Medicine and Health Sciences Commons^™

Outcomes In Pediatric Studies Of Medium-Chain Acyl-Coa Dehydrogenase (Mcad) Deficiency And Phenylketonuria (Pku): A Review., Michael Pugliese, Kylie Tingley, Andrea Chow, Nicole Pallone, Maureen Smith, Alvi Rahman, Pranesh Chakraborty, Michael T Geraghty, Julie Irwin, Laure Tessier, Stuart G Nicholls, Martin Offringa, Nancy J Butcher, Ryan Iverson, Tammy J Clifford, Sylvia Stockler, Brian Hutton, Karen Paik, Jessica Tao, Becky Skidmore, Doug Coyle, Kathleen Duddy, Sarah Dyack, Cheryl R Greenberg, Shailly Jain Ghai, Natalya Karp, Lawrence Korngut, Jonathan Kronick, Alex Mackenzie, Jennifer Mackenzie, Bruno Maranda, John J Mitchell, Murray Potter, Chitra Prasad, Andreas Schulze, Rebecca Sparkes, Monica Taljaard, Yannis Trakadis, Jagdeep Walia, Beth K Potter

Paediatrics Publications

BACKGROUND: Inherited metabolic diseases (IMDs) are a group of individually rare single-gene diseases. For many IMDs, there is a paucity of high-quality evidence that evaluates the effectiveness of clinical interventions. Clinical effectiveness trials of IMD interventions could be supported through the development of core outcome sets (COSs), a recommended minimum set of standardized, high-quality outcomes and associated outcome measurement instruments to be incorporated by all trials in an area of study. We began the process of establishing pediatric COSs for two IMDs, medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and phenylketonuria (PKU), by reviewing published literature to describe outcomes reported by authors, …

Fatigue In Young People With Duchenne Muscular Dystrophy, Basmah El-Aloul, Kathy N Speechley, Yi Wei, Piotr Wilk, Craig Campbell

Paediatrics Publications

AIM: To describe fatigue in Duchenne muscular dystrophy (DMD) from patients' and parents' perspectives and to explore risk factors for fatigue in children and adolescents with DMD.

METHOD: A multicentre, cross-sectional study design was used. Seventy-one patients (all males; median age 12y, age range 5-17y) identified via the Canadian Neuromuscular Disease Registry, and their parents completed questionnaires. Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale by child self-report and parent proxy-report.

RESULTS: Patients with DMD across ages and disease stages experienced greater fatigue compared to typically developing controls from published data. Sleep disturbance symptoms …

Sex Differences In The Effects Of Exercise On Cognition Post-Stroke: Secondary Analysis Of A Randomized Controlled Trial, Shereen Khattab, Janice J. Eng, Teresa Liu-Ambrose, Julie Richardson, Joy Macdermid, Ada Tang

Bone and Joint Institute

OBJECTIVE: To determine whether there are differences in exercise-associated changes in cognitive func-tion between males and females living with stroke. DESIGN: Secondary analysis of data from a prospective assessor-blinded randomized controlled trial. PARTICIPANTS: Fifty participants (50-80 years, > 1 year post-stroke, able to walk ≥ 5 m). METHODS: Participants were allocated into a 6-month aerobic exercise programme (14 males, 11 females) or balance and flexibility programme (15 males, 10 females). Working memory (Verbal Digit Span Backwards Test), selective attention and conflict resolution (Stroop Colour-Word Test), and set shifting/cognitive flexibility (Trail-Making Test B) were assessed before and after the programmes. RESULTS: There …

Growth Hormone Deficiency In Megalencephaly-Capillary Malformation Syndrome: An Association With Activating Mutations In Pik3ca, Shanlee Davis, Meredith A Ware, Jordan Zeiger, Matthew A Deardorff, Katheryn Grand, Adda Grimberg, Stephanie Hsu, Megan Kelsey, Shideh Majidi, Revi P Matthew, Melanie Napier, Natalie Nokoff, Chitra Prasad, Andrew C Riggs, Margaret L Mckinnon, Ghayda Mirzaa

