Medicine and Health Sciences Commons^™

Language In Genetics Research Informed Consent: The Language Gap And Unrecognized Miscommunication, Justin Morgenstern

Electronic Thesis and Dissertation Repository

Informed choice is fundamentally a process of communication, reliant entirely on the tools of language. However, the meanings and understandings of words change with time, setting, and context, threatening the basis of consent. We conducted a qualitative content analysis of Canadian genetics research documents, exploring the impacts of language on informed consent. Numerous language usages were noted as potential barriers to informed consent, including language that was vague, variable, and unusually defined. Unique combinations of words were observed to generate novel concepts without clear meanings and definitions were absent or unclear. However, the ambiguity of the language was concealed by …

Magnetic Resonance Imaging Of Brain Tissue Abnormalities: Transverse Relaxation Time In Autism And Tourette Syndrome And Development Of A Novel Whole-Brain Myelin Mapping Technique, Yann Gagnon

Electronic Thesis and Dissertation Repository

The transverse relaxation time (T2) is a fundamental parameter of magnetic resonance imaging sensitive to tissue microstructure and water content, thus offering a non-invasive approach to evaluate abnormalities of brain tissue in-vivo. Prevailing hypotheses of two childhood psychiatric disorders were tested using quantitative T2 imaging and automated region of interest (ROI) analyses. In autism, the under-connectivity theory, which proposes aberrant connectivity within white matter (WM) was assessed, finding T2 to be eleveted in the frontal and parietal lobes, while dividing whole brain data into neurodevelopmentally relevant WM ROIs found increased T2 in bridging and radiate WM. In Tourette syndrome, tissue …

Factors That Contribute To Adverse Events Involving Care- Dependent Community Dwelling Older Adults And Their Caregivers., Dorothy J. Gotzmeister

Electronic Thesis and Dissertation Repository

The research on home and community care shows that when safely delivered it can be an efficient way to support elders who require care, potentially preventing a move into costlier institutional care. Learning from system-wide safety breakdowns that occur is necessary to establish appropriate prevention strategies. The purpose of this study was to identify the factors that contributed to adverse events in care-dependent community-dwelling older adults and their caregivers. Using a multiple case study methodology, eight falls were investigated using a comprehensive Systemic Falls Investigative Method. Using within case and across case analyses, a total of 280 contributing factors were …

Hospital-Based Nurse Practitioner Practice: An Exploration Of Interprofessional Teams., Christina J. Hurlock-Chorostecki

Electronic Thesis and Dissertation Repository

Nurse practitioner (NP) roles within hospital teams are evolving worldwide. However, understanding of their practice within the context of interprofessional (IP) teamwork remains limited. This two-phase study undertaken within Ontario, Canada provides a new multi-perspective understanding of the value of NP practice within IP hospital teams. Constructivist grounded theory, a modification of the classic methodology, guided an interpretive approach based in exploration of process and meaning construction, privilege and power exposure, and juxtaposition with extant theory. A conceptual rendering of NP practice was determined through supplemental analysis of 30 team member focus groups. This new perspective emerged as three practice …

New Graduate Nurses' Structural Empowerment And Their Experience Of Co-Worker Incivility And Burnout, Pamela Bushell

Electronic Thesis and Dissertation Repository

Burnout among new graduate nurses [NGNs] is a risk to workplace retention and commitment to the nursing profession. With threats of nursing shortages, safeguarding and supporting NGN to maintain workplace allegiance and professional commitment is paramount. Research has highlighted the harmful effects of uncivil working environments and the deleterious effects it can have on working relationships. In this secondary analysis, Kanter’s (1977) theory of structural empowerment was tested using a predictive, non-experimental design in a sample of NGN working in acute care hospitals in Ontario. Two hypothesized models predicted that high levels of structural empowerment and low levels of coworker …

Awareness Of Physical Activity Levels And Sedentary Behaviour: An Assessment Of Awareness Of Physical Activity Levels And Sedentary Behaviour Among Parents And Children, Tripat Simran Kaur Grewal

Electronic Thesis and Dissertation Repository

The purpose of this study was to assess awareness of physical activity and sedentary behaviour among parents and children aged 10-13 years. Associations between awareness and factors including age, BMI, gender, and obesity status were also examined. A total of 53 parent-child dyads participated in the study. Agreement between parent and child subjective measures (self-report) and objectively measured physical activity was examined to determine awareness. Most parents (87%) and children (83%) overestimated child moderate-vigorous physical activity (MVPA) beyond 30 minutes/day. The majority of parents (87%) and children (85%) also underestimated child sedentary behaviour by at least 3 hours/day. Older children …

Exploring The Neural Basis Of Top-Down Guided Action In Macaque Monkeys, Jessica M. Phillips

Electronic Thesis and Dissertation Repository

To thoroughly characterize any brain mechanism requires an appropriate animal model for invasive studies. An invaluable model system used toward a comprehension of cognitive neurophysiology is the macaque monkey. It is important to delineate similarities and limitations for this model in relation to the human brain and cognition. In this thesis, we have thus conducted three experiments to investigate putative generalizations between monkeys and humans regarding the neural processes associated with top-down action control in monkeys.

