The Impact Of Access To Oral Health Care On Inadequate Oral Health And Multimorbidity, Luis Limo

Electronic Thesis and Dissertation Repository

The connection between oral health and other non-communicable chronic conditions—commonly referred in the dental literature as the oral-systemic health connection—emphasizes the role of oral health care on both oral diseases and chronic conditions, particularly in vulnerable populations like the elderly. This thesis comprises 2 studies: the first is a systematic review on the impact of oral health care interventions, as an indicator of access to oral health care, on chronic conditions of which their co-existence would result in multimorbidity; the second study is a cross-sectional investigation of the associations between oral health, access to oral health care, and multimorbidity among …

Social Determinants Of Access To Primary Care In Canada, Feben W. Alemu

Electronic Thesis and Dissertation Repository

Despite the promise of universal care, many Canadians report having unmet healthcare needs. We conducted two studies: (1) a systematic review of studies on social determinants of health (SDH) and unmet need; and (2) a secondary analysis using the Canadian Longitudinal Study on Aging (CLSA) to investigate the association of SDH and (2a) self-reported unmet need and (2b) having a family physician. The review (n=40) found a positive association between unmet need and lower income, mental health and chronic conditions, and negative association with older age, better perceived health and having a family physician. The CLSA analysis found the odds …

The Effects Of Gases From Food Waste On Human Health: A Systematic Review, Paulina Rudziak

Undergraduate Student Research Internships Conference

Food waste is an everyday activity in many developed countries; however, the risks from emissions are either not acknowledged or poorly regulated in many food waste plants worldwide. The literature lacks a systematic review that gives a thorough overview of the effects of food waste emissions on human health, directly affecting physiology and indirectly affecting human health through environmental health effects. The aim of this study is to address this gap to support decision-makers in public health when inspecting food waste facilities and the surrounding areas. To inform this systematic review, the four databases, Web of Science, OVID, EMBASE, and …

Spin And Distortion In Surgical Trials, Andrea Mataruga

Electronic Thesis and Dissertation Repository

Research problem: Randomized controlled trials (RCTs) are essential; however, their validity can be threatened through distortion or spin. This study quantifies publication bias and distorted outcome reporting.

Methodology: All surgical RCTs registered on ClinicalTrials.gov from 1997-2017 were identified and a sample was obtained through random and intentional selection. Failure to publish (proportion of studies that remain unpublished), outcome distortion (changing intended outcomes), and spin (distorted presentation) were explored. Comparisons were made for positive versus negative studies and for high-income (HICs) versus low-middle income countries (LMICs).

Results: In total, 13,761 RCTs were registered (median enrollment size = 96, 94% from …

Health Care Utilization By Immigrants With Multimorbidity: A Population Based Cross-Sectional Study Of The 2015-2016 Canadian Community Health Survey (Cchs), Chinmoy Talukder

Electronic Thesis and Dissertation Repository

Immigrants face unique healthcare barriers, which can negatively impact their health and health service use. Those with multimorbidity face a particular challenge as multimorbidity is associated with increased need for healthcare. The purpose of this study was to compare healthcare utilization, as measured by number of visits to family physicians and specialists, between immigrants and Canadian-born populations with multimorbidity, stratified by sex and for specific chronic diseases. A cross-sectional analysis using 2015-2016 Canadian Community Health Survey (CCHS) was conducted. After adjusting for relevant covariates, no statistically significant differences in visits to family physicians or specialists were observed between immigrants and …

Descriptive Analysis Of Fall-Related Injuries Among Older Adults In Ontario, Nicolette Lappan

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. The purpose of this study was to describe the characteristics of older adults who experienced fall-related injuries (FRIs) and the types of falls that caused them. We analyzed Ontario-wide secondary data from three databases (NACRS, DAD, RPDB) covering 2010-2014. Older adults (≥ 65 years) who visited emergency departments (ED) with FRIs were selected using ICD-10-CA codes for a fall and injury. Counts, measures of central tendency, and prevalence rates (crude, age- and sex-specific, age-standardized) were calculated. There were 304,610 (63.0% females) ED admissions (3,089 per 100,000 population) …

