The Process Of Art Creation Among Mothers From Ontario Who Have Experienced Gender-Based Violence, Madison L. Broadbent

Electronic Thesis and Dissertation Repository

Mothers who have experienced gender-based violence (GBV) face physical, mental, and social health implications. Participating in artmaking has the potential to reduce these consequences. An arts-based study including in-depth interviews was conducted with 13 mothers with histories of GBV. The creative processes involved in artmaking amongst mothers with histories of GBV were explored. Mothers demonstrated using symbols, thoughtful colour selection, and choice of artistic medium when creating their artforms. Moreover, mothers’ experiences of storytelling experiences of GBV through art were examined. Mothers described using art as a means of communication, emotional processing and healing through art, and the process of …

Fracture Prediction And Prevention In Individuals With Chronic Kidney Disease, Andrea C.J. Cowan

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Patients with chronic kidney disease (CKD) face increased fracture risk yet our understanding and management of this risk remains poor. We conducted three studies using retrospective cohort analysis in Ontario, Canada. We developed a 3-year fracture prediction model for patients receiving dialysis. Secondly, we contrasted fracture rates among patients on SGLT2i or DPP4i medications, stratified by kidney function. Lastly, we examined hypocalcemia incidence post-denosumab prescription, stratified by kidney function.

Findings: The fracture risk tool, incorporating demographic and lab data, performed well (AUC 0.72). SGLT2i did not elevate fracture risk vs. DPP4i (HR 0.95 [95% CI 0.79,1.13]). In those prescribed denosumab, …

Social Connectedness, Adolescent Mental Health And Well-Being At The Later Stages Of The Covid-19 Pandemic: A Mixed Methods Exploration, Sarah Abdunnabi

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COVID-19 posed novel challenges by limiting in-person interactions and shifting interactions online. Effects of online and offline social connectedness on adolescent mental health and well-being, and the moderating role of the social determinants of health (SDoH) were explored. Canadian adolescents (n=1,586; M_age=15.3, range 13 to 18 years; surveyed summer 2022) reported their social connectedness, psychological distress, and mental well-being. An ordinal logistic regression was performed to examine the association between social connectedness (online and offline) and dual-factor mental health. Responses to two open-ended survey questions were analyzed. Social disconnection was associated with higher odds of being in a …

Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

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Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

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This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

The Impact Of Access To Oral Health Care On Inadequate Oral Health And Multimorbidity, Luis Limo

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The connection between oral health and other non-communicable chronic conditions—commonly referred in the dental literature as the oral-systemic health connection—emphasizes the role of oral health care on both oral diseases and chronic conditions, particularly in vulnerable populations like the elderly. This thesis comprises 2 studies: the first is a systematic review on the impact of oral health care interventions, as an indicator of access to oral health care, on chronic conditions of which their co-existence would result in multimorbidity; the second study is a cross-sectional investigation of the associations between oral health, access to oral health care, and multimorbidity among …

A Comparison Of The Thulium Fiber Laser Versus Holmium:Yag Laser Lithotripsy Of Upper Urinary Tract Calculi: Preliminary Results Of A Randomized Prospective Clinical Trial, Eduardo Gonzalez Cuenca

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The Holmium:yttrium-aluminium-garnet (Ho:YAG) laser has become an indispensable tool in Endourology since its introduction in 1995, due to its safe and efficient urinary stone fragmentation capabilities. The Thulium Fiber Laser (TFL), is the latest innovation with early clinical experience suggesting improvements over the Ho:YAG. This prospective, randomized controlled study aims to compare clinical outcomes of Ho:YAG versus TFL lithotripsy for upper urinary tract calculi. Patients undergoing ureteroscopy for renal stones (size 8-20mm, density >600 HU) from a single institution were prospectively recruited.

