Medicine and Health Sciences Commons^™

Interdisciplinary Lens On Indigenous Health Iniquities: Planning, Nursing, Anthropology, Geography, Education, Chantal Francouer, Alana Kehoe, Ivy Tran, Steven Vanloffeld, Lillian Woroniuk, Jacob Renaud

Learning with your Head & Heart

Indigenous peoples experience poorer health outcomes on almost every measure of health and wellbeing, when compared to the rest of Canada. For decades researchers have been working independently on addressing health inequalities, yet little progress has been made on closing the gap. This Discipline-specific way of thinking is too narrow and neglects indigenous ideologies of holistic approaches to health. An interdisciplinary approach to indigenous health research provides a more collaborative and integrated opportunity to address the multidimensional aspects of health. This paper has the goals to contribute to the limited research on interdisciplinary indigenous health research.

The Application Of Community-Based Participatory Research (Cbpr), Riley Kennedy

Learning with your Head & Heart

Community-based participatory research is a contemporary research methodology used largely in health research. Community-based participatory research works to balance power and control in research. Indigenous people around the world have had an continue to have an uncomfortable research. Community-based participatory research is viewed as a way to do ethical research with Indigenous people. This project seeks to understand factors that influence community-based participatory research on Indigenous health using a narrative literature review approach.

Examining Indigenous Learner Recruitment And Retention Strategies Through An Environmental Scan Of Canadian Medical Schools, Sebastian Deagle

Learning with your Head & Heart

The 2015 Truth and Reconciliation Commission (TRC) of Canada’s Calls to Action Report outlined the need to better resolve the disparities in health status between Indigenous and non-Indigenous Canadian population. IN response, several Canadian medical schools began implementing recruitment and retention strategies to increase Indigenous matriculation. This is crucial, as Indigenous physicians are more likely to practice – and provide culturally-competent and comprehensive primary care – in Indigenous communities than physicians of other ethnicities. Therefore, enhancing Indigenous medical workforce development programs will have a strong return on investment in terms of improving the health status of Indigenous populations. However, while …

Sharing Of Injection Drug Preparation Equipment Is Associated With Hiv Infection: A Cross-Sectional Study, Laura J. Ball, Klajdi Puka, Mark Speechley, Ryan Wong, Brian Hallam, Joshua C. Weiner, Sharon Koivu, Michael S. Silverman

Epidemiology and Biostatistics Publications

Background: Sharing needles/syringes and sexual transmission are widely appreciated as means of HIV transmission among persons who inject drugs (PWIDs). London, Canada, is experiencing an outbreak of HIV among PWIDs, despite a large needle/syringe distribution program and low rates of needle/syringe sharing.

Objective: To determine whether sharing of injection drug preparation equipment (IDPE) is associated with HIV infection.

Methods: Between August 2016 and June 2017, individuals with a history of injection drug use and residence in London were recruited to complete a comprehensive questionnaire and HIV testing.

Results: A total of 127 participants were recruited; 8 were excluded because of …

Interdisciplinary Lens On Indigenous Health Iniquities: Planning, Nursing, Anthropology, Geography, Education, Chantal Francouer, Alana Kehoe, Ivy Tran, Steven Vanloffeld, Lillian Woroniuk, Jacob Renaud

2019 Cohort

Indigenous peoples experience poorer health outcomes on almost every measure of health and wellbeing, when compared to the rest of Canada. For decades researchers have been working independently on addressing health inequalities, yet little progress has been made on closing the gap. This Discipline-specific way of thinking is too narrow and neglects indigenous ideologies of holistic approaches to health. An interdisciplinary approach to indigenous health research provides a more collaborative and integrated opportunity to address the multidimensional aspects of health. This paper has the goals to contribute to the limited research on interdisciplinary indigenous health research.

The Application Of Community-Based Participatory Research (Cbpr), Riley Kennedy

2019 Cohort

Community-based participatory research is a contemporary research methodology used largely in health research. Community-based participatory research works to balance power and control in research. Indigenous people around the world have had an continue to have an uncomfortable research. Community-based participatory research is viewed as a way to do ethical research with Indigenous people. This project seeks to understand factors that influence community-based participatory research on Indigenous health using a narrative literature review approach.