Mood And Anxiety Disorders, Measurement, And Migrant Groups In Ontario, Jordan Edwards

Electronic Thesis and Dissertation Repository

Our objectives were to: (1) evaluate the current literature on the epidemiology of mood or anxiety disorders among migrant groups; (2) assess how current tools for measuring mood or anxiety disorders at the population level influence our understanding of the epidemiology by a) analyzing the concordance between two commonly used population measures, and b) using a Bayesian analysis to create a combined estimate using both measures; (3) estimate the prevalence and effects of potential risk factors on the prevalence of mood or anxiety disorders among first-generation migrant groups compared to the general population in Ontario. We conducted a systematic review …

The Story Behind The Ontario Health Insurance Plan And Its Impact On The Public Sector, Marvin L. Simner

History Publications

The Ontario Health Insurance Plan is a provincially supported health care program that required fifteen years to develop and emerged though seven distinct and frequently controversial stages. It was said at the time to have generated more heated debate in the House than any other legislation that previously had been approved by the provincial government. The purpose of this report is to provide a comprehensive review of these seven stages, the arguments that accompanied each stage, and the impact of the stages on the local community. In the final section we discuss how certain elements in these stages, if known …

A Coaching And/Or Education Intervention Targeting Physical Activity And Nutrition Behaviours In Parents With Overweight/Obesity And Their Children, Shazya Karmali

Electronic Thesis and Dissertation Repository

The purpose of this dissertation is to provide a detailed overview of, findings from, and experiences participating in a 3-month randomized controlled trial (RCT) targeting obesity-related behaviours in parents with overweight/obesity (body mass index [BMI] ≥ 25 kg/m²) and their children (2.5-10 years old, any weight; N = 50 dyads). A concurrent mixed methods study comprised of an RCT and descriptive qualitative design was utilized. Parent-participants received Co-Active Life Coaching (CALC) and webinar-based health education (intervention) or education only (control). To address the dissertation’s purpose, Chapter II provides a detailed methodological account of the program, including rationale and …

Health Policy And Social Change: Women’S Advocacy Groups And Narrative Mobilization, Jill Moffatt

Electronic Thesis and Dissertation Repository

The goal of this study is to systematically investigate the mobilization of co-created (storyteller and story-gatherer) narratives for policy and social change. A case study format investigated the mobilization of narratives by a women’s health organization in London, Ontario. Semi-structured interviews resulted in transcripts from key actors. These transcripts were thematically coded and analyzed. All interview participants emphasized that from their perspective the organization did influence health policy or social change through their narrative use. Specific policy change examples were provided by participants, and social change was subjectively recognized as realized through the creation of awareness and affirmed through audience …

Hiv-1 Group M Subtype Fitness, Disease Progression, And Entry Efficiency, Colin M. Venner

Electronic Thesis and Dissertation Repository

Human immunodeficiency virus type 1 (HIV-1) emerged in the human population shortly after the turn of the 19th century. Distribution of HIV-1 across the globe over the past 30–35 years can be traced to founder events with primordial HIV strains from sub-Saharan Africa. Even considering the burden of HIV in Africa, our knowledge of HIV-1 disease is still largely limited to subtype B HIV-1, a strain responsible for 3 million infections in North America and Europe as compared to the 33 million that are infected with HIV-1 subtypes A, C, D, and circulating and unique recombinant forms.

This dissertation analyzes …

Normalizing Masculinity: Explaining Processes, Factors, And Contexts That Influence How Rural Male Farmers Seek Health Information In Southwest Ontario, Bradley C. Hiebert

Electronic Thesis and Dissertation Repository

Disproportionately high mortality and morbidity rates experienced by rural men are often related to the high prevalence of rural male farmers (RMFs) who are consistently exposed to chemicals, animal waste, and dust, or injured or killed while working. This dissertation aimed to explain processes by which RMFs seek health information (HI), and how these processes are influenced by rural social, cultural, political, and geographical factors.

