Medicine and Health Sciences Commons^™

Exploring The Quality Performance Of Ethno-Specific And Mainstream Not-For-Profit Long-Term Care Homes In Ontario, Lanei Amein

Electronic Thesis and Dissertation Repository

The purpose of this retrospective study was to determine how ethno-specific not-for-profit long-term care (LTC) homes in Ontario perform in comparison to mainstream not-for-profit LTC homes using nine RAI-MDS 2.0 quality indicators. Publicly available data from three sources: the Canadian Institute for Health Information "Your Health System: In Depth" database from the Continuing Care Reporting System, data on Ontario ethno-specific not-for-profit LTC homes from the Home and Community Care Support Services, and data on home and ownership records from the Ministry of Long-Term Care “Public Reporting” website, between 2017-2022, were retrieved and analyzed. Descriptive analysis suggests that for all quality …

Optimizing The Management Of Anterior Monteggia Fractures: A Biomechanical Evaluation Of Treatment Options, Kirk D. Vannitamby

Electronic Thesis and Dissertation Repository

Anterior Monteggia injuries are frequently complicated by persistent radial head instability and suboptimal outcomes. Using a cadaveric elbow motion simulator, we quantified the contributions of ligaments of the proximal radius on maintaining radial head stability, evaluated the effectiveness of ulnar overcorrection to create an apex dorsal angulation in stabilizing the radiocapitellar joint, and finally compared the stabilizing effect of annular ligament repair to three different reconstruction techniques. Our results showed increased anterior radial head translation with progressive soft tissue sectioning with the annular ligament as the primary stabilizer. Ulnar overcorrection and forearm pronation were shown to decrease anterior translation of …

Older Adolescent Perspectives On The Use Of Research Within Online Communities, Ahrrabie Thirunavukkarasu

Electronic Thesis and Dissertation Repository

This study explores the attitudes of older adolescents (aged 16 to 19) regarding researchers collecting personal information from Social Networking Sites (SNSs) through passive observation to support Non-Suicidal Self-Injury (NSSI) research. The aim of this study is to add to the ongoing discourse in the scientific community, by providing a unique perspective on how researchers can uphold ethical conduct throughout their research process. This study adopts a mixed-methods approach and incorporates a Qualtrics^XM survey and online focus groups (FGs). The findings reveal that participants have reservations toward passive, hidden observational researchers. Despite their concerns, participants support researchers using their …

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 …

Chest Computed Tomography And Magnetic Resonance Imaging Texture Measurements Of Chronic Obstructive Pulmonary Disease, Maksym Sharma

Electronic Thesis and Dissertation Repository

Pulmonary imaging using computed tomography (CT) and magnetic resonance imaging (MRI) provide a method to measure airway and parenchymal pathologic information that cannot be provided using spirometry. Currently, it remains difficult to predict which chronic obstructive pulmonary disease (COPD) patients will worsen using spirometry, which although safe and inexpensive, does not provide small airway information where COPD is believed to initiate. Quantitative CT and MRI measurements provide regional structure and function information but are not included in mortality risk assessments, prognosis, or COPD staging. Therefore, my overarching hypothesis is that CT and MRI ventilation texture measurements combined with machine learning …

The Together Study: Exploring The Relationship Between Ontario Undergraduate University Students’ Levels Of Resilience And Their Experiences Of Diversity And Inclusion, Manvir Ahluwalia

Electronic Thesis and Dissertation Repository

This study’s primary purpose was to assess, quantitatively, the relationship between Ontario undergraduates’ levels of resilience and experiences of diversity and inclusion, and to identify demographic factors most associated with these outcomes. The secondary purpose was to explore, qualitatively, students’ experiences of diversity and inclusion and their perspectives on how these experiences influenced their resilience. Demographic questions, three scales, and (focus group and individual) interviews were used. Undergraduates (n = 276) from 19 Ontario universities completed the survey. Pearson’s correlation revealed a positive relationship between resilience and experiences of diversity and feelings of inclusion. Demographics indicative of equity-deserving group …

