Medicine and Health Sciences Commons^™

Social Determinants Of Health And Uptake Of Colorectal Cancer Screening In Canada, Seth F. Kadish

Electronic Thesis and Dissertation Repository

Colorectal cancer (CRC) screening uptake may be associated with social determinants of health and could indicate potential barriers to health service access. The goal of this thesis was to evaluate the association of social determinants with CRC screening in screen-eligible adults. We used Andersen’s Behavioural Model of Health Service Utilization and the PROGRESS-Plus Framework to conceptualize potential social determinants. Our first study was a systematic review of peer-reviewed Canadian studies, and the second was a cross-sectional analysis of data from the Canadian Longitudinal Study on Aging (CLSA). The systematic review found lower uptake was associated with non-White ethno-racial identity, less …

Association Between Air Pollution And Incidence Of Dementia: A Systematic Review And Meta-Analysis Of Cohort Studies, Ehsan Abolhasani

Electronic Thesis and Dissertation Repository

Objective. To estimate the risk of dementia in association with exposure to air pollutants.

Methods. Six databases were searched. Cohort studies that reported the hazard ratio (HR) of dementia in association with exposure to air pollutants in adults > 40y were included. For all meta-analyses, the random-effects model was used.

Results. A total of 16 and 13 studies were included in the systematic review and the meta-analysis, respectively. Risk of dementia increased by 4% per 1μg/m³ increase in fine particulate matter level (HR, 1.04; 95%CI, [1.02, 1.06]), which was statistically significant. The risk of dementia increased by 3% per 10μg/m …

Correlates Of Preventable Emergency Department Visits In Canada: Evidence From The Literature And The Canadian Community Health Survey, Tammy Lau

Electronic Thesis and Dissertation Repository

Emergency department (ED) visits for primary healthcare-treatable conditions are preventable and indicate barriers to primary healthcare. The goal of this thesis was to explore the prevalence and key correlates of preventable ED visits among adults in Canada. Our systematic review found that the prevalence of these visits ranged from 4.3% to 59.1% and were associated with younger age, low education, low income, rural residence, and worse self-rated health. Our analysis of data from the 2015-2016 Canadian Community Health Survey found that 39.9% of adults with a regular healthcare provider considered their last ED visit to be preventable. In addition to …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

The Association Between Intimate Partner Violence And Functional Gastrointestinal Disorders And Symptoms Among Adult Women: Systematic Review, Ohud Shawqi Banjar

Electronic Thesis and Dissertation Repository

Functional gastrointestinal disorders (FGIDs) and symptoms have been identified as possible health consequences of intimate partner violence (IPV). However, whether specific types of abuse (i.e., psychological, physical and sexual) affect the health of women in different ways, and the mechanisms that explain how these forms of abuse affect their health and quality of life are not well understood. The aims of this systematic review were to examine the association between the different types of IPV and the risk of FGIDs and symptoms among adult women, identify the factors that mediate and/or moderate these health effects, and assess the impact of …

Therapeutic Interventions For Managing Diabetic Shoulder, Sanaa A. Alsubheen

Electronic Thesis and Dissertation Repository

Shoulder pain is a common complaint of diabetic patients that causes motion limitations and functional disability. Adhesive capsulitis (AC) is the most common disabling shoulder disorder. There is no optimal non-surgical treatment for managing AC in diabetic patients. Furthermore, the impact of diabetes on shoulder recovery and factors predicting shoulder function following shoulder arthroplasty is not well investigated.

Purpose and Methods

The main purpose of this thesis was to inform clinical practice about the best intervention for managing AC in diabetic patients, and to assess the impact of diabetes on functional outcomes after shoulder arthroplasty, with the following objectives: 1) …

Breastfeeding Experiences Of African Migrant Women In Developed Countries: A Qualitative Systematic Review., Odinaka Ogoegbunam Anunike

Electronic Thesis and Dissertation Repository

The American Academy of Pediatrics and the World Health Organization (WHO) recommend that newborns be fed breastmilk exclusively for the first 6 months of life unless medically contraindicated. Non-White African migrant women in developed countries experience breastfeeding challenges that shorten breastfeeding duration compared to women in their countries of origin. The purpose of this systematic review was to synthesize available qualitative research evidence to understand the breastfeeding experiences of non-White African migrant women residing in industrialized nations. Eight electronic databases were assessed and the Critical Appraisal Skills Programme (CASP) was used for quality assessment of studies. Ten peer-reviewed qualitative research …

Choice Of Implant Filler In Breast Reconstruction: A Study Of The Cost-Effectiveness Of Saline And Silicone Implants, Kathleen Nelligan

Electronic Thesis and Dissertation Repository

Breast reconstruction following mastectomy is increasing and implant-based breast reconstruction is the most common surgical approach. Saline and silicone implants have different cost and complication profiles and it is unclear which is the more cost-effective option. A systematic review of the literature was undertaken to summarize the quality of life data in breast reconstruction, specifically, previously published health state utility values relevant to breast reconstruction. In addition, a cost-utility analysis was undertaken from the perspective of the third-party payer, accounting for the most common complications associated with saline and silicone implants. This demonstrated that despite the increased initial cost of …

