Medicine and Health Sciences Commons^™

Radiographic Thresholds With Increased Odds Of A Poor Outcome Following Distal Radius Fractures In Patients Over 65 Years Old, Caitlin J. Symonette, Joy C. Macdermid, Ruby Grewal

Bone and Joint Institute

© 2019 Purpose: Older patients (aged older than 65 years)appear to tolerate a great degree of anatomic deformity after DRFs; however, the threshold beyond which the deformity becomes unacceptable is unknown. The purposes of this study were to identify the acceptable threshold for radiographic parameters after DRFs in patients aged over 65 years according to a patient-rated pain and disability outcome measure and to determine whether baseline activity levels influenced these parameters. Methods: A cohort of 190 older adults (aged 65 years and older)with DRF were selected from an existing prospectively collected database. The influence of specific radiographic parameters (ulnar …

Annual Research Review: Educational Neuroscience: Progress And Prospects, Michael S.C. Thomas, Daniel Ansari, Victoria C.P. Knowland

Brain and Mind Institute Researchers' Publications

© 2018 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. Educational neuroscience is an interdisciplinary research field that seeks to translate research findings on neural mechanisms of learning to educational practice and policy and to understand the effects of education on the brain. Neuroscience and education can interact directly, by virtue of considering the brain as a biological organ that needs to be in the optimal condition to learn (‘brain health’); or indirectly, as neuroscience shapes psychological theory and psychology influences education. In …

A Consensus Guide To Capturing The Ability To Inhibit Actions And Impulsive Behaviors In The Stop-Signal Task, Frederick Verbruggen, Adam R. Aron, Guido P.H. Band, Christian Beste, Patrick G. Bissett, Adam T. Brockett, Joshua W. Brown, Samuel R. Chamberlain, Christopher D. Chambers, Hans Colonius, Lorenza S. Colzato, Brian D. Corneil, James P. Coxon, Annie Dupuis, Dawn M. Eagle, Hugh Garavan, Ian Greenhouse, Andrew Heathcote, Rene´ J. Huster, Sara Jahfari, J. Leon Kenemans, Inge Leunissen, Chiang Shan R. Li, Gordon D. Logan, Dora Matzke, Sharon Morein-Zamir, Aditya Murthy, Martin Paré, Russell A. Poldrack, K. Richard Ridderinkhof, Trevor W. Robbins, Matthew Roesch

Brain and Mind Institute Researchers' Publications

© Verbruggen et al. Response inhibition is essential for navigating everyday life. Its derailment is considered integral to numerous neurological and psychiatric disorders, and more generally, to a wide range of behavioral and health problems. Response-inhibition efficiency furthermore correlates with treatment outcome in some of these conditions. The stop-signal task is an essential tool to determine how quickly response inhibition is implemented. Despite its apparent simplicity, there are many features (ranging from task design to data analysis) that vary across studies in ways that can easily compromise the validity of the obtained results. Our goal is to facilitate a more …

Rethinking Interhemispheric Imbalance As A Target For Stroke Neurorehabilitation, Jing Xu, Meret Branscheidt, Heidi Schambra, Levke Steiner, Mario Widmer, Jörn Diedrichsen, Jeff Goldsmith, Martin Lindquist, Tomoko Kitago, Andreas R. Luft, John W. Krakauer, Pablo A. Celnik, Nathan Kim, Michelle D. Harran, Benjamin Hertler, Juan C. Cortes

Brain and Mind Institute Researchers' Publications

© 2019 American Neurological Association Objective: Patients with chronic stroke have been shown to have failure to release interhemispheric inhibition (IHI) from the intact to the damaged hemisphere before movement execution (premovement IHI). This inhibitory imbalance was found to correlate with poor motor performance in the chronic stage after stroke and has since become a target for therapeutic interventions. The logic of this approach, however, implies that abnormal premovement IHI is causal to poor behavioral outcome and should therefore be present early after stroke when motor impairment is at its worst. To test this idea, in a longitudinal study, we …

Spinal Stretch Reflexes Support Efficient Hand Control, Jeffrey Weiler, Paul L. Gribble, J. Andrew Pruszynski

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s), under exclusive licence to Springer Nature America, Inc. Motor behaviour is most efficiently controlled by correcting only disturbances that influence task success. It is currently thought that such control is computed within a transcortical feedback pathway. Here we show that, for postural hand control, even the fastest spinal feedback pathway can produce efficient corrective responses, forcing a re-evaluation of how the nervous system derives the control laws that support motor behavior.

