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Articles 1 - 30 of 102
Full-Text Articles in Public Health
Exploring The Lived Experiences Of Women With Chronic Obstructive Pulmonary Disease, Madeline M. Dougherty
Exploring The Lived Experiences Of Women With Chronic Obstructive Pulmonary Disease, Madeline M. Dougherty
Electronic Thesis and Dissertation Repository
Currently, there are many barriers to women seeking diagnosis and treatment for chronic obstructive pulmonary disease (COPD). These barriers include greater under-diagnosis and fewer medical consultations. Often thought of as a "male smoker's" disease, in the past decade there has been a sharp increase in the number of COPD cases in women. This research explored the lived experiences of women with COPD through diagnosis and treatment. This research used van Manen’s hermeneutic phenomenological methodology guided by a critical theory paradigm. The results highlighted the experiences of women with COPD, what women want from their care, and recommendations to better support …
Examining Global Mental Health, Bio-Politics And Depression In Ethiopia: A Critical Ethnography Study., Gojjam B. Limenih
Examining Global Mental Health, Bio-Politics And Depression In Ethiopia: A Critical Ethnography Study., Gojjam B. Limenih
Electronic Thesis and Dissertation Repository
Depressive disorder stands as a significant global health challenge and recognized as the primary cause of disability worldwide. Collaborating with the World Health Organization (WHO), Global Mental Health (GMH) initiatives have devised tailored international guidelines and intervention programs for low- and middle-income countries (LMICs) in response to this crisis. Despite concerted efforts, depressive disorder often remains underdiagnosed and undertreated in LMICs. However, our global understanding of depression is predominantly based on Western nosology, potentially limiting its universality. Consequently, existing clinical research and practices may fail to capture culturally relevant and salient aspects of depression.
Utilizing qualitative ethnographic methods, including Foucauldian …
Closing The Know-Do Gap In Global Health In Sub-Saharan Africa: A Critical Scoping Review Of Knowledge Translation Practices In Global Health Research Partnerships., Wale Fadare
Electronic Thesis and Dissertation Repository
Introduction: Sub-Saharan Africa is unlikely to achieve the Sustainable Development Goals by 2030. With poor health outcomes and a dependence on external funding, global health research partnerships (GHRPs) with high-income countries are criticized for being inequitable and inadequately representing local researchers.
Objective: This study examined the barriers and facilitators to Knowledge Translation (KT) in GHRPs in Sub-Saharan Africa, critiquing them through the lens of local researchers’ experiences and the degree of congruence with partnership principles in contemporary literature.
Methods: A critical scoping review of literature from five databases was conducted to identify barriers and facilitators to KT. Alignment with published …
Examining Fragility Of Health Systems In Afghanistan: Development And Application Of A Theoretical Framework For Fragile Health Systems, Faiza Rab
Electronic Thesis and Dissertation Repository
Globally, health systems face destabilization amidst conflicts and natural disasters, adversely affecting populations' well-being. Understanding domains of health system fragility remains a gap in literature, hampering effective mitigation. In protracted conflict, Afghanistan's health system offers a crucial case for studying health system fragility. This research aimed to bridge gaps in comprehending health system fragility, with research questions:
1. What is the conceptual understanding of the fragility of health systems and its relationship with resilience, and how can it be applied in Afghanistan?
2. Did the introduction of female health workers to support Maternal, Neonatal, and Child Health service delivery by …
Sociodemographic Determinants Of Potentially Avoidable Hospitalizations Due To Ambulatory Care Sensitive Conditions Among Hospitalized Patients In The United States, Munira Kashem
Electronic Thesis and Dissertation Repository
Social determinants of health play a crucial role in explaining the variation of potentially avoidable hospitalizations (PAH) due to Ambulatory Care Sensitive Conditions (ACSCs). Utilizing data from the National Inpatient Sample from 2018 to 2020 in the United States, this study conducted retrospective cohort analyses to explore the relationships between sociodemographic factors, specifically income, race, geography, age, and sex and PAH. Our approach used multilevel logistic regression models to adjust for potential confounders and account for clustering of admissions within hospitals. Of the 17,629,891 hospital admissions examined in this study, 1,868,609 (10.6%) were attributable to ACSCs. Our results indicate that …
Physiotherapists Description Of Patient-Centered Care, And Barriers And Facilitators Experienced To Implementation, Maclean Jordan
Physiotherapists Description Of Patient-Centered Care, And Barriers And Facilitators Experienced To Implementation, Maclean Jordan
Electronic Thesis and Dissertation Repository
Patient-centered care (PCC) is a growing standard for healthcare delivery due to the benefits to patient autonomy. Lacking a cohesive definition in the physiotherapy literature, it is also lacking in implementation. Employing interpretive description with semi-structured interviews, the goal was to understand how physiotherapists drawn from private for-profit clinics in Canada describe PCC, and barriers and facilitators to providing it. Results included requiring person-centered communication in PCC, seeing Health holistically, centering the patient in care, and being a skill that becomes clearer with practice experience. Barriers included: lack of practitioner reflexivity, patient not desiring self-directed care, and limited access to …
Sex And Gender Differences In Arthritis Health Information, Tania Al-Jilawi
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 …
The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.
