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Western University

2023

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Full-Text Articles in Medicine and Health Sciences

Sasah Experiential Learning: Global Health Equity, Anjali Singh Dec 2023

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, …


Experiential Learning Final Report: Ase Leadership And Usri, Lauren Cowell Dec 2023

Experiential Learning Final Report: Ase Leadership And Usri, Lauren Cowell

SASAH 4th Year Capstone and Other Projects: Publications

This reflective journey encapsulates the profound impact of my SASAH experiential learning, encompassing roles as an ASE Transition Leader and a USRI intern during my undergraduate years. From fostering academic growth to developing practical skills applicable in professional settings, this program provided unique opportunities for multidimensional learning. Collaboration emerged as a cornerstone, teaching adaptability, resilience, and the nuances of teamwork. Engaging with professionals contributed to workplace insights and personal growth. The roles undertaken enriched my skill set, from refining public speaking to engaging in collaborative research. The CliftonStrengths framework played a pivotal role, guiding me through challenges and leveraging collective …


Sleep, Sleepiness, And Driving Performance In Healthcare Shiftworkers, Melissa Knott Dec 2023

Sleep, Sleepiness, And Driving Performance In Healthcare Shiftworkers, Melissa Knott

Electronic Thesis and Dissertation Repository

Almost half of Canadian healthcare workers are employed in rotating day/night shifts to provide essential 24-hour services. However, poor sleep quantity and quality are pervasive in shiftwork and may negatively impact cognitive functions required for driving. Furthermore, healthcare shiftworkers (HCSW) are under-represented in research examining shiftworkers’ sleep and driving performance. Thus, this dissertation examined sleep, sleepiness and driving performance in HCSW via three aims. First, chapter 2 aimed to quantify and describe HCSWs’ sleep-related driving experiences and advance the understanding of occupational adaptations used by HCSWs to meet driving demands. Second, chapter 3 aimed to quantify differences in sleep, sleepiness, …


Oral Health Inequalities In Adolescents And Young Adults In Ontario, Maria Rahman Dec 2023

Oral Health Inequalities In Adolescents And Young Adults In Ontario, Maria Rahman

Electronic Thesis and Dissertation Repository

Oral health is consistently linked to physiological, psychological, and social aspects of well-being in adolescents and young adults. In this thesis, I aimed to examine the social determinants of oral health and dental care utilization. First, I conducted a scoping review of the literature, demonstrated the multifaceted nature of oral health and its connections to broader social and economic factors. Then, I conducted a cross-sectional analysis of the Canadian Community Health Survey which showed a social gradient in oral health and dental care utilization among adolescents and young adults in Ontario. When stratified by age, there was a protective association …


A Picture Of Spirituality In Youth Living With Bipolar Disorder, Michelle S. Solomon Dec 2023

A Picture Of Spirituality In Youth Living With Bipolar Disorder, Michelle S. Solomon

Electronic Thesis and Dissertation Repository

There is a paucity of literature concerning how youth living with bipolar disorder understand and experience spirituality. The management of bipolar disorder through psychosocial interventions such as spirituality is critical due to the chronic and complex nature of the illness and the fact that pharmacotherapy has not been found to fully restore mood and quality of life (Michalak et al., 2016; Miller et al., 2014; Sanchez-Moreno et al., 2009; Stroppa & Moreira-Almeida, 2013). Spirituality has been defined as being concerned with the ultimate questions in life; the meaning in life that a person gains in relation to something bigger than …


Regulation Of Health Ai Chatbots In Ontario, Mingi Chu Dec 2023

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 …


Cognitive Decline In Thrombotic Thrombocytopenic Purpura Survivors: The Role Of White Matter Health As Assessed By Mri., F Hannan, J Hamilton, C J Patriquin, K Pavenski, M T Jurkiewicz, L Tristao, A M Owen, P K Kosalka, S C L Deoni, J Théberge, J Mandzia, S H S Huang, J D Thiessen Dec 2023

Cognitive Decline In Thrombotic Thrombocytopenic Purpura Survivors: The Role Of White Matter Health As Assessed By Mri., F Hannan, J Hamilton, C J Patriquin, K Pavenski, M T Jurkiewicz, L Tristao, A M Owen, P K Kosalka, S C L Deoni, J Théberge, J Mandzia, S H S Huang, J D Thiessen