Thirty-eight patients have been recruited (Ho:YAG=20, TFL=18). The laser-on time (p=.330), total operative time (p …

Treatment Of Blunt Cerebrovascular Injury - A Systematic Review And Meta-Analysis, Multicenter Retrospective Review, And Protocol For A Feasibility Randomized Controlled Trial, Jovana Momic

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Blunt cerebrovascular injury (BCVI) is an often-overlooked clinical problem that can result in stroke and cause devastating, potentially permanent, neurologic disabilities in young and otherwise healthy trauma patients. Early diagnosis and treatment of BCVI can reduce the risk of stroke and prevent disability, however, treatment also carries a risk of bleeding complications. More research is needed to understand the optimal management strategy to reduce the risk of stroke while minimizing bleeding complications.

The aim of this thesis is to review and critically appraise the literature to better understand the efficacy of various treatment strategies in preventing stroke following BCVI, evaluate …

Understanding The Information Needs Of Clients And Caregivers Regarding Early Psychosis: A Conventional Content Analysis, Tanvin K. Juneja

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A first episode of psychosis is defined by the first presentation of psychotic symptoms that have gone untreated, characterized by a loss of contact with reality and significant declines in functioning. Low psychosis literacy among clients and caregivers can result in a delay in receiving treatment. This study sought to understand the information needs of clients and caregivers regarding early psychosis. Using a conventional content analysis, we conducted a secondary analysis of 64 transcripts from clients, caregivers, family physicians, and early psychosis intervention clinicians. Clients and caregivers often described having difficulties recognizing symptoms of early psychosis until they became overt …

Islamic Ethical Considerations On Medical Decision-Making In Adolescence, Nuray Catic

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Medical decision-making in adolescence has not been studied in-depth from the Islamic bioethics perspective. The objective of this dissertation is to use the Islamic ethical position to explore the adolescent medical decision-making process in Canada so as to contribute to building frameworks for Islamic bioethics consumers such as patients, physicians and policymakers. A descriptive literature review is conducted to analyze data from related disciplines such as Islamic theology, developmental psychology, law and clinical ethics through principles of Islamic ethics such as objectives of Sharīʿa, legal maxims and operational maxims. The concepts of taklīf, ahliyya, bulūgh and rushd are focused on …

Fluoroscopic Guided Peritoneal Dialysis Catheter Placement: An Analysis Of Pelvic Catheter Positioning And Early Catheter Flow Dysfunction, David Clark

Electronic Thesis and Dissertation Repository

Fluoroscopic peritoneal dialysis catheter (FPDC) positioning has not been thoroughly evaluated. Using a retrospective cohort of adult patients who underwent FPDC insertion in London, Ontario (Feb 1, 2010 - Aug 1, 2017); we retrieved procedural radiographs measuring the level of intraabdominal radiocontrast to pubic symphysis (IRPS), and catheter tip to pubic symphysis (CTPS). The median (Q1-Q3) distance (millimeters) of IRPS was larger in females [35(25-44)] than males [28(19-37); P=0.001]; but this distance was not associated with variables: Age (years), BMI (Kg/m²), Race, PKD, abdominopelvic surgeries, in correlation/regression analyses. CTPS distance increased with BMI [(β; 95% Confidence Interval …

Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma

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Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …

(In)Dependence, Socio-Sexual Relationships, And Sexual Health Among Adults With Mild Intellectual Disability (Mid): A Critical, Qualitative Exploration, Vanessa L.E. Cox Ms

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The purpose of this critical, qualitative study was to explore how adults with mild intellectual disability navigate independent socio-sexual relationships in settings where they are highly dependent upon caregivers and family members who exert significant control over most aspects of their lives. Data were gathered during one-on-one interviews conducted with adults with MID (n=15), and parental caregivers (n=6). Theoretical insights from critical disability studies and sexual citizenship were used to analyze the findings, which are presented thematically by study population. Participants with MID faced challenges to establishing and maintaining meaningful relationships, including a lack of choice about where and how …

Investigating The Effects Of Infantile Hydrocephalus On Visuomotor Integration: A Study Utilizing Behavioural And Neuroimaging Analyses, Derya Adil

