used as web-based e-Visit to predict early post-operative adverse events. Gold standard comparison was the surgeon’s opinion as to the presence or absence of an event at follow-up. Secondary objective was evaluation of a simplified model. We found good area under the curve (AUC) statistics (0.76 (95% CI 0.69 - 0.84) and 0.80 …

Effect Of Carbon Monoxide-Releasing Molecule-3 On The Severity Of Endothelial Dysfunction Due To Elevation Of Hydrostatic Pressure In An In Vitro Model Of Compartment Syndrome, Michel A. Taylor

Electronic Thesis and Dissertation Repository

Compartment syndrome (CS) is a surgical emergency caused by elevated pressure within a closed osseofascial compartment. It leads to microvascular dysfunction, limiting oxygen and nutrient delivery, gas exchange, resulting in cellular anoxia, muscle necrosis and cell death.

Currently, the only effective treatment is surgical fasciotomy. Recently, carbon monoxide (CO) delivered via carbon monoxide releasing molecule-3 (CORM-3) has been shown to improve microvascular perfusion and convey anti-inflammatory benefits in animal models of CS.

The contribution of elevated hydrostatic pressure (EHP) to the pathophysiology of CS was examined in an in vitro model of CS. We found that EHP led to increased …

Expanding The Concept Of ‘Care’: A Narrative Study Exploring Lessons From End-Of-Life Patients To Inform ‘Medical Assistance In Dying’ Curriculum In Canada, Jill Dombroski

Electronic Thesis and Dissertation Repository

This research primarily investigates what we can learn from patient experiences that can help inform the expected curricula that will be developed in response to the new Canadian legislation regarding Medical Assistance in Dying (MAID). This is a compelling area of research because of the rapidly evolving attitudes in the general population — largely driven by terminally ill patients asserting their legal rights over their bodies and the decision to put an end to their lives as a consequence of the illness they face. The issue of medical assistance in dying has been patient initiated and patient driven. Through the …

The Effect Of High Baseline Pain On Impairment Outcomes One Year After Distal Radius Fracture, Farrukh Riaz

Electronic Thesis and Dissertation Repository

Objective

The purpose of this study is to evaluate whether high baseline pain predicts impairment outcomes in grip strength or wrist range of motion (ROM) at one year after a distal radius fracture (DRF). Impairments occur for less than 15% of patients.

Methods:

In this cohort study patients with a DRF were recruited from a hand clinic in London, Ontario. This data was collected at two evaluation time points: at baseline (within the first 10 days after fracture) and at one year after fracture. Baseline pain was assessed using the pain subscale of the Patient-Rated Wrist Evaluation (PRWE) and classified …

Understanding Participation Of Children With Cerebral Palsy In Family And Recreational Activities., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy

Physical Therapy Publications

AIMS: The primary aim of this study was to determine the effect of age, sex, gross motor, manual ability, and communication functions on the frequency and enjoyment of children's participation in family and recreational activities. The secondary aim was to determine the relationships between motor and communication functions and participation.

METHODS: Participants were 694 children, 1.5-12 years old, with cerebral palsy (CP) and their parents across the US and Canada. Parents rated children's frequency and enjoyment of participation using the Child Engagement in Daily Life measure. Parents and therapists identified children's level of function using Gross Motor Function Classification System …

Advancing Social Transformation Through Occupation: A Critical Examination Of Epistemological Foundations, Discourses And Contextual Factors Shaping Research And Practice, Lisette Farias Vera

Electronic Thesis and Dissertation Repository

Widespread appeals to advance a social justice agenda have emerged within health-related fields. However, expressing a commitment to social justice has created tensions within occupational science and therapy as scholars attempt to enact social transformative scholarship while at the same time having roots within health sciences, a field largely dominated by positivist/postpositivist thinking. The broader intent of this thesis is to inform further development of occupation-based social transformative scholarship aligned with the critical paradigm.

This doctoral dissertation is comprised of five integrated manuscripts, in addition to introduction and discussion chapters. Chapter two examines the increasing use of critical perspectives and …

Investigating The Health Meanings Of Young Saudi Women, Tagreed Alnajjar

Electronic Thesis and Dissertation Repository

Women’s structural position within society and their family roles significantly influence their health. Previous studies have shown women hold lower health and socioeconomic status because of their gender within the Saudi culture. This study aimed to provide an understanding of how Saudi women value health and define being healthy within their social contexts. Adopting an ethnographic perspective, three focus groups (31 participants in total) were conducted with volunteer undergraduate Saudi female students on campus during a nine-week field trip to the participants’ university, King Abdulaziz University in Jeddah, Saudi Arabia. Three themes were generated from this study that characterize the …

Asset-Based Community Capacity Building: A Process For Expanding A Retirement Home Physical Activity Program, Charlotte W. Crombeen

Electronic Thesis and Dissertation Repository

The population is aging rapidly and physical inactivity and sedentary behaviour are on the rise, a trend noticed at a northern Ontario retirement home looking to improve the choices for, and attendance at, physical activities provided for residents. A community capacity building (CCB) approach using an asset-based, partnership methodology was utilized to create internal and external asset maps. These maps were used to inform potential partnerships within the community. Partnerships were recommended with a university, college, and two high schools, whose staff and students could help to implement new physical activities. Walking and gardening clubs were presented as examples that …