Department of Medicine Publications

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare condition caused by severe ADAMTS13 deficiency, leading to platelet aggregation and thrombosis. Despite treatment, patients are prone to cognitive impairment and depression. We investigated brain changes in iTTP patients during remission using advanced magnetic resonance imaging (MRI) techniques, correlating these changes with mood and neurocognitive tests. Twenty iTTP patients in remission (30 days post-haematological remission) were compared with six healthy controls. MRI scans, including standard and specialized sequences, were conducted to assess white matter health. Increased T1 relaxation times were found in the cingulate cortex (p < 0.05), and elevated T2 relaxation times were observed in the cingulate cortex, frontal, parietal and temporal lobes (p < 0.05). Pathological changes in these areas are correlated with impaired cognitive and depressive scores in concentration, short-term memory and verbal memory. This study highlights persistent white matter damage in iTTP patients, potentially contributing to depression and cognitive impairment. Key regions affected include the frontal lobe and cingulate cortex. These findings have significant implications for the acute and long-term management of iTTP, suggesting a need for re-evaluation of treatment approaches during both active phases and remission. Further research is warranted to enhance our understanding of these complexities.


Polisci 3210f: Feasibility Of A National Disability Insurance Plan (Ndip) In Canada, Twana Hassan, Aditi Priya, Dylan Poole, Samantha Rubin, Ethan Chen Dec 2023

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 Dec 2023

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 …


Identifying Canonical And Replicable Multi-Scale Intrinsic Connectivity Networks In 100k+ Resting-State Fmri Datasets., A Iraji, Z Fu, A Faghiri, M Duda, J Chen, S Rachakonda, T Deramus, P Kochunov, B M Adhikari, A Belger, J M Ford, D H Mathalon, G D Pearlson, S G Potkin, A Preda, J A Turner, T G M Van Erp, J R Bustillo, K Yang, K Ishizuka, A Faria, A Sawa, K Hutchison, E A Osuch, Jean Theberge, C Abbott, B A Mueller, D Zhi, C Zhuo, S Liu, Y Xu, M Salman, J Liu, Y Du, J Sui, T Adali, V D Calhoun Dec 2023

Identifying Canonical And Replicable Multi-Scale Intrinsic Connectivity Networks In 100k+ Resting-State Fmri Datasets., A Iraji, Z Fu, A Faghiri, M Duda, J Chen, S Rachakonda, T Deramus, P Kochunov, B M Adhikari, A Belger, J M Ford, D H Mathalon, G D Pearlson, S G Potkin, A Preda, J A Turner, T G M Van Erp, J R Bustillo, K Yang, K Ishizuka, A Faria, A Sawa, K Hutchison, E A Osuch, Jean Theberge, C Abbott, B A Mueller, D Zhi, C Zhuo, S Liu, Y Xu, M Salman, J Liu, Y Du, J Sui, T Adali, V D Calhoun

Department of Medicine Publications

Despite the known benefits of data-driven approaches, the lack of approaches for identifying functional neuroimaging patterns that capture both individual variations and inter-subject correspondence limits the clinical utility of rsfMRI and its application to single-subject analyses. Here, using rsfMRI data from over 100k individuals across private and public datasets, we identify replicable multi-spatial-scale canonical intrinsic connectivity network (ICN) templates via the use of multi-model-order independent component analysis (ICA). We also study the feasibility of estimating subject-specific ICNs via spatially constrained ICA. The results show that the subject-level ICN estimations vary as a function of the ICN itself, the data length, …


Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson Dec 2023

Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: To describe the provision of care for young people following first diagnosis of psychotic disorder.

DESIGN: Retrospective cohort study using health administrative data.

SETTING: Ontario.

PARTICIPANTS: People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).

MAIN OUTCOME MEASURES: Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.

