Medicine and Health Sciences Commons^™

Realist Evaluation Of Ldcp Funded Health Equity Indicators, Shamiram Zendo Ms

Western Research Forum

Background: The Health Equity Indicators were developed by a group of public health practitioners, and academics to assist Local Public Health Agencies (LPHAs), across Ontario, Canada, determine whether their public health programs and activities meet the equity standards required by the Ministry of Health and Long-term Care (MOHLTC). The Health Equity Indicators have been designed to assess organizational internal practice and determine whether programs meet equity standards.

Objective: A realist evaluation is currently underway to determine who these indicators work for and under what conditions, across the LPHAs in the province of Ontario.

Method: Realist methodology has been …

Dance As A Protective Measure Against The Cognitive And Physical Declines Associated With Aging: A Proposed Study, Sarah M. Schwanz, Jeffrey Holmes, Jessica Grahn

Western Research Forum

Background:

Dance is considered a multimodal activity in that it requires both physical and cognitive engagement. Combining physical activity with music may have a synergistic effect, enabling dance to enhance physical and cognitive functions more than music and physical activity alone. The positive changes attributed to dance training such as improved visuospatial and motor ability, high coordination, greater balance, and increased cognitive ability may also benefit individuals as they age.

Methods:

This proposed study will examine whether dance training has the potential to protect against age-related cognitive and physical decline by assessing the cognitive and physical domains that show decline …

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how …

Public Policy Advocacy In The Canadian Context: A Review Of The Current Literature, Amy Lewis, Abram Oudshoorn, Helene Berman

Western Research Forum

Public Policy Advocacy in the Canadian Context: A Review of the Current Literature

Background: Public policy advocacy is an important competency for students from healthcare and social service programs to develop; however, integration of policy advocacy within university curricula remains inconsistent. Identifying the knowledge and skills that healthcare and social service professionals use in policy advocacy supports the development of educational competencies to achieve entry-to-practice objectives. A review of the literature published on the topic of public policy advocacy in higher education was undertaken to determine the current state of this evidence.

Methods: For this scoping review, CINAHL, Scopus, and …

Identifying The Enzyme Involved In Vacuolar Atpase Acetylation During Doxorubicin-Induced Cardiotoxicity, Rebecca Dang, Tianqing Peng

Western Research Forum

Doxorubicin is an established anticancer medication infamous for its bright colouration and extremely toxic side effects. Emerging studies support that the imbalance between acetylation and deacetylation disrupts the autophagic flux leading to doxorubicin-induced cardiotoxicity. Vacuolar ATPases are a family of electrogenic proton pumps present on the lysosomal membrane that create an acidic environment for proteases to degrade proteins. Our preliminary study found that acetylated Vacuolar ATPase subunit V₀ D1 levels increased in doxorubicin-injected mouse hearts. However, it is unknown how acetylation of subunit V₀ D1 is modulated and whether this modification plays a role in doxorubicin-induced cardiotoxicity.

The …

Does Improved Physical Function Following A Nustep® Seated All Extremity Exercise Intervention Reduce The Fear Of Falling And Improve Quality Of Life In Older Adults With Fear Of Falling Living In Community Care Homes?, Navjot Gill, Denise Connelly

Western Research Forum

Background:

Decreased physical activity associated with fear of falling invokes a dangerous cycle of more fear, reduced activity and falls. NuStep is a seated all-extremity recumbent cross trainer which provides safe and efficient exercise training.

Hypotheses/Objectives:

The objectives of this study are to:

i. improve physical function and mobility of older adults living with a fear of falling with a NuStep;

ii. assess change in self-reported fear of falling and quality of life before and after the exercise intervention; and

iii. determine whether there is a relationship between exercise-related improved physical function/mobility with change in fear of falling and/or quality …

Role Of Gp120 Glycosylation In Sexual Transmission Of Hiv, Yingxue Sun, Adam Meadows, Najwa Zebian, Eric Arts, Carole Creuzenet

Western Research Forum

Background:

In chronic HIV patients, the viral populations are genetically diverse due to mutations introduced by the viral reverse transcriptase during HIV replication. However, more than 80% new infections result from single transmission founder (TF) viruses; therefore, targeting the TFs is key to control AIDS worldwide.