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 The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma
Electronic Thesis and Dissertation Repository
Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …
The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., Silvio Ndoja
The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., Silvio Ndoja
Electronic Thesis and Dissertation Repository
Orthopedic surgery is a field which has often been talked about with regards to surgeon underemployment. This is particularly important given the paradoxical increasing demand for orthopedic care. There has not been well studied literature understanding the state of orthopedic surgery training in Ontario, Canada. Using a combination of various databases and surveying surgeons trained in Ontario we sought to provide some insight.
We demonstrated multiple important findings. More recent graduates are feeling less ready to enter practice and almost all graduates do at least 1 fellowship, with equal amount of 1 versus 2 fellowships. We showed an effect of …
Examining Individualized Participatory Approaches To Care For Individuals With Intellectual And Developmental Disabilities, Megann Yen Dong
Examining Individualized Participatory Approaches To Care For Individuals With Intellectual And Developmental Disabilities, Megann Yen Dong
Electronic Thesis and Dissertation Repository
Person-centred plans have been identified as an upstream approach to addressing the inequities experienced by individuals with intellectual and developmental disabilities. However, little evidence on implemented approaches exists. This integrated thesis consists of two studies exploring individualized participatory approaches to care within community-care services, guided by an integrated knowledge translation approach. The first study is a scoping review aimed to identify individualized participatory approaches to care in the literature. The second study is a qualitative descriptive study utilizing semi-structured interviews with community-care staff (n=11) to understand an operationalized person-centred planning approach. The scoping review provides insight into the variability of …
Primary Care Physician Engagement In Health System Transformation: A Case Study, Atharv Joshi
Primary Care Physician Engagement In Health System Transformation: A Case Study, Atharv Joshi
Electronic Thesis and Dissertation Repository
Primary care physician engagement is essential in enhancing organizational performance, system efficacy, and provider collaboration; yet limited literature exists within health systems research. This thesis explored physician engagement throughout the development of an organization known as the London Middlesex Primary Care Alliance (LMPCA). This thesis used a qualitative case study approach guided by a constructivist paradigm. The findings revealed six themes which contributed to the development of the LMPCA and provided insight into how physicians were engaged within health systems work. Unique to this study were two facilitators for engagement: the role of a transformation lead and the use of …
Sociodemographic Factors And The Risk Of Paediatric Out-Of-Hospital Cardiac Arrest, Samina Idrees
Sociodemographic Factors And The Risk Of Paediatric Out-Of-Hospital Cardiac Arrest, Samina Idrees
Electronic Thesis and Dissertation Repository
Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. This thesis aims to explore the relationship between sociodemographic factors and POHCA. The findings from our systematic review indicate that there are racial disparities in POHCA risk and in the provision of bystander cardiopulmonary resuscitation. There was little evidence of sociodemographic disparities in bystander defibrillation, survival and neurological outcome, particularly across adjusted analyses. The findings from our case-control study in Ontario, Canada, indicate that children living in marginalized areas have an elevated risk of experiencing POHCA. We also found that children living in northern urban or …
Social Determinants Of Health And Uptake Of Colorectal Cancer Screening In Canada, Seth F. Kadish
Social Determinants Of Health And Uptake Of Colorectal Cancer Screening In Canada, Seth F. Kadish
Electronic Thesis and Dissertation Repository
Colorectal cancer (CRC) screening uptake may be associated with social determinants of health and could indicate potential barriers to health service access. The goal of this thesis was to evaluate the association of social determinants with CRC screening in screen-eligible adults. We used Andersen’s Behavioural Model of Health Service Utilization and the PROGRESS-Plus Framework to conceptualize potential social determinants. Our first study was a systematic review of peer-reviewed Canadian studies, and the second was a cross-sectional analysis of data from the Canadian Longitudinal Study on Aging (CLSA). The systematic review found lower uptake was associated with non-White ethno-racial identity, less …
The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet
The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet
Health Studies Publications
ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a …
Perspectives Of Middle Eastern Immigrant Parents Regarding Accessing Healthcare Services For Children During The Covid-19 Pandemic In London, Ontario, Sarvenaz Mehrabi
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 …
