Genome-Based Pathogenicity Potential Of Salmonella Isolated From Diverse Sources, Jared Mr Crocco

Theses and Dissertations (Comprehensive)

Bacterial human pathogens are among the leading causes of death around the world, especially in low income and developing countries. One important element in a bacterium’s ability to cause disease are genes that directly contribute to pathogenicity called virulence factors. A second significant aspect are antimicrobial resistance genes which allow microorganisms to persist in the presence of antimicrobial agents. In this project I aimed to determine if Salmonella isolated from different sources differed in pathogenicity profiles based on the complement of genes identified through genomic analysis. Accordingly, Salmonella genomes were organized into 8 groups: animal, clinical, human, environmental, food, water …

"The Most Important Thing In Ipv Right Now": The Intersection Of Intimate Partner Violence And Brain Injury, Halina (Lin) Haag

Theses and Dissertations (Comprehensive)

The intersection of intimate partner violence (IPV) and brain injury (BI) has been almost entirely overlooked in research, practice, and policy, despite the known risks associated with the two conditions. Individually, IPV and BI are associated with elevated rates of unemployment, poverty, and homelessness, as well as increased mental health challenges. These social determinants of health, employment status, and income impact women’s wellbeing through access to safe accommodations, food security, and (dis)ability supports. These determinants are also related to an increased likelihood of experiencing addictions, mental health challenges, and physical danger, potentially leaving women vulnerable to ongoing violence. This qualitative …

Falling Into Action, Kent Hoffman

The Goose

Kent Hoffman explores human movement, his own mobility, and how it influences the way he moves on land. This personal essay, told through the lens of disability and accessibility, outlines his experience of living with Becker muscular dystrophy. Hoffman's approach to walking and mobility is heavily influenced by a fear of falling. As his mobility is changing, he's adapting and seeking out new ways to move on land. Different modes of mobility determine the way we experience personal movement, but accessibility determines who is welcome in spaces in the first place. Accessibility in the form of providing equal access is …

Complexities Of Health And Care Worker Migration Pathways And Corresponding International Reporting Requirements, Margaret Walton-Roberts, Ivy Bourgeault, Denise Spitzer

Global Nurse Migration Pathways: A Comparative Project

The increasing complexity of the migration pathways of health and care workers is a critical consideration in the reporting requirements of international agreements designed to address their impacts. There are inherent challenges across these different agreements including reporting functions that are misaligned across different data collection tools, variable capacity of country respondents, and a lack of transparency or accountability in the reporting process. Moreover, reporting processes often neglect to recognize the broader intersectional gendered and racialized political economy of health and care worker migration. We argue for a more coordinated approach to the various international reporting requirements and processes that …

The Future Of Health Care Work And The Place Of Migrant Workers Within It: Internationally Educated Nurses In Ontario Canada During The Covid-19 Pandemic, Margaret Walton-Roberts

Global Nurse Migration Pathways: A Comparative Project

The COVID-19 pandemic highlighted the importance of immigrant health workers in OECD nations, and intensified debates about the current and future supply and distribution of such workers, particularly nurses. This review paper considers internationally educated nurses in the case of Ontario, Canada, and the policy responses developed during the pandemic to address the increased utilization of immigrant health workers. To further consider the evolving place of migrant workers within health, the broader issue of the future of health care work is examined to imagine what a sustainable and resilient health workforce agenda that integrates internationally educated nurses might look like.

Ethical Dilemmas And Moral Distress In Companion Animal Veterinary Medicine: Mental Health Implications, Bronwyn Dickson

Theses and Dissertations (Comprehensive)

Mental health concerns are a significant problem in the veterinary community, and studies suggest that veterinarians working in Western countries are at higher risk of suicide compared to the general population and other healthcare professionals (Bartram et al., 2009; Bartram & Baldwin, 2010; Platt et al., 2012). Additionally, veterinary medicine is an occupation inundated with complex ethical and moral dilemmas. However, current studies are limited in their ability to contextualize the risk and contributing factors fully; therefore, they offer limited insight into effective preventative and support strategies. Using Interpretive Phenomenological Analysis (IPA), eight companion animal veterinarians were interviewed about their …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Internalized Homophobia: A Spiritually Integrated Psychotherapeutic Approach Using The Principles Of Complex Thinking, Daniel Rzondzinski

Consensus

This article describes the construction and application of a complex spiritually integrated psychotherapeutic model for assessment and treatment of internalized homophobia. Homophobia is a complex phenomenon because it includes multiple dimensions: personal, interpersonal, institutional, cultural, political, social, and historical. Internalized homophobia is a mental health problem that affects the subjectivity of 2SLGBTQ+ people. The model explained in this article is a product of the integration of principles from psychoanalytic psychotherapy, 2SLGBTQ+ affirmative framework, narrative therapy, and spiritually integrated psychotherapy. The integration is facilitated by the principles of complex thinking. This article emphasizes the problem of internalized homophobia and the coming …

The Need For Queer Education In Graduate Psychotherapy Programs, Rachel Warner

Consensus

No abstract provided.

