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 …

Fabrication And Modification Of Titania Nanotube Arrays For Harvesting Solar Energy And Drug Delivery Applications, Ahmed El Ruby Abdel Rahman Mohamed

Electronic Thesis and Dissertation Repository

The fast diminishing of fossil fuels in the near future, as well as the global warming caused by increasing greenhouse gases have motivated the urgent quest to develop advanced materials as cost-effective photoanodes for solar light harvesting and many other photocatalytic applications. Recently, titania nanotube arrays (TNTAs) fabricated by anodization process has attracted great interest due to their excellent properties such as: high surface area, vertically oriented, highly organized, one-dimensional, nanotubular structure, photoactivity, chemical stability and biocompatibility. This unique combination of excellent properties makes TNTAs an excellent photoanode for solar light harvesting. However, the relatively wide band gap energy of …

Effects Of Prenatal Bisphenol A Exposure On Adrenal Gland Development And Steroidogenic Function, Samantha Medwid

Electronic Thesis and Dissertation Repository

Developmental exposure to bisphenol A (BPA), a ubiquitous endocrine disrupting chemical, is associated with organ dysfunction and diseases in adulthood. However, little is known about its effects on the adrenal glands. Therefore, this thesis addresses this important question using both in vivo and in vitro approaches. BPA at environmentally relevant doses was administrated via diet to pregnant mice from embryonic day 7.5 to birth, following which mice were switched to a standard chow. At two months postnatally, adrenal glands and blood samples were collected from adult mouse offspring for structural and functional analysis. I found that: (a) BPA increased adrenal …

Hepcidin-Mediated Iron Regulation In P19 Cells Is Detectable By Mri, Kobra Alizadeh Pourbouyeh

Electronic Thesis and Dissertation Repository

Magnetic resonance imaging (MRI) can be used to track cellular activities in the body using iron-based contrast agents. However, intrinsic cellular iron handling mechanisms may also influence the detection of magnetic resonance (MR) contrast. For instance, inflammation involves downregulation of iron export in macrophages by the hormone hepcidin, due to degradation of the iron export protein, ferroportin (Fpn). We examined the effect of hepcidin on iron regulation and MR transverse relaxation rates in multi-potent P19 cells, which display high iron export activity, similar to macrophages. In response to varying conditions of iron supplementation, our results showed similar Fpn expression in …

Neuronal Correlates For Neuroendocrine Habituation To Repeated Stress, Sara Matovic

Electronic Thesis and Dissertation Repository

One way that the body actively responds to an impending stressor is by increasing systemic glucocorticoids through the activation of the hypothalamic-pituitary-adrenal (HPA) axis. While it is essential for short-term adaptation to stress, the sustained activation of the HPA axis during chronic stress can be detrimental and is linked to stress-related psychiatric conditions such as anxiety and depression. Therefore, it is important that the HPA axis adapts, or habituates, during chronic stress to minimize the negative consequences. Corticotropin releasing hormone (CRH) neurons in the paraventricular nucleus of the hypothalamus (PVN) function to assimilate incoming information from the stress circuitry and …

Navigating Occupation And Identity In Parkinson's Disease: A Qualitative Exploration Of Lived Experience, Sara G. Lutz

Electronic Thesis and Dissertation Repository

Evidence-based practice requires that health care providers interpret the best research evidence in the context of their clinical experience, while at the same time considering client knowledge and experiences. Although health care providers are becoming increasingly skilled at the evaluation of research evidence, client values and self-identified health issues are often neglected within the evidence-based practice process. Ignoring these key aspects of person-centered practice may lead to interventions that fail to target implications of a client’s disease that are important to occupational participation and quality of life. A focus on person-centeredness is particularly important in progressive neurodegenerative disorders such as …

Evaluating Small Airways Disease In Asthma And Copd Using The Forced Oscillation Technique And Magnetic Resonance Imaging, Heather M. Young