RESULTS: During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and …


Neuroimaging-Based Classification Of Ptsd Using Data-Driven Computational Approaches: A Multisite Big Data Study From The Enigma-Pgc Ptsd Consortium., Xi Zhu, Yoojean Kim, Orren Ravid, Xiaofu He, Benjamin Suarez-Jimenez, Sigal Zilcha-Mano, Amit Lazarov, Seonjoo Lee, Chadi G Abdallah, Michael Angstadt, Christopher L Averill, C Lexi Baird, Lee A Baugh, Jennifer U Blackford, Jessica Bomyea, Steven E Bruce, Richard A Bryant, Zhihong Cao, Kyle Choi, Josh Cisler, Andrew S Cotton, Judith K Daniels, Nicholas D Davenport, Richard J Davidson, Michael D Debellis, Emily L Dennis, Maria Densmore, Terri Deroon-Cassini, Seth G Disner, Wissam El Hage, Amit Etkin, Negar Fani, Kelene A Fercho, Jacklynn Fitzgerald, Gina L Forster, Jessie L Frijling, Elbert Geuze, Atilla Gonenc, Evan M Gordon, Staci Gruber, Daniel W Grupe, Jeffrey P Guenette, Courtney C Haswell, Ryan J Herringa, Julia Herzog, David Bernd Hofmann, Bobak Hosseini, Anna R Hudson, Ashley A Huggins, Jonathan C Ipser, Neda Jahanshad, Meilin Jia-Richards, Tanja Jovanovic, Milissa L Kaufman, Mitzy Kennis, Anthony King, Philipp Kinzel, Saskia B J Koch, Inga K Koerte, Sheri M Koopowitz, Mayuresh S Korgaonkar, John H Krystal, Ruth Lanius, Christine L Larson, Lauren A M Lebois, Gen Li, Israel Liberzon, Guang Ming Lu, Yifeng Luo, Vincent A Magnotta, Antje Manthey, Adi Maron-Katz, Geoffery May, Katie Mclaughlin, Sven C Mueller, Laura Nawijn, Steven M Nelson, Richard W J Neufeld, Jack B Nitschke, Erin M O'Leary, Bunmi O Olatunji, Miranda Olff, Matthew Peverill, K Luan Phan, Rongfeng Qi, Yann Quidé, Ivan Rektor, Kerry Ressler, Pavel Riha, Marisa Ross, Isabelle M Rosso, Lauren E Salminen, Kelly Sambrook, Christian Schmahl, Martha E Shenton, Margaret Sheridan, Chiahao Shih, Maurizio Sicorello, Anika Sierk, Alan N Simmons, Raluca M Simons, Jeffrey S Simons, Scott R Sponheim, Murray B Stein, Dan J Stein, Jennifer S Stevens, Thomas Straube, Delin Sun, Jean Theberge, Paul M Thompson, Sophia I Thomopoulos, Nic J A Van Der Wee, Steven J A Van Der Werff, Theo G M Van Erp, Sanne J H Van Rooij, Mirjam Van Zuiden, Tim Varkevisser, Dick J Veltman, Robert R J M Vermeiren, Henrik Walter, Li Wang, Xin Wang, Carissa Weis, Sherry Winternitz, Hong Xie, Ye Zhu, Melanie Wall, Yuval Neria, Rajendra A Morey Dec 2023