A Multi-Stage Process To Develop Quality Indicators For Community-Based Palliative Care Using Interrai Data, Dawn M. Guthrie, Nicole Williams, Cheryl Beach, Emma Buzath, Joachim Cohen, Anna Declercq, Kathryn Fisher, Brant E. Fries, Donna Goodridge, Kirsten Hermans, John P. Hirdes, Hsien Seow, Maria Silveira, Aynharan Sinnarajah, Susan Stevens, Peter Tanuseputro, Deanne Taylor, Christina Vadeboncoeur, Tracy Lyn Wityk Martin

Health Sciences Faculty Publications

Background: Individuals receiving palliative care (PC) are generally thought to prefer to receive care and die in their homes, yet little research has assessed the quality of home- and community-based PC. This project developed a set of valid and reliable quality indicators (QIs) that can be generated using data that are already gathered with interRAI assessments-an internationally validated set of tools commonly used in North America for home care clients. The QIs can serve as decision-support measures to assist providers and decision makers in delivering optimal care to individuals and their families.

Methods: The development efforts took part in multiple …

Prevalence Of Sensory Impairments In Home Care And Long-Term Care Using Interrai Data From Across Canada, Dawn M. Guthrie, Nicole Williams, Atul Jaiswal, Paul Mick, Hannah M. O'Rourke, M. Kathleen Pichora-Fuller, Walter Wittich, Rinku Sutradhar

Health Sciences Faculty Publications

Background

In the general population, sensory impairments increase markedly with age in adults over 60 years of age. We estimated the prevalence of hearing loss only (HL), vision loss only (VL), and a combined impairment (i.e., dual sensory loss or DSL) in Canadians receiving home care (HC) or long-term care (LTC).

Methods

Annual cross-sectional analyses were conducted using data collected with one of two interRAI assessments, one used for the HC setting (n = 2,667,199), and one for LTC (n = 1,538,691). Items in the assessments were used to measure three mutually exclusive outcomes: prevalence of VL only, …

B-Sure (Bereavement Support Research): The Differential Experiences Of Peer And Professional Support In Grief, Andrea Crowley

Theses and Dissertations (Comprehensive)

Abstract

The project aimed to investigate the differential experiences of those who have received peer or professional support for grief and bereavement. Although much is known with regards to the perceived impacts of peer and professional support in general, there is little research surrounding these support types in the context of grief and bereavement, the potential for these support types to be complementary, and how the COVID-19 pandemic may have impacted the experiences of those receiving these forms of support. The main goal of this project was to address a significant gap in the literature by investigating the following questions: …

The Interrai Chess Scale Is Comparable To The Palliative Performance Scale In Predicting 90-Day Mortality In A Palliative Home Care Population, Nicole Williams, Kirsten Hermans, Joachim Cohen, Anja Declercq, Ahmed Jakda, James Downar, Dawn M. Guthrie, John P. Hirdes

Health Sciences Faculty Publications

Background: Prognostic accuracy is important throughout all stages of the illness trajectory as it has implications for the timing of important conversations and decisions around care. Physicians often tend to over-estimate prognosis and may under-recognize palliative care (PC) needs. It is therefore essential that all relevant stakeholders have as much information available to them as possible when estimating prognosis.

Aims: The current study examined whether the interRAI Changes in Health, End-Stage Disease, Signs and Symptoms (CHESS) Scale is a good predictor of mortality in a known PC population and to see how it compares to the Palliative Performance Scale (PPS) …

"If We're Not Loud, We're Not Cared For": Empowerment In Transgender Peoples' Healthcare Experiences, Chase Valiant

Theses and Dissertations (Comprehensive)

Healthcare plays a crucial role in the health and quality of life of transgender (herein trans) people. The experiences people have when accessing healthcare, can have significant effects on future interactions with the healthcare system as well as individual health outcomes. The purpose of this study was to gather insights into trans peoples’ positive healthcare experiences and health outcomes through the lens of empowerment. Fifteen interviews with trans men and trans women were drawn from a larger study of trans peoples’ experiences of discrimination. Thematic analysis was undertaken to identify key themes in the data. Experiences of empowerment were facilitated …

Exploring Climate, Wellbeing, Resilience, And Resistance In 2slgbtq+ Leisure Spaces: A Mixed Methods Study To Advance Inclusion, Tin Vo

Theses and Dissertations (Comprehensive)