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This thesis describes studies which explore the impact of infantile hydrocephalus on the posterior cortex, specifically focusing on the parietal and occipital lobes. Using resting-state functional MRI, the functional connectivity within the visuomotor integration network was investigated and connectivity was traced through the corpus callosum. We hypothesized that children with hydrocephalus would demonstrate altered functional connectivity compared to typically developing controls. Our findings revealed that patients had reduced functional connectivity in visuomotor pathways, particularly the inferior frontal occipital fasciculus, superior longitudinal fasciculus, and the frontal aslant tract, with notable impact on the left and right fusiform gyrus and precuneus. We …

The Shared Contributions Of The Capsule, Labrum, And Bone On The Suction Seal Of The Hip, Alexander J. Hoffer

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The hip capsule, labrum, and bone contribute to hip stability. Abnormalities in these structures are associated with pain and microinstability. Previous studies have quantified the individual stabilizing roles of the capsule and labrum and have associated cam over-resection with decreased hip stability.

The first objective of this thesis was to identify the relative biomechanical contributions of the capsule, labrum, and bone to the hip suction seal, as a representation of hip stability. The second objective was to assess the effectiveness of a labral reconstruction in restoring the suction seal after a cam over-resection.

Ten human cadaveric hips were tested in …

The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., Silvio Ndoja

Electronic Thesis and Dissertation Repository

Orthopedic surgery is a field which has often been talked about with regards to surgeon underemployment. This is particularly important given the paradoxical increasing demand for orthopedic care. There has not been well studied literature understanding the state of orthopedic surgery training in Ontario, Canada. Using a combination of various databases and surveying surgeons trained in Ontario we sought to provide some insight.

We demonstrated multiple important findings. More recent graduates are feeling less ready to enter practice and almost all graduates do at least 1 fellowship, with equal amount of 1 versus 2 fellowships. We showed an effect of …

Examining Individualized Participatory Approaches To Care For Individuals With Intellectual And Developmental Disabilities, Megann Yen Dong

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Person-centred plans have been identified as an upstream approach to addressing the inequities experienced by individuals with intellectual and developmental disabilities. However, little evidence on implemented approaches exists. This integrated thesis consists of two studies exploring individualized participatory approaches to care within community-care services, guided by an integrated knowledge translation approach. The first study is a scoping review aimed to identify individualized participatory approaches to care in the literature. The second study is a qualitative descriptive study utilizing semi-structured interviews with community-care staff (n=11) to understand an operationalized person-centred planning approach. The scoping review provides insight into the variability of …

Disordered Eating Behaviours In Adolescents With And Without A Formal Ed Diagnosis: Comparing Individual And Contextual Factors, Eve G. Chapnik

Electronic Thesis and Dissertation Repository

This study explored various psychosocial factors associated with disordered eating in adolescents accessing mental health services across Ontario, Canada. Data were collected using the interRAI Child and Youth Mental Health (ChYMH) assessment tool and participants were categorized into three groups: individuals with diagnosed eating disorders (ED, n=207), disordered eating without a formal ED diagnosis (sub-ED, n=888), and other treatment-seeking youth (non-ED, n=3285). The ED and sub-ED groups did not differ in many ways, presenting with a similarly greater prevalence of mental health issues, and dysfunctional family and peer relationships, in comparison to non-ED youth. However, the ED …

Evaluation Of Conservative And Operative Treatments In Active Patients With Acromioclavicular (Ac) And Rotator Cuff (Rc) Injuries, Jesse Singh

Electronic Thesis and Dissertation Repository

Abstract

Introduction: Shoulder pain and disability, particularly acromioclavicular joint (ACJ) and rotator cuff (RC) injuries, are common in a physically active population. Determining operative or rehabilitative treatment plans involve multiple treatment choices influenced by the injury grade and treatment goals, such as return to sport. This thesis investigates the management of treatment for AC and RC injuries

Method: The first study is a scoping review that uses the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) to synthesize 32 studies involving athletes who have undergone conservative or operative treatment for their Rockwood grade III …

Developing Rehabilitation Treatment Decision Aid For People Living With Complex Regional Pain Syndrome (Crps), Erfan Shafiee

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This Ph.D. dissertation aimed to develop a treatment decision aid for people with Complex Regional Pain Syndrome (CRPS) using the Ottawa Decision Support Framework (ODSF). The decision aid was developed throughout a two-phase process.

