Digital Commons Network^™

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 …

Female Enrollment In Rehabilitation Trials: A Systematic Review Of Reporting Sex And Female Participation In Randomized Controlled Trials Of Poststroke Upper Extremity Rehabilitation Over 50 Years, Sarvenaz Mehrabi, Amber Harnett, Marcus Saikaley, Jamie L Fleet, Janice J Eng, Mark Bayley, Robert Teasell

Physical Medicine and Rehabilitation Publications

OBJECTIVE: To systematically assess the reporting of sex and the percentage of female participants in randomized controlled trials (RCTs) examining interventions for the post-stroke rehabilitation of upper extremity (UE) motor disorders.

DATA SOURCES: CINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to April 1, 2021. Additional articles were identified using the Evidence-Based Review of Stroke Rehabilitation.

STUDY SELECTION: Studies were eligible for inclusion if they (1) were RCTs or crossovers published in English, (2) ≥50% of participants were diagnosed and affected by stroke, (3) included adults ≥18 years old, and (4) applied an intervention to the …

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 …

Sasah Experiential Learning: Global Health Equity, Anjali Singh

SASAH 4th Year Capstone and Other Projects: Publications

My journey with the Global Health Equity (GHE) internship program through the SASAH experiential learning program has been a transformative experience. This report encapsulates an exploration of the four years I have spent at the placement, outlining the evolution of skills, collaborations, and impactful projects that have strengthened my academic development and career aspirations. The report starts with a reflective introduction on my initial anxiety about entering the GHE internship, ultimately highlighting the meeting of interests between diplomacy, global affairs, and journalism with the internship’s focus on global health equity. I highlight pivotal encounters with mentors, colleagues, staff, and experts, …

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 …

Polisci 3210f: Feasibility Of A National Disability Insurance Plan (Ndip) In Canada, Twana Hassan, Aditi Priya, Dylan Poole, Samantha Rubin, Ethan Chen

Community Engaged Learning Final Projects

This research report presents an overview of the feasibility and reliability of a National Disability Insurance Plan (NDIP) in Canada. Several Global North countries are leading the way in disability legislation and disability funding in comparison to Canada's inaction on the matter. A National Disability Insurance Plan in Canada will have social and economic benefits for everyone in Canada. The report concluded that Canada is capable of implementing a NDIP and doing so is the right choice.

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 …

Access To A Regular Primary Care Physician Among Young People With Early Psychosis In Ontario, Canada, Rebecca Rodrigues, Jennifer N S Reid, Joshua C. Wiener, Suzanne Archie, Richard G Booth, Chiachen Cheng, Arlene G Macdougall, Lena Palaniyappan, Bridget L Ryan, Aristotle Voineskos, Paul Kurdyak, Saadia Hameed Jan, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: Access to a primary care physician in early psychosis facilitates help-seeking and engagement with psychiatric treatment. We examined access to a regular primary care physician in people with early psychosis, compared to the general population, and explored factors associated with access.

METHODS: Using linked health administrative data from Ontario (Canada), we identified people aged 14-35 years with a first diagnosis of nonaffective psychotic disorder (n = 39 449; 2005-2015). We matched cases to four randomly selected general population controls based on age, sex, neighbourhood, and index date (n = 157 796). We used modified Poisson regression to estimate prevalence …

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 …

Jumping Ship And Going To The Other Side: Experiences Of Nurses Who Retrain As Doctors, Anne Robinson

Electronic Thesis and Dissertation Repository

Aim: To gain an understanding of the experience of medical training for nurses who retrain as doctors.

Methods: Using a Constructivist Grounded Theory design, semi-structured interviews were conducted with thirteen medical students and residents who had completed nursing training prior to entering medical school. Interviews were audiotaped and professionally transcribed. Transcripts were coded and analysis in an inductive manner to construct central themes.

Findings: Many left nursing due to negative effects of a hierarchal system. As preclinical medical students they felt both advantaged and burdened by their advanced clinical knowledge. During clinical placements, they experienced social distress and role confusion …

Data-Driven Decision Support Tool Co-Development With A Primary Health Care Practice Based Learning Network, Jacqueline K. Kueper, Jennifer Rayner, Sara Bhatti, Kelly Angevaare, Sandra Fitzpatrick, Paulino Lucamba, Eric Sutherland, Daniel J. Lizotte

Epidemiology and Biostatistics Publications

Background: The Alliance for Healthier Communities is a learning health system that supports Community Health Centres (CHCs) across Ontario, Canada to provide team-based primary health care to people who otherwise experience barriers to care. This case study describes the ongoing process and lessons learned from the first Alliance for Healthier Communities’ Practice Based Learning Network (PBLN) data-driven decision support tool co-development project.

