Medicine and Health Sciences Commons^™

A Comparison Of Clinical Trial And Model-Based Cost Estimates In Glaucoma – The Case Of Repeat Laser Trabeculoplasty In Ontario, Omar Akhtar

Electronic Thesis and Dissertation Repository

Background and objective: For cost-effectiveness analyses (CEA) of glaucoma interventions to be of use they require valid and accurate cost and effectiveness data. Costs remain understudied relative to effectiveness. The impact of cost estimation methods on resultant estimates is unknown in glaucoma. Direct measurement of costs is labour-intensive and expensive. Decision-analytic modelling of costs using literature sources, expert opinion, institutional experience and assumptions provides a quicker, less laborious alternative to empirical costing. A lack of long-term effectiveness data in chronic diseases like glaucoma means that modelling is widespread and inevitable, both for CEAs and budget impact projections. The same problem …

An Examination Of Psychological Variables Influencing Perceptions Of The Self Among A Sample Of Female Exercise Initiates, Lisa Cooke

Electronic Thesis and Dissertation Repository

The general purpose of this dissertation was to explore the relationship among and within cognitive variables associated with exercise initiation and maintenance in a sample of female exercise initiates.

Manuscript 1 was structured to explore the changes to exercise identity among a population of female exercise initiates (N = 78) grouped into an imagery or control condition. Previous research has found that a strong exercise identity is associated with more frequent exercise (Strachan et al., 2009) and increases over time as a person continues to exercise (Cardinal & Cardinal, 1997). Participants were assessed multiple times (weeks 0, 5, 9, …

Environmental Health Effects Of Multiple Exposures: Systemic Risks And The Detroit River International Crossing Study, Tor H. Oiamo

Electronic Thesis and Dissertation Repository

This thesis examines cumulative exposures to traffic noise and outdoor air pollution on environmental and health related quality of life in Windsor, Ontario, and provides a critical analysis of the environmental assessment process for the Detroit River International Crossing (DRIC) Study. The research utilizes a systemic risk framework to understand environmental health and stress effects of cumulative exposures. The significance of this research is based on a relative absence of literature on the systemic health risks of cumulative exposures and the need to elucidate environmental annoyance as a health outcome for risk assessment. The objectives of the research were to …

Exploring Communication Apprehension And Its Relationship To Communication Attitude And Socio-Communicative Functioning In Children With Velopharyngeal Insufficiency, Agnieszka Dzioba

Electronic Thesis and Dissertation Repository

Myriad findings on children with velopharyngeal insufficiency (VPI) indicate the potential for this population of children to experience feelings of apprehension specific to communication and the potential for other psychological and social difficulties. The purpose of the present investigation was to explore the construct of communication apprehension (CA) and its potential relationship to social and communicative functioning in a diverse group of children with VPI. Potential linkages between CA and multiple socio-communicative constructs including attitude, speech satisfaction, speech and language skill, social competence, and speech severity were explored in a cohort of children with and without VPI, followed by an …

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Older Woman Workers: Met And Unmet Needs For Health And Wellbeing In The Workplace, Gillian Gorfine

Electronic Thesis and Dissertation Repository

Older women workers report experiencing occupational injustices however the literature focuses on barriers faced rather than understanding the needs-based strategies empowering women as they age at work. This study engaged women aged 55 and older in a participatory action research project defining and examining strategies for older women workers’ health and wellbeing. In Phase 1, a key informant advisory group (N = 4) defined the problem and guided the design of an open answer survey conducted with 72 older women in work. Three categories emerged informing the fundamental, instrumental, and contextual needs of older women workers. Meeting fundamental needs may …

The Antisaccade Task: Visual Distractors Elicit A Location-Independent Planning 'Cost', Jesse C. Desimone

Electronic Thesis and Dissertation Repository

Prosaccades are rapid eye movements with direct stimulus and response relations and are designed to bring the fovea onto a target or area of interest. In contrast, antisaccades require the inhibition of a prosaccade and the evocation of a saccade to a target’s mirror-symmetrical location. Previous work has shown that a remote (i.e., midline, contralateral) – but not proximal (i.e., ipsilateral) – task-irrelevant distractor relative to a visual target delays prosaccade reaction times (RT) (i.e., remote distractor effect: RDE). To my knowledge, however, no work has examined whether antisaccade RTs are similarly influenced by a RDE. Accordingly, I sought to …

Task-Switching In Oculomotor Control: Systematic Investigations Of The Unidirectional Prosaccade Switch-Cost, Jeffrey Weiler

Electronic Thesis and Dissertation Repository

An antisaccade requires suppressing a stimulus-driven prosaccade (i.e., response suppression) and remapping a target’s spatial location to its mirror-symmetrical position (i.e., vector inversion). Notably, my previous work demonstrated that the successful execution of an antisaccade selectively lengthens the reaction time (RT) of a subsequently completed prosaccade (i.e., the unidirectional prosaccade switch-cost; Weiler & Heath, 2012a; Weiler & Heath, 2012b). Thus, the objective of this dissertation was further investigate, and ultimately provide a mechanistic explanation for the unidirectional prosaccade switch-cost.

In Chapter Two, I demonstrate that the magnitude of the unidirectional prosaccade switch-cost is not dependent of the number of …

Knowledge Translation And The Governance Of Health Research In Canada: A Critical Discourse Analysis, Kathleen S. Ellis

Electronic Thesis and Dissertation Repository

Knowledge translation (KT) is a dominant discourse in the governance of health research in Canada. I critically examine the KT discourse of the Canadian Institutes of Health Research (CIHR), Canada’s major health research funder. Informed by a governmentality perspective, I explore how the KT discourse operates to shape the directions of health research and the activities of health researchers using critical discourse analysis with a sample of publicly available CIHR documents.

