Medicine and Health Sciences Commons^™

The Role Of Mobile Phones In Health Education For Rural Communities In Ghana: An Exploratory Study In Digital Technologies, Kinful Lartebea Aryee

Electronic Thesis and Dissertation Repository

The use of wireless, mobile, and handheld digital devices is growing in every sector, including education and health. The increase in mobile (handheld) phone usage has gradually drawn most healthcare practitioners’ and patients’ attention to its capability as a promoter of health education. It has helped with reduction in social and economic impact of preventive and curative and unexplained non-curable illnesses, especially among rural communities in sub-Saharan African countries such as Ghana.

Activity theory—an object-driven activity— was employed as the conceptual framework to answer the following research questions: What views do people have about information that relates to their health? …

Ultra High Field (7t) Magnetic Resonance Imaging Of Intracranial Vessel Wall, Pablo Lopez-Ojeda

Electronic Thesis and Dissertation Repository

Intracranial vessel wall imaging may be accomplished with high-field (7T) magnetic resonance (MRI). To determine its feasibility, a 7T MR protocol was defined using Polyvinyl-alcohol cryogel (PVA-C) phantom vessels and healthy subjects.

A 2D matrix construct of PVA-C vessel phantoms of different diameters and wall thicknesses was scanned. Three observers measured the phantom images, one of which three times. Physical measurements were performed using a digital caliper. Ten volunteers were scanned using three different MRI sequences (TSE-3D, FLAIR, MPRAGE). Imaging assessment was performed in different circle of Willis (COW) segments. Reliability and accuracy of the measurements was analyzed by inter …

Functional Anatomy Of The Anconeus: Muscle Architecture And Motor Unit Number Estimation, Daniel E. Stevens

Electronic Thesis and Dissertation Repository

Exploring muscle architecture in vivo and estimating the number of MUs in the human anconeus muscle have important implications related to the neuromuscular function of this muscle as a model for study in health and disease. The two studies presented in this thesis investigate the functional anatomy of the anconeus in 10 healthy young men (25±3y).

Ultrasound imaging has facilitated the measure of the architectural variables, fascicle length (L_F) and pennation angle (PA), in many human skeletal muscles in vivo. However, the functional anatomy of the anconeus has been investigated mainly from cadavers exclusively. Thus, the purpose …

The Association Between Women's Autonomy And Women's Hiv/Aids Knowledge And Attitudes In Ethiopia, Fadumo Rirash

Electronic Thesis and Dissertation Repository

Low autonomy resulting from gender inequalities in women has been identified as a contributing factor to the disproportionate impact of HIV/AIDS on women, especially in Sub-Saharan Africa.

This study explored the association between women’s autonomy and HIV/AIDS knowledge and attitudes in Ethiopia using the 2005 and 2011 Ethiopia Demographic and Health Surveys. The women’s spouses’ perceptions of the women’s autonomy and socio-demographic variables associated with HIV/AIDS knowledge and attitudes identified by the literature were included in the analyses. Multiple linear regression identified positive associations between women’s autonomy (and men’s perception of women’s autonomy), socio-demographic variables including education and mass media …

Secondary Traumatic Stress And Alexithymia In High-Risk Professionals, Matthew R. J. Vandermeer

Electronic Thesis and Dissertation Repository

This study investigated the role that cognitive deficits in emotional processing (i.e., alexithymia) play in the development of traumatic responses, such as secondary traumatic stress (STS), following work with clients who have experienced trauma. Using a prospective cohort of novice counselling psychology and pre-service education students, participants were measured for traits of alexithymia and STS before and after their first practicum placements. Elevated rates of STS consistent with a diagnosis of post-traumatic stress disorder were identified in participants following initial practicum placement. Correlation analyses demonstrated that alexithymia and alexithymia symptom clusters were significantly, and robustly, associated with STS and STS …

Obtaining A Diagnosis Of Fetal Alcohol Spectrum Disorder: Experiences Of Caregivers And Professionals, Erica R. Lundberg

Electronic Thesis and Dissertation Repository

The current study describes the lived experiences of stakeholders in a community-based fetal alcohol spectrum disorders assessment clinic. A qualitative methodology was used. Five participants, one caregiver and four professionals, were interviewed about their experiences. Six themes emerged from this process including: clinic organization: systemic strengths and challenges; attitudes and approach: laying the foundation; beyond yes or no: assessment and diagnosis; the moment of truth: delivering the diagnosis; outcomes: what happens after the diagnosis?; what does the future hold? next steps and needs. These themes formed a sequential story-telling of participant experience. Study results are critiqued and practical implications are …