Gp120 is a glycosylated envelope protein required for HIV infection, propagation, and transmission. Glycans on gp120 influence HIV infectivity through their interactions with lectins, the carbohydrate-binding immune proteins in the host mucosa. To transmit sexually, viruses must overcome the lectin traps to access more target T cells.

Hypothesis:

TF viruses are less likely to …

An Application Of The Modifiable Areal Unit Problem: Optimizing Cluster Method Parameters To Produce Predictive Data For Hiv Outbreaks, Connor J. Chato, Art Fy Poon

Western Research Forum

Background

A popular approach to study HIV outbreaks is to cluster cases based on genetic similarity. However, there is no widely-used statistical criterion which optimizes the parameters for sequence-based clustering methods. The relationship between a cluster-defining similarity threshold and it’s associated set of clusters can be analogized to the aggregation level in the Modifiable Areal Unit Problem (MAUP).

Hypothesis

Based on the selection of aggregation level for study partitions in MAUP, we present a statistical framework to optimize the similarity threshold for pairwise distance algorithm TN93 (http://github.com/veg/tn93). We hypothesize that defining this threshold includes case connections such that …

The Wet Bridge Transfer System: An Novel In Vitro Tool For Assessing Exogenous Surfactant As A Pulmonary Drug Delivery Vehicle, Brandon J. Baer

Western Research Forum

Background:

Due to its complex branching structure, direct drug delivery to the remote areas of the lung is a major challenge. Consequently, most therapies, such as those treating pulmonary infection and inflammation, must utilize large systemic dosing, with the potential for adverse side effects. A novel alternative strategy is to use exogenous surfactant, a material capable of distributing throughout the lung, as a pulmonary drug delivery vehicle.

Objective:

Utilize an in vitro transferring system to assess exogenous surfactant (BLES) as a pulmonary delivery vehicle for different therapeutics.

Methods:

An in vitro technique was developed to simultaneously study surfactant delivery and …

Psychometric Properties Of Standardized Balance Confidence, Fear Of Falling, And Falls-Efficacy Measures In People With Lower Limb Amputations, Jack Y. Wang, Susan W. Hunter, Ricardo Viana, Jeffrey D. Holmes, Michael Payne

Western Research Forum

Background:

In Canada, >50% of community-dwelling lower limb amputees (LLA) fall at least once each year, a rate that is almost twice that of community-dwelling older adults. While the physical consequences of falls may be readily apparent, psychological sequelae that follow may be just as, if not more, detrimental than an actual fall itself. Current measures of balance confidence show no change in LLA following discharge from rehabilitation. The limited detectable change may be due to content validity challenges of the measures as they were not developed for the unique challenges faced by LLA.

Objectives:

1) Review items from standardized …

Depression Affects Recovery Following Distal Radius Fracture: A Latent Class Analysis, Shirin Modarresi, David M. Walton, Joy C. Macdermid

Western Research Forum

Background: Most people recover within six months following distal radius fractures (DRFs) but some experience pain and disability for one year or longer. Therefore, it is important to understand the factors that can help predict recovery. According to the biopsychosocial model of pain, psychological aspects of a condition can play important roles in explaining recovery.

Objectives: To identify the recovery trajectories of patients with DRFs and to determine the degree to which depression affects these trajectories.

Methods: Recovery was assessed in 318 patients using the Patient-Rated Wrist Evaluation scale at baseline, three, six, and 12 months. Demographic information was collected …

Where On Ice? Algorithmically Deconstructing Nhl Shot Locations As A Method For Player Classification, Devan Becker, Douglas G. Woolford, Charmaine B. Dean

Western Research Forum

Where do hockey players shoot from? How does this vary from player to player? We present the results of a study that uses data-driven statistical methods to investigate these questions. The locations of shots by National Hockey League (NHL) players from 2011 to 2017 are analyzed using a combination of an image recognition algorithm and spatial statistical methodology. An unsupervised classifier is applied to output from a spatial point process model in order to determine which shot locations best characterize a given player. We define the number of regions a priori, but the image recognition algorithm chooses the shape …

Phylogenetic Estimates Of Hiv-1 Gp120 Indel Rates Across The Group M Subtypes, John Palmer, Art Poon

Western Research Forum

Insertions and deletions (indels) in the HIV-1 envelope glycoprotein gp120 play a significant role in the evolution of HIV pathogenesis and transmission fitness. While substitution rates in HIV-1 are well characterized by phylogenetic models, there is a lack of quantitative measures of indel rates in HIV-1. Here we use a dated-tip phylogenetic analysis of gp120 sequences to estimate indel rates for 7 subtypes and CRFs of HIV-1 group M.

