Translational Medical Research Commons^™

A Clinically Relevant Relevant Post-Traumatic Osteoarthritis Mouse Model, Chantel P. Arce

Electronic Thesis and Dissertation Repository

Osteoarthritis affects 13-20% of Canadians with the majority being under 65years of age. Post-traumatic osteoarthritis (PTOA) is of great concern in young athletes following knee injury. Current research attempts at modeling the disease fall short. This study aimed to incorporate two important aspects of injury, the nature of the injury and the post-injury standard of care in humans, to a model of PTOA in mice. The study validated a non-invasive protocol to elicit an anterior cruciate ligament (ACL) injury at varying loading speeds addressing the closed capsule nature of an ACL injury that occurs in humans. Secondly, we proposed a …

Quantifying The Effects Of Systematic Stn-Dbs Programming On Rest And Postural Tremor In Idiopathic Parkinson Disease Patients, Kristina Ognjanovic

Electronic Thesis and Dissertation Repository

Parkinson’s disease (PD) is a complex neurodegenerative disorder that encompasses both motor and non-motor symptoms. These symptoms and their severity are typically assessed by scale based measures in a clinical setting. Scale- based assessments of PD patients undergoing bilateral subthalamic nucleus deep brain stimulation surgery (STN-DBS) such as the Unified Parkinson Disease Rating Scale (UPDRS) are commonly used in a clinical setting to assess symptom severity and progression. However, the subjective nature of these and other clinical scales call into question both the sensitivity and accuracy of patient assessment over time. An objective quantification of rest and postural tremor of …

Prostate Cancer Microparticles As A Next Generation Screening Tool For Prostate Cancer, Khurram M. Siddiqui

Electronic Thesis and Dissertation Repository

Currently available screening tests for prostate cancer (PCa) are neither very sensitive nor specific. Microparticles (MP) are submicron tumor cell fragments released by PCa cells into the circulation and offer a possible means of sampling the tumor. We evaluated the utility of a MP blood test using nanoscale flow cytometry to distinguish patients with PCa from patients with benign prostatic hyperplasia (BPH). We used monoclonal antibodies against prostate specific membrane antigen, gastrin releasing peptide receptor and ghrelin peptide ligand.

We found higher but statistically insignificant, PSMA and Ghrelin dual +ve MP counts in the BPH group. Our results show that …

The Clinic Narrative: A Multiple Case Study Of Integrated Knowledge Translation And Equity-Oriented Primary Health Care, Christine A. Garinger

Electronic Thesis and Dissertation Repository

Understanding how PHC organizations implement changes to achieve equity-oriented care will add to the knowledge base regarding primary care renewal. Implementation science or knowledge translation (KT) has emerged, with the goal of enhancing evidence-based practice by implementing strategies of knowledge mobilization. Questions in this qualitative multiple case study were: 1) How does a new knowledge product, a ‘clinic narrative’, co-created by the researchers and the clinic leads, influence practices in the clinic specific to equity-oriented care?, 2) What facilitates or constrains the use of the narrative? and, 3) What are the novel uses of the narrative for organizational goals? The …

Knowledge Translation And The Governance Of Health Research In Canada: A Critical Discourse Analysis, Kathleen S. Ellis

Electronic Thesis and Dissertation Repository

Knowledge translation (KT) is a dominant discourse in the governance of health research in Canada. I critically examine the KT discourse of the Canadian Institutes of Health Research (CIHR), Canada’s major health research funder. Informed by a governmentality perspective, I explore how the KT discourse operates to shape the directions of health research and the activities of health researchers using critical discourse analysis with a sample of publicly available CIHR documents.

This KT discourse is constructed through three rationales: a “gap” between knowledge creation and its application; financial and health care accountabilities for public investment in health research; and, the …

Managing Uncertainty In Young-Onset Parkinson's Disease, Michael J. Ravenek

Electronic Thesis and Dissertation Repository

Typically considered a disease of old-age, Parkinson’s disease can affect those younger in life, i.e., before the age of 55, when it is referred to as young-onset Parkinson’s disease (YOPD). Using constructionist grounded theory, this research sought to understand how, and why, individuals with YOPD became informed about their disease over time. A total of 39 individuals, who self-identified as living with YOPD, took part in this study which was organized according to four cycles of data collection. These cycles utilized focus groups, in-depth interviews and a private online discussion board, supplemented by 14 autobiographies written by individuals living with …

Exploring Accuracy In Journalism Stories Reporting On Neuroscience Research Findings: A Comparative Case Study, Andrea M. Campbell-Davison

Electronic Thesis and Dissertation Repository

Abstract

Neuroscience has seen explosive growth in research and public interest, but research findings are often reported inaccurately, impacting public understanding. Exploratory descriptive case study methods were used to analyze two peer reviewed research articles, one on brain imaging for patients in a Persistent Vegetative State (PVS), and another on Brain Training (BT), and all journalism stories regarding these two studies. Statistical and content analyses were used to analyze the accuracy of the translation of the research into journalism stories. PVS research received more media attention and this reporting was less accurate than for BT research; the information was also …

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 …

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 …

Reassembling Knowledge Translation Through A Case Of Autism Genomics: Multiplicity And Coordination Amidst Practiced Actor-Networks, Julia J. Bickford

Electronic Thesis and Dissertation Repository

Knowledge translation (KT) has become a ubiquitous and important component within the Canadian health research funding environment. Despite a large and burgeoning literature on the topic of KT, research on the science of KT spans a very narrow philosophical spectrum, with published studies almost exclusively positioned within positivism. Grounded in a constructionist philosophical position and influenced by actor-network theory, this dissertation aims to contribute to the Canadian KT discussion by imagining new possibilities for conceptualizing KT.