Electronic Thesis and Dissertation Repository

Obstructive lung disease, including asthma and chronic obstructive pulmonary disease (COPD), is characterized by heterogeneous ventilation. Unfortunately, the underlying structure-function relationships and the relationships between measurements of heterogeneity and patient quality-of-life in obstructive lung disease are not well understood. Hyperpolarized noble gas MRI is used to visualize and quantify ventilation distribution and the forced oscillation technique (FOT) applies a multi-frequency pressure oscillation at the mouth to measure respiratory impedance to airflow (including resistance and reactance). My objective was to use FOT, ventilation MRI and computational airway tree modeling to better understand ventilation heterogeneity in asthma and COPD. FOT-measured respiratory system …

Intraoperative Photoacoustic Imaging Of Breast Cancer, Ivan Kosik

Electronic Thesis and Dissertation Repository

Breast cancer is one of the most common cancers to affect women, presenting a lifetime risk of 1 in 8. Treatment of stage 1 and 2 cancers usually involves breast conserving surgery (BCS). The goal of BCS is to remove the entire tumour with a surrounding envelope of healthy tissue, referred to as a negative margin. Unfortunately, up to 50% of surgeries fail to remove the whole tumour. To minimize the risk of cancer recurrence, a second surgery, must therefore be performed. Currently, there is no widely accepted intraoperative tool to significantly mitigate this problem. Employed systems are usually based …

A Biomechanical Study Examining The Subacromial Balloon Spacer And Superior Capsular Reconstruction In The Treatment Of Massive, Irreparable Rotator Cuff Tears, Supriya Singh

Electronic Thesis and Dissertation Repository

Rotator cuff tears are common tendon injuries and can be a major source of pain and disability. Massive, irreparable rotator cuff tears are a challenging surgical dilemma as currently there is no gold standard treatment algorithm. Multiple possible treatment options exist yet no clear guidelines for optimal surgical technique for this disorder have been established.

In this study, two new techniques described in the treatment of massive, irreparable rotator cuff tears were explored; the insertion of a subacromial balloon spacer and superior capsular reconstruction. Their ability to restore glenohumeral joint kinematics was examined in cadaveric specimens with surgically created massive, …

Improving Transitions In Care For People With Dementia: The Cared Tool, Yuwen Deng, Jamie Bisset, Silk Lim, Maryssa Edwards

Community Engaged Learning Final Projects

Transitions in Care are challenging for people with dementia due to impairments in communication and disorientation from being in a foreign environment. Transitions in care have lead to incidents of unnecessary physical and chemical restraints of this vulnerable population. To investigate how to optimize care transitions, qualitative descriptive information was collected through three personal interviews to gain a broader understanding of mechanisms of care transitions in London, ON. After conducting interviews and literature review, the CARED Tool was developed. The CARED Tool promotes social inclusion of patients with dementia through recognizing that people with dementia have complex needs, thereby allowing …

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 …

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 …

Assessment Of Embedded Conjugated Polymer Sensor Arrays For Potential Load Transmission Measurement In Orthopaedic Implants, Carolina Micolini, Frederick Benjamin Holness, James A. Johnson, Aaron David Price

Bone and Joint Institute

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. Load transfer through orthopaedic joint implants is poorly understood. The longer-term outcomes of these implants are just starting to be studied, making it imperative to monitor contact loads across the entire joint implant interface to elucidate the force transmission and distribution mechanisms exhibited by these implants in service. This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smart polymer sensor array using conductive polyaniline (PANI) structures embedded within a polymeric parent phase. The piezoresistive characteristics of PANI were investigated to characterize the sensing behaviour inherent to these …

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 …

When Patients Ask To Die: The Role Of Nurses In Medical Assistance In Dying, Laura Sheridan