Three studies were conducted as part of this dissertation. The first study was a literature review that explored the relationship between rural men’s health, health information seeking (HIS) theory, and masculinity theory. The second study …

Assessment Of Interprofessional Team Collaboration Scale (Aitcs): Further Testing And Instrument Revision., Carole Orchard, Linda L Pederson, Emily Read, Cornelia Mahler, Heather Laschinger

Nursing Publications

INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether …

Promoting Healthy Beverage Consumption Habits Among Elementary School Children: Evaluating The Healthy Kids Community Challenge 'Water Does Wonders' Interventions In London, Ontario, Bridget R. Irwin

Electronic Thesis and Dissertation Repository

Childhood obesity is a major public health concern and has been attributed to poor diet, among other factors. Sugar-sweetened beverage (SSB) consumption, in particular, has been linked to excess weight gain in childhood, while water consumption is a protective factor. Taking advantage of the Water Does Wonders theme of the Healthy Kids Community Challenge, an initiative by the provincial government to promote water consumption, this thesis uses pre-post surveys of children aged 8-14 years to examine (a) the association between knowledge and beverage consumption habits, and (b) the effectiveness of a school- based education and environment intervention to reduce SSB …

The Indigenous Determinants Of Health As Predictors For Diabetes And Unmet Health Needs Among Urban Indigenous People: A Respondent-Driven Sampling Study In Toronto, Ontario, Stephanie Rachael Mcconkey

Electronic Thesis and Dissertation Repository

National statistics commonly present Indigenous peoples as a falsely homogenous group of people experiencing disproportionate ill health when compared to non-Indigenous peoples. There are significant gaps in statistical information regarding the health services access barriers experienced by Indigenous people that disrupts the quality of care they receive or prevents them from accessing care altogether. Our Health Counts Toronto is a community-based study that employed respondent-driven sampling (RDS) methodologies to sample 917 urban Indigenous adults. Prevalence estimates and prevalence ratios were calculated using RDS-II weights and adjusting for clustering by shared recruiter in SAS 9.4 and SAS-callable SUDAAN 11.0 software. This …

Quality Of Antenatal Care And Its Relationship With Women’S Intended Use Of Their Anc Facility For Delivery: A National Cross-Sectional Study In Kenya, Jisoo Kim

Electronic Thesis and Dissertation Repository

Maternal deaths have been one of the leading causes of deaths in sub-Saharan Africa. Delivering at an institution can prevent the majority of maternal deaths in developing countries. A national cross-sectional survey of Kenya was used to determine if the quality of antenatal care (ANC) provided to women is associated with their intention to deliver at the same facility. Multilevel mixed-effects logistic regression was used to examine this relationship. Quality of ANC variables assessed in this study were not significantly associated with women’s intention to deliver at the same facility. Mothers preferred to deliver at hospitals, rather than clinics/dispensaries. ANC …

Carbohydrates And Fungal Toxin Exposure Influence The Vaginal Microbiota, Metabolome, And Reproductive Health Of Women, Stephanie L. Collins

Electronic Thesis and Dissertation Repository

The reproductive health of women is influenced by microorganisms and their metabolites, namely those representing the vaginal microbiota and those producing toxins that are ingested. To manipulate the vaginal microbiota toward a health-associated, Lactobacillusdominant state, an approach adopting prebiotic lactulose was taken. Using batch culture, lactulose supported Lactobacillus maintenance and positively altered metabolites, while not disrupting indigenous L. crispatus epithelial adherence. The vagina also harbours abundant glycogen, but initial assumptions that lactobacilli utilize it were incorrect. I have now shown that glycogen selectively stimulates organisms associated with dysbiosis and L. iners in a self-limiting manner. Other compounds such as environmental …

Determining The Detective Quantum Efficiency (Dqe) Of X-Ray Detectors In Clinical Environments, Terenz R. Escartin