Participating in queer sports groups, rainbow choirs, trans virtual discussion groups and other Two-Spirit, lesbian, gay, bisexual, transgender, queer, and other sexually and gender diverse (2SLGBTQ+) leisure activities can offer participants safety from societal heterosexism and cisgenderism and opportunities for community connection and peer support, as well as foster their overall wellbeing. Yet, transgender/gender nonconforming (TGNC), racialized, and/or disabled individuals, and those with other diverse identities are often marginalized in these spaces. Though researchers have studied exclusion within 2SLGBTQ+ leisure spaces, relatively little is known about how the climate of these spaces shapes social and mental health outcomes. Connected to …

Prognosis Does Not Change The Landscape: Palliative Home Care Clients Experience High Rates Of Pain And Nausea, Regardless Of Prognosis, Nicole Williams, Kirsten Hermans, Tara Stevens, John P. Hirdes, Anja Declercq, Joachim Cohen, Dawn M. Guthrie

Health Sciences Faculty Publications

Background: Most individuals who typically receive palliative care (PC) tend to have cancer and a relatively short prognosis (< 6 months). People with other life-limiting illnesses can also benefit from a palliative care approach. However, little is known about those who receive palliative home care in Ontario, Canada's largest province. To address this gap, the goal of this project was to understand the needs, symptoms and potential differences between those with a shorter (< 6 months) and longer prognosis (6+ months) for individuals receiving PC in the community.

Methods: A cross-sectional analysis was conducted using interRAI Palliative Care (interRAI PC) assessment data collected between 2011 and 2018. Individuals with a shorter prognosis (< 6 months; n = 48,019 or 64.1%) were compared to those with a longer prognosis (6+ months; n = 26,945) across several clinical symptoms. The standardized difference (stdiff), between proportions, was calculated to identify statistically meaningful differences between those with a shorter and longer prognosis. Values of the stdiff of 0.2 or higher (absolute value) indicated a statistically significant difference.

Results: Overall, cancer was the most prevalent diagnosis (83.2%). Those with a shorter prognosis were significantly more likely to experience fatigue (75.3% vs. 59.5%; stdiff = 0.34) and shortness of breath at rest (22.1% vs. 13.4%; stdiff = 0.23). However, the two groups were similar in terms of severe pain (73.5% vs. 66.5%; stdiff = - …

“The System Is Well Intentioned, But Complicated And Fallible” Interviews With Caregivers And Decision Makers About Palliative Care In Canada, Nicole Luymes, Nicole Williams, Liz Garrison, Donna Goodridge, Maria Silveira, Dawn M. Guthrie

Health Sciences Faculty Publications

Background: Canadian palliative care (PC) philosophy seeks to support individuals in a person-centered and sensitive manner. Unfortunately, philosophy does not necessarily translate into practice and this divide may leave patients without appropriate care at the end of life, causing distress for some families. The primary goal of the study was to identify key factors affecting perceptions of quality PC from the perspective of informal caregivers and decision makers (e.g., program managers) and to understand how their experiences within the health care system may have influenced their perceptions.

Methods: Nine caregivers and 11 decision makers from Yukon Territory, British Columbia, Alberta, …

A Newly Identified Impairment In Both Vision And Hearing Increases The Risk Of Deterioration In Both Communication And Cognitive Performance, Dawn M. Guthrie, Nicole Williams, Jennifer Campos, Paul Mick, Joseph B. Orange, M. Kathleen Pichora-Fuller, Marie Y. Savundranayagam, Walter Wittich, Natalie A. Phillips

Health Sciences Faculty Publications

Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Mama! I Hear Your Silence: Grief And Covid-19 On The Global North And South Disparity, Magnus Mfoafo-M'Carthy

Lyle S. Hallman Social Work Faculty Publications

In this conversation with Mama, I use my mother’s voice as a reflexive mirror to explore the social work silences that the COVID-19 pandemic expresses so eloquently in my own life and work. I seek to highlight the intimate link between Mama’s silence and social work silence.

St. Andrew’S Gratitude Project: The Impact Of Daily Practices Of Gratitude On Feelings Of Loneliness, Eric Partridge

Consensus

No abstract provided.

Spiritual Care In Sparsely Populated Regions, Robin Haensel

Consensus

No abstract provided.

Cross-Sectional Nutrition Profile Of Palliative Home Care Clients In Ontario And Performance Of The Interrai Palliative Care Nutrition Clinical Assessment Protocol, Tara Stevens, Heather Keller, Nicole Williams, James Downar, Dawn M. Guthrie

Health Sciences Faculty Publications

Background: The nutrition profile of palliative home care clients is unknown. This study describes this group and their nutrition issues and evaluates the performance of the interRAI nutrition Clinical Assessment Protocol (CAP).