Our daily behaviour is largely comprised of automatic routine actions. The frequent repetition of certain behaviours in response to particular contexts can give rise …

Understanding First Nations Young Adults' Health Literacy, Ebony Rempel

Electronic Thesis and Dissertation Repository

Relative to non-First Nations, Inuit, and Metis (FNIM) Canadians, FNIM people have poorer health status. A qualitative investigation of the health literacy skill and the health information (HI) needs of young FNIM adults was conducted. Eight single mothers living on-reserve were interviewed. Data analysis generated four main themes along with the subthemes of: (1) Traditional Health (TH), (i) TH Culture Excised, and (ii) Wanting to Know More about TH; (2) HI Needs of First Nations young Mothers; (3) Access to HI, (i) Asking the Doctor / Telehealth (ii) other Female Family and Friends; (4) Online Accessibility, (i) HI Online, (ii) …

The Impact Of Protection Motivation Theory Grounded Messaging On Diabetes Prevention Behaviours Following Gestational Diabetes, Jennifer M. Jacob

Electronic Thesis and Dissertation Repository

Women diagnosed with Gestational Diabetes (GDM) are more likely to develop Type 2 Diabetes (T2DM). Despite this risk, few women are engaging in diabetes prevention behaviours. Methods: The Protection Motivation Theory (PMT) was employed to design and evaluate a post-GDM diabetes prevention information session. The utility of this theory in predicting intentions and diabetes prevention behaviours was assessed using regression analysis. Results: Two of the four PMT variables, response efficacy and self efficacy were found to be consistent predictors of intention across most of the recommended behaviours, accounting for between 25% and 77% of the variance in intention. Intention was …

What Shapes Family Physicians' Patterns Of Care For Community Patients At End Of Life?, Joshua D. Shadd

Electronic Thesis and Dissertation Repository

Family physicians (FPs) care for the majority of community patients approaching end of life. Variations among FPs in care activities for these patients have potential implications for equitable access to care. This thesis used mixed methods to explore how FPs in southwestern Ontario, Canada care for these patients, and what shapes the variations. In the primary study, using grounded theory based on in-depth interviews, FPs reported differing in the timing, location and purpose of their activities. These variations were shaped by a process of ‘making it fit’, in which FPs weighed the implications of choices in their unique contexts. In …

Semantics-Based Automated Quality Assessment Of Depression Treatment Web Documents, Yanjun Zhang

Electronic Thesis and Dissertation Repository

The past decade has witnessed a dramatic expansion in the amount of publicly available health care information on the Web. The health care information on the web, however, is of extremely variable quality. The evaluation of content quality is a big challenge because non-automated methods for information content rating can be easily overwhelmed by the huge data volume. This study proposes an automated approach for assessing the quality of web health care information through comparing the text content with evidence-based health care recommendations. This method relies on semantic analysis and text classification to identify the presentation of evidence-based recommendations in …

Effects Of Coordinated Bilateral Hearing Aids And Auditory Training On Sound Localization, Iman Elsabah Ibrahim

Electronic Thesis and Dissertation Repository

This thesis has two main objectives: 1) evaluating the benefits of the bilateral coordination of the hearing aid Digital Signal Processing (DSP) features by measuring and comparing the auditory performance with and without the activation of this coordination, and 2) evaluating the benefits of acclimatization and auditory training on such auditory performance and, determining whether receiving training in one aspect of auditory performance (sound localization) would generalize to an improvement in another aspect of auditory performance (speech intelligibility in noise), and to what extent. Two studies were performed. The first study evaluated the speech intelligibility in noise and horizontal sound …

Synthesis And Spectroscopic Studies Of Substituted Pyrrolocytidines, Mckenry Charles

Electronic Thesis and Dissertation Repository

This thesis reports work in the area of modified nucleosides for potential use as molecular probes in nucleic acid chemistry. These heterocyclic base surrogates that are capable of canonical base pairing have use in the study of nucleic acid conformation, as reporters of the state of hybridization.^[1]

The synthesis of a 5-phenylpyrrolocytidine was attempted in order to compare its properties with its 6-substituted pyrrolocytidine counterpart. Unfortunately, the 5-substituted pyrrolocytidine was not achieved.

