Medicine and Health Sciences Commons^™

Investigating Synergistic Effects Of Mild Traumatic Brain Injury And Reduced Cholinergic Tone On Attentional Deficits And Alzheimer's-Like Pathology In Haβ And Htau Mice, Elizabeth M. Teasell

Electronic Thesis and Dissertation Repository

Mild traumatic brain injury (mTBI) increases the risk of Alzheimer’s disease. The early cholinergic decline in Alzheimer’s disease and cholinergic damage observed after TBI suggest a distinct role of this neural system in vulnerability to Alzheimer’s disease following TBI. This thesis evaluated the role of repetitive mTBI and cholinergic dysfunction in the development of cognitive deficits, specifically attentional deficits, and Alzheimer’s-related pathology in mice expressing humanized amyloid-beta and tau and a vesicular acetylcholine transporter knockdown to induce a mild cholinergic deficit. Using the rodent continuous performance test, it was shown that repetitive mTBI in the presence of an already vulnerable …

The Association Between Prenatal Maternal Stress, Infant Brain Volumes, And Temperament During The Covid-19 Pandemic, Amber L. Di Paolo

Electronic Thesis and Dissertation Repository

Prenatal maternal stress (PNMS) is associated with altered trajectories of infant socio-emotional and brain development, including brain structures such as the amygdala and prefrontal cortex (PFC). During the COVID-19 pandemic, which was a major global stressor, PNMS was significantly elevated, yet the impact on infant neurodevelopment remains uncertain. The objective of the present study was to determine whether PNMS during the pandemic was associated with infant amygdala and PFC volumes as well as temperament. In addition, we examined whether social support and resilience during pregnancy were protective factors.

Participants were enrolled in the Canadian ‘Pregnancy during the COVID-19 Pandemic’ cohort …

How Different Insulin Administration Routes Affect Hepatic Glycogen Levels After An Aerobic Exercise Bout In Male Rats With Type 1 Diabetes, Amit P. Sayal Mr.

Electronic Thesis and Dissertation Repository

Type 1 diabetes mellitus (T1DM) is an autoimmune disease resulting in the destruction of pancreatic beta cells leading to deficient insulin production. Insulin plays a crucial role in regulating glucose metabolism, facilitating the utilization of dietary energy. Individuals with T1DM exhibit dysregulated blood glucose concentration and necessitate exogenous insulin administration. Intensive insulin therapy (IIT) is employed commonly, typically via subcutaneous (SQ) injections to treat individuals with T1DM. However, SQ insulin delivery fails to mimic endogenous insulin secretion, particularly its physiological distribution directly to the liver via the hepatic portal vein. Insulin concentration in the liver contributes significantly to glucose homeostasis, …

Enhancing Recovery: Investigating Outcome In Supercharged End-To-Side Anterior Interosseous Nerve To Ulnar Nerve Transfer, Tachit Jiravichitchai

Electronic Thesis and Dissertation Repository

Navigating the complexities of proximal ulnar nerve lesions presents a formidable challenge, prompting an urgent call for standardized outcome measures in the realm of supercharged end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, compounded by the intricacies of ulnar nerve transposition. This thorough thesis takes a dual-method approach, utilizing a rigorous Delphi study in addition to a scoping review methodology to clarify the complex terrain of SETS procedures.

The scoping review comprehensively delves into the outcomes and associated factors of SETS procedures, unraveling the intricate recovery trajectories while shedding light on the hurdles of standardization. Additionally, it incorporates …

Cognitive Changes In Early Untreated Parkinson's Disease, Kunj Patel

Electronic Thesis and Dissertation Repository

Cognitive impairment is the most common non-motor symptom in Parkinson’s disease (PD), affecting up to one-third of early-stage patients. However, the cognitive profile in early PD remains unclear due to the use of heterogenous samples of disease severity, small sample sizes, and the inclusion of medication effects. This study aims to characterize cognitive deficits in early PD using a large, drug-naive sample. This study examined performance on the Montreal Cognitive Assessment and the Hopkins Verbal Learning Test from the Parkinson’s Progression Markers Initiative dataset (n= 643 patients with PD; n= 240 healthy controls). Patients were restricted to …

Examining Global Mental Health, Bio-Politics And Depression In Ethiopia: A Critical Ethnography Study., Gojjam B. Limenih

Electronic Thesis and Dissertation Repository

Depressive disorder stands as a significant global health challenge and recognized as the primary cause of disability worldwide. Collaborating with the World Health Organization (WHO), Global Mental Health (GMH) initiatives have devised tailored international guidelines and intervention programs for low- and middle-income countries (LMICs) in response to this crisis. Despite concerted efforts, depressive disorder often remains underdiagnosed and undertreated in LMICs. However, our global understanding of depression is predominantly based on Western nosology, potentially limiting its universality. Consequently, existing clinical research and practices may fail to capture culturally relevant and salient aspects of depression.

