Medicine and Health Sciences Commons^™

Establishing The Minimum Clinically Important Difference (Mcid) Of The Quality Of Life In Childhood Epilepsy Questionnaire (Qolce-55), Mariela Leda

Electronic Thesis and Dissertation Repository

The Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) is a validated, parent-reported measure of health-related quality of life (HRQOL) in children with epilepsy (CWE). The QOLCE-55 currently has no minimum clinically important difference (MCID), which is the minimum amount of change required to be considered meaningful to patients. The primary objective of this study was to estimate the MCID for the QOLCE-55 using the Making Mindfulness Matter© in Children with Epilepsy trial data. Parent-child dyads (n=66) completed the QOLCE-55 at baseline (week 0) and follow-up (week 9). MCID values for the QOLCE-55 were calculated using two types of methods: …

Adverse Effects And Pharmacokinetic Characteristics Of High-Dose Glucocorticoid Treatment In Children With Rheumatic Diseases, Renee X. Pang

Electronic Thesis and Dissertation Repository

This integrated-article thesis explores the impact of long-term glucocorticoid (GC) therapy on children with RD. Long-term GC treatment is potentially associated with severe adverse drug reactions (ADRs). Our scoping review summarizes the current evidence health-related quality of life (HRQOL) impacts of this treatment on children with RD. We describe the frequency of ADRs related to long-term GC treatment in a convenience sample of pediatric RD patients on long-term prednisone therapy and evaluate clinical characteristics that may be associated with risk for of GC-related ADRs. Lastly, we present a pilot study to evaluate the feasibility of monitoring GC PK in children …

Return To Play: Impact Of Urbanicity And Socioeconomic Status On Parents’ Attitudes Regarding Their Children's Play And Sport During The Covid-19 Pandemic, Kendall Saravanamuttoo

Electronic Thesis and Dissertation Repository

The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. The primary aim of this study was to explore the influence of socioeconomic status (SES) and urbanicity on parents’ attitudes toward their children’s active play opportunities 6 months and 1.5 years into COVID-19. The secondary objective was to explore how parents’ attitudes at 6 months related to the structured and unstructured play opportunities that children returned to 1 year later, while moderating the effects of SES and urbanicity. A sample of 239 Ontario parents of children (< 12) completed two online surveys (August – December 2020; 2021). In general, parents in communities with urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents of lower-income were more hesitant to return their children to active play during the pandemic. Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.

Perspectives Of Middle Eastern Immigrant Parents Regarding Accessing Healthcare Services For Children During The Covid-19 Pandemic In London, Ontario, Sarvenaz Mehrabi

Electronic Thesis and Dissertation Repository

Background: During the COVID-19 pandemic, immigrants have been disproportionally affected and faced difficulties in accessing healthcare services. While it has been reported that the rate of pediatric healthcare utilization decreased during the COVID-19 pandemic, the reasons behind this decline are unclear. It has been suggested that immigrant children might be affected by the COVID-19 pandemic restrictions regarding accessing healthcare services. This study aims to understand the Middle Eastern immigrant parents’ perspectives regarding their access to healthcare services for their children in the London, Ontario, area during the COVID-19 pandemic.

Methods: This qualitative study was conducted with an interpretive description methodology …

Piloting A Study To Examine Children’S Understandings Of Chronic Pain And Coping, Kristina P. Ferreira

Electronic Thesis and Dissertation Repository

Many of our understandings of how children conceptualize and cope with chronic pain are drawn from adult accounts or extrapolated from research in adult populations. Accordingly, there is scant knowledge relating to children’s own experiences of chronic pain and coping. This study begins to address this gap by piloting a methodology combining arts-based methods with semi-structured interviews to generate data with children aged 6-13 years. Participants with chronic pain were invited to draw and/or photograph what represents a ‘good pain day’ and ‘a bad pain day’, before engaging in a tailored, semi-structured interview. Results, interpreted using a constructivist lens, contribute …

Long-Term Behavioural Problems In Youth With Childhood-Onset Epilepsy, Rebecca Grace Couper

Electronic Thesis and Dissertation Repository

Children with epilepsy are impacted far beyond having seizures, as children with epilepsy often have more psychiatric and behavioural problems than the general population. Whether these problems remain at elevated rates in the long-term is unclear. This study revealed that the prevalence of long-term behavioural problems in youth with childhood-onset epilepsy did not differ significantly from the assessment normative data. Multivariable regression was used to assess associations of baseline and current characteristics with long-term behavioural problems. No associations with baseline characteristics were found, but current attitude towards epilepsy was associated with total, internalizing, and externalizing behavioural problems while seizure control …