Feasibility Of A Web-Based Neurocognitive Battery For Assessing Cognitive Function In Critical Illness Survivors, Kimia Honarmand, Sabhyata Malik, Conor Wild, Laura E. Gonzalez-Lara, Christopher W. Mcintyre, Adrian M. Owen, Marat Slessarev

Brain and Mind Institute Researchers' Publications

Purpose To assess the feasibility of using a widely validated, web-based neurocognitive test battery (Cambridge Brain Sciences, CBS) in a cohort of critical illness survivors. Methods We conducted a prospective observational study in two intensive care units (ICUs) at two tertiary care hospitals. Twenty non-delirious ICU patients who were mechanically ventilated for a minimum of 24 hours underwent cognitive testing using the CBS battery. The CBS consists of 12 cognitive tests that assess a broad range of cognitive abilities that can be categorized into three cognitive domains: reasoning skills, short-term memory, and verbal processing. Patients underwent cognitive assessment while still …

Validity Of The Early Activity Scale For Endurance And The 6-Minute Walk Test For Children With Cerebral Palsy., Alyssa Laforme Fiss, Lynn Jeffries, Allison Yocum, Sarah Westcott Mccoy, On Track Study Team

Physical Therapy Publications

PURPOSE: This study aimed to describe Early Activity Scale for Endurance (EASE) scores and 6-minute walk test (6MWT) distances of children with cerebral palsy (CP) by functional ability level, sex, and age and to examine the convergent validity of the 2 tests.

METHODS: A total of 708 participants with CP, Gross Motor Function Classification System (GMFCS) levels I to V, completed the EASE, and 376 of the study participants (3-12years), GMFCS levels I to III, completed the 6MWT.

RESULTS: Children with CP vary in EASE scores and 6MWT distances based on GMFCS level and, to a lesser extent, age. The …

Longitudinal Trajectories And Reference Centiles For The Impact Of Health Conditions On Daily Activities Of Children With Cerebral Palsy., Doreen J Bartlett, Jan Willem Gorter, Lynn M Jeffries, Lisa Avery, Steven E Hanna, On Track Study Team

Physical Therapy Publications

AIM: First, to describe the impact of health conditions on daily activities over time in children with cerebral palsy (CP) and to create age-specific reference centiles. Second, to determine the amount of change typical over a 1-year period, across Gross Motor Function Classification System (GMFCS) levels.

METHOD: A prospective, cohort design, with five assessments over 2 years, involved 708 children with a confirmed diagnosis of CP participating in the On Track Study (396 males, 312 females; mean age 6y [SD 2y 7mo]; range 18mo-12y at first assessment; 32.1% in GMFCS level I, 22.7% in GMFCS level II, 11.2% in GMFCS …

Risk Factors For Falls In Individuals With Lower Extremity Amputations During The Pre-Prosthetic Phase: A Retrospective Cohort Study, Kimberly Vu, Michael W C Payne, Susan W. Hunter, Ricardo Viana

Physical Therapy Publications

BACKGROUND: Falls in individuals with lower limb amputations (LLAs) pose significant health concerns. The literature is limited regarding falls during the preprosthetic phase of rehabilitation for persons with LLAs.

OBJECTIVE: To determine the incidence of falls and identify factors associated with falls during the preprosthetic recovery phase.

DESIGN: Retrospective chart audit.

SETTING: Inpatient rehabilitation program.

