Public Health Commons^™

Rapid Rhino Vs. Merocel: A Retrospective Analysis Of Patients With Anterior Epistaxis Visiting Emergency Rooms In London, Ontario, Dhatri Shukla

Electronic Thesis and Dissertation Repository

When patients present to an emergency room (ER) with a nosebleed, one technique that physicians employ is the application of nasal packing. Merocel is a common nasal pack utilized in ER because of their low cost. Rapid Rhino is a nasal packing that is more comfortable for patients but is more costly than Merocel. Costing for epistaxis treatment is more than initial treatment costs and needs to consider rebleed rates. Using a retrospective cohort study design with covariates adjusted by propensity scores, we compared the costs associated with Merocel, and Rapid Rhino from the hospital and provincial healthcare perspectives. Merocel …

Examining The Socio-Economic And Gendered Structure Of Canada's Live-In Caregiver Program: A Qualitative Study Of Filipina Women's Health Experiences, Andrea Bobadilla

Electronic Thesis and Dissertation Repository

The primary aim of this critical ethnographic study was to examine how Filipina women in the Canadian live-in caregiver program (LCP) negotiate their own physical and mental well-being while managing the complex health needs of their clients. Using global care chain and postcolonial theoretical frameworks, I also sought to identify how multi-scalar forces including caregiving and migrant policies in Canada and South East Asia exacerbate pre-existing gendered and labour inequities faced by these women. The distressing impact of this precarious form of employment on family dynamics and relationships among family members in the Philippines was also explored. Data collection took …

Fertility Preservation Discussions With Transgender People In Canada Prior To Beginning Medical Gender Affirmation, Emily K. Sanders

Electronic Thesis and Dissertation Repository

Background. Prevalence of fertility preservation discussions and procedures, participant characteristics associated with discussions, and prevalence of desire to parent are described.

Methods. Describes, for a clinical sample of < 16-year-olds: medical chart-recorded discussion and procedure prevalence, and desire to parent longitudinally. Describes self-reported discussion prevalence for a community sample of 14- to 39-year-olds. Bivariate and multivariable modified Poisson analyses were conducted for this sample.

Results. Discussion prevalence was confirmed for approximately 80% of the clinical sample, with approximately 20% unconfirmed. Self-reported discussion prevalence was 45% in the community sample. Non-binary gender with female sex at birth, greater family religiosity, and diagnosed mental health condition excluding depression or anxiety were crudely associated with less discussions. Multivariable analyses revealed no statistically significant predictors. Desire to parent was fairly consistent over time.

Conclusion. Discussions should be standard practice for …

Association Of Socioeconomic, Racial, And Regional Factors With In-Hospital Management And Outcomes Of Acute Myocardial Infarction Patients In The United States: National Analyses Of 2.8 Million Admissions, Olivia Haldenby

Electronic Thesis and Dissertation Repository

Social determinants of health contribute to variations in clinical outcomes among acute myocardial infarction (AMI) patients. Using the National Inpatient Sample, we conducted retrospective cohort analyses to evaluate the association of income, race, and geography with in-hospital mortality and revascularization procedures among AMI admissions in the United States from 2015 to 2019. Multilevel logistic regression models were used while accounting for hospital clustering and relevant predictors. A sequential model-building approach produced model 1 (unadjusted patient-level exposures), model 2 (lifestyle factors), model 3 (clinical characteristics), and model 4 (fully adjusted hospital-level factors). We identified 2,798,225 AMI hospitalizations (≥18 years) with 1,567,575 …

Social Determinants Of Access To Primary Care In Canada, Feben W. Alemu

Electronic Thesis and Dissertation Repository

Despite the promise of universal care, many Canadians report having unmet healthcare needs. We conducted two studies: (1) a systematic review of studies on social determinants of health (SDH) and unmet need; and (2) a secondary analysis using the Canadian Longitudinal Study on Aging (CLSA) to investigate the association of SDH and (2a) self-reported unmet need and (2b) having a family physician. The review (n=40) found a positive association between unmet need and lower income, mental health and chronic conditions, and negative association with older age, better perceived health and having a family physician. The CLSA analysis found the odds …

Severe Lower Extremity Trauma In Ontario: A Linked Population-Based Analysis, Stephanie M. Kim