The Adolescent Experience Of Motivational Interviewing-Via-Co-Active Life Coaching As A Motivational Intervention: A Constructivist Grounded Theory, Elizabeth A. Hall

Electronic Thesis and Dissertation Repository

Adolescents are often suffused in social, emotional, and scholastic pressures. The bombardment of stressors provoked by social media, external demands, self-doubt, and consequences of dangerous and spontaneous acts can result in a perception of self-inadequacy. Consequently, an increase in unhealthy activities and a decline in self-actualization become possible. Negative outcomes that result from avoidance of goal setting and ill-conceived decisions lead to familial and social sanctions, and adolescents become further detached from personal growth and success. The persistence of some youth to negative behaviour suggests that further investigation of effective interventions is a worthwhile undertaking. From this perspective, MI-via-CALC was …

Provincially-Funded Insulin Pump Therapy And Glycaemic Control: Real-World Experience In London, Ontario, Selina L. Liu

Electronic Thesis and Dissertation Repository

Background: Limited “real-world” evidence exists supporting insulin pump therapy (IPT) benefits in adults with type 1 diabetes mellitus (T1DM).

Methods: A retrospective matched cohort study compared the change in glycated hemoglobin (A1C) and incidence of adverse events before and after IPT start in adults with T1DM at St. Joseph’s Healthcare in London, Ontario started on IPT between September 2008 – August 2011 to those of a matched control cohort. Paired t-tests, McNemar’s test and negative binomial regression were used.

Results: 174 matched pairs were included. At 1 year, glycaemic control significantly improved in IPT users but not in controls—the …

Multiparametric Imaging And Mr Image Texture Analysis In Brain Tumors, Harish A. Sharma

Electronic Thesis and Dissertation Repository

Discrimination of tumor from radiation injured (RI) tissues and differentiation of tumor types using noninvasive imaging is essential for guiding surgical and radiotherapy treatments are some of the challenges that clinicians face in the course of treatment of brain tumors. The first objective in this thesis was to develop a method to discriminate between glioblastoma tumor recurrences and radiation injury using multiparametric characterization of the tissue incorporating conventional magnetic resonance imaging signal intensities and diffusion tensor imaging parameters. Our results show significant correlations in the RI that was missing in the tumor regions. These correlations may aid in differentiating between …

Trends In The Utilization Of Antiglaucoma Medication: An Analysis Of Canadian Drug Insurance Claims, Kwun (Bryan) Hung Chan

Electronic Thesis and Dissertation Repository

Objectives: To assess: i) utilization of generic anti-glaucoma drugs in Canada; ii) the impact of the 2010 Ontario Drug System Reform on generic anti-glaucoma drug usage in Ontario.

Methods: Monthly drug insurance cost and claims from January 2001 to January 2013 were used as proxies for drug utilization. Evaluation of the impact of the 2010 reform was conducted using interrupted time series analysis with ARIMA models.

Results: Generic antiglaucoma medication utilization increased in Ontario during Quarter 3, 2006. Increases in utilization across study provinces were observed in Quarter 4, 2011. The 2010 reform was not associated with …

Indoleamine 2,3-Dioxygenase Confers Resistance To Chemotherapy And Γ Radiation To Cancer Cells, Independent Of Direct Immune Involvement, Saman Maleki Vareki

Electronic Thesis and Dissertation Repository

Indoleamine 2,3-dioxygenase-1 (IDO) is an immunosuppressive molecule expressed by most human tumours. IDO levels correlate with poor prognosis in cancer patients and IDO inhibitors are under investigation to enhance endogenous anticancer immunosurveillance. Little is known regarding the immune-independent functions of IDO relevant to cancer therapy. In this thesis I show, for the first time, that IDO mediates human tumour cell resistance, in a cell-autonomous fashion, to single and combination treatment with a diverse group of chemotherapy drugs and g radiation. These drugs include a PARP inhibitor (olaparib), a DNA cross-linking agent (cisplatin), a folate antimetabolite (pemetrexed), a nucleoside analogue (gemcitabine), …

Resting State Functional Magnetic Resonance And Diffusion Tensor Imaging Of Hemiplegic Cerebral Palsy Patients Treated With Constraint-Induced Movement Therapy: Predictors And Clinically Correlated Evidence Of Neuroplasticity, Kathryn Y. Manning

