Medicine and Health Sciences Commons^™

First-Responders And Emergency Department Healthcare Provider Interactions During Emergency Situations: A Grounded Theory Study, Jennifer A. Mohaupt

Electronic Thesis and Dissertation Repository

Interactions between and among first-responders and emergency department (ED) healthcare providers impact the way in which patients are managed during emergency situations. The purpose of this study was to develop a grounded theory to explain the interactions between and among first-responders and ED healthcare providers during emergency situations. Interprofessional collaboration and teamwork has been extensively studied, however little is known about interactions that include first-responders. This study was guided by Strauss and Corbin’s (1990) approach to grounded theory. Data were collected through 256 hours of first-responder and ED observational opportunities and informal interviews with accompanying detailed field notes. As well, …

Markerless Radiostereogammetry Of The Shoulder Joint In Humans: Comparisons Of Scapulohumeral Kinematics Between Individuals With Healthy And Supraspinatus-Impaired Shoulders, Ashley N. Hannon

Electronic Thesis and Dissertation Repository

The purpose of this collection of studies was to further develop the knowledge of shoulder motion in order to better understand joint function through direct measurement of 3D scapulohumeral joint kinematics using a technique of high accuracy. Markerless, bi-planar fluoroscopic radiostereometric analysis using a generic shoulder model was developed in this thesis, reducing the amount of radiation exposure to subjects. The studies compared kinematic data of the scapulohumeral joint in six degrees of freedom with a precise, in-vivo measuring technique. Data were collected on young and older healthy individuals, individuals with a torn supraspinatus and post-surgical intervention.

Although this generic …

The Euthanasia Debate: International Experience And Canadian Policy Proposals, Lorna M. Fratschko

Electronic Thesis and Dissertation Repository

This thesis examines the problematic prospect of the introduction of euthanasia and physician-assisted suicide into Canadian society. The thesis argues that euthanasia is too simplistic an approach to address the complexities of end of life issues. The policy proposal under active discussion is profoundly mistaken. The language of euthanasia is examined in relation to the choice of words used, drawing attention to how words, when used loosely, can distort reality in this matter. Historical experience from other jurisdictions is presented to provide a context for this discussion. A "slippery slope" argument emerges via the claim that, in practice and in …

Arthrokinematics Of The Distal Radioulnar Joint In The Normal Wrist And Following Distal Radius Malunion, Braden M. Gammon

Electronic Thesis and Dissertation Repository

Contact patterns in the distal radioulnar joint (DRUJ) are not well understood for normal anatomy or with distal radius deformity. This thesis presents three studies which investigate the arthrokinematics of the DRUJ for these conditions. The first study compared casting and Tekscan, two standard methods for contact measurement, with a novel technique of proximity mapping termed Inter-cartilage Distance (ICD). The relative benefits, limitations and role for ICD in DRUJ contact assessment were examined and discussed. The second study used ICD to characterize contact patterns in the native DRUJ. Contact was found to be maximal in 10 degrees of supination and …

Angiogenic Therapy In A Fibrotic Murine Model Of Duchenne Muscular Dystrophy, Kelly M. Gutpell

Electronic Thesis and Dissertation Repository

Duchenne muscular dystrophy (DMD) is a devastating neuromuscular disorder that affects approximately 1 in 5000 males. Vascular-targeted therapy has been proposed as a treatment for DMD to reduce ischemia and enhance endogenous repair. Additionally, a more vascularized environment may enhance regenerative approaches currently under investigation. Vascular endothelial growth factor (VEGF) and angiopoietin-1 (ANG1) are two of the most studied pro-angiogenic factors for this approach. To date, little is known regarding the effect of these pro-angiogenic factors on muscle function and whether they may exacerbate fibrosis in a relevant murine model of DMD. The first aim of this thesis was to …