Electronic Thesis and Dissertation Repository

Open tibia fractures (OTF) are a management challenge. Admission to a trauma center (TC) and a coordinated approach to bony fixation and soft-tissue reconstruction (STR) have been shown to improve outcomes. The objective of this study was to describe patients who had OTF in Ontario and analyze their outcomes. Linked population data pertaining to patients who had OTF between the years 2009-2020 were examined. Demographic information, admission location, and management course were collected. 4240 patients were found. The mean age was 47, and majority were males. Patients admitted to TC had greater proportion of having Injury Severity Score >15, and …

Encouraging Movement Opportunities Through Theory-Informed Video Education In Undergraduate Students: The Move Study, Carmen T. Labadie

Electronic Thesis and Dissertation Repository

This mixed methods randomized control trial explored the impact of a tailored, Health Belief and Transtheoretical Model informed educational video on undergraduate students’: (1) motivational readiness, self-efficacy, and decisional balance about changing sedentary behaviour; (2) levels of sedentary time; and (3) perceptions of sedentary behaviour over time and when compared to a control condition. Students (N = 160) were randomly assigned to the intervention or control group. Participants completed: two previously validated questionnaires at baseline, immediate post-intervention, and one-month follow-up; and open-ended questions at post-intervention (intervention group only). Linear mixed models and inductive content analysis were used. Significant differences …

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

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 …

Multimorbidity And Cognition Among Canadian Older Adults: A Three-Decade Perspective, Juan Camilo Vargas Gonzalez

Electronic Thesis and Dissertation Repository

Background: Scarce information exists about whether the relationship between multimorbidity and cognitive decline has changed over the past decades.

Objectives: 1) To summarize knowledge about the association of multimorbidity and cognitive decline by performing a systematic review. 2) To estimate the association between multimorbidity in two cohorts selected three decades apart. 3)To identify which multimorbidity combinations have the strongest associations with cognitive decline 4) To identify protective factors that reduce the risk of cognitive decline in the presence of multimorbidity.

Methods: We performed a systematic review following the PRISMA statement. We then addressed objectives 2-4 by analyzing data from two …

Examining Bourdieu’S Concepts Of Capital, Habitus, And Field In Women’S Health Research In Nigeria: A Feminist Perspective, Mary Ndu

Health Studies Publications

Global health’s persistent focus on women’s health-seeking behaviour necessitates a philosophical understanding of the meaning behind women’s health decision-making. In studying health-seeking behaviour, researchers use philosophical paradigms to explicate and understand complex social concepts that continue to maintain health inequities and injustices. A commonly used theory is Bourdieu’s Theory of Practice. This paper examines the scholastic application of Bourdieu’s theory of practice to theorize women’s health-seeking behaviour in qualitative research to understand the rationale behind using health services. The theory of practice consists of four concepts: practice, habitus, field, and capital. Each concept conceptualizes the theory to find a logical …

Cancer Incidence And Stage At Diagnosis Among People With Psychotic Disorders: Systematic Review And Meta-Analysis., Jared C Wootten, Joshua C Wiener, Phillip S Blanchette, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Research regarding the incidence of cancer among people with psychotic disorders relative to the general population is equivocal, although the evidence suggests that they have more advanced stage cancer at diagnosis. We conducted a systematic review and meta-analysis to examine the incidence and stage at diagnosis of cancer among people with, relative to those without, psychotic disorders. We searched the MEDLINE, EMBASE, PsycINFO, and CINAHL databases. Articles were included if they reported the incidence and/or stage at diagnosis of cancer in people with psychotic disorders. Random effects meta-analyses were used to determine risk of cancer and odds of advanced stage …

Quantifying And Predicting Real-World Iatrogenic Severe Hypoglycemia In Adults With Type 1 Or 2 Diabetes Mellitus (The Inphorm Study, United States), Alexandria A. Ratzki-Leewing

Electronic Thesis and Dissertation Repository

Clinical outpatient strategies to accurately predict diabetes-related iatrogenic severe hypoglycemia (SH) are lacking. To redress this gap, we conducted the first-ever prognosis investigation of guideline-defined (Level 3) SH in the United States (US) (iNPHORM).