PARTICIPANTS: Four hundred forty individuals with LLAs (age ± SD = 61.93 ± 14.53 years, 73.18% male) who attended inpatient rehabilitation from 26 July 2011 to 21 August 2017.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASUREMENTS: The number of self-reported falls was recorded from the time …

Intensive Balance Training For Adults With Incomplete Spinal Cord Injuries: Protocol For An Assessor-Blinded Randomized Clinical Trial., Janelle Unger, Katherine Chan, Carol Y Scovil, B Catharine Craven, Avril Mansfield, Kei Masani, Kristin E Musselman

Physical Therapy Publications

BACKGROUND: Impaired reactive balance control can lead to increased falls in people with neurological impairments. Perturbation-based balance training (PBT), which involves repetitive exposure to destabilizing external perturbations, improves the ability to take reactive steps in older adults and individuals who have had a stroke.

OBJECTIVE: The objective is to investigate whether PBT or conventional intensive balance training (CIBT) results in greater improvements in reactive stepping ability in individuals with chronic incomplete spinal cord injury (iSCI).

DESIGN: The design consists of an assessor-blind randomized clinical trial comparing the efficacy of 2 balance training programs (PBT and CIBT) matched for training duration …

Pathological Changes In Microvascular Morphology, Density, Size And Responses Following Comorbid Cerebral Injury, Zareen Amtul, Jun Yang, Ting-Yim Lee, David F. Cechetto

Anatomy and Cell Biology Publications

Aberrations in brain microcirculation and the associated increase in blood-brain-barrier (BBB) permeability in addition to neuroinflammation and Aβ deposition observed in Alzheimer’s disease (AD) and ischemia have gained considerable attention recently. However, the role of microvascular homeostasis as a pathogenic substrate to disturbed microperfusion as well as an overlapping etiologic mechanism between AD and ischemia has not been thoroughly explored. In this study, we employ temporal histopathology of cerebral vasculature in a rat model of β-amyloid (Aβ) toxicity and endothelin-1 induced-ischemia (ET1) to investigate the panorama of cerebral pathology and the protein expression on d1, d7, and d28 post-injury. The …

Canadian Undergraduate Nursing Students' Experiences Of Learning Indigenous Health, Ivy Tran

Western Research Forum

Western Research Forum Abstract Submission

Canadian Undergraduate Nursing Students’ Experiences with Learning Indigenous Health

Background
The purpose of this study is to better understand undergraduate nurses’ experiences in learning about Indigenous health. This will determine what changes are needed within nursing education locally and across Canada. Implications for nursing education, research, practice, policy, and leadership will be drawn to provide pragmatic suggestions in improving Indigenous health status and outcomes. A qualitative study will be conducted using critical ethnography and semi-structured interviews to determine facilitators and barriers to learning about Indigenous health.

Methods
Critical ethnography will be utilized to examine 12 …

The Effect Of Sepsis On Cerebral Microvascular Blood Flow, Laura Mawdsley, Mamadou Diop, Chris G. Ellis

Western Research Forum

Background: Sepsis is a dysregulated host response to infection that affects 18 000 000 people worldwide, and over 325 000 000 dollars are spent treating sepsis in Canada every year. One of the symptoms of severe sepsis is an altered mental state, which is accompanied with a measured decrease in oxygen levels in the skeletal muscle microvasculature. It is hypothesized that his altered mental state is due to a lack of oxygenated blood reaching the brain.

Hypothesis: After the onset of sepsis, microvascular cerebral blood flow and oxygen levels in the blood will decrease. Onset of decreased blood flow in …

Obstacle Negotiation And Dual-Tasking In People With A Unilateral Transtibial Amputation., Humberto Omana, Michael Payne, Ricardo Viana, Susan Winnifred Hunter

Western Research Forum

Background: Falls in people with a lower limb amputation (PLLAs) are common and most often occur while walking, resulting in physical and psychological consequences that adversely affect quality of life. Walking is a complex motor task requiring cognitive resources. Due to walking with a prosthesis, PLLAs report focussing on every step they take, indicating greater cognitive needs. However, cognitive resources are limited, and most of our everyday activities also involve the simultaneous performance of motor and cognitive tasks, known as dual-tasking. The inter-relationship between mobility, cognition and postural stability in PLLAs using a prosthesis is just starting to be understood. …