Electronic Thesis and Dissertation Repository

According to Health Canada, dental and medical radiography accounts for more than 90% of total man-made radiation dose to the general population. Ensuring patients receive the health benefits of diagnostic x-ray imaging without use of higher radiation exposures requires knowledge and understanding of the detective quantum efficiency (DQE). Currently, the DQE is not measured in clinics because it requires specialized instrumentation and specific DQE-expertise to perform an accurate analysis. In this regard, the goals of this thesis were to: 1) address the limitations of measuring the DQE in clinical environments that affects the accuracy of the measurement; 2) develop and …

Promoting Benefits Of Physical Activity Through Persuasive Communication, Priynka Patil

Electronic Thesis and Dissertation Repository

Inactivity early in life can lead to inactively later in life, which can result in negative outcomes. The primary purpose was to determine if gain- or loss-framed messages about physical activity would change the attitudes, intentions, and behaviours of students in the contemplation or preparation stage of the Transtheoretical model. The secondary purpose was to determine if framing the message in terms of the physical health benefits, appearance/social benefits, or mental health benefits (benefit condition) would change attitude, intention and behaviour. Undergraduate female students (N=60) between the ages of 18 and 36 were recruited from the university. The results found …

Standing Up For Student Health: An Application Of The Health Action Process Approach For Reducing Student Sedentary Behavior., Wuyou -. Sui

Electronic Thesis and Dissertation Repository

Sedentary behavior (SB) has been associated with chronic diseases, such as Hypertension and Obesity; the risk appears greater the longer one engages in SB. University Students are a high-risk population for excessive SB due to academic responsibilities. Increasing frequency/length of breaks from sitting is an effective way to attenuate effects of SB. The Health Action Process Approach (HAPA) is a proven health behavior change model for behaviors like nutrition, but has yet to show effectiveness for increasing non-sedentary behaviors. Forty-five university students (12 Males, Mean age 23.3) were randomized into HAPA-intervention (sedentary behavior) or HAPA-control (nutrition) groups. Occupational Student and …

A Gender-Sensitized Weight Loss And Healthy Lifestyle Program For Overweight And Obese Male Hockey Fans: Effects On Dietary Behaviours, Ashleigh De Cruz

Electronic Thesis and Dissertation Repository

BACKGROUND: Male dietary behaviours have often been associated with overweightness and obesity. Although little research exists to help prevent the problem, this can somewhat be explained by the lack of men engaging in healthy eating and lifestyle change. A gender-sensitized intervention study using hockey as a draw to participate may positively change dietary behaviours and associated health outcomes. METHODS: A 12 week, 12 session, weight loss and healthy lifestyle intervention program was conducted in which overweight and obese male fans of a local hockey team were coached to adopt healthy eating and lifestyle behaviour changes in collaboration with …

Inequalities In Social Determinants Of Health In The Ontario Transgender Population, Rachel E. Giblon

Electronic Thesis and Dissertation Repository

This study examined how everyday living conditions known to influence health outcomes – social determinants of health – differ between transgender Ontarians and the general Ontario population. Previously collected data on social determinants, demographics, health, and health care from trans (n=433) and non-trans individuals (n=39980) living in Ontario were used. Standardized risk differences showed that significantly more trans individuals were underpaid and underemployed, unable to complete their post-secondary education, and had experienced food insecurity, social exclusion and unmet health care needs. Differences were largest comparing trans men to cisgender men of the same age distribution. Findings from this study identified …

The Experiences Of Criminalized Women When Accessing Health Care Services During Incarceration Within Provincial Jails: A Critical Narrative Study, Shamiram Zendo

Electronic Thesis and Dissertation Repository

Abstract

There has been a noticeable increase in the imprisonment of women in Canada, within the last 20 years. The purpose of this critical inquiry was to capture and promote the voices and stories of criminalized women, in order to serve their interest. Five individual in-depth interviews were conducted with women, who were incarcerated in provincial jail. A critical paradigm was used to explore how socioeconomic and gender inequalities, embedded in the social, political, and historical contexts, influenced criminalized women’s experiences when accessing health care. The findings of this study described how criminalized women experience fragmentation in health care access, …