This is an empirical-theoretical study which is based on eight months of data collection, including interviews, participant observation, and document analysis. This data collection …

Gender Does Not Influence The Relationship Between Posterior Cruciate Ligament Design And Patient-Reported Outcomes In Patients Receiving Primary Unilateral Total Knee Arthroplasty, Ryan Milan

Electronic Thesis and Dissertation Repository

The effect of the interaction between gender and posterior cruciate ligament (PCL) prosthesis design on patient-reported outcomes is an understudied area of research. We evaluated 1613 patients, from the Ontario Joint Replacement Registry (2001-2006), who underwent primary total knee replacement. This study investigated the impact of the gender-PCL design interaction on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) change scores and patient satisfaction, by performing linear regression analysis, using full-adjusted models that also included the gender-PCL prosthesis design interaction variable. PCL prosthesis design did not affect WOMAC change scores or satisfaction (p>0.05). Moreover, Gender did not influence either …

Exploring Pregnant Women’S Perceptions And Decision Making Of Household Chemicals: Phthalates As A Model, Justin M. Ashley

Electronic Thesis and Dissertation Repository

Recent research has identified a group of plasticizers known as phthalates as potential anti-androgens and a risk to developing male fetuses. A constructivist grounded theory study was used to understand pregnant women and obstetrical care providers’ perceptions of phthalates. Twenty-three pregnant women and twelve obstetrical care providers (Obstetricians, Family Physicians, and Midwives) from Southwestern Ontario participated in semi-structured interviews. Pregnant women and clinicians had little knowledge regarding phthalates and the potential associated risks. Women felt that knowledge of these risks would be important to prenatal counselling while clinicians required more evidence. Two separate but related models emerged from the data …

“We Should Be Listening To Our Elders”: Evaluation Of Transfer Of Indigenous Knowledge Between Anishinabe Youth And Elders, Kassandra Kulmann

Electronic Thesis and Dissertation Repository

Indigenous knowledge (IK) (knowledge held by Indigenous peoples regarding local environments, ways of life and culture) can potentially improve health and environment conditions. This thesis examines IK transfer between Anishinabe Elders and youth. A knowledge translation intervention was applied to address community concerns regarding decline of IK transfer between Elders and youth.

Youth were hired to participate in a summer school and interview Elders regarding environment and health issues. Qualitative interviews were conducted with youth before and after their internships to evaluate their experiences and IK uptake. The summer school and internships were effective for facilitating IK transfer between Elders …

How Do Parents Use Health Information With The Aid Of A Knowledge Broker When Living With And Caring For Their Young Children With Cerebral Palsy?, Stephanie E. Lagosky

Electronic Thesis and Dissertation Repository

This research aims to understand how parents use health information (such as those developed from the Move & PLAY study) with the aid of a knowledge broker when living with and caring for young children with cerebral palsy. This research was conducted under a qualitative case study methodology and used questionnaires and in-depth interviews to collect data. Findings include the complexity of both parental use of health information and the desire to use a knowledge broker. A provisional model has been created to help describe information use of parents with young children with cerebral palsy. This provisional model is an …

Adherence To Canadian Best Practice Recommendations For Stroke Care: The Case Of Post-Stroke Depression, Katherine L. Salter

Electronic Thesis and Dissertation Repository

Context: Canadian best practice recommendations for identification and treatment of post-stroke depression (PSD) have been established, but whether they have been adopted is not known.

Objectives: To compare current with recommended best practice.

Methods: A retrospective chart review from 5 inpatient rehabilitation programs in Southwestern Ontario was completed and a short online survey addressing current practices, opinions and attitudes regarding PSD conducted.

Results: Screening for PSD was documented in 41 of 294 patient records. Of the 41 patients screened, 16 were referred for assessment and 6 diagnosed with PSD. However, 113 patients (38.9%) received pharmacotherapy. Most staff …

Hearts And Minds: Examining The Evolution Of The Egyptian Excerebration And Evisceration Traditions Through The Impact Mummy Database, Andrew D. Wade

Electronic Thesis and Dissertation Repository

Egyptian mummification and funerary rituals were a transformative process, making the deceased a pure being; free of disease, injury, and disfigurements, as well as ethical and moral impurities. Consequently, the features of mummification available to specific categories of individuals hold social and ideological significance. This study refutes long-held classical stereotypes, particularly dogmatic class associations; demonstrates the apocryphal nature of universal heart retention; and expands on the purposes of excerebration and evisceration implied by synthetic and radiological analyses.

Features of the embalming traditions, specifically the variable excerebration and evisceration traditions, represented the Egyptian view of death. Fine-grain analyses, through primary imaging …

An Exploration Of Knowledge Translation Amongst Homecare Providers, Family Caregivers, And Clients, L. Jansen

Electronic Thesis and Dissertation Repository

The aim of this two-phased investigation was to enhance understanding of urinary incontinence (UI) knowledge translation (KT) to inform how UI management knowledge might be translated within in-home nursing practice and family caregiving. Although UI can be managed conservatively, it is a principal reason for the breakdown of family-care and care recipient admission to long-term care. Research has afforded little insight into family caregivers’ experience of KT and the process of in-home KT for UI management.

The first study used a hermeneutic phenomenological approach to explore family caregivers’ experience of UI KT. Data were collected from in-depth interviews with a …