Risk Of Kidney Stones In Living Kidney Donors: A Matched Cohort Study, Sonia Thomas

Electronic Thesis and Dissertation Repository

A kidney stone in a person with one kidney requires urgent attention which may result in surgical and/or hospital attention. We conducted a matched retrospective cohort study to determine if living kidney donors compared to healthy non-donors have a higher risk of: 1) kidney stones with surgical intervention, and 2) hospital encounters for kidney stones. We reviewed and linked information from pre-donation charts to Ontario healthcare databases. We selected healthy non-donors from the general population, matching ten non-donors to every donor, to generate a cohort of 2,019 donors and 20,190 non-donors. There was no difference in the rate of 1) …

How Age Friendly Is This City? Strategies For Assessing Age-Friendliness, Michelle Dellamora

Electronic Thesis and Dissertation Repository

The Age-Friendly Cities framework, created by the World Health Organization (WHO), has emerged as a community-based response to the challenges of demographic aging and increasing urbanization. In 2010, London, Ontario, became the first city in Canada to join the WHO Global Network of Age-Friendly Communities. Network milestones require the measurement of the baseline age-friendliness of the community. The objectives of this thesis are: 1. Determine the best available assessment tools for measuring the age-friendliness of a community, and 2. Establish the baseline age-friendliness of London, Ontario. A scoping review was utilized to collect and assess available surveys and questionnaires. A …

The Impact Of Intrauterine Exposure To Gestational Diabetes Mellitus On Early Childhood Body Mass Index Trajectories, Aniq Anam

Electronic Thesis and Dissertation Repository

Background: Although gestational diabetes mellitus (GDM) has been linked to pediatric obesity, there is limited research on the impact of intrauterine exposure to GDM on trajectories of childhood growth. Objective: To assess the effect of prenatal GDM exposure on childhood body mass index (BMI) trajectories. Design: Analyses were conducted using data from cycles 2 to 6 (1994-2004; N=3412 children) of the National Longitudinal Survey of Children and Youth. Latent growth curve modelling (LGCM) was used to model BMI trajectories from age 2 to 10 years with prenatal exposure to GDM as a predictor. Effect modification by breastfeeding was assessed. Results: …

Children At-Risk For Hearing Impairment: A Retrospective Study Of The Ontario Infant Hearing Program Population, Katherine M. Smith

Electronic Thesis and Dissertation Repository

There is widespread agreement that infant hearing screening programs are effective but such programs may fail to detect all hearing impairment and children can develop subsequent hearing loss after passing the initial screen. This is the core rationale for surveillance programs that are analyzed in this thesis. Infants with hearing risk factors are followed using surveillance programs that include monitoring by audiological assessment.

The study population in this thesis consists of 2,390 children with normal hearing and 248 children with hearing impairment from different referral routes. The Infant Hearing Program Surveillance group is 1.48% of the number of hearing-impaired children. …

Resilience As Health Promotion In Action: University Students Who Grew Up Amid Violence Directed Towards Their Mothers, Tatiana Murkin (Zdyb)

Electronic Thesis and Dissertation Repository

Abstract

Violence against women is among the greatest threats to the health of our population. An estimated three hundred and sixty thousand children in Canada, and over two million worldwide are exposed to violence in their homes (UNICEF, 2006). Growing up amidst such violence seriously compromises children’s capacities for healthy development. Violence against women is not limited by culture, geography or socioeconomic status. It constitutes one of the most pervasive and yet least openly discussed human rights violations and public health issues known today.

Researchers and allied health professionals generally agree that children whose development has been interfered with by …

An Exploration Of Early Childhood Education Students' Knowledge And Preparation To Facilitate Physical Activity For Preschoolers, Olivia Martyniuk

Electronic Thesis and Dissertation Repository

Early childhood educators play an important role in influencing preschoolers’ physical activity levels. The current study sought to explore Early Childhood Education (ECE) students’ physical activity (PA)-related knowledge and educational experience. A total of 1,113 ECE students from 20 Ontario Colleges completed the study survey (online or on paper), which examined students’ PA course content; awareness of PA guidelines; understanding of health-related benefits of PA; self-efficacy to facilitate PA for preschoolers; as well as PA resource needs. Survey results identified that 72.1% of ECE students had not completed any PA/physical education specific courses, while only 28.7% were familiar with, and …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

Electronic Thesis and Dissertation Repository

In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

Evaluation Of Ontario's Street Racers, Stunt And Aggressive Drivers Legislation, Aizhan Meirambayeva

Electronic Thesis and Dissertation Repository

The purpose of this thesis was to conduct a process and outcome evaluation of the deterrent effect of Ontario’s Street Racers, Stunt and Aggressive Drivers Legislation. The focus of this study was on police enforcement (implementation), a change in speeding on the provincial highways (intermediate outcome) as well as on a decrease in both extreme speeding convictions and casualties, measured as a sum of injuries and fatalities (criterion outcomes). The deterrent effect of the legislation on Ontario drivers was examined, using data obtained from the Ministry of Transportation of Ontario. Employing interrupted time series …

The Relationship Between Quality Of Parks And Playgrounds And Park-Based Physical Activity In Children, Hammad Ali Qazi

Electronic Thesis and Dissertation Repository

Research on the quality of parks and playgrounds has been limited, particularly regarding how conditions and cleanliness of parks and playgrounds influence park-based physical activity in children. This thesis explored the relationship between the quality of parks and playgrounds and physical activity in children, through a scoping review and a mixed-methods study.