The Utility Of A Protection Motivation Theory Framework For Understanding Sedentary Behaviour, Tiffany S. Wong

Electronic Thesis and Dissertation Repository

This study aimed to 1) examine the factor structure and composition of sedentary-derived Protection Motivation Theory (PMT) constructs and 2) determine the utility of these constructs in predicting general and leisure sedentary goal intention (GI), implementation intention (II), and sedentary behaviour (SB). PMT, GI, II constructs, and a modified SB questionnaire were completed by undergraduate students. After completing socio-demographics and the PMT items (n = 787), participants were randomized to complete general or leisure intention and SB items. Irrespective of model, principal axis factor analysis revealed that the PMT items grouped into eight coherent and interpretable factors. Using linear …

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Through The Eyes Of Children: First Nations Children's Perceptions Of Health, Kyla Annui Ursa English

Electronic Thesis and Dissertation Repository

Few studies addressing Indigenous children’s health have incorporated the voices of children or integrated an occupational science perspective. In partnership with the Southwest Ontario Aboriginal Health Access Centre, this community-based study used artwork and sharing circles to understand First Nations children’s perceptions of health during a week-long culture camp. The objectives were: (1) to understand how First Nations children view their health, and (2) to explore how children connect health and culture. Findings demonstrated that children’s perceptions (n=20, aged 10 to 12) focused on physical aspects of health, such as diet and fitness. Children attended much less to spiritual, mental, …

The Effectiveness Of Gain- Versus Loss-Framed Advertisements To Minimize Hazardous Drinking Among University Students: A Test Of Regulatory Fit, Barlas Gunay

Electronic Thesis and Dissertation Repository

University binge drinking is a concern. Traditionally, social norms marketing campaigns have been employed. Regulatory focus theory – based on the premise that behavior is driven either by the motivation to maximize gains (promotion) or to minimize losses (prevention) – offers an alternative approach to crafting persuasive appeals in this population. This study investigated the effectiveness of gain-framed versus loss-framed advertisements in lowering drinking intentions in a university sample. It further explored whether the effects were moderated by regulatory focus – primed and dispositional – and trait reactance. Online surveys were completed by 208 Introductory Psychology students (51.7% female, mean …

Socioeconomic Disparities In Physical Health Among Aboriginal And Torres Strait Islander Children In Western Australia, Carrington C.J. Sheperd, Jianghong Li, Stephen R. Zubrick

Aboriginal Policy Research Consortium International (APRCi)

Objective. Few empirical studies have specifically examined the relationship between socio-economic status (SES) and health in Indigenous populations of Australia. We sought to provide insights into the nature of this relationship by examining socio-economic disparities in physical health outcomes among Aboriginal and Torres Strait Islander children in Western Australia.

Design. We used a diverse set of health and SES indicators from a representative survey conducted in 2000􏰣2002 on the health and development of 5289 Indigenous children aged 0􏰣17 years in Western Australia. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results. After controlling for age and sex, …

Using First Nations Children's Perceptions Of Food And Activity To Inform An Obesity Prevention Strategy, Ashlee-Ann E. Pigford, Noreen D. Willows, Nicholas L. Holt, Amanda S. Newton, Geoff D.C. Ball

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Planning, Implementation, And Formative Evaluation Of A Food Literacy Program, Heather M. Thomas

Electronic Thesis and Dissertation Repository

The overall purpose of this dissertation was to examine the planning, implementation, and formative evaluation of a community-based food literacy program for youth. Article 1 provided a summary of the community-based cooking program for at-risk youth. Objectives included the provision of applied food literacy and cooking skills education augmented with fieldtrips to local farms. Eight at-risk youth (five girls and three boys, mean age = 14.6) completed the intervention. Post intervention, five of eight participants completed in-depth interviews about their experiences.

Article 2 was a formative evaluation of the cooking program focused on gaining an understanding of participants’ (i.e., at-risk …