Towards A Conceptual Model Applying Trauma Informed Care Principles And Healthcare Professional Resilience To Interfacility Transport Of Acutely Ill And Preterm Neonates, Megha R. Rao
Electronic Thesis and Dissertation Repository
The purpose of this dissertation was to acquire a greater depth of knowledge surrounding the experiences of the interfacility transport process for acutely ill and preterm neonates based on the perspectives of healthcare professionals and parent-caregivers who are involved. In doing so, an overall goal was to develop a conceptual model that explains how healthcare professionals and parents experience the process while also offering insights into how to foster more positive experiences through clinical interventions that are aligned with Family Centred Care. This program of research is uniquely guided by the paradigms and theoretical frameworks of Trauma Informed Care (TIC), …
Learning From Lived Experience: Substance Use Policies, Emergency Shelters, And Harm Reduction In London, On, Jesse Cram, Dena Salehipour
Learning From Lived Experience: Substance Use Policies, Emergency Shelters, And Harm Reduction In London, On, Jesse Cram, Dena Salehipour
Undergraduate Student Research Internships Conference
Since 2018, the number of overdoses reported by London housing and emergency shelter agencies to the city of London has increased by 790%.These agencies currently have inconsistent overdose response policies that lack research-based support, and want to establish comprehensive best practices that support those involved at all levels.
Through a community based course, we initially collected and analyzed survey data from managers and staff from various London housing and emergency shelter agencies with the aim of understanding the limitations of the current approaches to the opioid crisis. Wanting to expand on this, our current project focuses on those who are …
Improving Governance In Ontario Health Teams, Mausam Vadakkayil
Improving Governance In Ontario Health Teams, Mausam Vadakkayil
Undergraduate Student Research Internships Conference
The aim of this research brief is to provide recommendations on how Ontario Health Teams (OHTs) can incorporate the three key functions of successful health systems, priority setting, performance monitoring, and accountability, within their governance structure.
The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp
The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp
Electronic Thesis and Dissertation Repository
The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …
Effectiveness Of Machine Learning Classifiers For Cataract Screening, Ronald Cheung
Effectiveness Of Machine Learning Classifiers For Cataract Screening, Ronald Cheung
Electronic Thesis and Dissertation Repository
Cataract is the leading cause of blindness and vision loss globally. The implementation of artificial intelligence (AI) in the healthcare industry has been on the rise in the past few decades and machine learning (ML) classifiers have shown to be able to diagnose patients with cataracts. A systematic review and meta-analysis were conducted to assess the diagnostic accuracy of these ML classifiers for cataracts currently published in the literature. Retrieved from nine articles, the pooled sensitivity was 94.8% and the specificity was 96.0% for adult cataracts. Additionally, an economic analysis was conducted to explore the cost-effectiveness of implementing ML to …
Does The Way We Pay Primary Care Providers Influence Emergency Department Use During After-Hours?, Michael Hong
Does The Way We Pay Primary Care Providers Influence Emergency Department Use During After-Hours?, Michael Hong
Electronic Thesis and Dissertation Repository
In the early 2000s, Ontario introduced extensive primary care reforms to increase around-the-clock access to comprehensive primary care in response to inadequate access to primary care, including the way Ontario primary care physicians were paid. This thesis investigates the extent to which changes in physician payment could affect emergency department visits. First, a review evaluating the impact of access to primary care on primary care and emergency department utilization was conducted. Secondly, the impact of Ontario’s after-hours premium on emergency department visits was investigated, first within Ontario, then compared to four control provinces. Finally, rates of primary care services and …
Cost-Effectiveness Analysis Of Tpmt Genotype-Guided Azathioprine Treatment Compared To Standard Treatment For Patients With Moderate/Severe Ulcerative Colitis, Ali Unsal
Electronic Thesis and Dissertation Repository
This study assessed cost-effectiveness of pharmacogenomics (PGx)-based azathioprine (AZA) compared to standard AZA therapy for ulcerative colitis (UC) patients in Canada. A patient-level Microsimulation model was developed to compare the lifetime costs and quality-adjusted life years (QALYs) gained by a hypothetical cohort of UC patients with age and sex characteristics. The parameters used in the model were derived from the published literature and costs from the Ontario Schedules of Payments and published sources. The results were summarized in terms of the incremental cost-effectiveness ratio (ICER). Compared to standard AZA, PGx-based AZA care was the dominant strategy with 0.17 incremental QALYs …