Machine Learning Of Lifestyle Data For Diabetes, Yan Luo

Electronic Thesis and Dissertation Repository

Self-Monitoring of Blood Glucose (SMBG) for Type-2 Diabetes (T2D) remains highly challenging for both patients and doctors due to the complexities of diabetic lifestyle data logging and insufficient short-term and personalized recommendations/advice. The recent mobile diabetes management systems have been proved clinically effective to facilitate self-management. However, most such systems have poor usability and are limited in data analytic functionalities. These two challenges are connected and affected by each other. The ease of data recording brings better data for applicable data analytic algorithms. On the other hand, the irrelevant or inaccurate data input will certainly commit errors and noises. The …

Exploring The Mobile Phone Digital Divide Among Individuals Experiencing Mental Illness: A Secondary Analysis, Jefferey R. Reed

Electronic Thesis and Dissertation Repository

ABSTRACT

Aim: To test van Dijk’s (2005) Framework for Understanding the Digital Divide. This framework examines social inequalities that influence the phenomenon of the digital divide and the implications it has upon social participation for individuals with mental illness.

Background: Mental illness is the second leading cause of disability and premature death, and constitutes more than 15% of the burden of disease in Canada (Centre for Addiction and Mental Health, 2012). Mobile phones may be useful in promoting health and social wellness among this population. It is unclear whether these individuals face disparities in the access to and use of …

Characterization Of Microbial Communities In The Mammary Glands And The Influence Of This Microbiota On Health And Disease, Camilla Urbaniak

Electronic Thesis and Dissertation Repository

The collective microbes and their genomic activity within us, referred to as the human microbiome, is crucial in maintaining health, and disruptions in composition and activity have been associated with various diseases. Considering the importance of breast milk in neonatal development and the high rate of breast cancer in women, the objective of my thesis was to obtain a comprehensive analysis of the microbiota of the mammary glands and to examine the influence of these organisms on health and disease.

Human milk is an important source of bacteria for the developing infant. While a variety of studies over the last …

Optimizing The Rehabilitation Of Elbow Lateral Collateral Ligament Injuries, Ranita Harpreet Kaur Manocha

Electronic Thesis and Dissertation Repository

Elbow lateral collateral ligament (LCL) injuries frequently arise following trauma, and can result in disabling instability. Typically such injuries are managed with immobilization followed by a graduated exercise regime; however there is minimal biomechanical evidence to support current treatment protocols. This investigation examines the in vitro effectiveness of several rehabilitation techniques using a custom elbow motion simulator. It was found that active range of motion is safest in the overhead position (n = 7). Early motion in this position may reduce the incidence of elbow stiffness without compromising ligament healing following LCL injury. Forearm pronation and active motion stabilize …

A Study To Understand And Compare Evidence Based Practice Among Health Professionals Involved In Pain Management, Vanitha Arumugam

Electronic Thesis and Dissertation Repository

Pain management is a common concern of multiple health professionals. Evidence-based practice (EBP) in pain management is a recognized approach used to improve health outcomes. EBP tools can facilitate its implementation. PAIN⁺ is a tool that provides access to pre-appraised current best research evidence on pain to support clinical decisions. It is important to understand the knowledge, attitudes and behavior of professionals towards EBP and more specifically how they access research about pain management.

The overarching purpose of this thesis is to better understand how clinicians from different professions involved in pain management view EBP and implement specific strategies …

Informed Decision Making During Pregnancy: Risk Consideration In Clinical Practice And Research, Kyoko Wada

Electronic Thesis and Dissertation Repository

This thesis addressed a cluster of issues related to risk and the pregnant woman’s decision making in clinical practice and research. In terms of clinical practice, the minimal risk concept - a low risk standard codified in research ethics regulations - was applied to clinicians’ information provision to the patient. As clinicians must discuss a variety of health risks, minimal risk standards may be useful as a threshold to demarcate risks that clinicians should discuss with the patient. Application of minimal risk standards to risk factors in pregnancy showed the usefulness and limitations of these standards. In terms of pregnant …