The scoping review used a systematic search to identify gaps in the literature and to disseminate research findings on the topic. A total of 10 articles were selected in accordance with the selection criteria. The review showed that the features, amenities, and safety of parks and playgrounds were …

"Being Stuck": Understanding The Health-Related And Everyday Lived Experiences Of Young Mothers In Rexdale, Ontario Through A Social Determinants Framework, Jaspreet Kaur

Electronic Thesis and Dissertation Repository

The purpose of this study was to gain an understanding of the ways the health-related and everyday lived experiences of young mothers are shaped by various social determinants, and in the context of their neighbourhood. Using a critical qualitative methodology, five mothers between the ages of 17 to 19 were interviewed from Rexdale, a neighbourhood in the City of Toronto characterized by a number of social risk factors(e.g. high rates of visible minorities, unemployment, and teen mothers). In-depth thematic analysis led to the emergence of four themes: 1) Living in Rexdale: Representations and realities; 2) Leaving Rexdale and wanting something …

Violence Among Cocaine And Simultaneous Cocaine And Alcohol Abusers: Results From A Cross-Sectional Study Of Treatment Clients, Sameer Imtiaz

Electronic Thesis and Dissertation Repository

A population known for substantial violence is the substance abuse treatment population. This study assessed: (1) extent of violence, (2) personality and mental health correlates of violence, and (3) sex differences in correlates of violence. Data were obtained from the Patterns and Consequences of Cocaine and Alcohol Use for Substance Abuse Treatment Clients Study (N = 403). Logistic regression with backward elimination procedures and modified Poisson regression were used to assess the study objectives. Violence was reported by 44% of treatment clients. Furthermore, number of other drugs used per week (RR: 1.124, 95% CI: 1.063 - 1.189) and aggressive personality …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

Electronic Thesis and Dissertation Repository

Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

A Baseline Assessment Of University Students’ Vitamin D Knowledge, Shaunessey Boland

Electronic Thesis and Dissertation Repository

Vitamin D is necessary for many aspects of health and development yet 25% of Canadians are not getting enough and university-aged students are at particularly high risk of insufficiency. It seems program development is needed to help university students in acquiring adequate vitamin D. The purpose of this study was to acquire a baseline assessment of university students’ vitamin D related knowledge to help inform future program development. Subjects were asked to complete a Vitamin D Knowledge Survey which assessed knowledge on aspects such as vitamin D sources, health benefits, and recommended intake. A Vitamin D Knowledge Score was computed …

The Impact Of Social Integration On The Lived Experience Of Resilience Among Women Who Lived In Poverty During Childhood, Nedra R. Peter

Electronic Thesis and Dissertation Repository

This thesis is a study of the lived experience of poverty and resilience among women who lived in poverty during childhood. The aim of this study was to investigate the impact of social integration on resilience to the adverse effects of poverty. This investigation was conducted as a retrospective study. Using a hermeneutic phenomenological approach, seven women who lived in poverty during childhood were interviewed in semi-structured interviews lasting 60 to 90 minutes. These interviews, along with a member-checking meeting, were the primary method of data collection. Data was analyzed through thematic analysis informed by van Manen (1990, 1997). The …

The Smart Technology To Manage Type 2 Diabetes And Achieve Health Goals Through Record Keeping And Tailored Feedback (Smart) Study, Jody C. Schuurman

Electronic Thesis and Dissertation Repository

Lifestyle interventions reduce the risk of diabetic complications; however, many of these interventions are difficult to implement in everyday practice. This study investigated whether a smartphone application and data mining system, GlucoGuide™, could be a functional and effective tool to supplement a lifestyle intervention in order to enhance patient care for people with prediabetes or type 2 diabetes (T2D). Using a quasi-experimental design, seventeen participants diagnosed with prediabetes or T2D were given the STEP™ test and a lifestyle prescription, and either a paper journal or the GlucoGuide™ system to record important health markers. The primary analysis compared clinical fasting blood …

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

Electronic Thesis and Dissertation Repository

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

Atypical Antipsychotic Drugs And The Risk Of Acute Kidney Injury: A Population-Based Cohort Study, Yoseob Joseph Hwang