Resolving The Longitudinal Triglyceride Phenotype Of Heterozygous Lpl And Apo A-V Deficiency, Shehan D. Perera

Electronic Thesis and Dissertation Repository

Hypertriglyceridemia (HTG) is a risk factor for cardiovascular disease. However, only the triglyceride (TG) phenotype produced by biallelic loss-of-function (LOF) variants in the canonical TG metabolism genes is well understood. The TG phenotype produced by monoallelic LOF variants is poorly understood. We aimed to evaluate the TG phenotype associated with monoallelic LOF variants in the canonical TG metabolism genes.

Next-generation sequencing panel was employed to identify patients heterozygous for LOF variants in two of the canonical TG metabolism genes LPL and APOA5, followed by chart review to determine baseline and longitudinal TG phenotype in these patients.

My findings suggest …

Structure And Function Of Long-Covid Evaluated Using Pulmonary Imaging, Harkiran Kaur Kooner

Electronic Thesis and Dissertation Repository

The COVID-19 pandemic has resulted in millions of global respiratory infections, ranging in severity from asymptomatic to fatal. One of the many consequences of the pandemic is the emergence of long-COVID, which is an umbrella term used to describe the long-term sequelae and poor quality-of-life following recovery from acute COVID-19 infection. However, the pathophysiology and mechanisms responsible for the heterogenous manifestation of long-COVID remain poorly understood. Hyperpolarized ¹²⁹Xe magnetic resonance imaging (MRI) provides a non-invasive and radiation-free method to regionally visualize and quantify inhaled gas distribution and ventilation in vivo. A strong foundation for the use of pulmonary …

Voice: Exploring The Experiences Of University Students Who Have Experienced Gender-Based Violence, Rabani Nagra

Electronic Thesis and Dissertation Repository

Introduction: The occurrence and severity of gender-based violence (GBV) on Canadian higher education campuses has been a concern for decades. In September 2021, there were multiple reports of GBV at several Canadian universities with Western University being an exceptional case. The goal of this study was to explore: (1) the experiences of students who have experienced GBV during their enrollment at Western University; (2) the impact of GBV on students’ academics; and (3) student knowledge and experience with GBV resources.

Methods: This cross-sectional, qualitative study used an interpretive description framework and dialogue maps, underpinned by intersectionality. Seventeen undergraduate students were …

Precision Of Metabolite-Selective Mrs Measurements Of Glutamate, Gaba And Glutathione: A Review Of Human Brain Studies., Kesavi Kanagasabai, Lena Palaniyappan, Jean Theberge

Department of Medicine Publications

Single-voxel proton magnetic resonance spectroscopy (SV 1 H-MRS) is an in vivo noninvasive imaging technique used to detect neurotransmitters and metabolites. It enables repeated measurements in living participants to build explanatory neurochemical models of psychiatric symptoms and testing of therapeutic approaches. Given the tight link among glutamate, gamma-amino butyric acid (GABA), glutathione and glutamine within the cellular machinery, MRS investigations of neurocognitive and psychiatric disorders must quantify a network of metabolites simultaneously to capture the pathophysiological states of interest. Metabolite-selective sequences typically provide improved metabolite isolation and spectral modelling simplification for a single metabolite at a time. Non-metabolite-selective sequences provide …

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 …

The Development And Testing Of A Gyroscope-Based Neck Strengthening Rehabilitation Device, Nicole D. Devos

Electronic Thesis and Dissertation Repository

Neck pain can be debilitating, and is experienced by the majority of people at some point over the course of their life. Resistance training has been shown to have significant improvement in pain or disability for patients. There are few options available for telerehabilitation, and the use of gyroscope stabilizers is proposed for this use. A biomechanics model of a head--neck--gyroscope system was created. In order to also model the dynamics of such a system, this work proposes a blended method using the Denavit--Hartenberg (DH) convention, popular in the field of robotics, with the Lagrangian mechanics approach to analyze an …