Chronic Disease Risk Prediction Models And Their Impacts On Behavioural And Health Outcomes: A Systematic Review And Meta-Analysis, Patrick Kim

Electronic Thesis and Dissertation Repository

Risk prediction models are tools that predict an individual’s risk of developing a health outcome. They were developed to influence patient management by guiding preventive interventions, with the goal of reducing the incidence of new diseases. Studies examining their impacts are uncommon, and no consensus regarding their effects has been reached. This systematic review sought to determine the impact of risk prediction models for chronic diseases on physician behaviour, patient behaviour, and patient health outcomes. Twenty-two studies were found to be eligible for review. The results demonstrated that: 1) physician behaviour may be positively influenced, though a statistically significant result …

A Systematic Review Of The Antecedents, Mediators And Outcomes Of Authentic Leadership In Healthcare, Bayan Alilyyani

Electronic Thesis and Dissertation Repository

Authentic leadership is a relational leadership style derived from the field of positive organizational behavior and is purported to promote healthy work environments that influence staff performance and positive organizational outcomes. The aim of this thesis was to conduct a systematic review to describe the state of the evidence on the relationship between authentic leadership, staff, and patient outcomes in healthcare. Published English-only research articles that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders/managers in healthcare settings were selected from eleven online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies. …

Improving The Use Of Electronic Medical Records In Primary Health Care: A Systematic Review And Meta-Analysis, Noura Hamade

Electronic Thesis and Dissertation Repository

Electronic Medical Records were first introduced in the 1970s to organize patient information, improve coordination of care, and improve communication. The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary health care settings. Of 2,098 identified studies twelve were included in the review. Results showed that interventions focused on the use of EMR functions were five times more likely to show improvements in EMR use compared to controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared to controls. Individuals in primary …

The Effectiveness Of Teleglaucoma Versus In-Patient Examination. Assessment: Systematic Review, Meta-Analysis, And Cost-Effectiveness Analysis, Sera-Melisa Thomas

Electronic Thesis and Dissertation Repository

Teleglaucoma is a screening device that remotely detects glaucoma cases at earlier stages using electronically-transferred stereoscopic digital imaging. Thus, patient wait and travel times are reduced, as well as, patient load in ophthalmic clinics. The purpose is to synthesize literature to evaluate teleglaucoma: its diagnostic accuracy, the healthcare system benefits, and its cost-effectiveness. A systematic review was conducted with published and unpublished studies. A meta-analysis was conducted to provide estimates of diagnostic accuracy, diagnostic odds ratio, and the relative percentage of glaucoma cases detected. Using Markov Modelling, a cost-effectiveness analysis was conducted. Of 11237 studies reviewed, 45 were included. Teleglaucoma …

Methotrexate And Cardiovascular Events, Alpesh Shah

Electronic Thesis and Dissertation Repository

We conducted a systematic review and meta-analysis to assess the association of MTX with cardiovascular morbidity, cardiovascular mortality and all-cause mortality in patients with autoimmune disease. Our primary outcome was incident cardiovascular events. After screening 13,479 citations, we identified a total of 30 eligible studies. We synthesized adjusted risk estimates using a random effects model. MTX was significantly associated with a 25% reduction in cardiovascular events (pooled RR: 0.75, 95% CI: 0.65, 0.86, I²: 11%), a 55% reduction in cardiovascular mortality (0.45, 95% CI: 0.26, 0.80, I²: 33%) and a 40% reduction in all-cause mortality (0.60, …

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 …

Physical Therapy Following Shoulder Rotator Cuff Repair, Ravindiran Appunni

Electronic Thesis and Dissertation Repository

ABSTRACT

Introduction

Rotator cuff (RC) tears are one of the common causes of pain and disability in the upper extremity. Currently there are no fixed guidelines for choosing testing positions for shoulder range of motion measurement. Optimal rehabilitation following RC repair is yet to be defined.

Purpose and Method

The purpose was to inform about postoperative Physical therapy following rotator cuff repair, with the following objectives:

• To systematically review the content of clinical research, which addresses various physical therapy programs.
• To describe validity and responsiveness of different testing positions for goniometric measurement of shoulder active external rotation.
• To pilot test …

Shift Work And Cardiovascular Events: Systematic Review And Meta-Analysis, Manav V. Vyas

Electronic Thesis and Dissertation Repository

The prevalence of shift work is increasing in the general population. There is conflicting epidemiologic evidence on the association between shift work and cardiovascular disease. We performed a systematic review and meta-analysis of observational studies that measured shift work-cardiovascular disease associations. We screened 12,350 articles and identified 35 eligible studies. The pooled risk ratios (RR) for myocardial infarction, all coronary events and ischemic stroke were 1.23 (95% confidence interval [CI] 1.15 to 1.31, I² = 0), 1.24 (95% CI 1.10 to 1.39, I² = 85%) and 1.05 (95% CI 1.01 to 1.09, I² = 0), respectively. The …