Utilizing qualitative ethnographic methods, including Foucauldian …

Computational Modelling Of Branching Arteriolar Networks Using Constrained Constructive Optimization, Yuki Bao

Electronic Thesis and Dissertation Repository

The microcirculation plays a critical role in tissue blood flow distribution and is thus a topic of importance for understanding organ pathophysiology. As an alternative to experimental investigations of microvasculature, this thesis introduces a computational algorithm based on constrained constructive optimization (CCO) which aims to generate visually and statistically realistic branching arteriolar network architecture in healthy skeletal muscle tissue. The algorithm includes a list of user-specified adjustable model parameters to generate networks characteristic of different skeletal muscle tissues. Geometric (including mean vessel diameters, lengths, and numbers of bifurcations per order, Horton’s Law ratios, and fractal dimension) and hemodynamic (Murray’s Law …

Women's Mental Health During The Covid-19 Pandemic: A Mixed-Methods Sequential Explanatory Analysis Of The Role Of Sex, Gender, And Parenthood In The Experiences Of Depression And Anxiety, Hoda Seens

Electronic Thesis and Dissertation Repository

Research Questions

We examined the mental health experiences of women and gender-diverse people during the pandemic by answering three research questions. Q1. How did the levels of depressive and anxiety symptoms change during the pandemic by sex and gender? Q2. What individual and intersectional factors were related to experiencing the greatest levels of depressive and anxiety symptoms following the start of the pandemic? Q3. Why did some individuals experience more negative mental health outcomes?

Methods

This was a two-part mixed methods study. The first part was a quantitative study using an online survey; the second part was a qualitative explanatory …

Closing The Know-Do Gap In Global Health In Sub-Saharan Africa: A Critical Scoping Review Of Knowledge Translation Practices In Global Health Research Partnerships., Wale Fadare

Electronic Thesis and Dissertation Repository

Introduction: Sub-Saharan Africa is unlikely to achieve the Sustainable Development Goals by 2030. With poor health outcomes and a dependence on external funding, global health research partnerships (GHRPs) with high-income countries are criticized for being inequitable and inadequately representing local researchers.

Objective: This study examined the barriers and facilitators to Knowledge Translation (KT) in GHRPs in Sub-Saharan Africa, critiquing them through the lens of local researchers’ experiences and the degree of congruence with partnership principles in contemporary literature.

Methods: A critical scoping review of literature from five databases was conducted to identify barriers and facilitators to KT. Alignment with published …

Quantifying Resting-State Functional Connectivity In Critically Brain-Injured Patients: A Graph-Theoretical Approach With Fnirs, Ira Gupta

Electronic Thesis and Dissertation Repository

Assessment of consciousness in behaviourally unresponsive patients with critical brain injuries continues to be a challenge. There remains a need for robust tools that can accurately characterize preserved cortical function and predict patient outcomes. In the present study, functional near-infrared spectroscopy is employed in conjunction with graph theory and machine learning to quantify resting-state functional connectivity in 16 acutely brain-injured patients and 23 healthy controls. Results revealed significant channel-level differences between the groups for three graph metrics, including degree, clustering coefficient, and local efficiency. Further investigation using machine learning algorithms revealed that these metrics can be used to distinguish between …

Health Care And Social Predictors Of Gender Positivity And Gender Distress Among Transgender And Nonbinary People In Canada, Lux Li

Electronic Thesis and Dissertation Repository

Background: Transgender (trans) health care is focused on gender dysphoria and overlooks the diverse gender experiences of trans and nonbinary (TNB) individuals, especially gender positivity (also known as gender euphoria), a crucial aspect and resilience factor of trans well-being. Existing research on gender positivity is primarily qualitative, lacking quantitative assessment tools. This thesis provides quantitative insights by utilizing new assessment scales to evaluate gender positivity (GP) and gender distress (GD).

Methods: Data (n = 2316) were from Trans PULSE Canada, a 2019 cross-sectional community-based survey of TNB people aged 14+ in Canada. Social and bodily dimensions of gender …

Stress, Geographic And Sociodemographic Factors, And Oral Health Outcomes In Adolescents And Young Adults, Naima Abouseta

Electronic Thesis and Dissertation Repository

Oral health disparities are influenced by socioeconomic and demographic factors. Recent research suggests that stressors can contribute to these disparities. Adolescents and young adults are particularly vulnerable to these stressors, which can affect hypothalamic-pituitary-adrenal (HPA) axis reactivity. This thesis aimed to enhance understanding of the relationships among stress, geographic and sociodemographic factors, and oral health outcomes in adolescents and young adults. Additionally, salivary levels of mRNA encoding the glucocorticoid receptor (GR) were assessed and their relationship to stress and oral health outcomes investigated.

In the first study, the association between neighborhood-level socioeconomic status and dental care outcomes was explored in …

Period Poverty And Menstrual Perceptions Among Unhoused Menstruators In An Urban Center In Southern Ontario, Kristina D N Fernando

Electronic Thesis and Dissertation Repository

The purpose of this study is to uncover, describe and examine period poverty among unhoused menstruators accessing an urban shelter in Southern Ontario. Situated in a postmodern feminist lens and explored through thematic analysis, I employ participant observations and semi-structured interviews with shelter residents (n=13) and shelter staff (n=3) to conduct an exploratory case study at Dahlia Women and Family Shelter. The study findings suggest that menstruators at Dahlia experience period poverty and undergo significant challenges to their menstrual hygiene management. Menstrual perceptions were also found to vary based on the menstrual education that menstruators received …

Experience Of Community Physicians Who Provide Medical Assistance In Dying: A Qualitative Analysis, Rimpy Cheema

Electronic Thesis and Dissertation Repository

Aims: Since decriminalization in 2016, medical assistance in dying (MAiD) has transformed the landscape of end-of-life care in Canada. This study explored the experiences of community family physicians who provide MAiD.

Methods: Using a qualitative study design and phenomenological approach, semi-structured interviews were conducted of twelve physician providers in Southwestern Ontario. The transcripts were coded and inductively analyzed for overarching themes.

Findings: At the individual level, providers felt a profound sense of purpose. At the local level, participants reflected on the practical challenges encountered. At the system level, participants described the critical role of organizational support structures and the effects …

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 …

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 …

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 …

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 …