Medicine and Health Sciences Commons^™

Cost-Effectiveness Of Selective Laser Trabeculoplasty (Slt) Versus Argon Laser Trabeculoplasty (Alt) In Uncontrolled Open Angle Glaucoma Patients Having At Least One Full Previous Slt: An Economic Evaluation Alongside An Ongoing Randomized Controlled Clinical Trial, Muhammad Rakibuz-Zaman

Electronic Thesis and Dissertation Repository

Background and objective: ALT and SLT are both safe and effective for glaucoma treatment. We performed a cost-effectiveness analysis (CEA) of SLT versus ALT for a six-month follow-up period in uncontrolled open angle glaucoma patients having at least one full previous SLT from an ongoing RCT. Methods: Trial based treatment costing and IOP reduction at 6-month follow-up from baseline for both intervention arms were calculated. A decision tree model was developed considering possible clinical pathways of patients undergoing repeat laser trabeculoplasty. CEA among ALT and SLT was done, and ICERs were calculated from both societal and ministry perspective. One way …

Sample Size Formulas For Estimating Intraclass Correlation Coefficients In Reliability Studies With Binary Outcomes, Mengxiao Xu

Electronic Thesis and Dissertation Repository

Introduction: Measurement errors can seriously affect quality of clinical practice and medical research. It is therefore important to assess such errors by conduct- ing studies to estimate a coefficients reliability and assessing its precision. The intraclass correlation coefficient (ICC), defined on a model that an observation is a sum of information and random error, has been widely used to quantify reliability for continuous measurements. Sample formulas have been derived for explicitly incorporation of a prespecified probability of achieving the prespecified precision, i.e., the width or lower limit of a confidence interval for ICC. Although the concept of ICC is applicable …

Evaluation Of Sexual Orientation Items In Population Health Surveys Among Canadians: A Mixed Methods Approach, Christoffer Dharma

Electronic Thesis and Dissertation Repository

A single item sexual orientation question has been asked in Statistics Canada health surveys to identify health inequalities in Canada. Using a mixed methods study with convenience sample of Canadians, we evaluated this question in comparison to a set of US questions that includes domains of sexual identity, behaviour and attraction. The single item question had an 85.8% sensitivity and 100% specificity in capturing sexual minorities from the broadest definition (n = 311). Chance-corrected agreements with sexual identity, 12 months and life time sexual behaviour were 0.89, 0.39 and 0.48 respectively. Both trans and cisgender people revealed that there were …

Inequalities In Social Determinants Of Health In The Ontario Transgender Population, Rachel E. Giblon

Electronic Thesis and Dissertation Repository

This study examined how everyday living conditions known to influence health outcomes – social determinants of health – differ between transgender Ontarians and the general Ontario population. Previously collected data on social determinants, demographics, health, and health care from trans (n=433) and non-trans individuals (n=39980) living in Ontario were used. Standardized risk differences showed that significantly more trans individuals were underpaid and underemployed, unable to complete their post-secondary education, and had experienced food insecurity, social exclusion and unmet health care needs. Differences were largest comparing trans men to cisgender men of the same age distribution. Findings from this study identified …

The Association Between Social Cohesion And Physical Activity In Communities Across Canada: A Multilevel Analysis, Calvin Yip

Electronic Thesis and Dissertation Repository

Background: In Canada, only 15% of adults meet physical activity guidelines for optimal health. Previous research has suggested that social cohesion may promote physical activity.

Objective: To assess the association between social cohesion and physical activity among adults aged 18 to 64 years in Canada.

Methods: Data from the 2009-2010, 2011-2012, and 2013-2014 cycles (N=245,150) of the Canadian Community Health Survey were used. Physical activity level was operationalized using average daily energy expenditure, social cohesion was determined by self-rated sense of belonging to the local community, and communities were represented by Canada’s Forward Sortation Areas. Multilevel regression models were used …

Infants Born Large For Gestational Age And Developmental Attainment In Early Childhood, Cairina E. Frank

Electronic Thesis and Dissertation Repository

Birth weight is a strong predictor of neonatal health outcomes. The majority of literature has focused on those infants born SGA. Infants born LGA have been shown to be at higher risk of immediate obstetrical complications and metabolic deficits, yet less research has focused on subsequent development. This study aims to investigate whether LGA is associated with developmental attainment and to examine the attribution of upstream factors and variables along the causal pathway. Data from the NLSCY was used. LGA was defined as a BW >90^th percentile. Outcomes were poor verbal ability (scoring <15^th percentile on the PPVT-R) and …

Etiology Of Motor Vehicle Collision Fatalities In Urban And Rural Canada, James R. Roos

Electronic Thesis and Dissertation Repository

While it has been consistently demonstrated that fatal motor vehicle collision (MVC) rates are higher for rural than urban roadways, it remains to be elucidated which collision factors account for this difference. Fatal MVC rates have been demonstrated to be higher in rural locations even when controlling for age, restraint use, and vehicle speed. This study aims to assess which collision factors are most prevalent for fatal rural motor vehicle collisions, and to address how those factors differ in significance between rural and urban regions. Our study indicates that a combination of human, environmental, and vehicular factors may account for …

A Link Between Paediatric Asthma And Obesity: Are They Caused By The Same Environmental Conditions?, Phylicia Gonsalves

Electronic Thesis and Dissertation Repository

The highly associated paediatric conditions of asthma and overweight have seen dramatic increases over the past few decades. This thesis explored air pollution exposure as a potential underlying mechanism of co-morbid asthma and overweight among adolescents aged 12 to 18 years. Data from the Canadian Community Health Survey were merged with a database containing estimates of air pollution as assessed by particulate matter ≤ 2.5 microns (PM_2.5) concentrations at the postal code centroid in southwestern Ontario. Logistic regression was used to conduct the analysis. Adolescents were more likely to be overweight as PM_2.5 concentrations increased. There was …