Paediatrics Publications

Megalencephaly-capillary malformation syndrome (MCAP) is a brain overgrowth disorder characterized by cortical malformations (specifically polymicrogyria), vascular anomalies, and segmental overgrowth secondary to somatic activating mutations in the PI3K-AKT-MTOR pathway (PIK3CA). Cases of growth failure and hypoglycemia have been reported in patients with MCAP, raising the suspicion for unappreciated growth hormone (GH) deficiency. Here we report an observational multicenter study of children with MCAP and GH deficiency. Eleven participants were confirmed to have GH deficiency, all with very low or undetectable circulating concentrations of insulin-like growth factor-1 and insulin-like growth factor binding protein-3. Seven underwent GH stimulation testing and all had …

The Pancreas-Specific Form Of Secretory Pathway Calcium Atpase 2 Regulates Multiple Pathways Involved In Calcium Homeostasis, Melissa Fenech, Mckenzie M Carter, Peter B Stathopulos, Christopher Pin

Paediatrics Publications

Acinar cell exocytosis requires spatiotemporal Ca²⁺ signals regulated through endoplasmic reticulum (ER) stores, Ca²⁺ATPases, and store-operated Ca²⁺ entry (SOCE). The secretory pathway Ca²⁺ATPase 2 (SPCA2) interacts with Orai1, which is involved in SOCE and store independent Ca²⁺ entry (SICE). However, in the pancreas, only a C-terminally truncated form of SPCA2 (termed SPAC2C) exists. The goal of this study was to determine if SPCA2C effects Ca²⁺ homeostasis in a similar fashion to the full-length SPCA2. Using epitope-tagged SPCA2C (SPCA2C^FLAG) expressed in HEK293A cells and Fura2 imaging, cytosolic [Ca²⁺] was …

Intranasal Dexmedetomidine For Procedural Distress In Children: A Systematic Review., Naveen Poonai, Joseph Spohn, Ben Vandermeer, Samina Ali, Maala Bhatt, Shawn Hendrikx, Evelyne D Trottier, Vikram Sabhaney, Amit Shah, Gary Joubert, Lisa Hartling

Paediatrics Publications

CONTEXT: Intranasal dexmedetomidine (IND) is an emerging agent for procedural distress in children.

OBJECTIVE: To explore the effectiveness of IND for procedural distress in children.

DATA SOURCES: We performed electronic searches of Medline (1946-2019), Embase (1980-2019), Google Scholar (2019), Cumulative Index to Nursing and Allied Health Literature (1981-2019), and Cochrane Central Register.

STUDY SELECTION: We included randomized trials of IND for procedures in children.

DATA EXTRACTION: Methodologic quality of evidence was evaluated by using the Cochrane Collaboration's risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. The primary outcome was the proportion of participants …

Brain Metabolite Levels In Sedentary Women And Non-Contact Athletes Differ From Contact Athletes., Amy L Schranz, Gregory A Dekaban, Lisa Fischer, Kevin Blackney, Christy Barreira, Timothy J Doherty, Douglas Fraser Md, Phd, Frcpc, Arthur Brown, Jeff Holmes, Ravi S Menon, Robert Bartha

Paediatrics Publications

White matter tracts are known to be susceptible to injury following concussion. The objective of this study was to determine whether contact play in sport could alter white matter metabolite levels in female varsity athletes independent of changes induced by long-term exercise. Metabolite levels were measured by single voxel proton magnetic resonance spectroscopy (MRS) in the prefrontal white matter at the beginning (In-Season) and end (Off-Season) of season in contact (

Mtorc1 Transcriptional Regulation Of Ribosome Subunits, Protein Synthesis, And Molecular Transport In Primary Human Trophoblast Cells., Fredrick J Rosario, Theresa L Powell, Madhulika B Gupta, Laura Cox, Thomas Jansson

Paediatrics Publications

Mechanistic Target of Rapamycin Complex 1 (mTORC1) serves as positive regulator of placental nutrient transport and mitochondrial respiration. The role of mTORC1 signaling in modulating other placental functions is largely unexplored. We used gene array following silencing of raptor to identify genes regulated by mTORC1 in primary human trophoblast (PHT) cells. Seven hundred and thirty-nine genes were differentially expressed; 487 genes were down-regulated and 252 up-regulated. Bioinformatic analyses demonstrated that inhibition of mTORC1 resulted in decreased expression of genes encoding ribosomal proteins in the 60S and 40S ribosome subunits. Furthermore, down-regulated genes were functionally enriched in genes involved in eIF2, …

The Cost-Utility Of Measles-Mumps-Rubella Immunization Strategies During A Mumps Outbreak, Kikanwa Anyiwe, David Naimark, Oliver Baclic, Vinita Dubey, Marina Salvadori, Man Wah Yeung, Matthew Tunis, Beate Sander

Paediatrics Publications

No abstract provided.