Examining Indigenous Learner Recruitment And Retention Strategies Through An Environmental Scan Of Canadian Medical Schools, Sebastian Deagle

2019 Cohort

The 2015 Truth and Reconciliation Commission (TRC) of Canada’s Calls to Action Report outlined the need to better resolve the disparities in health status between Indigenous and non-Indigenous Canadian population. IN response, several Canadian medical schools began implementing recruitment and retention strategies to increase Indigenous matriculation. This is crucial, as Indigenous physicians are more likely to practice – and provide culturally-competent and comprehensive primary care – in Indigenous communities than physicians of other ethnicities. Therefore, enhancing Indigenous medical workforce development programs will have a strong return on investment in terms of improving the health status of Indigenous populations. However, while …

Hyperpolarized Helium 3 Mri In Mild-To-Moderate Asthma: Prediction Of Postbronchodilator Reversibility, Rachel L Eddy, Sarah Svenningsen, Christopher Licskai, David G Mccormack, Grace Parraga

Medical Biophysics Publications

Background: Longitudinal progression to irreversible airflow limitation occurs in approximately 10% of patients with asthma, but it is difficult to identify patients who are at risk for this transition.

Purpose: To investigate 6-year longitudinal changes in hyperpolarized helium 3 (3He) MRI ventilation defects in study participants with mild-to-moderate asthma and identify predictors of longitudinal changes in postbronchodilator forced expiratory volume in 1 second (FEV1) reversibility

Materials and Methods: Spirometry and hyperpolarized 3He MRI were evaluated in participants with mild-to-moderate asthma in two prospectively planned visits approximately 6 years apart. Participants underwent methacholine challenge at baseline (January 2010 to April 2011) …

Angiotensin Ii Type I Receptor Agonistic Autoantibodies Are Associated With Poor Allograft Survival In Liver Retransplantation., Qingyong Xu, Vivian Mcalister, Steve Leckie, Anton Skaro, Paul Marotta

Data and Test Instruments

Angiotensin II type I receptor (AT1R) agonistic autoantibodies (AT1R-AA) are detrimental to kidney transplantation. Early studies suggested a similar negative effect in primary liver transplantation. Here, we studied AT1R-AA in a retrospective cohort of 94 patients who received a second liver transplant to determine their prevalence and effects. The concentrations of preformed AT1R-AA before transplantation were higher (p=0.019) in the 48 patients who lost their liver grafts than in the 46 patients whose grafts survived. About half (48/94, 51.1%) of the patients were positive for AT1R-AAandgt;17U/ml before the second liver transplantation. In 22 (23.4%) patients, strong positive AT1R-AA (defined as …

Offspring From Maternal Nutrient Restriction In Mice Show Variations In Adult Glucose Metabolism Similar To Human Fetal Growth Restriction., B N Radford, V K M Han

Paediatrics Publications

Fetal growth restriction (FGR) is a pregnancy condition in which fetal growth is suboptimal for gestation, and this population is at increased risk for type 2 diabetes as adults. In humans, maternal malnutrition and placental insufficiency are the most common causes of FGR, and both result in fetal undernutrition. We hypothesized that maternal nutrient restriction (MNR) in mice will cause FGR and alter glucose metabolism in adult offspring. Pregnant CD-1 mice were subjected to MNR (70% of average ad libitum) or control (ad libitum) from E6.5 to birth. Following birth, mice were fostered by mothers on ad libitum feeds. Weight, …

Classification Criteria For Autoinflammatory Recurrent Fevers., Marco Gattorno, Michael Hofer, Silvia Federici, Federica Vanoni, Francesca Bovis, Ivona Aksentijevich, Jordi Anton, Juan Ignacio Arostegui, Karyl Barron, Eldad Ben-Cherit, Paul A Brogan, Luca Cantarini, Isabella Ceccherini, Fabrizio De Benedetti, Fatma Dedeoglu, Erkan Demirkaya, Joost Frenkel, Raphaela Goldbach-Mansky, Ahmet Gul, Veronique Hentgen, Hal Hoffman, Tilmann Kallinich, Isabelle Kone-Paut, Jasmin Kuemmerle-Deschner, Helen J Lachmann, Ronald M Laxer, Avi Livneh, Laura Obici, Seza Ozen, Dorota Rowczenio, Ricardo Russo, Yael Shinar, Anna Simon, Nataša Toplak, Isabelle Touitou, Yosef Uziel, Marielle Van Gijn, Dirk Foell, Claudia Garassino, Dan Kastner, Alberto Martini, Maria Pia Sormani, Nicolino Ruperto

Paediatrics Publications

BACKGROUND:
Different diagnostic and classification criteria are available for hereditary recurrent fevers (HRF)-familial Mediterranean fever (FMF), tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS), mevalonate kinase deficiency (MKD) and cryopyrin-associated periodic syndromes (CAPS)-and for the non-hereditary, periodic fever, aphthosis, pharyngitis and adenitis (PFAPA). We aimed to develop and validate new evidence-based classification criteria for HRF/PFAPA.