Investigating Physiological Determinants Of Mental Health In Children With Cerebral Palsy, Daniela A. Testani

Electronic Thesis and Dissertation Repository

Background

Fifty-seven percent of children with cerebral palsy (CP) experience mental health symptoms including symptoms of anxiety and depression. Although CP is non progressive, secondary conditions can have progressive effects on an individuals’ functional abilities. Particularly, untreated mental health symptoms can negatively affect a child’s quality of life. Children with CP also experience fatigue, pain, poor physical activity, and sleep disturbances. The presence of these physiological symptoms, separate and in combination, may impact mental health; however, it has not been systematically examined. Identifying factors that contribute to mental health symptoms may prevent the maintenance of these issues into adulthood.

Objectives …

A Novel Spatio-Temporal Examination Of Children's Accessibility, Exposure, And Engagement To Parks And Recreation Spaces In Middlesex-London, Ontario, Malcolm K. Little

Electronic Thesis and Dissertation Repository

Children are spending more free time engaged in activities indoors, rather than in outdoor environments such as parks and recreation spaces. Parks and recreation spaces provide amenities that promote physical, cognitive, and social health among children. As it relates to the complexities of children’s living situations, properly measuring children’s levels of interactions with these spaces is poorly understood in geography research.

By examining various attributes of children, this thesis improves on the measurement of children’s levels of interactions with parks and recreation spaces. Research herein utilized household survey data, a high-resolution GIS dataset of environmental factors, and GPS logs from …

Investigating Children's Experiences And Participation In A Free Community-Based Physical Activity Program: The Grade 5 Act-I-Pass, Emma E. Ostermeier

Electronic Thesis and Dissertation Repository

Physical activity is an important component of children’s health and development; however, a majority of Canadian children are not meeting the physical activity recommendations. This thesis aimed to identify the factors that influenced children’s enrollment and participation in a free community-based physical activity program, the Grade 5 ACT-i-Pass (G5AP). This thesis consisted of two individual, but interrelated studies. First, focus groups with G5AP participants were used to explore the factors that influenced children’s perceived physical activity levels and participation in the program. Second, a spatially-targeted promotional campaign was developed and implemented to help evaluate the impact of promotions on program …

Evaluating The Implementation Of The Centrally Procured School Food Program (Cpsfp) In Southwestern Ontario Elementary Schools, Mariam R. Ismail

Electronic Thesis and Dissertation Repository

School food programs can improve children’s health and well-being, while also creating economic opportunities for local food systems. Program evaluations of such interventions have always been done, but from the perspectives of their effectiveness. Yet, few have thoroughly examined the process or implementation practices of these interventions. The aim of this dissertation was to evaluate the implementation of the Centrally Procured School Food Program (CPSFP), a procurement and delivery-based school food program in Southwestern Ontario, that aims to improve elementary school-aged children’s intake of fruit and vegetables (FVs). Canada remains one of the few industrialized nations without a national school …

The Impact Of School Nutrition Policy On Diet Quality Of Children And Youth In Canada, Victoria Gaudin

Electronic Thesis and Dissertation Repository

Improving diet quality is an important public policy initiative targeted to enhance population health worldwide. In this regard, school nutrition policy is an important means to promote healthy diet among children and youth. In Canada, six provinces implemented mandatory school nutrition policies at different times between 2005 and 2011. We investigated the impact of mandatory school nutrition policy on diet quality of Canadian children and youth using a quasi- experimental study design. Using 24-hour dietary recall data from the 2004 Canadian Community Health Survey (CCHS) Cycle 2.2 and 2015 CCHS-Nutrition, we constructed the Diet Quality Index (DQI). We used multivariable …

Examining Geographic Variation In Children's Perceived Barriers To Physical Activity And The Implications On Behaviour, Leah Gabrielle Taylor

Electronic Thesis and Dissertation Repository

Low levels of physical activity among Canadian children has become a national public health issue. Recent research has suggested that children’s physical activity levels are associated with their perceptions of their everyday environments. A better understanding of the formation of these perceptions within different contexts is needed to explain the extent of the relationship. Using a multi-tool quantitative protocol, this thesis examines geographic variation in socio-ecological factors influencing children’s perceptions of barriers to PA, and the extent to which perceptions mediate the relationship of the environment and PA. Results indicate that perceptions form within contexts, and have an influence on …

Fatigue In Children And Adolescents With Duchenne Muscular Dystrophy, Basmah El-Aloul