Electronic Thesis and Dissertation Repository

Canadians are increasingly living with chronic illness heightening the importance of palliative and end of life care. Nurses have significant involvement in end of life care which, in Canada, may now include medical assistance in dying (MAiD). This qualitative study used interpretive description to explore the perspectives of nine palliative care nurses regarding best practices in care related to MAiD. The analysis produced three overarching themes of: (a) Business as usual which reflects participants’ perspective that MAiD is an aspect of existing practices in end of life decision making in palliative care; (b) Nursing role within MAiD discusses the importance …

Multiparametric Mri Changes Persist Beyond Recovery In Concussed Adolescent Hockey Players, Kathryn Y. Manning, Amy Schranz, Robert Bartha, Gregory A. Dekaban, Christy Barreira, Arthur Brown, Lisa Fischer, Kevin Asem, Timothy J. Doherty, Douglas D. Fraser, Jeff Holmes, Ravi S. Menon

BrainsCAN Publications

Objective: To determine whether multiparametric MRI data can provide insight into the acute and long-lasting neuronal sequelae after a concussion in adolescent athletes.

Methods: Players were recruited from Bantam hockey leagues in which body checking is first introduced (male, age 11–14 years). Clinical measures, diffusion metrics, resting-state network and region-to-region functional connectivity patterns, and magnetic resonance spectroscopy absolute metabolite concentrations were analyzed from an independent, age-matched control group of hockey players (n 5 26) and longitudinally in concussed athletes within 24 to 72 hours (n 5 17) and 3 months (n 5 14) after a diagnosed concussion.

Results: There were …

Binding Of Salivary Proteins To Orthodontic Brackets, Maria Pia Canales

Electronic Thesis and Dissertation Repository

Objectives: The aim of this study was to investigate the effect of different orthodontic materials on the formation of the protein pellicle on the bracket surface.

Materials and Methods: We used X-ray Photoelectron Spectroscopy (XPS) to analyze the atomic composition of orthodontic metallic and ceramic brackets. Following XPS, the brackets were immersed in human whole saliva supernatant for 2-hour incubation at 37°C. Hydroxyapatite (HA) discs were used as control. Acquired pellicle was harvested with sonication for each group, and liquid chromatography electrospray ionisation mass spectrometry was used for protein identification.

Results: Differences reported by XPS and mass spectrometry were noted …

Ventilation Inhibits Sympathetic Action Potential Recruitment Even During Severe Chemoreflex Stress, Mark B. Badrov, Otto F. Barak, Tanja Mijacika, Leena N. Shoemaker, Lindsay J. Borrell, Mihajlo Lojpur, Ivan Drvis, Zeljko Dujic, J. Kevin Shoemaker

Bone and Joint Institute

© 2017 the American Physiological Society. This study investigated the influence of ventilation on sympathetic action potential (AP) discharge patterns during varying levels of high chemoreflex stress. In seven trained breath-hold divers (age 33 ± 12 yr), we measured muscle sympathetic nerve activity (MSNA) at baseline, during preparatory rebreathing (RBR), and during 1) functional residual capacity apnea (FRCApnea) and 2) continued RBR. Data from RBR were analyzed at matched (i.e., to FRCApnea) hemoglobin saturation (HbSat) levels (RBRMatched) or more severe levels (RBREnd). A third protocol compared alternating periods (30 s) of FRC and RBR (FRC-RBRALT). Subjects continued each protocol until …

Manipulation Of Auditory Feedback In Individuals With Normal Hearing And Hearing Loss, Le Truc Linh Vaccarello

Electronic Thesis and Dissertation Repository

Auditory feedback, the hearing of one’s own voice, plays an important role in the detection of speech errors and the regulation of speech production. The limited auditory cues available with a hearing loss can reduce the ability of individuals with hearing loss to use their auditory feedback. Hearing aids are a common assistive device that amplifies inaudible sounds. Hearing aids can also change auditory feedback through digital signal processing, such as frequency lowering. Frequency lowering moves high frequency information of an incoming auditory stimulus into a lower frequency region where audibility may be better. This can change how speech sounds …