We obtained and processed 26,359 HIV-1 gp120 sequences from the Los Alamos National Laboratory HIV Sequence database. After filtering these sequences, we extracted the conserved and variable regions from the remaining …

Mouse Performance On A Novel Touchscreen Continuous Performance Task Is Dependent On Signaling In The Prelimbic Cortex, Tyler D. Dexter, Daniel Palmer, Amy C. Reichelt, Anita Taksokhan, Lisa M. Saksida, Tim J. Bussey

Western Research Forum

Attention is the cognitive processing that facilitates the ability to target and attend to relevant environmental stimuli, while filtering out irrelevant or distracting stimuli. Control over selective attention is theorized to be dependent on organized neural communication that stems from the medial prefrontal cortex (mPFC). To evaluate selective and sustained attention, mice were trained on the novel touchscreen rodent continuous performance task (rCPT), a task designed to emulate the human CPT. In the rodent version, images are continuously presented on a touchscreen, where mice have been trained to selectively respond to one image type while suppressing responses to all others. …

Dairy Intake And Cognitive Function In Canadian Older Adults, Mariam R. Ismail Miss, Alan Salmoni

Western Research Forum

Background: Dietary intake is one of the modifiable factors that may affect older adults’ cognitive function in their later years. Few research has considered the potential role of dairy foods on cognitive function. Methods: Across-sectional study was undertaken in 2014. Cognitive function was assessed using The Montreal Cognitive Assessment (MoCA), Rey Complex Figure Test and Recognition Trial (RCFT), Trail-Making Test (TMT), Victoria Stroop Test (VST) and the Digit Span Test (DST). Dietary intake was assessed via estimated 5-day food intake records and analyzed for saturated fat, vitamin D and calcium. Results: A total of 32 participants (8 males and 24 …

Using Molecular Dynamics To Study Qs21 Interactions And Penetration Of Lipid-Cholesterol Bilayers, Sarai Guerrero, Mikko Karttunen

Western Research Forum

Saponins have been used as adjuvant agents for decades in vaccines and therapies, but none are as well studied or heavily used as QS-21. This achievement is notwithstanding the fact that QS-21 usage is limited by its stability, toxicity, and scarcity. These shortcomings have only pushed researchers to develop and experiment with artificial recreations of the saponin to harness its unique benefits. A considerable number of research hours have been poured into this topic, but like QS-21 there is a shortcoming here as well. The number of articles that look at QS-21 interactions with the bilayer or the conditions under …

Cell-Free Dna Release During Programmed Cell Death In Ischemia Reperfusion Injury, Alexander Dionne, Anthony M. Jevnikar, Zhu-Xu Zhang

Western Research Forum

Transplantation is invariably associated with acute allograft injury caused by ischemia reperfusion injury (IRI). This injury causes cells of the allograft to undergo various forms of programmed cell death including apoptosis and necroptosis. During programmed cell death, immunogenic molecules are released from cells, one of which is cell-free DNA (cfDNA). We hypothesize that cfDNA is released by microvascular endothelial cells (MVECs) during programmed cell death of IRI and that cfDNA acts as both a biomarker for cellular injury as well as a biologically active molecule capable of amplifying inflammation and organ injury.

Our results indicate that cfDNA is released by …

Pparg Signaling In The Nucleus Accumbens Regulates Mesolimbic Dopamine Activity, Tony Jung, Roger Hudson, Hanna Szkudlarek, Walter Rushlow, Steve Laviolette

Western Research Forum

Background: The mesolimbic dopamine system consists of dopamine neuron projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAc). The NAc regulates VTA dopamine release through inhibitory GABA projections to the VTA. Hyperactive mesolimbic dopamine signaling is implicated in anxiety. Cannabidiol, a compound found in cannabis, demonstrates promising therapeutic potential for anxiety through the regulation of the mesolimbic dopamine system. Previous studies have revealed that cannabidiol infusions into the NAc decreases mesolimbic dopamine activity - potentially through the inhibitory GABA signaling to the VTA. However, the receptor mechanism in the NAc through which CBD produces its effects is …

Exercise To Combat Neurocognitive Decline In Older Adults, Joyla Furlano

Western Research Forum

Background: Older adults with type 2 diabetes (T2D) experience cognitive decline and neural atrophy, and therefore are at high risk for developing dementia. Consequently, older adults at-risk for developing T2D (i.e., overweight or pre-diabetic individuals) are at higher risk for cognitive decline, and intervening at this point may prevent or delay the onset of such decline. One promising lifestyle intervention that may improve neurocognitive function is exercise. For example, 6 months of aerobic training improves cognitive function in overweight or pre-diabetic older adults, but research has not examined whether resistance training (RT) can produce comparable results in this population.