Improving Access And Mental Health For Youth Through Virtual Models Of Care, Cheryl Forchuk, Sandra Fisman, Jeffrey P. Reiss, Kerry Collins, Julie Eichstedt, Abraham Rudnick, Wanrudee Isaranuwatchai, Jeffrey S. Hoch, Xianbin Wang, Daniel Lizotte, Shona Macpherson, Richard Booth

Paediatrics Publications

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through …

Caring Near And Far By Connecting Community-Based Clients And Family Member/Friend Caregivers Using Passive Remote Monitoring: Protocol For A Pragmatic Randomized Controlled Trial, Lorie Donelle, Sandra Regan, Michael Kerr, Merrick Zwarenstein, Michael Bauer, Grace Warner, Wanrudee Isaranuwatchai, Aleksandra Zecevic, Elizabeth Borycki, Dorothy Forbes, Lori Weeks, Bev Leipert, Emily Read

Nursing Publications

Background: Significant chronic disease challenges exist among older adults. However, most older adults want to remain at home even if their health conditions challenge their ability to live independently. Yet publicly funded home care resources are scarce, private home care is expensive, and family/friend caregivers have limited capacity. Many older adults with chronic illness would require institutional care without the support from family member/friend caregivers. This role raises the risk of physical health problems, stress, burnout, and depression. Passive remote monitoring (RM), the use of sensors that do not require any action by the individual for the system to work, …

Cortical Activation During Shoulder And Finger Movements In Healthy Adults: A Functional Near-Infrared Spectroscopy (Fnirs) Study., Chieh-Ling Yang, Shannon B Lim, Sue Peters, Janice J Eng

Physical Therapy Publications

Characterization of cortical activation patterns during movement of the upper extremity in healthy adults is helpful in understanding recovery mechanisms following neurological disorders. This study explores cortical activation patterns associated with movements of the shoulder and fingers in healthy adults using functional near-infrared spectroscopy (fNIRS). Twelve healthy right-handed participants were recruited. Two motor tasks (shoulder abduction and finger extension) with two different trial lengths (10 s and 20 s) were performed in a sitting position at a rate of 0.5 Hz. The hemodynamic response, as indicated by oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR), over both hemispheres was acquired using a 54-channel …

Nox2 Is Critical To Endocardial To Mesenchymal Transition And Heart Development, Hoda Moazzen, Yan Wu, Anish Engineer, Xiangru Lu, Simran Aulakh, Qingping Feng

Paediatrics Publications

NADPH oxidases (NOX) are a major source of reactive oxygen species (ROS) production in the heart. ROS signaling regulates gene expression, cell proliferation, apoptosis, and migration. However, the role of NOX2 in embryonic heart development remains elusive. We hypothesized that deficiency of Nox2 disrupts endocardial to mesenchymal transition (EndMT) and results in congenital septal and valvular defects. Our data show that 34% of Nox2-/- neonatal mice had various congenital heart defects (CHDs) including atrial septal defects (ASD), ventricular septal defects (VSD), atrioventricular canal defects (AVCD), and malformation of atrioventricular and aortic valves. Notably, Nox2-/- embryonic hearts show abnormal development of …

Estimation Of Gfr In Patients With Cystic Fibrosis: A Cross-Sectional Study, Andrea Wallace, April Price, Erin Fleischer, Michael Khoury, Guido Filler

Paediatrics Publications

Background: Patients with cystic fibrosis (CF) have frequent infectious complications requiring nephrotoxic medications, necessitating monitoring of renal function. Although adult studies have suggested that cystatin C (CysC)-based estimated glomerular filtration rate (eGFR) may be preferable due to reduced muscle mass of patients with CF, pediatric patients remain understudied. Objective: Our objective was to determine which eGFR formula is best for estimating glomerular filtration rate (GFR) in pediatric patients with CF. Methods: A total of 17 patients with CF treated with nephrotoxic antibiotics were recruited from the Children’s Hospital at London Health Sciences Centre, London, Ontario, Canada. 99Tc DTPA GFR (measured …