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 …

Epigenetic Etiology Of Intellectual Disability., Shigeki Iwase, Nathalie G Bérubé, Zhaolan Zhou, Nael Nadif Kasri, Elena Battaglioli, Marilyn Scandaglia, Angel Barco

Paediatrics Publications

Intellectual disability (ID) is a prevailing neurodevelopmental condition associated with impaired cognitive and adaptive behaviors. Many chromatin-modifying enzymes and other epigenetic regulators have been genetically associated with ID disorders (IDDs). Here we review how alterations in the function of histone modifiers, chromatin remodelers, and methyl-DNA binding proteins contribute to neurodevelopmental defects and altered brain plasticity. We also discuss how progress in human genetics has led to the generation of mouse models that unveil the molecular etiology of ID, and outline the direction in which this field is moving to identify therapeutic strategies for IDDs. Importantly, because the chromatin regulators linked …

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 …

The Feasibility Of Square-Stepping Exercise As A Universal Intervention For Older Adults With Chronic Disease To Improve Cognitive And Physical Function, Erin M. Shellington

Electronic Thesis and Dissertation Repository

Square-stepping exercise (SSE) is a cognitive training program with a physical component. An instructor demonstrates a stepping pattern across a gridded mat and participants are required to memorize and repeat the patterns on their own. In community-dwelling older adults, SSE has demonstrated some benefits on global cognitive functioning (GCF), balance, functional fitness, and social interaction.

Aims: to investigate the feasibility and efficacy of SSE in varied populations and settings to improve mobility and cognition. Populations included older adults with: knee osteoarthritis (OA), type 2 diabetes mellitus (T2DM) and self-reported cognitive complaints (sCC), and those living in long-term care (LTC) …

Canadian Guidelines For Controlled Pediatric Donation After Circulatory Determination Of Death-Summary Report, Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael Van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie

Paediatrics Publications

OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada.

METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory …

The Anatomy Of The Infrarenal Lumbar Splanchnic Nerves In Human Cadavers: Implications For Retroperitoneal Nerve-Sparing Surgery, Tyler Beveridge, Dale Fournier, Adam M.R. Groh, Marjorie Johnson, Nicolas E. Power, Brian L. Allman

Anatomy and Cell Biology Publications

Injury to the nerves of the aortic- and superior hypogastric plexuses during retroperitoneal surgery often results in significant post-operative complications, including retrograde ejaculation and/or loss of seminal emission in males. Although previous characterizations of these plexuses have done well to provide a basis for understanding the typical anatomy, additional research into the common variations of these plexuses could further optimize nerve-sparing techniques for retroperitoneal surgery. To achieve this, the present study aimed to document the prevalence and positional variability of the infrarenal lumbar splanchnic nerves (LSNs) through gross dissection of 26 human cadavers. In almost all cases, two LSNs were …

Multiparametric Mri Changes Persist Beyond Recovery In Concussed Adolescent Hockey Players, Kathryn Y. Manning Msc, Amy Achranz Bmsc, Robert Bartha Phd, Gregory A. Dekaban Phd, Christy Barreira Bsc, Arthur Brown Phd, Lisa Fischer Md, Kevin Asem Md, Timothy J. Doherty, Douglas D. Fraser Md Phd, Jeff Holmes Phd, Ravi S. Menon

Anatomy and Cell Biology Publications

Objective: To determine whether multiparametric MRI data can provide insight into the acute and long-lasting neuronal sequelae after a concussion in adolescent athletes.

Methods: Players were recruited from Bantam hockey leagues in which body checking is first introduced (male, age 11–14 years). Clinical measures, diffusion metrics, resting-state network and region-to-region functional connectivity patterns, and magnetic resonance spectroscopy absolute metabolite concentrations were analyzed from an independent, age-matched control group of hockey players (n 5 26) and longitudinally in concussed athletes within 24 to 72 hours (n 5 17) and 3 months (n 5 14) after a diagnosed concussion.

Results: …