Methods: We employ an iterative approach to problem identification and methods development for the decision support tool, moving between discussion sessions and case studies with CHC electronic health record (EHR) data. We summarize our work to date in …

Transformational Leadership Approach For Encouraging Historically Marginalized Communities To Access Admission To Naturopathic Medicine, Baljit Khamba

The Dissertation in Practice at Western University

Many healthcare training institutions lack cultural diversity, including naturopathic medicine. One potential reason is a lack of historically marginalized individuals applying to these medical schools. Attracting communities of colour to healthcare professions, like naturopathic medicine is important for improving healthcare access and delivery across all individuals within North America. This OIP explores the lack of diversity in applicants to the naturopathic medical program at a large multi-centre institution. The role that education and mentorship of faculty members can play to improve implicit biases and eventually encourage historically marginalized individuals to apply to the program is explored. Moreover, the OIP presents …

The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.

Electronic Thesis and Dissertation Repository

Background: Distal radius fracture (DRF) is a common upper extremity fracture that causes significant impairment and leads to difficulties in fulfilling important life roles such as indoor and outdoor cleaning, meal preparation, grocery shopping, caring for others, and earning and managing family income. However, clinicians do not routinely address home and family life roles after a DRF. Patient and rehabilitation factors are crucial in addressing home and family work roles (HFWRs). The HFWR questionnaire consists of tasks that are typically performed at home.

Objective: The overarching objective of this thesis is to explore the role of patient and rehabilitation …

Can The Power Of Sport Help Men With Overweight/Obesity Improve Their Health Through A Tailored Healthy Lifestyle Program?, Robert Petrella, Melissa Majoni, Marisa Kfrerer, Narton Boa Sorte Silva, Brendan Riggin, Wendy Blunt, Dawn P. Gill, Brooke Bliss, Guangyong Zou, Paul Aspinall, Jennifer Irwin

Department of Medicine Publications

Abstract

Context: In Canada and the U.S., a greater proportion of men (vs. women) have overweight or obesity. Despite this, men are underrepresented in weight loss research and fewer are recruited into weight loss services.

Objective: To determine whether participants who received an innovative gender-sensitized healthy lifestyle program (Hockey Fans in Training: Hockey FIT) would have greater weight loss and reduced waist circumference (WC), after 3 and 12 months, compared with a wait-list control group.

Study Design and Analysis: Cluster randomized controlled trial whereby 42 sites were randomly assigned to either the intervention (i.e., Hockey FIT) or a wait-list control …

Hockey Fit For Women (Hfit For Women): Evaluating Reach And Implementation Of A Gender-Sensitized Healthy Lifestyle Program, Robert Petrella, Melissa Majoni, Marisa Kfrerer, Brendan Riggin, Wendy Blunt, Dawn P. Gill, Brooke Bliss, Olivia Crozier, Paul Aspinall

Department of Medicine Publications

Context: 57% of Canadian women have obesity or are overweight, indicating a need for novel mitigation strategies. Research suggests health promotion programs tailored to at-risk groups are more likely to be effective in improving health and sustaining implementation and outcomes long-term. Hockey FIT for Women (HFIT for Women) was adapted from Hockey Fans In Training (HFIT), a 12-week gendersensitized healthy lifestyle program for men who were hockey fans with obesity/overweight. Process evaluation findings from both a HFIT pilot and large-scale trial indicated a need to adapt to women. Objective: Evaluate reach and implementation of the HFIT for Women program from …

Recruitment And Characteristics Of Men With Overweight/Obesity From A Trial Of A Gender-Sensitized Healthy Lifestyle Program, Robert Petrella, Melissa Majoni, Marisa Kferer, Narlon Boa Sorte Silva, Precious Adekoya, Brendan Riggin, Wendy Blunt, Dawn P. Gill, Brooke Bliss, Matthew Dinunzio, Paul Aspinall, Jennifer Irwin

Department of Medicine Publications

Context: Engaging men in chronic disease prevention is critical as rates of obesity in men continue to increase, coupled with men being less likely to proactively seek preventative health care services.

Objective: To report on the recruitment and baseline characteristics of a healthy lifestyle program using the power of sport (hockey) to engage men.

Study Design and Analysis: Cluster randomized controlled trial where 42 sites were randomly assigned to either the intervention or wait-list control group. The intervention group received the Hockey Fans in Training (Hockey FIT) program (3-month active phase; 9-month minimally-supported phase) while the control group continued with …

"We Are The Living Dead": The Gendered Impacts Of Open-Pit Mining In The Dominican Republic, Klaire Gain

Electronic Thesis and Dissertation Repository

Despite a rhetorical commitment to enhancing community well-being, Canadian mining corporations have a history marked by ecological degradation and human rights violations, with women experience disproportionately negative impacts. While Latin America and the Caribbean (LAC) is a desired topography for open-pit mining, the geographical area of the Dominican Republic has been largely absent from the literature. As such, this dissertation, rooted in decolonial ecofeminism, enacted a critical narrative inquiry with 7 women from the Dominican Republic to explore the gendered impacts of open-pit mining on their health and well-being.