Factors Affecting Nurses’ Job Satisfaction In Rural And Urban Acute Care Settings: A Prisma Systematic Review, Yasin Yasin, Mickey Kerr, Carol A Wong, Charles H. Bélanger

Western Research Forum

This review aims to systemically describe the findings of primary studies in order to identify the intrinsic and extrinsic factors that affect nurses’ job satisfaction using PRISMA guidelines. It also aims to analyze the finding according to the two-factor theory; and compare studies based on rural and urban settings.

Two reviewers completed study selection, screening, and quality assessment. After data extraction, content analysis was used to categorize identified factors into themes.

Thirty-eight studies were selected for this review. Extrinsic factors reported in the findings were: work conditions (n=17), monetary benefits (n=5), hospital policies (n=6), supervision (n=7), interpersonal relationships (n=8), organization …

Quantifying Physical And Psychological Outcomes After Periprosthetic Femoral Fracture In Older Adults, Rifat Islam, Brent Lanting, Susan Hunter, Somerville Lyndsay

Western Research Forum

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and effective treatments for osteoarthritis. Falls risk is increased after these surgeries due to age, proprioceptive changes and leg weakness. One devastating consequence of falling after these surgeries, both functionally and psychologically, is a peri-prosthetic femoral fracture (PFF). Existing research on PFF has focused on surgical management and not the functional or psychological impacts to the person after this injury.

Hypothesis/Objectives: The study objectives are: 1) To evaluate the subjective and objective functional and psychological outcomes after sustaining a PFF, and 2) to estimate the prevalence of falls …

Changes In The Left Atrial-Esophageal Relationship With The Insertion Of An Esophageal Protective Device: A Cadaveric Imaging Study, Akmal Shahzad, Charys M. Martin, Michele L. Barbeau

Western Research Forum

Background: Atrial fibrillation is the most common cardiac rhythm disorder in North America and is frequently treated by a minimally invasive procedure called catheter ablation. A rare, but often fatal complication of this procedure is development of an atrial-esophageal fistula (AEF) due to the proximity of the esophagus to the left atrium (LA) of the heart. Esophageal protective devices may potentially mitigate the risk of developing an AEF but their impact on the relationship between the esophagus and LA is unknown. This study will investigate the relevant anatomical changes that occur upon insertion of an esophageal protective device.

Methods: 13 …

Executive Functioning Deficits Following Right Hemisphere Brain Damage: A Systematic Review, Ghalia Albakri

Western Research Forum

Background:

A growing body of literature has indicated that various executive functioning (EF) abilities are compromised subsequent to right hemisphere brain damage (RHD). EF supports communication and other complex daily activities via planning, monitoring, and controlling other cognitive processes to accomplish goal-oriented behaviors. Individuals with intact EF can achieve desirable tasks through fine cognitive control. The ability to use and understand pragmatics and discourse is dependent on one or more of these EF abilities. Consequently, if one of these cognitive abilities is impaired, communication challenges are expected.

Hypotheses/Objectives:

The goals of this systematic review are to: (a) examine the RHD …

Antibacterial Activity Of Polymers: Discussions On The Nature Of Amphiphilic Balance, Edmund F. Palermo, Karen Lienkamp, Elizabeth R. Gillies, Paul J. Ragogna

Bone and Joint Institute

© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim The purpose of this Viewpoint is to discuss the molecular design principles that guide development of synthetic antimicrobial polymers, especially those intended to mimic the structure of host defense peptides (HDPs). In particular, we focus on the principle of “amphiphilic balance” as it relates to some recently developed polyphosphoniums with somewhat atypical structure. We find that the fundamental concept of amphiphilic balance is still applicable to these new polymers, but that the method to achieve such balance is somewhat unique. We then briefly outline the future challenges and opportunities in this …

Ebola Virus Disease And Palliative Care In Humanitarian Crises, Favila Escobio, Elysée Nouvet

Health Studies Publications

No abstract provided.