Concussion-Related Symptomatology And Outcomes In Individuals With Mental Health Conditions: Symptom Number And Severity, Balance Performance, And Time Course To Discharge, Kathryn J. Schulze

Electronic Thesis and Dissertation Repository

Symptomatology can overlap between concussions and common mental health conditions (MHCs) – such as anxiety, depression, and attention-deficit/hyperactivity disorder. Research determined that there can be an onset of new or worsening symptoms related to pre-existing MHCs in individuals post-concussion. Pre-existing MHCs may affect concussion outcomes. Therefore, the relationship between pre-existing MHCs and concussions was further examined. Study One examined the difference in symptom severity and number of symptoms reported at the initial clinical assessment for concussion for individuals with and without a pre-existing MHC. A chart review determined that individuals with anxiety or multiple MHCs had significantly more concussion symptoms …

Female Enrollment In Rehabilitation Trials: A Systematic Review Of Reporting Sex And Female Participation In Randomized Controlled Trials Of Poststroke Upper Extremity Rehabilitation Over 50 Years, Sarvenaz Mehrabi, Amber Harnett, Marcus Saikaley, Jamie L Fleet, Janice J Eng, Mark Bayley, Robert Teasell

Physical Medicine and Rehabilitation Publications

OBJECTIVE: To systematically assess the reporting of sex and the percentage of female participants in randomized controlled trials (RCTs) examining interventions for the post-stroke rehabilitation of upper extremity (UE) motor disorders.

DATA SOURCES: CINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to April 1, 2021. Additional articles were identified using the Evidence-Based Review of Stroke Rehabilitation.

STUDY SELECTION: Studies were eligible for inclusion if they (1) were RCTs or crossovers published in English, (2) ≥50% of participants were diagnosed and affected by stroke, (3) included adults ≥18 years old, and (4) applied an intervention to the …

The Signs And Symptoms Of Discogenic Low Back Pain, Joe J. Putos

Electronic Thesis and Dissertation Repository

The signs and symptoms of low back pain (LBP) associated with disc herniation (DLBP) and its underlying mechanism(s) are not well supported. One theory proposes that some low back pain (LBP) is the result of a disc herniation compressing adjacent tissues innervated with nociceptors. The theory proposes that spinal manipulation (SM) and/or mobilizations (SMOB) can reduce the size and position of the herniation, and relieve pain and improve range of motion. There is no research to support or negate the theory even though clinical evidence supports its plausibility.

In this three-part study we examined clinical practices that have an anecdotal …

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 …

Clinical Care Of Masters Athletes: A Health Needs Assessment, Princess A. Ulona

Electronic Thesis and Dissertation Repository

Little is known about the current state of clinical care that Masters Athletes (MAs) receive, their perceptions, and whether they meet their health needs. A 22-item online health needs assessment (HNA) survey was conducted to investigate the characteristics of clinical care received by MAs and determine their perceived health needs. 80 MAs completed our survey. In assessing three key categories of care, less than 40% of MAs reported receiving Pre-Participation Evaluation (PPE), Medical Monitoring, and Injury Management as part of their standard routine care. Dissatisfied MAs reported unmet needs due to a lack of educated clinicians, lack of accessibility to …

Share Cannabidiol Exposure During Gestation Leads To Adverse Cardiac Outcomes Early In Postnatal Life In Male Rat Offspring., Daniel B. Hardy, Steven R. Laviolette, Kendrick Lee, David Rc Natale

Physiology and Pharmacology Publications

Introduction: Studies indicate that *7% of pregnant individuals in North America consume cannabis in pregnancy. Pre-clinical studies have established that maternal exposure to D9-tetrahydrocannabinol (THC; major psychoactive component in cannabis) leads to fetal growth restriction and impaired cardiac function in offspring. However, the effects of maternal exposure to cannabidiol (CBD; major non-euphoric constituent) on cardiac outcomes in offspring remain unknown. Therefore, our objective is to investigate the functional and underlying molecular impacts in the hearts of offspring exposed to CBD in pregnancy. Methods: Pregnant Wistar rats were exposed to either 3 or 30mg/kg CBD or vehicle control i.p. daily from …