METHODS:
Step 1: selection of clinical, laboratory and genetic candidate variables; step 2: classification of 360 random patients from the Eurofever Registry by a panel of 25 clinicians and 8 geneticists blinded to patients' diagnosis (consensus ≥80%); step 3: statistical analysis for the selection of …

Brain Activity Associated With Dual-Task Performance Of Ankle Motor Control During Cognitive Challenge., Sue Peters, Janice J Eng, Teresa Liu-Ambrose, Michael R Borich, Elizabeth Dao, Ameen Amanian, Lara A Boyd

Physical Therapy Publications

INTRODUCTION: Skilled Ankle motor control is frequently required while performing secondary cognitively demanding tasks such as socializing and avoiding obstacles while walking, termed "Dual tasking." It is likely that Dual-task performance increases demand on the brain, as both motor and cognitive systems require neural resources. The purpose of this study was to use functional MRI to understand which brain regions are involved in resolving Dual-task interference created by requiring high levels of Ankle motor control during a cognitive task.

METHODS: Using functional MRI, brain activity was measured in sixteen young adults during performance of visually cued Ankle plantar flexion to …

Effectiveness Of High-Intensity Interval Training For Fitness And Mobility Post Stroke: A Systematic Review., Joshua C. Wiener, Amanda Mcintyre, Scott Janssen, Jeffrey Ty Chow, Cristina Batey, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.

LITERATURE SURVEY: Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.

METHODOLOGY: Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted.

SYNTHESIS: Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre-post studies. HIIT protocols ranged …

Methodological Consensus On Clinical Proton Mrs Of The Brain: Review And Recommendations, Martin Wilson, Ovidiu Andronesi, Peter B. Barker, Robert Bartha, Alberto Bizzi, Patrick J. Bolan, Kevin M. Brindle, In Young Choi, Cristina Cudalbu, Ulrike Dydak, Uzay E. Emir, Ramon G. Gonzalez, Stephan Gruber, Rolf Gruetter, Rakesh K. Gupta, Arend Heerschap, Anke Henning, Hoby P. Hetherington, Petra S. Huppi, Ralph E. Hurd, Kejal Kantarci, Risto A. Kauppinen, Dennis W.J. Klomp, Roland Kreis, Marijn J. Kruiskamp, Martin O. Leach, Alexander P. Lin, Peter R. Luijten, Małgorzata Marjańska, Andrew A. Maudsley, Dieter J. Meyerhoff, Carolyn E. Mountford

Medical Biophysics Publications

© 2019 International Society for Magnetic Resonance in Medicine Proton MRS (1H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a …

Physical, Occupational, And Speech Therapy For Children With Cerebral Palsy., Sarah Westcott Mccoy, Robert Palisano, Lisa Avery, Lynn Jeffries, Alyssa Laforme Fiss, Lisa Chiarello, Steve Hanna

Physical Therapy Publications

AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).

METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal …

Self-Care Trajectories And Reference Percentiles For Children With Cerebral Palsy., Robert J Palisano, Lisa A Chiarello, Lisa Avery, Steven Hanna, On Track Study Team

Physical Therapy Publications

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP).

Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles. …

Cortical Beta Oscillations Are Associated With Motor Performance Following Visuomotor Learning, Svenja Espenhahn, Bernadette C.M. Van Wijk, Holly E. Rossiter, Archy O. De Berker, Nell D. Redman, Jane Rondina, Joern Diedrichsen, Nick S. Ward

Brain and Mind Institute Researchers' Publications

© 2019 The Authors People vary in their capacity to learn and retain new motor skills. Although the relationship between neuronal oscillations in the beta frequency range (15–30 Hz) and motor behaviour is well established, the electrophysiological mechanisms underlying individual differences in motor learning are incompletely understood. Here, we investigated the degree to which measures of resting and movement-related beta power from sensorimotor cortex account for inter-individual differences in motor learning behaviour in the young and elderly. Twenty young (18–30 years) and twenty elderly (62–77 years) healthy adults were trained on a novel wrist flexion/extension tracking task and subsequently retested …