This thesis is composed of six chapters, with chapter one introducing …

Intimate Partner Violence, Mental Health Services And The Covid-19 Pandemic In Ontario: What Are The Differences, If Any, In Mental Health Service Accessibility And Service Satisfaction During Covid-19 Between Women In Abusive Relationships And Women In Non-Abusive Relationships?, Nokuzola Ncube

Electronic Thesis and Dissertation Repository

Introduction: Intimate partner violence (IPV) increased during the COVID-19 pandemic in Canada as a result of increased economic pressures and social isolation brought on by stay-at home orders. During the COVID-19 pandemic, women experiencing IPV experienced declines in mental health conditions and unique difficulties in accessing mental health services amid closures, shifts in service delivery, and inconsistent availabilities.

Methods: An online survey was administered to 44 women living in Ontario (23 who had not experienced IPV and 16 who had not) to explore their satisfaction and access to mental health services during the COVID-19 pandemic. Descriptive statistics were used to …

Developing An Online Questionnaire To Investigate The Covid-19 Pandemic’S Impacts On Social Isolation And Health In Older Adults Living With Multimorbidity: A Pilot Study, Patricia Nistor

Electronic Thesis and Dissertation Repository

Introduction. Social restrictions preventing the spread of COVID-19 possibly increased social isolation and loneliness. The validity and reliability of a questionnaire assessing the COVID-19 pandemic’s impact on social isolation and loneliness in community dwelling older adults with multimorbidity was investigated.

Methods. A conceptual framework was developed to guide questionnaire construction. Participants were recruited through professional networks, comprising a convenience sample. Feedback interviews assessed usability and face validity. Content validity was assessed using a Content Validity Matrix, and construct validity through tests of association. Reliability of validated scales was assessed using Cronbach’s ⍺. Descriptive statistics and logistic regression were computed. …

Corrosion Of Implant Materials In The Human Body, Maedeh Barzmehri

Corrosion Research

This paper extensively examines the complex problem of implant corrosion occurring within the human body. The corrosion of implants gives rise to substantial challenges, encompassing compromised implant durability, patient safety concerns, and potential adverse impacts on the long-term functionality of the medical device. The study's primary objectives include offering a concise overview of the various corrosion mechanisms that impact a range of implant materials and outlining health complications linked to the byproducts of implant corrosion. Furthermore, it delves into a cost analysis specific to hip or knee revision arthroplasty, which has become a prevalent scenario in implant failure cases on …

Social Supports For Adolescent And Young Adult Polycystic Ovary Syndrome Patients: A Scoping Review, Caitlin E. Mungall

Western Libraries Undergraduate Research Awards (WLURAs)

Polycystic ovary syndrome (PCOS) is a chronic disorder with negative health consequences for millions of women. The paucity of research regarding interventions targeting the psychosocial symptoms of PCOS for adolescents and young adults (AYAs), susceptible to low self-esteem and depression, warranted this review. This paper provides an overview of research on the social supports currently available for AYAs and identifies areas where further research is required to elucidate their support needs. A scoping review methodology identified 15 studies that met inclusion criteria. Findings revealed that this is an emerging field of research and most included studies originated in North America. …

Sex-Related Differences In Gait Characteristics And Their Associations With Symptoms In Individuals With Patellofemoral Osteoarthritis, Harvi Hart Dr.

Physical Therapy Publications

Background

Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.

Research question

Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.

Methods

Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to …

The Process Of Art Creation Among Mothers From Ontario Who Have Experienced Gender-Based Violence, Madison L. Broadbent

Electronic Thesis and Dissertation Repository

Mothers who have experienced gender-based violence (GBV) face physical, mental, and social health implications. Participating in artmaking has the potential to reduce these consequences. An arts-based study including in-depth interviews was conducted with 13 mothers with histories of GBV. The creative processes involved in artmaking amongst mothers with histories of GBV were explored. Mothers demonstrated using symbols, thoughtful colour selection, and choice of artistic medium when creating their artforms. Moreover, mothers’ experiences of storytelling experiences of GBV through art were examined. Mothers described using art as a means of communication, emotional processing and healing through art, and the process of …

Fracture Prediction And Prevention In Individuals With Chronic Kidney Disease, Andrea C.J. Cowan

Electronic Thesis and Dissertation Repository

Patients with chronic kidney disease (CKD) face increased fracture risk yet our understanding and management of this risk remains poor. We conducted three studies using retrospective cohort analysis in Ontario, Canada. We developed a 3-year fracture prediction model for patients receiving dialysis. Secondly, we contrasted fracture rates among patients on SGLT2i or DPP4i medications, stratified by kidney function. Lastly, we examined hypocalcemia incidence post-denosumab prescription, stratified by kidney function.

Findings: The fracture risk tool, incorporating demographic and lab data, performed well (AUC 0.72). SGLT2i did not elevate fracture risk vs. DPP4i (HR 0.95 [95% CI 0.79,1.13]). In those prescribed denosumab, …