The Application Of Clear Speech In Electrolaryngeal Speakers, Steven R. Cox

Electronic Thesis and Dissertation Repository

The present work was comprised of a series of experiments that investigated the application of clear speech (CS) in a group of electrolaryngeal (EL) speakers. Three experiments were conducted to assess the impact of CS on three important aspects of EL speech. More specifically, Experiment 1 sought to identify the impact of CS on EL speakers’ word and consonant intelligibility; Experiment 2 examined the influence of CS on the acoustic characteristics of words and vowels in EL speech; and finally, Experiment 3 sought to identify the influence of CS produced by EL speakers on auditory-perceptual ratings by naïve listeners. Results …

The Globalization Of Healthcare: International Agreements & Ontario Academic Health Science Centres, Andrew D. Scarffe

Electronic Thesis and Dissertation Repository

Health systems are beginning to recognize the tremendous opportunity that globalization and international activities present for Academic Health Science Centres. This study explored the nature of international agreements within Ontario Academic Health Science Centres (OAHSC) and presents the exploratory findings to begin to develop an academically defensible body of literature on the topic. This study employed a constructivist grounded theory qualitative methodology, interviewing 14 participants who hold leadership positions within OAHSCs that actively participate in, or interface with, institutions that participate in international agreements (IAs). A conceptual framework is proposed that highlights the: (1) drivers, (2) barriers, (3) international activities, …

Domestic Homicide And Homicide-Suicide In The Older Population, Brianna L. O'Neil

Electronic Thesis and Dissertation Repository

Extensive research has been conducted on domestic homicide in younger populations; however, very little is known about such incidents in the older population. It is vital that this gap in the literature be filled as Canada’s older population has been increasing. Data for this study was provided by the Ontario Domestic Violence Death Review Committee. Ninety-two domestic homicide and suicide cases were examined to determine whether there were differences between younger age groups (30 to 50 years of age) and older age groups (55 years of age and older). Information was gathered on prominent characteristics and risk factors within cases …

Antenatal Depressive Symptoms And Antidepressant Use In Pregnancy, Jerry Yu-Hsiang Chen

Electronic Thesis and Dissertation Repository

Review of the current literature reveals inconsistent findings on potential associations between antidepressant use during pregnancy and adverse fetal and child health and development. This study aims to examine the effect of antenatal SSRI exposure on several neonatal (preterm birth, small- and large-for-gestational age, Apgar score, and neonatal intensive care unit admission) and child developmental outcomes (measured by Ages and Stages Questionnaire) while controlling for confounding by indication. Data were obtained from the Prenatal Health Project, a longitudinal cohort study of 2,357 women in London, Ontario. Results from univariable analysis discovered that infants exposed to in utero SSRIs were more …

An Evaluation Of The Determinants Of Job Satisfaction In Canadian Family Physicians, Jana L. Malhotra

Electronic Thesis and Dissertation Repository

Physicians as a group appear to be satisfied with their work. However, there are some gaps in our current understanding of the determinants that impact the job satisfaction of Canadian family physicians. This thesis examined determinants of family physician job satisfaction using in-depth interviews with family physicians to achieve a broad perspective on their job satisfaction. This was complemented by a multivariate analysis that examined the professional and work-life balance satisfaction of physicians across this country. The findings from this research confirm the significance of a number of factors to the professional and work-life balance satisfaction of family physicians. Novel …

Testing The Interpersonal Theory Of Suicide In Community - Residing Older Adults, Dorian Murariu

Electronic Thesis and Dissertation Repository

Suicide rates among older adults are high in Canada and around the world. Evidence-informed and theory-driven research on late life suicide may help to devise effective interventions to reduce suicide rates among older adults. In this thesis, I tested the Interpersonal Theory of Suicide (IPTS: Joiner, 2005; Van Orden et al, 2010) using data collected from a community-based sample of older adults recruited for a larger study designed to assess risk and resiliency factors for late life suicide (Dr. Marnin Heisel, PI). According to the IPTS, (Hypothesis 1) the interpersonal constructs of perceived burdensomeness (PB) and thwarted belongingness (TB) can …

The Influence Of Areas Of Worklife And Compassion Satisfaction On Burnout Of Mental Health Nurses, Michelle Corinne Fredette-Carragher