Electronic Thesis and Dissertation Repository

Older adults are frequently prescribed atypical antipsychotic drugs and may be at a risk for kidney-related adverse events. This population-based retrospective cohort study examined the 90-day risk of acute kidney injury (AKI) and the potential reasons for AKI in 96,471 matched pairs of older adults who received and who did not receive a new atypical antipsychotic drug prescription from 2003 to 2011 in Ontario. Atypical antipsychotic drug use was associated with a higher risk of hospitalization with AKI (relative risk (RR) 2.06 [95% confidence interval (CI) 1.85–2.29]). The drug use was also associated with potential reasons for AKI including hypotension …

Patency And Complication Rates Of The Arteriovenous Fistula: A Systematic Review, Ahmed A. Al-Jaishi

Electronic Thesis and Dissertation Repository

Advantages of fistulas, which include long patency and low complication rates, were ascertained over two decades ago and may not apply to the contemporary dialysis population. We conducted a systematic review to summarize the patency and complication rates of fistulas from literature published after 1999. We screened 7,008 citations and 62 articles met our criteria. The risk of primary failure was 27% (95% confidence interval (CI): 23–32%). When primary failures were included, the primary and secondary patency rates were 59% (CI 53–64%) and 66% (CI 58–74%) at one year, respectively. The median rates of infection, ischemic steal syndrome, and thrombosis …

Describing The Falls Prevention Program At An Acute Care Hospital In Ontario Using Leveson’S Systems Model, Mahboubeh Mehrjoo

Electronic Thesis and Dissertation Repository

Falls are the most frequent adverse event in acute care hospitals. Although a large number of studies have addressed the patients’ risk factors for falls and best practices in fall prevention, patients falls still remain a major problem. This study applied a systemic methodology (Causal Analysis based on STAMP (CAST)) to depict Ontario’s acute care hospital structure related to patient fall prevention. The system’s component behaviours and interactions were described and deficits and inappropriate control mechanisms among the system’s controllers were identified. As a result of the CAST analysis, the complexity of the health care system, lack of a consistent …

An Exploration Of The Relationships Between Markers Of Social Status And Position And Hiv Risk Behaviours In African, Caribbean, And Other Black Populations, Shamara M. Baidoobonso

Electronic Thesis and Dissertation Repository

African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. The overall goal of this thesis is to guide HIV prevention interventions for ACB communities. It focuses on social factors that impact HIV vulnerability.

This research used data from the Black, African, and Caribbean Canadian Health Study—a mixed methods study that used 30 semi-structured interviews, and a cross-sectional survey using a structured, self-administered quantitative questionnaire to collect information about HIV and health from 188 ACB people.

The first manuscript compares risk …

Exploring Parental Experiences And Decision-Making Processes Following A Fetal Anomaly Diagnosis, Ramona L. Fernandez

Electronic Thesis and Dissertation Repository

Often the first indication that something may be wrong in a seemingly normal pregnancy occurs during the first detailed ultrasound appointment between 16 and 20 weeks gestation. Even the most tentative suspicions of fetal anomalies is jarring. Parent’s default reality of a normal pregnancy and a ‘perfect child’ changes to one of risk factors and the possibility of an ‘unhealthy child’. This study begins with the realization of this first loss in a series of losses that follow for parents as they grapple with diagnostic information to be able to make informed medical decisions regarding their fetus and pregnancy. The …

Governing Occupation Through Constructions Of Risk: The Case Of The Aging Driver, Silke Dennhardt

Electronic Thesis and Dissertation Repository

Risk and risk-management have become increasingly pervasive features of modern society and governmentality scholars have highlighted various ways risk discourses are taken up to govern citizens and their everyday conduct. Thus, attending to risk is imperative to advance an understanding of how everyday occupation is shaped and governed within contemporary society. Within this study, the example of driving in later life is drawn upon to address two objectives: 1. to advance the understanding of how risk is taken up to govern everyday occupation, and 2. to explicate how risk is taken up in discourses to constitute particular subjectivities and their …

Factors That Contribute To Adverse Events Involving Care- Dependent Community Dwelling Older Adults And Their Caregivers., Dorothy J. Gotzmeister

Electronic Thesis and Dissertation Repository

The research on home and community care shows that when safely delivered it can be an efficient way to support elders who require care, potentially preventing a move into costlier institutional care. Learning from system-wide safety breakdowns that occur is necessary to establish appropriate prevention strategies. The purpose of this study was to identify the factors that contributed to adverse events in care-dependent community-dwelling older adults and their caregivers. Using a multiple case study methodology, eight falls were investigated using a comprehensive Systemic Falls Investigative Method. Using within case and across case analyses, a total of 280 contributing factors were …

Awareness Of Physical Activity Levels And Sedentary Behaviour: An Assessment Of Awareness Of Physical Activity Levels And Sedentary Behaviour Among Parents And Children, Tripat Simran Kaur Grewal