The synthesis of five nucleosides based on the pyrrolocytidine scaffold was reported. Their synthesis was achieved through the tandem Sonogashira/annulations reaction between 5-iodocytidine derivatives and …

Atlas-Based Attenuation Correction For Pet/Mri, John Christian Patrick

Electronic Thesis and Dissertation Repository

Attenuation correction (AC) in PET/MRI is difficult as there is no clear relationship between MR signal and 511 keV attenuation coefficients (μ). One strategy is to align a pre-defined atlas of μ to the PET/MRI for AC. However, atlas design may influence quantitative accuracy of AC. In this thesis we compare 3 atlas design strategies and evaluate their performance in an oncology patient population. The 3 strategies were: correction with BMI-dependent atlases; gender-dependent atlases, and a gender- and sex-independent atlas. Patients were imaged with FDG PET/CT and 3T MRI. The atlases were created and then used for PET AC of …

Systematic Assessment Of The Contribution Of Superantigens To Nasopharyngeal Colonization In A Mouse Model Of Streptococcal Infection, Katherine J. Kasper

Electronic Thesis and Dissertation Repository

Streptococcus pyogenes is adapted for persistence in humans. It typically colonizes the tonsils and skin, and humans are the only known reservoir. S. pyogenes can cause a wide range of mild to serious infections. Most streptococci-related deaths are due to complications of rheumatic fever and invasive infections. S. pyogenes produces virulence factors that contribute to the pathogen’s ability to colonize and cause disease, including streptococcal superantigens (SAgs), also known as streptococcal pyrogenic exotoxins (Spes). SAgs function by cross-linking T cells and antigen presenting cells (APC) which may cause a massive inflammatory response, and as such have been found to contribute …

Women's Experiences Of The Intervention For Health Enhancement After Leaving (Iheal), Rachel Ann Colquhoun

Electronic Thesis and Dissertation Repository

Despite the high rates of service use across sectors, there is increasing evidence that women exposed to intimate partner violence have unmet care needs and face barriers in accessing health and other services. The purpose of this study was to explore women’s experiences of taking part in a primary health care intervention for adult women who had recently left an abusive intimate partner with a particular focus on how women’s varied social locations affect their experiences. The qualitative content analysis grounded in an intersectional perspective that is presented here is part of a larger feasibility study of the “Intervention for …

Community Integration After In-Patient Rehabilitation For Lower Extremity Musculoskeletal Disorders: A Pilot Study, Chandni Chadha

Electronic Thesis and Dissertation Repository

Purpose: To investigate change in community integration (CI) and functional status following discharge from in-patient musculoskeletal (MSK) rehabilitation, and to explore the concordance between the Reintegration to Normal Living Index (RNLI) and patient interviews. Participants: Twenty-five individuals with lower extremity MSK disorders discharged home after rehabilitation. Methods: For all outcome measures, categories of change between successive time points were created using the minimal detectable change. Change patterns were evaluated at the group and individual level across four time intervals. Percent agreement quantified concordance between interview and RNLI data. Results: Change over time was confirmed at the group level. However, individual-level …

Investigating Adenosine’S Role In Controlling The Cerebral Metabolic Rate Of Oxygen Following Hypoxia-Ischemia, Mustafa Ridha

Electronic Thesis and Dissertation Repository

The cerebral metabolic rate of oxygen (CMRO2) has been shown to be an early indicator of hypoxia-ischemia (HI); however, the mechanisms controlling post-HI CMRO2 are not clear. One potential mechanism is the activation of the adenosine A1 receptor due to increased adenosine concentrations during the insult. The present study investigated if the specific adenosine A1 antagonist, DPCPX, would reduce the typical reduction in CMRO2 and electrical cortical activity following HI. Measurements of CMRO2 and electrical cortical activity were obtained on piglets by near-infrared spectroscopy (NIRS) and amplitude-integrated electroencephalography (aEEG), respectively. The post-HI measurements of CMRO2 and mean aEEG background voltage …

Differentials In Physical Health Outcomes Among Children In Single-Parent And Dual-Parent Families, Jennifer Lynn Rayner

Electronic Thesis and Dissertation Repository

Children live in increasingly varied family structures and there is some suggestion that children who live with single mothers have poorer health outcomes than children who live with two-parents. The examination of the pathways that link family structure to children’s physical health is important because it will help increase our understanding of why some children are healthier than others. The purpose of this dissertation is to: 1) determine if there are differences in health status between children raised in female-headed single-parent families and children in two-parent families; 2) gain an understanding of why these differences may exist; and, 3) assess …

Reassembling Knowledge Translation Through A Case Of Autism Genomics: Multiplicity And Coordination Amidst Practiced Actor-Networks, Julia J. Bickford

Electronic Thesis and Dissertation Repository

Knowledge translation (KT) has become a ubiquitous and important component within the Canadian health research funding environment. Despite a large and burgeoning literature on the topic of KT, research on the science of KT spans a very narrow philosophical spectrum, with published studies almost exclusively positioned within positivism. Grounded in a constructionist philosophical position and influenced by actor-network theory, this dissertation aims to contribute to the Canadian KT discussion by imagining new possibilities for conceptualizing KT.

This is an empirical-theoretical study which is based on eight months of data collection, including interviews, participant observation, and document analysis. This data collection …