This KT discourse is constructed through three rationales: a “gap” between knowledge creation and its application; financial and health care accountabilities for public investment in health research; and, the …

Women's Navigation Of Maternal Health Services In Ghana's Upper West Region In The Context Of The National Health Insurance Scheme, Andrea C. Rishworth

Electronic Thesis and Dissertation Repository

In 2008 the sub Saharan African country of Ghana implemented a Maternal Exemption Policy (MEP) within its National Health Insurance Scheme. This policy provides coverage for free antenatal, postnatal, and facility delivery to all pregnant women for a one year period. By removing the fees associated with maternal health services, the MEP was intended to reduce maternal mortality and provide equitable health care for pregnant women. While the MEP is generally regarded as beneficial to the women of Ghana, challenges remain, especially in the poor, marginalized and rural communities of the Upper West Region. Given that access to a skilled …

Seeing With Sound: Investigating The Behavioural Applications And Neural Correlates Of Human Echolocation, Jennifer L. Milne

Electronic Thesis and Dissertation Repository

Some blind humans use the reflected echoes from self-produced signals to perceive their silent surroundings. Although the use of echolocation is well documented in animals such as bats and dolphins, comparatively little is known about human echolocation. The overarching goal of the work presented in this thesis was to shed light on some of the basic functions of human echolocation, including the perception of the shape, size, and material. I addressed these aspects of echolocation using behavioural psychophysics and neuroimaging.

In Chapter 2 I show that blind echolocators were able to accurately identify the shape of 2D objects, but that …

Mixed Methods Pilot Study Of Peri-Diagnostic Exercise Behaviour Change Among Women With Suspected Breast Cancer, Amy L. Deckert

Electronic Thesis and Dissertation Repository

Approximately 1 in 9 Canadian women will develop breast cancer in their lifetime (CCS, 2013). Over the past 30 years, population-based screening programs have contributed to decreased mortality rates (CCS, 2013), however the psychosocial sequelae associated with screening for breast cancer cannot be ignored (Holland et al., 2010). Although the majority of women screened will receive a benign diagnosis, the threat of malignancy can induce elevated levels of distress (Andrykowski et al., 2002).

We conducted a mixed methods pilot study to assess the feasibility and acceptability of a 6-week self-managed exercise behaviour change intervention to attenuate distress in women with …

From Their Perspective: How Adolescents And Young Adults Experience And Conceptualize Life And Occupation Surrounding Parental Divorce Or Separation, Laura R. Hartman

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Parental divorce affects adolescents’ emotions, routines, habits, occupations and relationships. The current body of research indicates that parental divorce leads to many unfavourable social, behavioural, and mental health outcomes for adolescents. This dissertation explores the daily lives and occupations of adolescents and young adults surrounding the transition of a parental divorce or marital separation.

This thesis contains four manuscripts in addition to the introductory and final reflection chapters. The first manuscript explores the current North American literature relating to adolescent life surrounding a parental divorce or marital separation, ranging form 1998 to 2014. The second manuscript provides an overview of …

Interesting Shapes Of Vegetables: Is It A Strategy To Promote Consumption Among Preschool Children?, Salma H. Alhabshi

Electronic Thesis and Dissertation Repository

This study highlighted the low intake of vegetables by preschool children and determined whether changing the shape of vegetables increased their level of consumption. A new strategy of repeated exposure to interesting-shaped vegetables was a step aimed at increasing vegetable consumption by increasing the fun element in having vegetables as snacks. Vegetables are the less desirable food in comparison to more attractive unhealthy choices available to children, and discovering a strategy to promote vegetables is considered an important step in nutrition. The primary aim was to explore the effect of repeated exposure (eight times) of shaped vegetables on consumption by …

Secondary Traumatic Stress And Alexithymia In High-Risk Professionals, Matthew R. J. Vandermeer

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This study investigated the role that cognitive deficits in emotional processing (i.e., alexithymia) play in the development of traumatic responses, such as secondary traumatic stress (STS), following work with clients who have experienced trauma. Using a prospective cohort of novice counselling psychology and pre-service education students, participants were measured for traits of alexithymia and STS before and after their first practicum placements. Elevated rates of STS consistent with a diagnosis of post-traumatic stress disorder were identified in participants following initial practicum placement. Correlation analyses demonstrated that alexithymia and alexithymia symptom clusters were significantly, and robustly, associated with STS and STS …

Obtaining A Diagnosis Of Fetal Alcohol Spectrum Disorder: Experiences Of Caregivers And Professionals, Erica R. Lundberg

Electronic Thesis and Dissertation Repository

The current study describes the lived experiences of stakeholders in a community-based fetal alcohol spectrum disorders assessment clinic. A qualitative methodology was used. Five participants, one caregiver and four professionals, were interviewed about their experiences. Six themes emerged from this process including: clinic organization: systemic strengths and challenges; attitudes and approach: laying the foundation; beyond yes or no: assessment and diagnosis; the moment of truth: delivering the diagnosis; outcomes: what happens after the diagnosis?; what does the future hold? next steps and needs. These themes formed a sequential story-telling of participant experience. Study results are critiqued and practical implications are …

The Nature Of Conflict In Sport: Development And Validation Of The Group Conflict Questionnaire, Kyle F. Paradis

Electronic Thesis and Dissertation Repository

The purpose of the present dissertation was to develop a questionnaire to assess intra-group conflict in sport teams. To this end, the current dissertation consisted of three phases which followed a logical progression that is typical in the questionnaire development process. A total of (N = 752) participants took part in the three phases (Phase 1: N = 10; Phase 2: N = 437; Phase 3: N = 305).

Phase 1 was a qualitative investigation of athletes’ (N = 10) perceptions of the nature of conflict in sport. This phase was undertaken to gain a better understanding of the conflict …