Electronic Thesis and Dissertation Repository

The purpose of this study was to assess awareness of physical activity and sedentary behaviour among parents and children aged 10-13 years. Associations between awareness and factors including age, BMI, gender, and obesity status were also examined. A total of 53 parent-child dyads participated in the study. Agreement between parent and child subjective measures (self-report) and objectively measured physical activity was examined to determine awareness. Most parents (87%) and children (83%) overestimated child moderate-vigorous physical activity (MVPA) beyond 30 minutes/day. The majority of parents (87%) and children (85%) also underestimated child sedentary behaviour by at least 3 hours/day. Older children …

Understanding First Nations Young Adults' Health Literacy, Ebony Rempel

Electronic Thesis and Dissertation Repository

Relative to non-First Nations, Inuit, and Metis (FNIM) Canadians, FNIM people have poorer health status. A qualitative investigation of the health literacy skill and the health information (HI) needs of young FNIM adults was conducted. Eight single mothers living on-reserve were interviewed. Data analysis generated four main themes along with the subthemes of: (1) Traditional Health (TH), (i) TH Culture Excised, and (ii) Wanting to Know More about TH; (2) HI Needs of First Nations young Mothers; (3) Access to HI, (i) Asking the Doctor / Telehealth (ii) other Female Family and Friends; (4) Online Accessibility, (i) HI Online, (ii) …

The Impact Of Protection Motivation Theory Grounded Messaging On Diabetes Prevention Behaviours Following Gestational Diabetes, Jennifer M. Jacob

Electronic Thesis and Dissertation Repository

Women diagnosed with Gestational Diabetes (GDM) are more likely to develop Type 2 Diabetes (T2DM). Despite this risk, few women are engaging in diabetes prevention behaviours. Methods: The Protection Motivation Theory (PMT) was employed to design and evaluate a post-GDM diabetes prevention information session. The utility of this theory in predicting intentions and diabetes prevention behaviours was assessed using regression analysis. Results: Two of the four PMT variables, response efficacy and self efficacy were found to be consistent predictors of intention across most of the recommended behaviours, accounting for between 25% and 77% of the variance in intention. Intention was …

A Critical Second Look At Integrated Knowledge Translation, Anita Kothari, Nadine Wathen

Anita Kothari

Integrated knowledge translation (IKT) requires active collaboration between researchers and the ultimate users of knowledge throughout a research process, and is being aggressively positioned as an essential strategy to address the problem of underutilization of research-derived knowledge. The purpose of this commentary is to assist potential "knowledge users", particularly those working in policy or service settings, by highlighting some of the more nuanced benefits of the IKT model, as well as some of its potential costs. Actionable outcomes may not be immediately (or ever) forthcoming, but the process of collaboration can result in group-level identity transformation that permits access to …

Differentials In Physical Health Outcomes Among Children In Single-Parent And Dual-Parent Families, Jennifer Lynn Rayner

Electronic Thesis and Dissertation Repository

Children live in increasingly varied family structures and there is some suggestion that children who live with single mothers have poorer health outcomes than children who live with two-parents. The examination of the pathways that link family structure to children’s physical health is important because it will help increase our understanding of why some children are healthier than others. The purpose of this dissertation is to: 1) determine if there are differences in health status between children raised in female-headed single-parent families and children in two-parent families; 2) gain an understanding of why these differences may exist; and, 3) assess …

Getting To The Root Of The Problem: Health Promotion Strategies To Address The Social Determinants Of Health, Dana Gore, Anita Kothari

Anita Kothari

Although extensive research shows that the social determinants of health influence the distribution and course of chronic diseases, there is little programming in public health that addresses the social determinants as a disease prevention strategy. This paper discusses different types of health promotion initiatives and differentiates them based on whether they attempt to impact intermediate (environmental) determinants of health or structural determinants of health. We argue for the importance of programming targeted at the structural determinants as opposed to programming targeted solely at the immediate environment. Specifically, the former has more potential to create significant improvements in health, contribute to …

Determinants Of Negative Pathways To Care And Their Impact On Service Disengagement In First-Episode Psychosis., Kelly K. Anderson, Rebecca Fuhrer, Norbert Schmitz, Ashok K Malla

Epidemiology and Biostatistics Publications

PURPOSE: Although there have been numerous studies on pathways to care in first-episode psychosis (FEP), few have examined the determinants of the pathway to care and its impact on subsequent engagement with mental health services.

METHODS: Using a sample of 324 FEP patients from a catchment area-based early intervention (EI) program in Montréal, we estimated the association of several socio-demographic, clinical, and service-level factors with negative pathways to care and treatment delay. We also assessed the impact of the pathway to care on time to disengagement from EI services.

RESULTS: Few socio-demographic or clinical factors were predictive of negative pathways …