Electronic Thesis and Dissertation Repository

The prevalence of burnout among nurses is linked to sub-optimal wellbeing and is reflected in higher than average rates of illness and absenteeism (Canadian Institute for Health Information, [CIHI], 2007). Additionally, there are consequences for clients including increased staff related errors and poor patient satisfaction. An improved person-job match in the six areas of worklife and higher compassion satisfaction may result in a workforce that is more engaged and able to achieve positive client outcomes. This study explores the relationship between person-job match and both compassion satisfaction and the emotional exhaustion component of burnout of mental health nurses through a …

The Impact Of Surgical Technique On Coronal Plane Motion In Total Knee Arthroplasty, Kevin I. Perry

Electronic Thesis and Dissertation Repository

There are two predominant techniques used by most surgeons to perform total knee arthroplasty: gap balancing and measured resection. The purpose of the current study was to observe if surgical technique has an effect on post-operative coronal plane balance throughout range of motion and to observe if surgical technique has an effect on tibial and femoral component migration. This was a randomized, prospective controlled trial. Twenty-three patients (24 knees) were enrolled: twelve knees in each group. All knees showed migration of their components from the initial RSA to their RSA at 6 months. Migration was similar for both groups, but …

Development And Initial Validation Of Novel Multi-Planar Neck Strength Assessment And Neuromuscular Training Protocols, Theo H. Versteegh

Electronic Thesis and Dissertation Repository

Concussions are a serious health concern in today’s active society. There are many contributing factors to concussions but one that is starting to draw significant attention is the potential role the neck muscles play in mitigating concussive forces. There is evidence that stronger neck muscles may decrease an individual’s concussion risk. In order to fully define this role, an appropriate outcome measure for assessing neck strength is required. Once this is established, methods of training to improve neck strength can be evaluated for their effect on neck strength and subsequently effect on concussion risk. This thesis included three studies. Chapter …

Values Of Hospital Chief Executive Officers In Ontario, Alexander Smith

Electronic Thesis and Dissertation Repository

Value-based health systems, where the fundamental goal of the system is to maximize patient value, have been suggested as a means to improve health service delivery. However, our understanding of various stakeholder values in Ontario is limited. This study collected interview responses from 26 Ontario hospital Chief Executive Officers (CEOs) in an attempt to understand their personal values, alignment with health-system values, and use of values to drive decision-making. Results suggest that Ontario hospital CEOs have two value sets; a set of core values (i.e. integrity, compassion, empathy) that are established at a young age and are largely non-negotiable, and …

Predictors Of Engagement In Community-Based Therapy For Youths With Mood And Anxiety Disorders, Hailey S. Saunders

Electronic Thesis and Dissertation Repository

The First Episode Mood and Anxiety Program (FEMAP) aims to identify and treat youths with mood and anxiety disorders. This research sought to identify factors associated with engagement in FEMAP, based on extensive data collected by FEMAP researchers. A logistic regression model was built from candidate variables using purposeful selection. Of the 366 participants offered treatment, 87% engaged in FEMAP. Quantity of alcohol consumed per occasion, gender, and anxiety sensitivity were found to be significant predictors of engagement. Gender and anxiety sensitivity interacted with each other such that at low anxiety sensitivity levels, the odds of engaging in FEMAP for …

Access To Care And The Impact Of Inequality Among Individuals With A History Of Mental Illness, Heather Atyeo

Electronic Thesis and Dissertation Repository

Using an Intersectionality framework, a secondary analysis of pre-existing data from the CURA2 Poverty and Social Inclusion study (Forchuk et al., 2010-2015) was used to explore the relationship between experiences of oppression and self-rated health among a cross-section of 293 community dwelling participants with a mental illness. Binary logistic regression was used to estimate the association between self-rated health and social identity (gender, ethnicity, education, homelessness, employment, disability); health care access was tested for both mediating and moderating effects. The final model explained between 18.9-25.2% of the variance in self-rated health; four independent variables made unique statistically significant contributions to …