Electronic Thesis and Dissertation Repository

Hemiplegic cerebral palsy is characterized by unilateral upper limb impairment and patients often compensate by performing most tasks with their unaffected arm. Constraint-induced movement therapy (CIMT) directly combats this learned non-use by casting the unaffected arm and forcing the patient to repetitively practice skills with the hemiplegic limb. Subjects with hemiplegic cerebral palsy were recruited from Holland Bloorview Kids Rehabilitation Hospital, Thames Valley Children’s Centre and McMaster Children’s Hospital. MRI acquisitions and clinical evaluations were collected at baseline, 1 and 6-months later. The case group participated in a CIMT camp after baseline evaluations and was compared to an untreated control …

Quantitative Susceptibility Imaging Of Tissue Microstructure Using Ultra-High Field Mri, David A. Rudko

Electronic Thesis and Dissertation Repository

This thesis has used ultra-high field (UHF) magnetic resonance imaging (MRI) to investigate the fundamental relationships between tissue microstructure and such susceptibility-based contrast parameters as the apparent transverse relaxation rate (R₂^*), the local Larmor frequency shift (LFS) and quantitative volume magnetic susceptibility (QS). The interaction of magnetic fields with biological tissues results in shifts in the LFS which can be used to distinguish underlying cellular architecture. The LFS is also linked to the relaxation properties of tissues in a gradient echo MRI sequence. Equally relevant, histological analysis has identified iron and myelin as two major sources of …

Community Physiotherapy And Chronic Disease Self-Management For Rural Community-Dwelling Older Adults, Laura J. Graham

Electronic Thesis and Dissertation Repository

Research problem: The majority of older Canadians live with at least one chronic disease. Exercise has been shown to be an effective means to reducing symptoms, and to improving physical dysfunction in chronically ill populations; and self-management is a nationally advocated approach to dealing with the growing health care issue of chronic disease. Physiotherapists are experts in prescribing therapeutic exercise and promoting chronic disease self-management.

Methods: This two-study dissertation explored older adults’ perceptions of exercise as a self-care activity within a chronic disease self-management strategy using focused ethnography; and physiotherapists’ experiences in promoting exercise as a means to chronic disease …

Releasing The Self From The Diagnostic Straitjacket: Making Meaning & Creating Understanding Through Dialogic Autobiography, Marnie L. Wedlake

Electronic Thesis and Dissertation Repository

ABSTRACT

To understand just one life, you have to swallow the world.

(Rushdie, 2006, pg. 121)

Mental health care in the Western world is situated firmly within a biomedical paradigm. Disorder is assumed, and symptoms are viewed as dis-abling deviations from normal. A disease-based model of care informs the treatment options that are most available and accessible.

I argue that bio-medical care separates the person from her/his experiences, the self from the individual. I advocate for the addition of a non-biomedical approach to health education that enables a connection between the individual and her/his experiences; one that does not …

The Nature Of Conflict In Sport: Development And Validation Of The Group Conflict Questionnaire, Kyle F. Paradis

Electronic Thesis and Dissertation Repository

The purpose of the present dissertation was to develop a questionnaire to assess intra-group conflict in sport teams. To this end, the current dissertation consisted of three phases which followed a logical progression that is typical in the questionnaire development process. A total of (N = 752) participants took part in the three phases (Phase 1: N = 10; Phase 2: N = 437; Phase 3: N = 305).

Phase 1 was a qualitative investigation of athletes’ (N = 10) perceptions of the nature of conflict in sport. This phase was undertaken to gain a better understanding of the conflict …

The Impact Of Obesity On Employment Participation And Earnings Among Working-Age Women In Canada: Evidence From The Nphs Longitudinal Data, Samantha L. Larose

Electronic Thesis and Dissertation Repository

Background: The direct medical care costs attributable to obesity are well-known, but little is known about the indirect costs of obesity. In particular, less is known about the impact of obesity on employment participation and earnings, especially among women in Canada.

Objectives: The objectives of this study are to examine the association between obesity and employment participation and earnings, if employed, among Canadian women.

Methods: Data were taken from the last six cycles of the National Population Health Survey from 2000/01-2010/11 longitudinal cohort data from women aged 18-53 years. The association between obesity and labour market participation was analyzed using …

Pre-Diabetes And Sympathetic Nervous System Mediated Microvascular Dysregulation In Skeletal Muscle, Nicole M. Novielli

Electronic Thesis and Dissertation Repository

Pre-diabetes is associated with impairments in cardiovascular health that manifest prior to the onset of overt type 2 diabetes. Characterized by hyperinsulinemia and insulin resistance, pre-diabetes has been associated with increases in sympathetic nerve activity, which may result in augmented sympathetic control of the peripheral vasculature within skeletal muscle. Currently however, there are no studies investigating the impact of pre-diabetes on sympathetically-mediated vascular control. The primary study of this thesis investigated the effects of pre-diabetes on baseline sympathetic neuropeptide Y Y1 receptor (NPY Y1R) and alpha 1 adrenergic receptor (a1R) control of hindlimb vascular tone. Experiments were carried out in …