Neuroimaging-Based Classification Of Ptsd Using Data-Driven Computational Approaches: A Multisite Big Data Study From The Enigma-Pgc Ptsd Consortium., Xi Zhu, Yoojean Kim, Orren Ravid, Xiaofu He, Benjamin Suarez-Jimenez, Sigal Zilcha-Mano, Amit Lazarov, Seonjoo Lee, Chadi G Abdallah, Michael Angstadt, Christopher L Averill, C Lexi Baird, Lee A Baugh, Jennifer U Blackford, Jessica Bomyea, Steven E Bruce, Richard A Bryant, Zhihong Cao, Kyle Choi, Josh Cisler, Andrew S Cotton, Judith K Daniels, Nicholas D Davenport, Richard J Davidson, Michael D Debellis, Emily L Dennis, Maria Densmore, Terri Deroon-Cassini, Seth G Disner, Wissam El Hage, Amit Etkin, Negar Fani, Kelene A Fercho, Jacklynn Fitzgerald, Gina L Forster, Jessie L Frijling, Elbert Geuze, Atilla Gonenc, Evan M Gordon, Staci Gruber, Daniel W Grupe, Jeffrey P Guenette, Courtney C Haswell, Ryan J Herringa, Julia Herzog, David Bernd Hofmann, Bobak Hosseini, Anna R Hudson, Ashley A Huggins, Jonathan C Ipser, Neda Jahanshad, Meilin Jia-Richards, Tanja Jovanovic, Milissa L Kaufman, Mitzy Kennis, Anthony King, Philipp Kinzel, Saskia B J Koch, Inga K Koerte, Sheri M Koopowitz, Mayuresh S Korgaonkar, John H Krystal, Ruth Lanius, Christine L Larson, Lauren A M Lebois, Gen Li, Israel Liberzon, Guang Ming Lu, Yifeng Luo, Vincent A Magnotta, Antje Manthey, Adi Maron-Katz, Geoffery May, Katie Mclaughlin, Sven C Mueller, Laura Nawijn, Steven M Nelson, Richard W J Neufeld, Jack B Nitschke, Erin M O'Leary, Bunmi O Olatunji, Miranda Olff, Matthew Peverill, K Luan Phan, Rongfeng Qi, Yann Quidé, Ivan Rektor, Kerry Ressler, Pavel Riha, Marisa Ross, Isabelle M Rosso, Lauren E Salminen, Kelly Sambrook, Christian Schmahl, Martha E Shenton, Margaret Sheridan, Chiahao Shih, Maurizio Sicorello, Anika Sierk, Alan N Simmons, Raluca M Simons, Jeffrey S Simons, Scott R Sponheim, Murray B Stein, Dan J Stein, Jennifer S Stevens, Thomas Straube, Delin Sun, Jean Theberge, Paul M Thompson, Sophia I Thomopoulos, Nic J A Van Der Wee, Steven J A Van Der Werff, Theo G M Van Erp, Sanne J H Van Rooij, Mirjam Van Zuiden, Tim Varkevisser, Dick J Veltman, Robert R J M Vermeiren, Henrik Walter, Li Wang, Xin Wang, Carissa Weis, Sherry Winternitz, Hong Xie, Ye Zhu, Melanie Wall, Yuval Neria, Rajendra A Morey

Department of Medicine Publications

BACKGROUND: Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. However, current machine learning studies limited to small homogeneous samples, different methodologies, and different imaging collection protocols, limit the ability to directly compare and generalize their results. Here we aimed to classify individuals with PTSD versus controls and assess the generalizability using a large heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group.

METHODS: We analyzed brain MRI data from 3,477 structural-MRI; 2,495 resting state-fMRI; and 1,952 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls …


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 Nov 2023

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 Nov 2023

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 Nov 2023

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 …


A Tale Of Two Targets: Examining The Differential Effects Of Posterior Cingulate Cortex- And Amygdala-Targeted Fmri-Neurofeedback In A Ptsd Pilot Study, Jonathan M. Lieberman, Daniela Rabellino, Maria Densmore, Paul Frewen, David Steyrl, Frank Scharnowski, Jean Theberge, Niki Hosseini-Kamkar, Richard W.J. Neufeld, Rakesh Jetly, Benicio N. Frey, Tomas Ros, Ruth A. Lanius, Andrew A. Nicholson Nov 2023

A Tale Of Two Targets: Examining The Differential Effects Of Posterior Cingulate Cortex- And Amygdala-Targeted Fmri-Neurofeedback In A Ptsd Pilot Study, Jonathan M. Lieberman, Daniela Rabellino, Maria Densmore, Paul Frewen, David Steyrl, Frank Scharnowski, Jean Theberge, Niki Hosseini-Kamkar, Richard W.J. Neufeld, Rakesh Jetly, Benicio N. Frey, Tomas Ros, Ruth A. Lanius, Andrew A. Nicholson

Department of Medicine Publications

Introduction: Real-time fMRI-based neurofeedback (rt-fMRI-NFB) is a non-invasive technology that enables individuals to self-regulate brain activity linked to neuropsychiatric symptoms, including those associated with post-traumatic stress disorder (PTSD). Selecting the target brain region for neurofeedback-mediated regulation is primarily informed by the neurobiological characteristics of the participant population. There is a strong link between PTSD symptoms and multiple functional disruptions in the brain, including hyperactivity within both the amygdala and posterior cingulate cortex (PCC) during trauma-related processing. As such, previous rt-fMRI-NFB studies have focused on these two target regions when training individuals with PTSD to regulate neural activity. However, the differential …


Jumping Ship And Going To The Other Side: Experiences Of Nurses Who Retrain As Doctors, Anne Robinson Nov 2023