Electronic Thesis and Dissertation Repository

Fatigue was recently reported to be the largest predictor of poor health-related quality of life (HRQOL) in children and adolescents with Duchenne muscular dystrophy (DMD). The objectives of this thesis were to describe fatigue from patients’ and parents’ perspectives and to explore associations of patient characteristics with fatigue in children and adolescents with DMD using a multicentre cross-sectional study design. Eligible patients and their parents were identified via the Canadian Neuromuscular Disease Registry and received mailed paper questionnaires. Children and adolescents with DMD experienced greater fatigue compared to healthy controls from published data. Fatigue was a significant issue in children …

Predictors Of Language Outcome For Children In The Ontario Infant Hearing Program, Olivia M. Daub

Electronic Thesis and Dissertation Repository

The Ontario Infant Hearing Program (OIHP) provides early interventions (i.e., hearing aids) to children who are hard of hearing (CHH) because research consistently demonstrates their benefit to language outcomes. The impact of pre-fitting language abilities on these outcomes are not well understood.

This retrospective cohort analysis examined the performance of OIHP children on the Preschool Language Scale-4 at the time of (n=47), and after (n=19), initial hearing aid intervention. Regression analyses revealed that, before amplification, hearing loss severity predicted language abilities. However, after amplification, severity of hearing loss did not uniquely predict language achievement, but rather …

Exploring The Conceptual Foundations Of Social Communication In Preschool And School-Aged Children, Kristen H. R. Izaryk

Electronic Thesis and Dissertation Repository

Introduction: Social communication is a complex and dynamic construct that is an important component of human functioning. However, an agreed upon conceptual understanding of social communication within the field of Speech-Language Pathology has been a persistent challenge. Among main issues that obscure our current understanding are those pertaining to terminology, classification, and the boundaries of social communication within social skill. All three impede the advancement of knowledge and sound clinical application. Therefore, the objective of the current study was to investigate the conceptual foundations of social communication.

Method: Two approaches were taken to begin to address these issues. The Delphi …

Exploring Communication Apprehension And Its Relationship To Communication Attitude And Socio-Communicative Functioning In Children With Velopharyngeal Insufficiency, Agnieszka Dzioba

Electronic Thesis and Dissertation Repository

Myriad findings on children with velopharyngeal insufficiency (VPI) indicate the potential for this population of children to experience feelings of apprehension specific to communication and the potential for other psychological and social difficulties. The purpose of the present investigation was to explore the construct of communication apprehension (CA) and its potential relationship to social and communicative functioning in a diverse group of children with VPI. Potential linkages between CA and multiple socio-communicative constructs including attitude, speech satisfaction, speech and language skill, social competence, and speech severity were explored in a cohort of children with and without VPI, followed by an …

Inter-Relationships Of Functional Status In Children With Cerebral Palsy: An Extension, Emily Dyszuk

Electronic Thesis and Dissertation Repository

The primary aim of this study was to establish functional profiles for children with cerebral palsy (CP), by determining the relationships between three classification systems (the Gross Motor Function Classification System, the Manual Ability Classification System, and the Communication Function Classification System). The secondary aim of this study was to investigate the number and impact of health conditions in the most prevalent clusters. Data were analyzed on 222 children with CP with an average age of 6.1 years, from several locations across North America. A total of 56 out of 125 possible combinations were recorded; four most prevalent cell combinations …

Identifying The Influence Of Parents' And Children's Perceptions Of Their Built And Social Environments On Children's Mode Of Travel To And From School, Emily S. Hill

Electronic Thesis and Dissertation Repository

This study examined the influence of parents’ and children’s perceptions of their built and social environments on children’s use of active transportation (AT) between home and school. A mixed-methods approach was used including an environmental/behavioural survey completed by students (grades 5 through 8) and parents from 32 schools throughout London, Ontario, (n=1,623); Geographic Information Systems (GIS) for generating built environment variables to be controlled for; Principal Component factor analysis; and step-wise logistic regression models that divided analysis between the journey to and from school to determine the most influential factors in either direction. Children’s personal attitudes were the …

Early Child Care And Adiposity At Kindergarten Entry, Jessica D. Mackle

Electronic Thesis and Dissertation Repository

The association between pre-school child care participation and markers of adiposity at kindergarten entry was examined using parent reported previous child care exposure and directly measured body mass index (BMI) and waist circumference (WC) of kindergarten children (N=201; boys=106, girls=95). It was hypothesized that kindergarten children with previous exposure to full-time non-parent child care (FNPC; >20h/week) would have increased risk of overweight/obesity (BMI≥ 85^th percentile) and high central adiposity (WC ≥80^th percentile) compared to parent care (PC). The data suggest that there was no significant relationship between FNPC (n=112) and risk of overweight/obesity (OR=1.17, …