Hypothesis: …

Obstacle Negotiation And Dual-Tasking In People With A Unilateral Transtibial Amputation., Humberto Omana, Michael Payne, Ricardo Viana, Susan Winnifred Hunter

Western Research Forum

Background: Falls in people with a lower limb amputation (PLLAs) are common and most often occur while walking, resulting in physical and psychological consequences that adversely affect quality of life. Walking is a complex motor task requiring cognitive resources. Due to walking with a prosthesis, PLLAs report focussing on every step they take, indicating greater cognitive needs. However, cognitive resources are limited, and most of our everyday activities also involve the simultaneous performance of motor and cognitive tasks, known as dual-tasking. The inter-relationship between mobility, cognition and postural stability in PLLAs using a prosthesis is just starting to be understood. …

The Effect Of Sepsis On Cerebral Microvascular Blood Flow, Laura Mawdsley, Mamadou Diop, Chris G. Ellis

Western Research Forum

Background: Sepsis is a dysregulated host response to infection that affects 18 000 000 people worldwide, and over 325 000 000 dollars are spent treating sepsis in Canada every year. One of the symptoms of severe sepsis is an altered mental state, which is accompanied with a measured decrease in oxygen levels in the skeletal muscle microvasculature. It is hypothesized that his altered mental state is due to a lack of oxygenated blood reaching the brain.

Hypothesis: After the onset of sepsis, microvascular cerebral blood flow and oxygen levels in the blood will decrease. Onset of decreased blood flow in …

Canadian Undergraduate Nursing Students' Experiences Of Learning Indigenous Health, Ivy Tran

Western Research Forum

Western Research Forum Abstract Submission

Canadian Undergraduate Nursing Students’ Experiences with Learning Indigenous Health

Background
The purpose of this study is to better understand undergraduate nurses’ experiences in learning about Indigenous health. This will determine what changes are needed within nursing education locally and across Canada. Implications for nursing education, research, practice, policy, and leadership will be drawn to provide pragmatic suggestions in improving Indigenous health status and outcomes. A qualitative study will be conducted using critical ethnography and semi-structured interviews to determine facilitators and barriers to learning about Indigenous health.

Methods
Critical ethnography will be utilized to examine 12 …

Factors Affecting Nurses’ Job Satisfaction In Rural And Urban Acute Care Settings: A Prisma Systematic Review, Yasin Yasin, Mickey Kerr, Carol A Wong, Charles H. Bélanger

Western Research Forum

This review aims to systemically describe the findings of primary studies in order to identify the intrinsic and extrinsic factors that affect nurses’ job satisfaction using PRISMA guidelines. It also aims to analyze the finding according to the two-factor theory; and compare studies based on rural and urban settings.

Two reviewers completed study selection, screening, and quality assessment. After data extraction, content analysis was used to categorize identified factors into themes.

Thirty-eight studies were selected for this review. Extrinsic factors reported in the findings were: work conditions (n=17), monetary benefits (n=5), hospital policies (n=6), supervision (n=7), interpersonal relationships (n=8), organization …

Quantifying Physical And Psychological Outcomes After Periprosthetic Femoral Fracture In Older Adults, Rifat Islam, Brent Lanting, Susan Hunter, Somerville Lyndsay

Western Research Forum

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and effective treatments for osteoarthritis. Falls risk is increased after these surgeries due to age, proprioceptive changes and leg weakness. One devastating consequence of falling after these surgeries, both functionally and psychologically, is a peri-prosthetic femoral fracture (PFF). Existing research on PFF has focused on surgical management and not the functional or psychological impacts to the person after this injury.