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 …


The Significance Of Injuries And Anatomical Patterns Of Trauma In Pedestrian And Cyclist Fatalities And Their Association With Motor Vehicle Collision Dynamics And Post-Collision Kinematics, Moheem M. Halari Nov 2023

The Significance Of Injuries And Anatomical Patterns Of Trauma In Pedestrian And Cyclist Fatalities And Their Association With Motor Vehicle Collision Dynamics And Post-Collision Kinematics, Moheem M. Halari

Electronic Thesis and Dissertation Repository

Deaths from motor vehicle collisions (MVCs) are a major global health concern, with over 1.35 million fatalities reported annually by the United Nations. More than half involve pedestrians, cyclists, and motorcyclists. Post-mortem examinations by pathologists determine the cause of death and mechanisms of injury and play a significant role in the investigation of the deaths of vulnerable road users.

The purpose of this study was to understand the injury patterns sustained by pedestrians and cyclists fatally injured in motor vehicle impacts.

This study reviews the development of injury patterns described in the medical literature and identifies their limitations in the …


Transformational Leadership Approach For Encouraging Historically Marginalized Communities To Access Admission To Naturopathic Medicine, Baljit Khamba Nov 2023

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 …


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 Nov 2023

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 …


The Predictors Of Multimorbidity (Defined As Diabetes + Hypertension) Amongst Males Aged 15-54 In India: An Analysis Of The Nfhs-5, Vikramjit Brar Nov 2023

The Predictors Of Multimorbidity (Defined As Diabetes + Hypertension) Amongst Males Aged 15-54 In India: An Analysis Of The Nfhs-5, Vikramjit Brar

Electronic Thesis and Dissertation Repository

Research Question: “What are the predictors of multimorbidity (defined as having diabetes + hypertension) amongst males aged 15-54 in India?”

Methods: Using mixed-effect multi-level binary logistic regression models, data from the 2019-2021 India NFHS-5 were analyzed. Separate multivariable analyses were conducted for males from urban and rural areas so the association between common predictors of interest (sociodemographic & lifestyle), and multimorbidity could be determined.

Results: Various predictors (listed below) were found to have a statistically significant association to multimorbidity with some variation across urban and rural areas:

Urban areas: Age, region of residence, wealth, religion, occupation, and …


Social Capital Associates With Better Cognitive Health, Oral Health And Epigenetic Age Deceleration: Findings From The Canadian Longitudinal Study On Aging., Aileen Liang, Noha Gomaa Nov 2023

Social Capital Associates With Better Cognitive Health, Oral Health And Epigenetic Age Deceleration: Findings From The Canadian Longitudinal Study On Aging., Aileen Liang, Noha Gomaa

Department of Medicine Publications

Background: Social exposures are linked to an array of health outcomes, especially around aging. In this study, we examined the association of social capital, defined as social relationships and networks, with clinical and biological outcomes including cognitive health, oral inflammation, and epigenetic aging. Methods: We used data from the Canadian Longitudinal Study on Aging (CLSA) (n =1,479; aged 45–85 years), categorizing social capital as structural and cognitive capital. Oral inflammation was determined as the presence of gum bleeding. Epigenetic aging was computed as the difference between chronological age and DNA methylation age. We constructed multivariable regression models adjusted for covariates …


Interaction Of Circularrna And Microrna-9-5p In The Mediation Of Cardiac Fibrosis In Diabetic Cardiomyopathy, Honglin Wang Nov 2023

Interaction Of Circularrna And Microrna-9-5p In The Mediation Of Cardiac Fibrosis In Diabetic Cardiomyopathy, Honglin Wang

Electronic Thesis and Dissertation Repository

Diabetic cardiomyopathy (DCM) is a chronic diabetic complication affecting the heart. It is a significant and independent contributor to heart failure and characterized by cardiac fibrosis and left ventricular hypertrophy. Endothelial cells are the first cells to be damaged by hyperglycemia, leading to epigenetic modifications and subsequent signaling and transcription derangements that lead to endothelial dysfunction and therefore cardiac fibrosis. The role of the two noncoding RNA microRNA-9-5p and circRNA_012164 are investigated using in vivo and in vitro models of hyperglycemia. CircRNA_012164 is upregulated in the hearts of diabetic mice and in cells exposed to high glucose. This results in …