Glucocorticoids And “Stress” Are Not Synonymous, Scott Macdougall-Shackleton

Brain and Mind Institute Researchers' Publications

Synopsis

Reference to glucocorticoids as “stress hormones” has been growing in prevalence in the literature, including in comparative and environmental endocrinology. Although glucocorticoids are elevated in response to a variety of stressors in vertebrate animals, the primary functions of glucocorticoids are not responding to stressors and they are only one component of complex suite of physiological and behavioral responses to stressors. Thus, the use of the short-hand phrase “stress hormone” can be misleading. Further, simply measuring glucocorticoids is not equivalent to measuring a stress response, nor is manipulating glucocorticoids equivalent to exposing an animal to a stressor. In this commentary …

Longitudinal Changes In Physical Caregiving For Parents Of Children With Cerebral Palsy., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy, Margo Orlin, Ehab M Abd-Elkafy

Physical Therapy Publications

Aims: To determine changes in physical caregiving for parents of children with cerebral palsy (CP) over a two-year period based on children’s gross motor function level and age.

Methods: 153 parents of children with CP rated their physical caregiving using the Ease of Caregiving for Children three times over two years. Parents and assessors classified children’s gross motor function using the Gross Motor Function Classification System (GMFCS). Physical caregiving was compared at three test times among parents of children grouped by GMFCS level (I, II–III, and IV–V) and age (1.7–5.9 and 6–11 years) using a three-way mixed ANOVA.

Results: Among …

Chromium: Rise And Shine In Peritoneal Dialysis Patients?, Guido Filler, Christopher Mcintyre

Paediatrics Publications

Some trace elements are altered with chronic kidney disease. Selenium, zinc, and manganese tend to be wasted, and there is growing evidence that selenium deficiency is associated with mortality on dialysis. Other trace elements accumulate, such as chromium, cobalt, lead, molybdenum, and vanadium. The highest chromium levels are found in dialysis patients. The dialysis modality may further affect these levels, especially in hemodialysis patients, where even small contaminations in the dialysis feed water may lead to a concentration gradient that increases the concentration of certain trace elements. Chromium levels in peritoneal dialysis (PD) patients have been understudied. A single cross-sectional …

The Effect Of Wrist Position On Finger Tendon Loads Following Pulley Sectioning And Operative Reconstruction, Mohammad M. Haddara, B. Byers, Shrikant Chinchalkar, Louis M. Ferreira, Nina Suh

Bone and Joint Institute

© 2019 The Authors Purpose: Postoperative rehabilitation is important for maximizing patient outcomes after surgical pulley reconstruction. The purpose of this study was to identify the optimal wrist position in which rehabilitation should be undertaken to decrease the load on surgically reconstructed pulleys. Methods: We tested 14 digits composed of the index, middle, and ring fingers from 5 cadaveric specimens in a novel in vitro finger motion simulator designed to achieve full finger flexion and extension actively. Servo-motors were used to generate motion through tendons under load or position control while measuring tendon forces, joint range of motion, and tendon …

Arthroscopy Association Of Canada Position Statement On Intra-Articular Injections For Knee Osteoarthritis, Michaela Kopka, Brendan Sheehan, Ryan Degen, Ivan Wong, Laurie Hiemstra, Olufemi Ayeni, Alan Getgood, Cole Beavis, Monika Volesky, Ross Outerbridge, Bogdan Matache

Bone and Joint Institute

No abstract provided.

Understanding The Neural Bases Of Implicit And Statistical Learning, Laura J. Batterink, Ken A. Paller, Paul J. Reber

Brain and Mind Institute Researchers' Publications

© 2019 Cognitive Science Society, Inc. Both implicit learning and statistical learning focus on the ability of learners to pick up on patterns in the environment. It has been suggested that these two lines of research may be combined into a single construct of “implicit statistical learning.” However, by comparing the neural processes that give rise to implicit versus statistical learning, we may determine the extent to which these two learning paradigms do indeed describe the same core mechanisms. In this review, we describe current knowledge about neural mechanisms underlying both implicit learning and statistical learning, highlighting converging findings between …

Macaque Anterior Cingulate Cortex Deactivation Impairs Performance And Alters Lateral Prefrontal Oscillatory Activities In A Rule-Switching Task, Liya Ma, Jason L. Chan, Kevin Johnston, Stephen G. Lomber, Stefan Everling