Chapter 4 details the design and implementation of iNPHORM: a prospective 12-wave panel survey (2020–2021). N=1206 adults with type 1 or insulin- and/or secretagogue-treated type 2 diabetes mellitus (T1DM or T2DM) were recruited from a US-wide, probability-based internet panel. For one-year, we collected monthly data on SH occurrence (frequencies, detection methods, symptoms, causes, and treatments) and related factors (anthropometric, sociodemographic, clinical, environmental/situational, behavioural, and psychosocial).

iNPHORM …

Cancer Incidence And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders: A Retrospective Cohort Study Using Health Administrative Data From Ontario, Canada., Jared C Wootten, Lucie Richard, Phillip S Blanchette, Joshua C. Wiener, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population.

METHOD: We constructed a retrospective cohort of people with a first diagnosis of non-affective psychotic disorder and a comparison group from the general population using linked health administrative databases in Ontario, Canada. The cohort was followed for incident diagnoses of cancer over a 25-year period. We used Poisson and logistic regression models to compare cancer incidence and stage at …

Using A One Health Approach For The Assessment Of Rabies Control In Rural Victoria Falls, Zimbabwe, Ryan Lapenna

Electronic Thesis and Dissertation Repository

Rabies, a viral zoonotic disease, is widespread in Zimbabwe, with human fatalities reported annually in the country. To supplement the Government’s effort on rabies control, the Victoria Falls Wildlife Trust and Veterinarians for Animal Welfare Zimbabwe have joined forces to carry out dog rabies vaccinations in rural communities adjacent to the major tourist attraction of The Victoria Falls. A One Health approach was used to 1) determine the level of protective rabies antibodies among a sample of rural dogs and 2) collect information and describe the knowledge, attitudes, and practices related to rabies among dog owners. In 2020, blood was …

How Can Single Mothers Care For Themselves And Their Children During The Covid-19 Pandemic?, Lisbeth Alexandra Pino Gavidia

Electronic Thesis and Dissertation Repository

This work investigates how single mothers maintain healthy behaviours for themselves and their children as they try to meet the evolving COVID-19 public recommendations. Everyone has had to adapt to changing public health rules. Single mothers may have unique challenges as they juggle to adapt to changing family responsibilities since they do not have another person helping in the home, and help outside the home may be restricted by public health rules. My research plan addressed these questions to learn more about the experiences of single mothers during the pandemic: 1) What are the changes in family responsibilities? 2) How …

Smart Indigenous Youth, Jamin Patel

Undergraduate Student Research Internships Conference

There is evidence that indicates the immense benefits of physical activity for the physical and mental health of youth. To respond to the youth mental health crisis in Indigenous communities in Canada, a culturally appropriate, land-based active living program called Smart Indigenous Youth (SIY) was developed by the Digital Epidemiology and Population Health Laboratory (DEPtH Lab). SIY is a longitudinal digital health community trial that applies the concept of citizen science to assess land-based active living’s impact on Indigenous youth mental health. My project examined the challenges to mental health faced by youth living in Indigenous Rural Communities during the …

Effect Of A Nutrition And Exercise Lifestyle Intervention Program (Nelip) With A Family Based Behavioural Treatment (Fbbt) During Pregnancy And Postpartum On The Prevalence Of Large Infants Up To 1 Year Of Age, Madeline E. Hubbard

Undergraduate Student Research Internships Conference

Overweight (OW; body mass index [BMI] of 25.0 to 29.9 kg/m² ), and obesity (OB; BMI of 30 and greater kg/m²) are conditions where excessive fat accumulation presents a risk to health. Prepregnancy BMI and maternal excessive gestational weight (EGWG) gain are risk factors for higher infant birthweight and childhood OW or OB. The Nutrition and Exercise Lifestyle Intervention Program (NELIP) is a combined intervention designed to prevent EGWG in individuals with OW and OB. This study was a convenience sample from a larger trial using the NELIP with family based behavioural treatment (FBBT) to increase program adherence. The objective …

Menstrual And Fertility Tracking Apps And The Post Roe V. Wade Era, Samantha T. Campanella

Undergraduate Student Research Internships Conference

In the first section of the paper, I will place current conversations about data privacy within the broader context of restrictions that have been placed on reproductive rights by examining historical trajectories. Emphasis will be placed on the historical trajectory of how past policies and ideologies have worked against Roe v. Wade, and how this trajectory contributes to a decrease in access to abortions. In addition, recent news stories have documented the overturning of Roe v. Wade in several jurisdictions within the United States, which confirms the criminalization of abortion. In light of this, experts have raised awareness about the …