Multi-Arm Randomized Control Trials In Inflammatory Bowel Disease: A Literature Review And An Illustration Of Methods For Analysis, Sahiba Saini Nov 2023

Multi-Arm Randomized Control Trials In Inflammatory Bowel Disease: A Literature Review And An Illustration Of Methods For Analysis, Sahiba Saini

Electronic Thesis and Dissertation Repository

This thesis aimed to review the literature on multiple-arm randomized control trials in inflammatory bowel disease (IBD) and to illustrate how to analyze these trials, focusing on appropriately controlling the type 1 error rates. The literature review found 247 trials published from the inception of each database to April 2014, of which 122 (49%) trials were multiple-arm trials and of those, 59 (48%) trials were on ulcerative colitis and 63 (52%) on Crohn’s disease. A published assessment tool was adopted to assess whether controlling of Type I error rates was needed. Despite the common use of this trial design and …


The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms. Nov 2023

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 …


Exploring Level Ii Nicu Case Study Research Challenges: Embracing The Proposal Journey, Engaging In Retrospective Pragmatic Reflection On Challenges, And Enhancing Research Within Graduate Education And The Profession Of Massage Therapy, Amanda R. Winter Nov 2023

Exploring Level Ii Nicu Case Study Research Challenges: Embracing The Proposal Journey, Engaging In Retrospective Pragmatic Reflection On Challenges, And Enhancing Research Within Graduate Education And The Profession Of Massage Therapy, Amanda R. Winter

Electronic Thesis and Dissertation Repository

Background

Infants born preterm and low birth weight face health risks; studies demonstrate massage therapy (MT) promotes weight gain and earlier hospital discharge. A gap remains in understanding the role of massage in preterm care within Canada.

Research Methods and Theoretical Orientation – Part A

Case study methodology is proposed to examine the nature of MT as a healthcare intervention within an Ontario Level II Neonatal Intensive Care Unit. Constrained by a Master’s program’s two-year time limit and contextual challenges, the project could not secure support.

Research Methods and Theoretical Orientation – Part B

Introducing a retrospective pragmatic reflective approach, …


The Lived Experience Of Persons With Parkinson's Disease In Non-Contact Boxing Programs, Laura Mulder Nov 2023

The Lived Experience Of Persons With Parkinson's Disease In Non-Contact Boxing Programs, Laura Mulder

Electronic Thesis and Dissertation Repository

We conducted a scoping review to identify articles examining non-contact boxing programs for persons with Parkinson’s disease (PwP). Results suggested that gait, mobility, balance, and quality-of-life were the most-studied outcomes. Many qualitative articles explored the experience within in-person boxing programs, but no articles explored experiences within virtual boxing programs. We followed this review with an interpretative phenomenological analysis aimed at addressing this research gap and interviewed six PwP who had engaged with both virtual and in-person Rock Steady Boxing programming. Results suggested that although the virtual setting improved elements of the individual experience, the physical and social aspects were better …


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 Nov 2023

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 Fans In Training Graduate Program (Hfit Grad): Process Evaluation Of An Add-On Fitness Program For Hfit Participants, Robert Petrella, Marisa Kfrerer, Olivia Crozier, Brendan Riggin, Wendy Blunt, Dawn P. Gill, Brooke Bliss Nov 2023

Hockey Fans In Training Graduate Program (Hfit Grad): Process Evaluation Of An Add-On Fitness Program For Hfit Participants, Robert Petrella, Marisa Kfrerer, Olivia Crozier, Brendan Riggin, Wendy Blunt, Dawn P. Gill, Brooke Bliss

Department of Medicine Publications

Context: Approximately 1 in 4 Canadian adults are living with obesity, indicating a need to provide accessible, sustainable, and locally tailored programs to manage the disease long-term. HFIT Grad was a 6-week exercise and physical activity pilot program offered to previous participants who completed Hockey FIT (a 12-week healthy lifestyle program for male hockey fans who were overweight or had obesity) within the last 12 months. Objective: Evaluate the acceptability of HFIT Grad for promoting maintenance of health behaviours developed in Hockey FIT. Study Design and Analysis: Participants who completed HFIT Grad (n=27) were invited to participate in a virtual …


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 Nov 2023

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 …