Plastic Effect Of Tetanic Stimulation On Auditory Evoked Potentials, Rajesh Tripathy

Electronic Thesis and Dissertation Repository

The goal of this thesis was to investigate tetanic acoustic stimulation (TS) and its effects on the human auditory system. Two experiments were completed to study the effects of a 2 minute duration 1 kHz TS on the auditory brainstem and cortex using auditory evoked potentials. At the cortical level the auditory long latency response (ALLR) was recorded and the P1, N1, and P2 components were measured; in the brainstem the amplitude of the 80 Hz auditory steady state response (ASSR) was measured. TS induced significant changes in ALLR component latencies, and a significant reduction in ASSR amplitude, but these …

Extracting Vessel Structure From 3d Image Data, Yuchen Zhong

Electronic Thesis and Dissertation Repository

This thesis is focused on extracting the structure of vessels from 3D cardiac images. In many biomedical applications it is important to segment the vessels preserving their anatomically-correct topological structure. That is, the final result should form a tree. There are many technical challenges when solving this image analysis problem: noise, outliers, partial volume. In particular, standard segmentation methods are known to have problems with extracting thin structures and with enforcing topological constraints. All these issues explain why vessel segmentation remains an unsolved problem despite years of research.

Our new efforts combine recent advances in optimization-based methods for image analysis …

A Critical Discourse Analysis Of Medical Students’ Reflective Writing: Social Accountability, The Hidden Curriculum, And Critical Reflexivity, Stacey Ritz

Electronic Thesis and Dissertation Repository

In recent years, many medical schools have adopted a ‘social accountability’ approach, implementing a variety of activities and curricula aimed at developing a sense of social responsibility in medical students. The research of this thesis uses critical discourse analysis (CDA) to scrutinize the writing of senior medical students, with a view to uncovering how identity, ideology, and social position are expressed by students who have undertaken a curriculum designed with social accountability in mind. The analysis examines the conditions of discourse practice, student orientations to a professional medical identity, and ideologies of community, rurality, indigeneity, and gender. I discuss these …

Mirna Regulation Of Programmed Cell Death-1 In T Cells: Potential Prognostic And Therapeutic Markers In Melanoma, Nathan J. Johnston

Electronic Thesis and Dissertation Repository

Immunoinhibitory cell receptors that can induce a state of T cell exhaustion upon exposure to tumor antigen include Programmed Cell Death-1 (PD1). Although much research has been conducted on PD1, global miRNA regulation of PD1 in a cancer model has not been investigated. We hypothesized that miRNAs exist that can silence PD1 in vitro and revert symptoms of T cell exhaustion. Eleven miRNAs were discovered with altered expression between PD1⁺ and PD1^- CD4⁺ T cells from melanoma-bearing mice. miR-28 and miR-107 mimics were shown to bind to and silence the 3’UTR of PD1, and miR-28, miR-150 and …

The Role Of Oxygen Tension And Insulin-Like Growth Factor Signaling In The Placental Mesenchymal Stem Cell Fate, Amer Youssef

Electronic Thesis and Dissertation Repository

The human placenta of different gestational ages is a readily available source for isolation of adult mesenchymal stem cell (MSC) for potential use in regenerative therapies. The chorionic villous region, the largest component of a placenta that interfaces with the maternal circulation, is a rich source of placental MSCs (PMSCs). To remain multipotent, PMSCs are best maintained in culture conditions that mimic the in vivo microenvironment. Insulin like growth factors (IGFs, IGF-I and -II) and oxygen tension are two of the most important microenvironmental factors in the placenta. They are of low concentration or tension respectively, at early gestation, and …

Image Fusion And Axial Labeling Of The Spine, Brandon Miles

Electronic Thesis and Dissertation Repository

In order to improve radiological diagnosis of back pain and spine disease, two new algorithms have been developed to aid the 75% of Canadians who will suffer from back pain in a given year. With the associated medical imaging required for many of these patients, there is a potential for improvement in both patient care and healthcare economics by increasing the accuracy and efficiency of spine diagnosis. A real-time spine image fusion system and an automatic vertebra/disc labeling system have been developed to address this. Both magnetic resonance (MR) images and computed tomography (CT) images are often acquired for patients. …