The first phase involved understanding the existing evidence and the factors influencing decision-making in CRPS rehabilitation: priorities and preferences of patients and therapists were considered. This phase encompassed the integration of diverse sources of evidence, including systematic reviews, overview of systematic reviews, critical appraisal of guidelines, and a survey exploring patients' and therapists' priorities and preferences for CRPS rehabilitation interventions. All forms of evidence were used …

Role Of Circular Rna Asph In Macrophage Polarization And Response In Sepsis, Tan Ze Wang

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Circular RNAs (circRNAs), a novel non-coding RNA species generated by back-splicing, has been shown to participate in gene regulation of leukocytes. Our previous RNA sequencing results show circular RNA ASPH (circASPH) to be highly expressed in peripheral blood mononuclear cells of sepsis patients at the start of intensive care. Macrophages, as ubiquitous innate immune cells, are responsible for the recruitment of other immune cells at sepsis onset. This work investigates the role of circASPH in the regulation of macrophage polarization in sepsis. Using an in vitro THP-1 cell model, it was found that circASPH levels peaked after 24 h of …

Decentering Whiteness In Nursing Education: The Pitfalls, Tensions, And Opportunities, Ivy Tran

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Statement of Research Problem: The Truth and Reconciliation 94 Calls to Action (TRC) (2015) calls for the implementation of accessible and appropriate Indigenous health education. Schools of Nursing are increasingly implementing various approaches to teach Indigenous health. Limited research exists for Canadian nursing students' experiences of learning Indigenous health. This study explored undergraduate nursing students' experiences of learning Indigenous health from four Schools of Nursing across Canada. Particular attention is paid to the factors that shaped student and faculty experiences of learning and teaching Indigenous health, respectively, the facilitators and challenges, and what constitutes a safe and effective learning environment. …

A Community Dweller’S Perspective Of A Day Shoulder Arthroplasty Surgery., Bansari D. Patel Ms.

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The following study was a qualitative interpretive descriptive study aimed at investigating immediate barriers or difficulties in the lives of the community dwellers as well as modifications occurring in the daily routine activities shortly after the out-patient total shoulder arthroplasty procedure. The personal and surgical factors affecting at-home recovery were focussed alongside exploring the coping mechanisms and adaptations in everyday day life. The study mainly focused on the initial three weeks' duration after the discharge. The study followed the constructivist paradigm, adopting the interpretive description methodology. A total of 19 subjects who underwent same/ single day discharge total shoulder arthroplasty …

Loudness Matching In Individuals With Parkinson’S Disease And Hypophonia, Catherine Johnson

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The purpose of the present study was to investigate speech loudness perception in 15 individuals with Parkinson’s disease (IWPD) and hypophonia (reduced speech intensity) and 15 healthy control (HC) participants. A loudness matching procedure was used to examine conditions involving speech loudness targets presented at various levels (60 to 80dB SPL). The loudness response conditions included manually controlled audio playback of external speech, self-vocalized speech, amplified self-speech, and speech projected to a distance of 2 meters. For most of the loudness matching conditions, the PD group did not demonstrate the predicted deficit in loudness matching. In some loudness matching conditions, …

Exploring The Relationship Between Hemispheric Prefrontal Cortex Activation, Standing Balance, And Fatigue In Individuals Post-Stroke: A Fnirs Study, Sarthak Kohli

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Balance impairments are common after stroke. Reasons for this are multifactorial and include motor dysfunction and fatigue. Limited research has explored the combined effects of post-stroke fatigue and balance on brain activation patterns. Research has shown that prefrontal cortex (PFC) activation may be involved in both motor control and fatigue throughout the recovery process post-stroke. The aim of this thesis was to determine whether: (1) PFC activation levels change between standing balance tasks, (2) PFC hemispheric activation is asymmetric during standing balance tasks, and (3) fatigue levels are associated with task-based activation. Patients with hemiparesis were recruited from the inpatient …

Assessing The Sensitivity Of Cerebral Blood Flow And Oxygenation To High Intracranial Pressure With Near-Infrared Light, Sule Karagulleoglu Kunduraci