Cannabidiol Exposure During Rat Pregnancy Leads To Labyrinth-Specific Vascular Defects In The Placenta And Reduced Fetal Growth, Daniel B. Hardy, David R C Natale, Kendrick Lee

Physiology and Pharmacology Publications

Introduction: Cannabis use is increasing among pregnant people, and cannabidiol (CBD), a constituent of cannabis, is often perceived as ‘‘natural’’ and ‘‘safe’’ as it is non-intoxicating. In utero, cannabis exposure is associated with negative health outcomes, including fetal growth restriction (FGR). The placenta supplies oxygen and nutrients to the fetus, and alterations in placental development can lead to FGR. While there has been some investigation into the effects of D9-THC, there has been limited investigation into the impacts of in utero gestational CBD exposure on the placenta. Methods: This study used histological and transcriptomic analysis of embryonic day (E)19.5 rat …

Validation Of A Virtual Auditory Space, And Its Use To Investigate How Pitch And Spatial Cues Contribute To Perceptual Segregation Of Auditory Streams, Nima Zargarnezhad

Electronic Thesis and Dissertation Repository

The human auditory system can decompose complex sound mixtures into distinct perceptual auditory objects through a process (or processes) known as Auditory Scene Analysis. Pitch and spatial cues are among the sound attributes known to influence sequential streaming (Plack 2018). In this project, the fidelity of a virtual acoustic space (the Audio Dome) in reproducing precisely located sound sources with a 9^th-order ambisonics algorithm was validated. The estimated horizontal Minimum Audible Angles aligned with previously reported values (Mills 1958) homogeneously across the space, and a robust low-frequency presentation was identified. Then, the Audio Dome was utilized to test …

The Impact Of Simulated Image Acquisition Time Reduction On Image Quality And Parameters Of Myocardial Perfusion Imaging Using A Dedicated Cardiac Camera, Alireza Khatami

Electronic Thesis and Dissertation Repository

Heart disease is the second leading cause of death in Canada, highlighting the crucial role of early diagnosis in disease management. Myocardial perfusion imaging (MPI), is widely employed for this purpose, involves injecting a radiopharmaceutical into the body, imaging its distribution with a gamma camera, and revealing cardiac blood flow patterns. A significant challenge in MPI is the lengthy 8 to 10 minutes required for stress and rest imaging, potentially causing patient discomfort and compromising image quality due to movement. In a clinical study with 26 patients, post-processed data manipulation simulated a reduction in MPI imaging time. The findings indicated …

Development Of Ph-Weighted Magnetic Resonance Imaging In The Spinal Cord: Application In Degenerative Cervical Myelopathy, Alicia E. Cronin

Electronic Thesis and Dissertation Repository

Degenerative cervical myelopathy (DCM) is a degenerative disease of the spinal cord that can lead to neurological dysfunction. It has been hypothesized that ischemia and hypoxia in the spinal cord at the site of compression could impact functional recovery after decompression surgery. Unfortunately, direct in-vivo quantification of hypoxia and ischemia in the spine has been limited in humans. Magnetic resonance imaging (MRI) can be utilized to measure hypoxia indirectly in soft tissue. Specifically, chemical exchange saturation transfer (CEST) is an MRI contrast that can be derived from the transfer of magnetization from selectively excited endogenous protons to bulk water protons. …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Working Towards Recommended Terminology In The Canadian Preschool Speech-Language Pathology Context, Alison Csercsics, Lisa Md Archibald, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose: This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multi-component knowledge translation intervention could increase speech-language pathologists’ (SLPs’) knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a three-month pilot period.