Moderating Effect Of Cortical Thickness On Bold Signal Variability Age-Related Changes, Daiana R. Pur, Roy Eagleson, Anik De Ribaupierre, Nathalie Mella, Sandrine De Ribaupierre

Anatomy and Cell Biology Publications

The time course of neuroanatomical structural and functional measures across the lifespan is commonly reported in association with aging. Blood oxygen-level dependent signal variability, estimated using the standard deviation of the signal, or "BOLDSD", is an emerging metric of variability in neural processing, and has been shown to be positively correlated with cognitive flexibility. Generally, BOLDSD is reported to decrease with aging, and is thought to reflect age-related cognitive decline. Additionally, it is well established that normative aging is associated with structural changes in brain regions, and that these predict functional decline in various cognitive domains. Nevertheless, the interaction between …

Perioperative Venous Thromboembolism Prophylaxis In Prostate Cancer Surgery, Zachary Klaasson, Christopher J.D. Wallis, Luke T. Lavallee, Philippe D. Violette

Department of Medicine Publications

Purpose

To describe a patient and procedure specific approach to selecting Venous thromboembolism (VTE) prophylaxis for men who undergo radical prostatectomy.

Methods

We performed a literature search and narrative review of VTE after radical prostatectomy. We describe the current paradigm of perioperative thromboprophylaxis and underlying rationale. Relevant findings from the European Association of Urology thromboprophylaxis guidelines are interpreted and summarized.

Results

The use of extended post-operative thromboprophylaxis for patients who undergo radical prostatectomy is appropriate when the risk of symptomatic VTE outweighs the risk of major bleeding. Patient and procedure factors impact VTE risk. Patient risk can be stratified as …

Edwardsiella Tarda Infection Triggering Acute Relapse In Pediatric Crohn’S Disease, A K Li, M Barton, J A Delport, D Ashok

Paediatrics Publications

Crohn's disease exacerbations can often be associated with bacterial infections causing gastroenteritis. We report a child who experienced exacerbation of his Crohn's disease associated with a positive stool culture for

Pain Management Practices Surrounding Lumbar Punctures In Children: A Survey Of Canadian Emergency Physicians., Naveen Poonai, Victoria Brzozowski, Antonia S Stang, Amy L Drendel, Philippe Boisclair, Michael Miller, Stuart Harman, Samina Ali

Paediatrics Publications

OBJECTIVES:
Lumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.

METHODS:
We surveyed physicians in the Pediatric Emergency Research Canada (PERC) or Canadian Association of Emergency Physicians (CAEP) databases from May 1 to August 1, 2016, regarding hypothetical scenarios for a 3-week-old infant, a 3-year-old child, and a 16-year-old child requiring an LP. The primary outcome was the willingness to provide analgesia. Secondary outcomes included …

Crf Mediates Stress-Induced Pathophysiological High-Frequency Oscillations In Traumatic Brain Injury, Chakravarthi Narla, Paul S. Jung, Francisco Bautista Cruz, Michelle Everest, Julio Martinez-Trujillo, Michael O. Poulter

Physiology and Pharmacology Publications

Copyright © 2019 Narla et al. It is not known why there is increased risk to have seizures with increased anxiety and stress after traumatic brain injury (TBI). Stressors cause the release of corticotropin-releasing factor (CRF) both from the hypothalamic pituitary adrenal (HPA) axis and from CNS neurons located in the central amygdala and GABAergic interneurons. We have previously shown that CRF signaling is plastic, becoming excitatory instead of inhibitory after the kindling model of epilepsy. Here, using Sprague Dawley rats we have found that CRF signaling increased excitability after TBI. Following TBI, CRF type 1 receptor (CRFR1)-mediated activity caused …

‘That's For Old So And So's!’: Does Identity Influence Older Adults’ Technology Adoption Decisions?, Colleen E. Mcgrath