Presence Of Benznidazole Conjugated Metabolites In Urine Identified By Β-Glucuronidase Treatment, María Elena Marson, Facundo García Bournissen, Jaime Altcheh, Guillermo Moscatelli, Samantha Moroni, Guido Enrique Mastrantonio

Paediatrics Publications

Chagas disease is a serious public health problem in Latin America and, due to migration, in other non-endemic regions. Benznidazole (BNZ) is first choice drug in pediatric therapeutics. However, little is known regarding its metabolism in humans. The aim of the study was to isolate and identify products of human BZN metabolism in urine samples obtained from a pediatric Chagas patient and a healthy adult volunteer both treated with BZN. Urine samples were collected after dose of BNZ. Urine was treated with β-glucuronidase followed by an extraction procedure under two different pH conditions and a HPLC/UV and MS/MS identification of …

After-Hours Incentives And Emergency Department Visits: Evidence From Ontario Forthcoming At Canadian Public Policy, Rose Anne Devlin, Koffi Ahoto Kpelitse, Lihua Li, Nirav Mehta, Sisira Sarma

Epidemiology and Biostatistics Publications

No abstract provided.

Evaluating The Effectiveness Of Aquatic Therapy On Mobility, Balance, And Level Of Functional Independence In Stroke Rehabilitation: A Systematic Review And Meta-Analysis., Alice Mary Iliescu, Amanda Mcintyre, Joshua C. Wiener, Jerome Iruthayarajah, Andrea Lee, Sarah Caughlin, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To meta-analyze and systematically review the effectiveness of aquatic therapy in improving mobility, balance, and functional independence after stroke.

DATA SOURCES: Articles published in Medline, Embase, CINAHL, PsycINFO, and Scopus up to 20 August 2019.

STUDY SELECTION: Studies met the following inclusion criteria: (1) English, (2) adult stroke population, (3) randomized or non-randomized prospectively controlled trial (RCT or PCT, respectively) study design, (4) the experimental group received >1 session of aquatic therapy, and (5) included a clinical outcome measure of mobility, balance, or functional independence.

DATA EXTRACTION: Participant characteristics, treatment protocols, between-group outcomes, point measures, and measures of variability …

The Occupational Therapy Examination And Practice Preparation (Otepp) Program: Development, Implementation And Evaluation Of An Educational Program For Internationally-Educated Occupational Therapists, Colleen E. Mcgrath

Occupational Therapy Publications

This paper provides a chronological overview of the development, implementation, and evaluation of an educational initiative aimed at ensuring internationally-educated occupational therapists are prepared to enter practice in their new country, Canada. The three major phases of the program’s 12-year evolution are described, to distill the key lessons learned at each phase. Data related to the demographics of participants, program content, results of the national examination, registration, and employment outcomes are included. An enhanced understanding of the transition experience of internationally educated occupational therapists provides a strong foundation from which to support internationally-educated colleagues and strengthen the occupational therapy profession.

Centering The Complexity Of Long-Term Unemployment: Lessons Learned From A Critical Occupational Science Inquiry, Rebecca Aldrich, Debbie Rudman, Na Eon(Esther) Park, Suzanne Huot

Occupational Therapy Publications

Inquiries that rely on temporal framings to demarcate long-term unemployment risk generating partial understandings and grounding unrealistic policy solutions. In contrast, this four-phase two-context study aimed to generate complex understandings of post-recession long-term unemployment in North America. Grounded in a critical occupational perspective, this collaborative ethnographic study also drew on street-level bureaucracy and governmentality perspectives to understand how social policies and discursive constructions shaped people’s everyday ‘doing’ within the arena of long-term unemployment. Across three phases, study methods included interviews with 15 organizational stakeholders who oversaw employment support services; interviews, participant observations, and focus groups with 18 people who provided …

Occupational Therapists As Street-Level Bureaucrats: Leveraging The Political Nature Of Everyday Practice., Rebecca M Aldrich, Debbie Rudman

Occupational Therapy Publications

BACKGROUND.: As front-line service providers who often work in systems regulated by governmental bodies, occupational therapists can be conceptualized as "street-level bureaucrats" ( Lipsky, 1980/2010 ) who effect and are affected by policy.

PURPOSE.: Drawing on understandings from a study of long-term unemployment, this article proposes that occupational therapists, as street-level bureaucrats, respond to inter-related policies and systems in ways that can perpetuate, resist, or transform opportunities for doing and being.