Method: The Diffusion of Innovations Theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre-post-follow-up testing) and included …

Sasah Experiential Learning: Global Health Equity, Anjali Singh

SASAH 4th Year Capstone and Other Projects: Publications

My journey with the Global Health Equity (GHE) internship program through the SASAH experiential learning program has been a transformative experience. This report encapsulates an exploration of the four years I have spent at the placement, outlining the evolution of skills, collaborations, and impactful projects that have strengthened my academic development and career aspirations. The report starts with a reflective introduction on my initial anxiety about entering the GHE internship, ultimately highlighting the meeting of interests between diplomacy, global affairs, and journalism with the internship’s focus on global health equity. I highlight pivotal encounters with mentors, colleagues, staff, and experts, …

Experiential Learning Final Report: Ase Leadership And Usri, Lauren Cowell

SASAH 4th Year Capstone and Other Projects: Publications

This reflective journey encapsulates the profound impact of my SASAH experiential learning, encompassing roles as an ASE Transition Leader and a USRI intern during my undergraduate years. From fostering academic growth to developing practical skills applicable in professional settings, this program provided unique opportunities for multidimensional learning. Collaboration emerged as a cornerstone, teaching adaptability, resilience, and the nuances of teamwork. Engaging with professionals contributed to workplace insights and personal growth. The roles undertaken enriched my skill set, from refining public speaking to engaging in collaborative research. The CliftonStrengths framework played a pivotal role, guiding me through challenges and leveraging collective …

Sleep, Sleepiness, And Driving Performance In Healthcare Shiftworkers, Melissa Knott

Electronic Thesis and Dissertation Repository

Almost half of Canadian healthcare workers are employed in rotating day/night shifts to provide essential 24-hour services. However, poor sleep quantity and quality are pervasive in shiftwork and may negatively impact cognitive functions required for driving. Furthermore, healthcare shiftworkers (HCSW) are under-represented in research examining shiftworkers’ sleep and driving performance. Thus, this dissertation examined sleep, sleepiness and driving performance in HCSW via three aims. First, chapter 2 aimed to quantify and describe HCSWs’ sleep-related driving experiences and advance the understanding of occupational adaptations used by HCSWs to meet driving demands. Second, chapter 3 aimed to quantify differences in sleep, sleepiness, …

Oral Health Inequalities In Adolescents And Young Adults In Ontario, Maria Rahman

Electronic Thesis and Dissertation Repository

Oral health is consistently linked to physiological, psychological, and social aspects of well-being in adolescents and young adults. In this thesis, I aimed to examine the social determinants of oral health and dental care utilization. First, I conducted a scoping review of the literature, demonstrated the multifaceted nature of oral health and its connections to broader social and economic factors. Then, I conducted a cross-sectional analysis of the Canadian Community Health Survey which showed a social gradient in oral health and dental care utilization among adolescents and young adults in Ontario. When stratified by age, there was a protective association …

A Picture Of Spirituality In Youth Living With Bipolar Disorder, Michelle S. Solomon

Electronic Thesis and Dissertation Repository

There is a paucity of literature concerning how youth living with bipolar disorder understand and experience spirituality. The management of bipolar disorder through psychosocial interventions such as spirituality is critical due to the chronic and complex nature of the illness and the fact that pharmacotherapy has not been found to fully restore mood and quality of life (Michalak et al., 2016; Miller et al., 2014; Sanchez-Moreno et al., 2009; Stroppa & Moreira-Almeida, 2013). Spirituality has been defined as being concerned with the ultimate questions in life; the meaning in life that a person gains in relation to something bigger than …

Regulation Of Health Ai Chatbots In Ontario, Mingi Chu

Electronic Thesis and Dissertation Repository

Artificial Intelligence (AI) has made remarkable strides in healthcare, from revolutionizing medical imaging, patient support, research insight, and health education. However, a recent shift from query-based to interactive and regenerative AI presents a question of properly facilitating its development. Upon close inspection, regulations and policy adaptations lag behind the rapidly advancing field of medical AI which raises concerns over governance and societal implications. This paper explains some of the technical and ethical considerations surrounding the use of health AI applications with chatbots as a specific example. It evaluates the existing policies and regulations in Ontario, Canada, that govern the production …