Occupational Therapy Publications

The role of identity in older adults’ decision-making about assistive technology adoption has been suggested but not fully explored. This scoping review was conducted to understand better how older adults’ self-image and their desire to maintain this influence their decision-making processes regarding assistive technology adoption. Using the five-stage scoping review framework by Arksey and O'Malley, a total of 416 search combinations were run across nine databases, resulting in a final yield of 49 articles. From these 49 articles, five themes emerged: (a) resisting the negative reality of an ageing and/or disabled identity; (b) independence and control are key; (c) the …

Initiating Participatory Action Research With Older Adults: Lessons Learned Through Reflexivity*, Colleen E. Mcgrath

Occupational Therapy Publications

Participatory action research (PAR) is well suited to research that aims to address social exclusion and inclusion in older age. Illustrations of and reflections on PAR with older adults are scarce, particularly the initiation stage, which sets the stage for the cyclical participatory action that follows. In this article, we describe the initiation of a PAR project with older adults and reflect on the alignment of this process with key participatory principles and fit within typical research structures. Findings point to the tensions between developing relationships over time and time-sensitive calls for funding, how traditional conceptions of research can influence …

Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device, Ryan Wood, James Robinson, Alan Getgood

Bone and Joint Institute

© 2018 Arthroscopy Association of North America The original description of the LaPrade technique for anatomic posterolateral corner reconstruction addresses the 3 main stabilizing structures: the fibular collateral ligament, the popliteus, and the popliteofibular ligament. The use of two separate grafts (originally described with a tendo-Achilles allograft) may restrict the utility of the technique when sources of allograft may be limited and autografts must be used, particularly in the context of multiligament reconstruction. We present a modification of the technique, in which an adjustable cortical button is used for tibial fixation, which allows for the use of a single graft …

Closed Limb Fractures With Compromised Vascularization: A Narrative Review, Christopher Vannabouathong, Emil Schemitsch, Bradley Petrisor, Mohit Bhandari

Bone and Joint Institute

© The Author(s) 2019. Vascular compromised fractures typically result in a high rate of healing complications, such as avascular necrosis, nonunion, delayed union, and arthritis, which severely affect a patient’s function and quality of life. The purpose of this review was to identify and describe the epidemiology and available treatment options for the most well-known vascular compromised closed fractures. The injuries discussed in detail in this review were scaphoid, lunate, femoral neck, and talar fractures. Current evidence suggests that optimal treatment for vascular compromised fractures is dependent on the degree of fracture displacement and comminution, and the patient’s post-injury functional …

Examination Of Psychological Risk Factors For Chronic Pain Following Cardiac Surgery: Protocol For A Prospective Observational Study, Michael H. Mcgillion, Shaunattonie Henry, Jason W. Busse, Carley Ouellette, Joel Katz, Manon Choinière, Andre Lamy, Richard Whitlock, Shirley Pettit, Jacqueline Hare, Krysten Gregus, Katheryn Brady, Nazari Dvirnik, Stephen Su Yang, Joel Parlow, Deborah Dumerton-Shore, Ian Gilron, D. Norman Buckley, Harsha Shanthanna, Sandra L. Carroll, Peter C. Coyte, Shanil Ebrahim, Wanrudee Isaranuwatchai, Denise N. Guerriere, Jeffrey Hoch, James Khan, Joy Macdermid, Geraldine Martorella, J. Charles Victor, Judy Watt-Watson, Kimberly Howard-Quijano, Aman Mahajan, Matthew T.V. Chan

Bone and Joint Institute

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. INTRODUCTION: Approximately 400 000 Americans and 36 000 Canadians undergo cardiac surgery annually, and up to 56% will develop chronic postsurgical pain (CPSP). The primary aim of this study is to explore the association of pain-related beliefs and gender-based pain expectations on the development of CPSP. Secondary goals are to: (A) explore risk factors for poor functional status and patient-level cost of illness from a societal perspective up to 12 months following cardiac surgery; and (B) determine the impact …