KEY ISSUES.: By highlighting practitioners' everyday negotiation of governmental, organizational, and professional power relations, the notion of street-level bureaucracy illuminates the political nature of practice as well as the …

Supports For Migrant Farmworkers: Tensions In (In)Access And (In)Action, Susana Caxaj, Amy Cohen, Sarah Marsden

Health and Rehabilitation Sciences Publications

Purpose: This study examined the role of support actors in promoting or hindering access to migrant agricultural workers' (MAWs) needs, and, to determine the factors that influence adequate support for this population.
Methodology: Employing a Situational Analysis methodology, we carried out focus groups and interviews with 35 support actors complimented by a community scan (n=28) with public-facing support persons and a community consultation with migrant agricultural workers (MAWs).
Findings: Two major themes were revealed: (In)access and (In)action, and; Blurred Lines in Service Provision. The first illustrated how support actors could both reinforce or challenge barriers for this population through tensions …

Intrinsic Measures And Shape Analysis Of The Intratemporal Facial Nerve, Thomas Hudson, Bradley Gare, Daniel Allen, Hanif Ladak, Sumit Agrawal

Electrical and Computer Engineering Publications

Hypothesis: To characterize anatomical measurements and shape variation of the facial nerve within the temporal bone, and to create statistical shape models (SSMs) to enhance knowledge of temporal bone anatomy and aid in automated segmentation.

Background: The facial nerve is a fundamental structure in otologic surgery, and detailed anatomic knowledge with surgical experience are needed to avoid its iatrogenic injury. Trainees can use simulators to practice surgical techniques, however manual segmentation required to develop simulations can be time consuming. Consequently, automated segmentation algorithms have been developed that use atlas registration, SSMs, and deep learning.

Methods: Forty cadaveric temporal bones were …

Memory Function And Brain Functional Connectivity Adaptations Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults At Risk Of Dementia: An Exploratory Sub-Study., Narlon C Boa Sorte Silva, Lindsay S Nagamatsu, Dawn P. Gill, Adrian M Owen, Robert J Petrella

Family Medicine Publications

BACKGROUND: Multiple-modality exercise improves brain function. However, whether task-based brain functional connectivity (FC) following exercise suggests adaptations in preferential brain regions is unclear. The objective of this study was to explore memory function and task-related FC changes following multiple-modality exercise and mind-motor training in older adults with subjective cognitive complaints.

METHODS: We performed secondary analysis of memory function data in older adults [

RESULTS: Our findings indicated that the M4 group showed greater improvements in the Paired Associates tasks compared to the M2 group at 24 weeks [mean difference: 0.47, 95% confidence interval (CI): 0.08 to 0.86,

CONCLUSION: Our findings …

Production Of Flavoured Fiti Probiotic Yoghurt For The London Community, Chengyu (Jennifer) Guo, Stephanie Huff, Maria Medina, Bob Gough, Sharareh Hekmat

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Using A One Health Approach To Address The Challenges Posed By Tuberculosis At The Human-Animal Interface In Kajiado County In Kenya, Joel Zhang, Timpiyian Leseni, Francisco Olea-Popelka

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Covid-19 Hospital Response In Canada And Kenya: A Comparative Study Of Practices At Aga Khan University Hospital Nairobi, Sunnybrook Health Sciences Centre, And University Hospital Network, Betty Wang

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

The Effect Of Interprofessional Conflict Resolution On Interprofessional Collaborative Practice Among Healthcare Providers In Hospitals, Sibylle Ugirase

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Nurses' And Nurse Educator's Experiences Of Applying Knowledge And Skills To Clinical And Academic Settings In Rwanda After Participating As Learners In Paediatric Nursing Continuing Professional Development Program, Amy Olson, Yolanda Babenko-Mould, Donatilla Mukamana

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Assessment Of The Medication Interruptions Among Nurses Working In Paediatric Unit At University Teaching Hospital Of Kigali, Aimable Nkurunziza, Geldine Chironda, Godfrey Katenda, Lakshmi Rajeswaran, Emmanuel Munyaneza, Madeleine Mukeshimana

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

A Literature Review Of Barriers To Scaling Up Vasectomy Among Men Of Reproductive Age In Nigeria: A Gender Perspective, Mary Ndu

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.