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 …

Functional Neuroimaging Techniques To Examine Falls And Cognition In Older Adults: A Systematic Review, Tia M. Seleem, Raphael Gabiazon

Undergraduate Student Research Internships Conference

Falls in older adults have been attributed to impaired cognition. There is potential for neuroimaging techniques to understand the biological components that are involved in the cognitive processes pertaining to falls. Therefore, the purpose of this systematic review was to analyze how functional neuroimaging can be used to examine the relationship between falls and cognition among older adults. The following five electronic databases were selected to identify peer-reviewed articles in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: 1) Medline (via OVID), 2) PsycINFO (via OVID), 3) CINAHL (via EBSCO), 4) EMBASE (via OVID), and 5) Pubmed. …

The Effects Of Gases From Food Waste On Human Health: A Systematic Review, Paulina Rudziak

Undergraduate Student Research Internships Conference

Food waste is an everyday activity in many developed countries; however, the risks from emissions are either not acknowledged or poorly regulated in many food waste plants worldwide. The literature lacks a systematic review that gives a thorough overview of the effects of food waste emissions on human health, directly affecting physiology and indirectly affecting human health through environmental health effects. The aim of this study is to address this gap to support decision-makers in public health when inspecting food waste facilities and the surrounding areas. To inform this systematic review, the four databases, Web of Science, OVID, EMBASE, and …

The Shadow Pandemic: A Systematic Review On The Effects Of The Covid-19 Pandemic On Children And Adolescents Obsessive-Compulsive Disorder., Nasong A. Luginaah

Undergraduate Student Research Internships Conference

No abstract provided.

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

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 …

The Quality Of Life Of Patients With Eye Diseases, Brian Edward Yu

Electronic Thesis and Dissertation Repository

Background: Health-related Quality of Life (HRQoL) values determined using direct elicitation methods and generic preference-based measures are important for economic evaluations of healthcare interventions. The ophthalmology clientele is vulnerable to psychological stressors in the context of the coronavirus disease 2019 (COVID-19) pandemic.

Objectives: To systematically identify and summarize the quality of life (QoL) of eye disease patients in general in North America and seniors with eye diseases during the COVID-19 pandemic.

Methods: A systematic review identified North American studies that quantified HRQoL of eye disease patients. A cross-sectional study was conducted among seniors with eye diseases and backwards stepwise regression …

Sex And Gender Differences In Symptoms Of Early Psychosis: A Systematic Review And Meta-Analysis, Brooke Carter, Jared Wootten, Suzanne Archie, Amanda L Terry, Kelly K. Anderson

Epidemiology and Biostatistics Publications

First-episode psychosis (FEP) can be quite variable in clinical presentation, and both sex and gender may account for some of this variability. Prior literature on sex or gender differences in symptoms of psychosis have been inconclusive, and a comprehensive summary of evidence on the early course of illness is lacking. The objective of this study was to conduct a systematic review and meta-analysis of the literature to summarize prior evidence on the sex and gender differences in the symptoms of early psychosis. We conducted an electronic database search (MEDLINE, Scopus, PsycINFO, and CINAHL) from 1990 to present to identify quantitative …

Supporting Post-Secondary Implementation Of Recovery-Oriented Practice In A Stepped Care Model, Janis Campbell

The Dissertation-in-Practice at Western University

Student mental health has been a growing concern for higher education communities for many years. Campuses have been struggling to keep up with the increasing demand for services which has been complicated further by the COVID-19 pandemic. A Stepped Care model (SCM) developed at a Canadian university has been offering new ways of organizing mental health resources based on open access, student choice, and recovery principles. There are diverse definitions of recovery in the literature and are usually based on values such as empowerment, respect, and self-determination. SCMs have been shown to increase access to resources and reduce or eliminate …

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 …

Evaluation Of Healthcare Facilities And Services Provided For Tuberculosis And Zoonotic Tuberculosis In Kajiado County, Kenya, Joel Zhang

Electronic Thesis and Dissertation Repository

There are key challenges people face due to the burden of tuberculosis (TB), caused by Mycobacterium tuberculosis, and zoonotic tuberculosis (ZTB), caused by Mycobacterium bovis, in Kenyan Maasai rural communities. Thus, the objective of this study was to describe current capacities/infrastructure for diagnosis/treatment of TB/ZTB, and knowledge, attitudes, and practices among healthcare workers in rural Kajiado, Kenya.