Examining Public Health Risk Communication Via Social Media By Provincial And Local Health Authorities In Ontario During The Covid-19 Pandemic, Marc Resendes
Electronic Thesis and Dissertation Repository
Risk communication campaigns are essential during public health crises to inform the public about ways to mitigate, alleviate and manage potential risks. The purpose of this study was to describe risk communication on social media by Ontarian health authorities amid COVID-19, in addition to examining the strategies that guided their social media use. This was completed through (a) a narrative review of risk communication literature; (b) a qualitative content analysis of select health authority Twitter messaging following three major COVID-19 milestones; and (c) key informant interviews with those coordinating social media responses to COVID-19. Information giving and news updates were …
Health Care Utilization By Immigrants With Multimorbidity: A Population Based Cross-Sectional Study Of The 2015-2016 Canadian Community Health Survey (Cchs), Chinmoy Talukder
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 …
Investigating The Statistical And Policy Frameworks Used To Gauge Potential Pharmacotherapy Recalls: A Scoping Review, Benson Law
Undergraduate Student Research Internships Conference
Paramount attention is often afforded to pharmacotherapies being brought to market. The anticipation from companies, their shareholders, and the patients poised to benefit are met with stiff statistical and methodological requirements set forth by Health Canada’s Health Products and Food Branch (HPFB). Once a pharmacotherapy has been approved by the HPFB, however, the onus to monitor these drugs falls largely on the shoulders of Health Canada, the manufacturers, and to a lesser degree, the Drug Safety and Effectiveness Network (DSEN). This scoping review identified existing pharmacovigilance frameworks recommendations from SCOPUS, PubMed and EMBASE and compared the guidelines employed by Health …
Integrating Residents As Partners In Long-Term Care (Ltc) Research, Ruthie Zhuang
Integrating Residents As Partners In Long-Term Care (Ltc) Research, Ruthie Zhuang
Undergraduate Student Research Internships Conference
This research poster summarizes patient-engagement throughout the study "COVID-19: Implementation of virtual P.I.E.C.E.S for LTC resident care planning with family to build and sustain team collaboration and workforce resilience". It describes two implementation frameworks (CFIR and PRISM) as well as two patient-engagement tools (PEIRS and PPEET) in relation to the study. Lastly, it offers preliminary insights into the current landscape of patient-engagement in research.
The Impact Of A Dedicated Pediatric Ambulance On Interfacility Transport Dispatch Times: Findings From The Canadian Pediatric Transport Network Database, Tiffany Liu
Electronic Thesis and Dissertation Repository
Introduction: This retrospective cohort study evaluates the impact of a dedicated ambulance on dispatch times of pediatric transports to the London Health Sciences Centre using the Canadian Pediatric Transport Network (CPTN) database.
Methods: After assessing the data quality of the CPTN database, we used multiple linear regressions to examine differences in dispatch times before and after June 2019, when a dedicated ambulance was introduced.
Results: We found that additional measures are needed to improve data quality in the CPTN database. A dedicated ambulance improved ambulance return times but not dispatch times.
Conclusion: Ongoing quality assessment is necessary to improve the …
The Contribution Of Memorial University Medical Graduates To The Family Physician Workforce In Newfoundland And Labrador, Emily M. Volpe
The Contribution Of Memorial University Medical Graduates To The Family Physician Workforce In Newfoundland And Labrador, Emily M. Volpe
Electronic Thesis and Dissertation Repository
Recruiting and retaining family physicians (FP) in rural communities has been an ongoing issue in Canada and other developed nations. The objective of this thesis was to analyze the long-term contribution that Memorial University medical graduate FP make to the physician workforce in Newfoundland and Labrador (NL). We found that 47% of our sample ever worked in NL, 15% ever worked in rural NL and 58% who ever worked in NL stayed for at least 10 years. Being from NL was a predictor of working in NL for at least 5 years and 10 years, respectively. Doing at least some …
Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica A. Starowicz
Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica A. Starowicz
Electronic Thesis and Dissertation Repository
The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service providing comprehensive, coordinated care to adolescents and adults with spina bifida (SB). This study sought to identify the most common health concerns among this population at initial consultation and identify patient factors related to these concerns to ultimately improve health care delivery. A retrospective chart review was performed. Descriptive analyses were completed and associations between concerns and patient factors were determined using Spearman’s rho correlation coefficients. A multiple linear regression was performed to estimate the relationship between patient factors and total number of concerns reported. Ninety-four patient charts …