Methods: This was a cross-sectional secondary analysis using Ontario interRAI Palliative Care (interRAI PC) Assessment data. The sample represents 74,963 unique Ontario home care clients assessed between 2011 and 2018. Frequencies and standardized differences (stdiffs) of nutrition characteristics were presented for cancer (n = 62,394) and noncancer (n = 12,569) diagnostic subgroups. Rates of triggering the nutrition CAP were presented by nutrition issue to evaluate its performance.

Results: …

The Impact Of Combined Flexion And Compression On The Mechanical Integrity Of The Annulus Fibrosus, Keaton Briar

Theses and Dissertations (Comprehensive)

Introduction: Intervertebral disc (IVD) herniation is characterized by an expulsion of nucleus pulposus (NP) material through the annulus fibrosus (AF). The AF contains two major adhesive structures, the intralamellar matrix and the interlamellar matrix, which act to maintain the strength of the AF and prevent NP material migration. As a herniation occurs, clefts form within the intralamellar matrix, pushing the NP between adjacent collagen fibres; meanwhile, delamination of the interlamellar matrix causes the NP to pool between layers of the AF. Further, herniation more readily occurs in a combined loading scenario of both compression and flexion. Flexion, and in particular …

Second Generation Christian Korean Canadians: Exploring Their Lived Experiences Of Mental Health Issues And Services, Kyoung Jung Kim

Theses and Dissertations (Comprehensive)

Abstract

This study explores the lived experiences of second-generation Christian Korean Canadian young adults with mental health issues (MHI) and their use of health services (MHS). In addition, this study asked this cohort to discuss their beliefs about the views their parents held about MHI and MHS. All research participants were born and raised in Canada by Korean born immigrant parents. This study was descriptive, phenomenological, and qualitative in nature; it consisted of in-depth interviews with six male and six female participants. In their experience with MHI, seven participants experienced fear and sadness (depression and anxiety) and three of them …

Evaluating Employees’ Experiences In Implementing Covid-19 Safety Protocols In Ontario Parks, Jessica Kaatz

Theses and Dissertations (Comprehensive)

The COVID-19 pandemic has created a wide range of public health challenges for park management and staff in Ontario. Green spaces have become a source of resilience during the spread of the virus, partly due to their proven positive impacts on social, mental and physical well-being. With the introduction of social distancing protocols, utilization of Personal Protective Equipment (PPE), and standardizing constant sanitation efforts, park employees are more responsible than ever for the daily implementation of rules governing park safety and security. At the same time, increased visitor numbers and continually changing government protocols that varied between regional jurisdictions have …

The Lived Experiences Of Developmental Disability Caregivers And Service Providers In Ontario, Tetyana Ali

Theses and Dissertations (Comprehensive)

Providing care for children with developmental disabilities (CwDD) is complex and is a life-long journey. Caregivers (CGs) of CwDD experience higher levels of stress, declining mental and physical health, feelings of isolation, diminished financial outcomes, and an overall lower quality of life. Additionally, they often face marginalization and numerous barriers when trying to access funding and supports. This study explored the experiences of CGs of CwDD in the context of Ontario and included the perspectives of CGs and service providers (SPs) to investigate the role the government played in CGs ability to provide adequate care.

Twenty participants were recruited through …

Visual Perception And Action In Reaching During Upper Limb Obstacle Avoidance, Nondon Chakraborty

Theses and Dissertations (Comprehensive)

During everyday activities, people reach to specific objects with their hands and avoid obstacles. For people to move successfully through an obstacle gap, it is necessary to be able to accurately perceive the actions that the surroundings afford and adjust hand movements accordingly. Reaching behaviours, including planning (perception) and execution (action), depend on visual information. This study aimed to understand and detect the differences between perceptual judgment and actual performance of both hands during a reaching task at the time of obstacle avoidance by using a hand-scaled approach. Participants were young adults (male (n=7) and female (n=10) aged 18 to …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

The Experiences Of Women Who Have A Child Diagnosed With An Eating Disorder: A Narrative Inquiry, Jennifer Scarborough

Theses and Dissertations (Comprehensive)

Eating disorders (EDs) are serious, life-threatening illnesses that typically occur in adolescence. Immediate intervention is necessary in order to interrupt the associated behaviours. Typically, adolescents struggling with EDs minimize the severity the illness has on their psychological and physiological wellbeing. For this reason, family involvement in the intervention is strongly recommended. Additionally, family involvement has shown to increase the likelihood of better outcomes. Parents are typically tasked with the responsibility of making and monitoring meals and/or interrupting compensatory behaviours. These tasks often lead to high conflict. Despite the importance of parental involvement, predominantly, it is mothers who fulfill the intensive …