Electronic Thesis and Dissertation Repository

Premature birth is associated with increased susceptibility to cerebral injuries because of the compounded effects of underdeveloped cerebral vascular and unstable hemodynamics. Notably, premature infants are highly vulnerable to intraventricular hemorrhage, which often leads to hydrocephalus and subsequently to high intracranial pressure (ICP). Current monitoring methods such as ultrasonography can only detect injuries that have already occurred, highlighting the need for prognostic tools. We hypothesize that concomitant measures of cerebral blood flow (CBF), blood oxygenation, and oxygen metabolism will be sensitive to high ICP. To test this hypothesis, experiments were conducted in a piglet model of high ICP using a …

Sex Differences In Mood And Anxiety-Related Outcomes In Response To Adolescent Nicotine Exposure, Tsun Hay Jason Ng

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Nicotine dependence is causally linked to increased risk of mood/anxiety disorders in later life. Females are reported to experience a higher prevalence of anxiety/depressive disorders and challenges in smoking cessation therapies, suggesting a potential sex-specific response to nicotine exposure and mood/anxiety disorder risk. However, pre-clinical evidence of sex-specific responses to adolescent nicotine exposure is unclear. Thus, to determine any sex differences in anxiety/depressive-related outcomes, adolescent male and female Sprague Dawley rats received nicotine (0.4 mg/kg; 3x daily) or saline injections for 10 consecutive days, followed by behavioural testing, in-vivo electrophysiology and Western Blot analyses. Our results revealed that adolescent nicotine …

Pannexin3 In Exercise, Obesity, And Osteoarthritis, Brent Wakefield

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Pannexin 3 (PANX3), is a glycoprotein that oligomerizes to form mechano-sensitive channels expressed in musculoskeletal tissues, and has been identified as a potential target for the treatment of obesity and osteoarthritis (OA). Obesity and OA are two of the most prevalent diseases worldwide, leading to disability and even death. These conditions are thought to originate from a complex interaction between genetics, aging, sex, and modifiable lifestyle factors, such as exercise. Investigating the interactions between genetic and exercise may provide a more comprehensive, context-specific understanding of gene function. This thesis aimed to understand the interactions between PANX3 and exercise interventions on …

The Role Of Dlc1Β In Attenuating Cardiac Ischemia-Reperfusion Injury During Heart Transplantation, Samantha L. Collings

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Cardiac ischemia-reperfusion injury (IRI) occurs intra-operatively during heart transplantation (HTx), underpinning graft survival. Past research implicated the PI3K/Akt1 & RhoA/ROCK pathways in IRI. Rho-GTPase activity/Akt regulates Deleted-in-liver-cancer 1 protein’s beta-isoform (DLC1β). Therefore, we hypothesized that DLC1β overexpression (OE) had anti-apoptotic effects. In vitro, HL-1 cells (mouse cardiomyocytes) received chamber hypoxia-oxygenation reperfusion (H/R) for 24H4R with/without DLC1β plasmid, before collection for protein/mRNA analyses. DLC1β-OE resulted in downregulated pro-apoptotic mRNA expression (Bax/Cycs/Casp3), upregulated protective mRNA targets (BCl2/Akt1) and less late/early apoptosis via flow cytometry. Results were confirmed via H9C2 (rat cardiomyocyte) cell lines. In vivo, C57/BL6 mice received heterotopic HTx with/without DLC1β-OE …

Sleep And Multimorbidity In The Canadian Longitudinal Study On Aging, Shreni Patel

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Sleep health is a latent construct comprising various sleep measures such as duration, quality, initiation, maintenance, and daytime sleepiness. This thesis compared the association of two measures of sleep health, a conventional summary score and a pooled index, with incident multimorbidity over a 3-year follow-up in 30,097 middle- to older-aged adults from the Canadian Longitudinal Study on Aging. At baseline, approximately 26% and 29% of participants with multimorbidity displayed poor sleep patterns according to additive and pooled indexing methods. Longitudinal analysis indicated that those with additive scores of 4 to 5 at baseline had a 1.54 (95% CI: 1.18, 2.03) …