Development And Evaluation Of An Audiological Outcome Measure Guideline For Use With Infants, Toddlers, And Preschool Children, Marlene P. Bagatto

Electronic Thesis and Dissertation Repository

The goals of the current work were to: 1) identify caregiver report questionnaires for inclusion in an outcome evaluation guideline for infants, toddlers, and preschool children who wear hearing aids and 2) evaluate the chosen tools to determine their usefulness for the population of interest. A critical review of auditory-related subjective outcome evaluation tools for infants, toddlers, and preschool children is presented (Chapter 2). Good psychometric properties and clinical feasibility were considered important elements for the guideline (Andresen, 2000). Existing norms for the chosen questionnaires were validated with normal hearing children from Canadian English-speaking families (Chapters 3 and 5). Finally, …

Physical Activity Among Latino Children In London, Ontario: An Assessment Of Physical Activity Levels, Sedentary Behaviours, And Physical Activity-Related Barriers And Facilitators, Gillian E. Mandich

Electronic Thesis and Dissertation Repository

The purpose of the study was to assess the physical activity (PA) levels, sedentary behaviours, and PA-related barriers and facilitators of a sample of Latino children in London, Canada. Forty boys and 34 girls (mean age = 11.4 years) completed questionnaires related to PA levels, sedentary behaviours, and PA-related barriers and facilitators, and 64 of these children wore an accelerometer for 4 consecutive days. Children spent an average of 53 minutes per day in moderate-to-vigorous PA. The average daily sedentary time for participants was 8.6 hours, and subjective measures revealed that participants spent 3.8 hours per day in front of …

An Integrated Knowledge Translation Experience: Use Of The Network Of Pediatric Audiologists Of Canada To Facilitate The Development Of The University Of Western Ontario Pediatric Audiological Monitoring Protocol (Uwo Pedamp V1.0)., Sheila T F Moodie

Electronic Thesis and Dissertation Repository

The goals of this project were: (1) to determine the important factors that influence implementation of evidence-based practice by Canadian audiologists; and (2) to utilize the knowledge-to-action process (Graham et al., 2006) during the development of a guideline for outcome measures to evaluate the auditory development and performance of young children who wear hearing aids, to facilitate clinical uptake and identify barriers to implementation (Bagatto, Moodie & Scollie, 2010; Bagatto et al., 2011; Bagatto, Moodie, Seewald, Bartlett, & Scollie, 2011; Moodie, Bagatto et al., 2011; Moodie, Kothari et al., 2011).

Two projects (Chapters 3 and 4) included the participation of …

Acoustic Signal Encoding In Children With Auditory Processing Disorders, Chris M. Allan

Electronic Thesis and Dissertation Repository

Auditory perception has been shown to be a problem for some children with diagnosed learning, language, reading, or attention disorders. Evaluation of discrimination abilities, as part of an auditory processing test battery, has been recommended but few commercial tools are available for the audiologist to accomplish this task. Few studies have investigated signal feature encoding with children at risk for an auditory processing disorder (APD). The purpose of this project was to investigate signal encoding abilities in children suspected of having APD.

School-aged children, part of a clinical population referred for assessment of their auditory processing skills, participated in the …

Development Of A Cohesion Inventory For Children's Sport Teams, Luc J. Martin

Electronic Thesis and Dissertation Repository

The general purpose of this dissertation was to develop an inventory designed to measure cohesion in children’s (ages 9-12) sport teams. To this end, three studies were conducted. In Study 1, children became active agents in the process of test construction. More specifically, children (N = 167) participated in focus groups and completed open-ended questionnaires in order to provide information on their perceptions of cohesion as well as motives for participating, continuing, and ceasing involvement on sport teams. Study 2 involved the use of the information obtained from Study 1 to develop potential items for the questionnaire. In addition, the …

The Importance Of Self-Efficacy And Basic Psychological Needs In Children’S Physical Activity: Measurement, Prediction And Intervention, Casey E. Gray

Electronic Thesis and Dissertation Repository

The importance of physical activity in the overall health promotion and primary prevention of cardiovascular disease risk factors and metabolic diseases in children is well established. Nonetheless, interventions to increase physical activity among this population have been largely unsuccessful. The main objective of the research in this dissertation was to explore the suitability of self-efficacy and basic psychological needs for physical activity prediction and intervention in children. Item generation and psychometric evaluation of psychological questionnaires occurred in study 1 (Chapter 2). Using a prospective design, study 2 (Chapter 3) established task efficacy, barriers efficacy, competence, and autonomy as significant predictors …