Brain and Mind Institute Researchers' Publications

© 2019 Ma et al. In primates, both the dorsal anterior cingulate cortex (dACC) and the dorsolateral prefrontal cortex (dlPFC) are key regions of the frontoparietal cognitive control network. To study the role of the dACC and its communication with the dlPFC in cognitive control, we recorded local field potentials (LFPs) from the dlPFC before and during the reversible deactivation of the dACC, in macaque monkeys engaging in uncued switches between 2 stimulus-response rules, namely prosaccade and antisaccade. Cryogenic dACC deactivation impaired response accuracy during maintenance of—but not the initial switching to—the cognitively demanding antisaccade rule, which coincided with a …

Modulation Of The Hoffmann Reflex In The Tibialis Anterior With A Change In Posture., Janelle Unger, Justin W Andrushko, Alison R Oates, Doug W Renshaw, Trevor S Barss, E Paul Zehr, Jonathan P Farthing

Physical Therapy Publications

Hoffmann (H-) reflex amplitudes in plantar flexor soleus muscle are modulated by posture, yet dorsiflexor tibialis anterior (TA) H-reflex parameters have sparingly been studied. The purpose was to investigate modulation of the TA H-reflex when postural demands are increased from sitting to standing. In this study, data from 18 participants (Age: 25 ± 4 years, Height: 170.9 ± 9.5 cm, Weight: 75.9 ± 17.2 kg) allowed comparison of two experimental conditions involving different postures (i.e. sitting and standing). Maximal amplitude of the TA H-reflex (H_max) as a percent of the maximal M-wave amplitude (M_max) …

Realist Evaluation Of Ldcp Funded Health Equity Indicators, Shamiram Zendo Ms

Western Research Forum

Background: The Health Equity Indicators were developed by a group of public health practitioners, and academics to assist Local Public Health Agencies (LPHAs), across Ontario, Canada, determine whether their public health programs and activities meet the equity standards required by the Ministry of Health and Long-term Care (MOHLTC). The Health Equity Indicators have been designed to assess organizational internal practice and determine whether programs meet equity standards.

Objective: A realist evaluation is currently underway to determine who these indicators work for and under what conditions, across the LPHAs in the province of Ontario.

Method: Realist methodology has been …

Dance As A Protective Measure Against The Cognitive And Physical Declines Associated With Aging: A Proposed Study, Sarah M. Schwanz, Jeffrey Holmes, Jessica Grahn

Western Research Forum

Background:

Dance is considered a multimodal activity in that it requires both physical and cognitive engagement. Combining physical activity with music may have a synergistic effect, enabling dance to enhance physical and cognitive functions more than music and physical activity alone. The positive changes attributed to dance training such as improved visuospatial and motor ability, high coordination, greater balance, and increased cognitive ability may also benefit individuals as they age.

Methods:

This proposed study will examine whether dance training has the potential to protect against age-related cognitive and physical decline by assessing the cognitive and physical domains that show decline …

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how …

Public Policy Advocacy In The Canadian Context: A Review Of The Current Literature, Amy Lewis, Abram Oudshoorn, Helene Berman

Western Research Forum

Public Policy Advocacy in the Canadian Context: A Review of the Current Literature

Background: Public policy advocacy is an important competency for students from healthcare and social service programs to develop; however, integration of policy advocacy within university curricula remains inconsistent. Identifying the knowledge and skills that healthcare and social service professionals use in policy advocacy supports the development of educational competencies to achieve entry-to-practice objectives. A review of the literature published on the topic of public policy advocacy in higher education was undertaken to determine the current state of this evidence.

Methods: For this scoping review, CINAHL, Scopus, and …

Identifying The Enzyme Involved In Vacuolar Atpase Acetylation During Doxorubicin-Induced Cardiotoxicity, Rebecca Dang, Tianqing Peng

Western Research Forum

Doxorubicin is an established anticancer medication infamous for its bright colouration and extremely toxic side effects. Emerging studies support that the imbalance between acetylation and deacetylation disrupts the autophagic flux leading to doxorubicin-induced cardiotoxicity. Vacuolar ATPases are a family of electrogenic proton pumps present on the lysosomal membrane that create an acidic environment for proteases to degrade proteins. Our preliminary study found that acetylated Vacuolar ATPase subunit V₀ D1 levels increased in doxorubicin-injected mouse hearts. However, it is unknown how acetylation of subunit V₀ D1 is modulated and whether this modification plays a role in doxorubicin-induced cardiotoxicity.

The …