The Effect Of The Dopamine Agonist Pramipexole On Measures Of Impulsivity In Young, Healthy Participants, Daniel Glizer

Electronic Thesis and Dissertation Repository

Patients with Parkinson disease are prescribed dopamine agonists such as pramipexole to improve motor symptoms. Several studies have found that patients taking dopaminergic medication develop impulse control disorders. In contrast, other studies suggest that some behaviors become less impulsive with pramipexole. We evaluated the performance of 20 young, healthy participants who received pramipexole (0.5 mg) and 20 participants who received placebo, on the Go/No-Go, the Stop Signal Task, and the Balloon Analogue Risk Task. We found that the pramipexole group had more timed out Go trials on the Go/No-Go task than the placebo group, suggesting reduced motor impulsivity. There were …

Storied Bodies In Motion And Stillness: Shifting Meanings Of Physical Activity In Women's Life History Narratives, Shellie Mcparland

Electronic Thesis and Dissertation Repository

Gender is a rarely studied social determinant of health. Qualitative methodologies, while underutilized in health promotion, may facilitate understanding of the gender and health relationship. The purpose of this work is to determine if narrative inquiry is a meaningful approach to study the relationship between femininity and physical activity and to examine this relationship within women’s life histories. Five women between 30 and 40 participated in two semi-structured interviews. Data were analyzed holistically, structurally, and categorically.

This dissertation is comprised of five integrated articles, in which I locate myself epistemologically as researcher through a discussion on the feminist underpinnings of …

Examining And Understanding Social Connectedness And Social Engagement Among Muslim Lebanese Canadian Older Adults, Nada Chams

Electronic Thesis and Dissertation Repository

With the projected increase in the older adult population and the rise of

immigrants to Canada, there is a critical need to explore immigrant older adults’

experiences of ageing. The objectives of this study are to: understand what it

means to be an ageing, Muslim Lebanese immigrant in Canada by

understanding their experiences of social connectedness and engagement.

Constructivist narrative inquiry was used to provide direct insight into the diverse

lived experiences of two men and two women who came to Canada during the

1960s and decided to stay and age in Canada. Participants were involved in two

in-depth narrative …

Predicting Important Patient-Reported Outcomes For Glaucoma Management: Cross-Sectional Study, Lavanya Uruthiramoorthy

Electronic Thesis and Dissertation Repository

The initiative to understand patient-reported outcomes (PROs) has increased to improve glaucoma management. We sought to identify important predictors of four PROs: social support and community integration, presence of depressive symptoms, vision-related quality of life (VRQoL) and preference-based Health-Related quality of life (HRQoL). A cross-sectional study was conducted among patients in London, Ontario (n=250). Regression models, and classification and regression trees were built. Leave-one-out cross-validation assessed the models’ predictive performance. Mobility aid use, best corrected visual acuity (BCVA), income and living arrangements were predictors identified for VRQoL, and social support and community integration. Mobility aid use was also predictive of …

Immunological Impact Of Cli-095 On Dendritic Cell Maturation And Hypoxia-Re-Oxygenation Induced Inflammatory Injury, Hajed Obaid Alharbi

Electronic Thesis and Dissertation Repository

Immunological Impact of CLI-095 on Dendritic Cell Maturation and Hypoxia-re-oxygenation induced inflammatory injury

Introduction: Ischemia reperfusion injury (IRI) activates innate immunity through the engagement of Toll-Like Receptors (TLRs) by endogenous ligands. TLR4 expressed within the kidney is a potential mediator of innate activation and inflammation. Stimulation of TLR4 induces distinct patterns of gene expression, which not only leads to the activation of innate immunity but also to the development of acquired immunity. CLI-095, a novel synthetic small-molecule, suppresses production of multiple cytokines by inhibiting TLR4 signaling. In this study, we have determined the role of TLR4 in hypoxia and re-oxygenation …

The Development And Evaluation Of A Smartphone Nutrition Intervention For Adolescents, Sarah A. Cappuccitti

Electronic Thesis and Dissertation Repository

A diet high in fruit and vegetables is associated with the prevention of many chronic diseases; however, only one in ten Canadian students in grades 6 to 12 consume the recommended daily intake of fruits and vegetables. Using smartphones to deliver nutrition interventions is an emerging area of research, although to-date these interventions typically limit their focus to weight loss. The overarching purpose of this research is to redevelop and evaluate an existing smartphone application for an adolescent population. This thesis used a mixed-methods approach to gain adolescent perspectives on how to redevelop the app and to evaluate its use …

Exploring Men's Social Support In The Hockey Fans In Training Weight Loss And Healthy Lifestyle Program, Ryan S. Scott

Electronic Thesis and Dissertation Repository

Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program for overweight and obese male hockey fans, consisting of a 12-week active phase followed by a 40-week maintenance phase. Following program completion, interviews and focus groups were conducted to explore the social support given and received by the men involved in Hockey FIT. A social cognitive model was used to illustrate how social support arising from group cohesiveness, friendly competition, family, and peers impacted self-esteem (characterized by accepting strengths, gaining a sense of belonging, and gaining a sense of accomplishment), which in turn produced positive …