Hypothesis/Objectives: The study objectives are: 1) To evaluate the subjective and objective functional and psychological outcomes after sustaining a PFF, and 2) to estimate the prevalence of falls …

Changes In The Left Atrial-Esophageal Relationship With The Insertion Of An Esophageal Protective Device: A Cadaveric Imaging Study, Akmal Shahzad, Charys M. Martin, Michele L. Barbeau

Western Research Forum

Background: Atrial fibrillation is the most common cardiac rhythm disorder in North America and is frequently treated by a minimally invasive procedure called catheter ablation. A rare, but often fatal complication of this procedure is development of an atrial-esophageal fistula (AEF) due to the proximity of the esophagus to the left atrium (LA) of the heart. Esophageal protective devices may potentially mitigate the risk of developing an AEF but their impact on the relationship between the esophagus and LA is unknown. This study will investigate the relevant anatomical changes that occur upon insertion of an esophageal protective device.

Methods: 13 …

Executive Functioning Deficits Following Right Hemisphere Brain Damage: A Systematic Review, Ghalia Albakri

Western Research Forum

Background:

A growing body of literature has indicated that various executive functioning (EF) abilities are compromised subsequent to right hemisphere brain damage (RHD). EF supports communication and other complex daily activities via planning, monitoring, and controlling other cognitive processes to accomplish goal-oriented behaviors. Individuals with intact EF can achieve desirable tasks through fine cognitive control. The ability to use and understand pragmatics and discourse is dependent on one or more of these EF abilities. Consequently, if one of these cognitive abilities is impaired, communication challenges are expected.

Hypotheses/Objectives:

The goals of this systematic review are to: (a) examine the RHD …

Head Injury Risk And Car Seat Use For Children In Collisions, Peyton A. Schroeder, M.J. Skhurm, D. Fraser, K. Mcclafferty

Western Research Forum

Background: Motor vehicle collisions (MVCs) are the leading cause of death for people under the age of 17 years. Almost 80% of rear seat motor vehicle passengers are children. Previous studies have shown that a large fraction of injuries to children in MVCs involved the head and chest. In this study, the hypothesis that children under the age of eight using a forward-facing child restraint system (FFCRS) will have more severe head injuries than children using any other type of restraints in an MVC was tested.

Methods: Several datasets obtained from Transport Canada and Level 1 Pediatric Trauma Centre emergency …

Investigating Ampk Signalling Regulation Of Autophagy In A Model Of Ovarian Tumour Dormancy, Jeremi Laski

Western Research Forum

Investigating AMPK signalling regulation of autophagy in a model of ovarian tumour dormancy

Jeremi Laski and Trevor G. Shepherd

Background:

Ovarian cancer is the most deadly gynecologic malignancy in women. A particular subset of this disease, epithelial ovarian cancer (EOC), is responsible for over 70% of all diagnosed ovarian cancer cases, yet the mechanisms governing disease progression are poorly understood. One of the unique hallmarks of EOC metastasis lies in the process of spheroid formation, whereby tumour cells aggregate into larger 3D structures. These EOC spheroids have been shown to be metabolically dormant, while concurrently up-regulating autophagy (cellular waste …

Organizational Behaviour During Instability: A Critical Discourse Analysis Of Shared Mental Model Through Various Forms Of Acute Care Learning Using Mixed Methods, Adam Morse, Ryan Chan

Western Research Forum

Background: The purpose of this study is to better understand nurses' performance based on training processes. This will determine if group training will increase performance compared to independent training through a shared mental model in a contextual setting of unpredictability mediated by the effects of nurses’ perceptions of patient safety climate. A mixed methods study is conducted using critical discourse analysis of organizational documentation and semi-structured interviews to determine measures of contextual setting when identifying and treating sex trade workers.

Methods: Pragmatic study will analyze two groups of 125 nurses each determining the impact of group and individual …

Developing Novel Therapeutics For Bacterial Lung Infections, Brandon J. Baer, Ruud Veldhuizen, Cory Yamashita

Western Research Forum

Background: Bacterial lung infections are leading causes of death worldwide. Unfortunately, increasing resistance to antibiotics and the inflammation often accompanying these infections are leading to poor outcomes despite antibiotic intervention. Complicating treatment further, the tree-like branching structure of the lung makes drug delivery to distal sites of infection difficult. Our research aims to address these challenges by developing new therapeutics and new tools to improve and assess drug delivery, bacterial killing and inflammation. Our therapy combines host defense peptides, which have been shown to kill antibiotic-resistant bacteria and down regulate inflammation, with a pulmonary vehicle, exogenous surfactant, that can improve …