Medicine and Health Sciences Commons^™

Towards A Framework Of Client-Centered Collaborative Practice, Carole A. Orchard, Carole Orchard

Nursing Publications

This chapter provides an overview of the topic of competence in general usage and then in professional practice and its application into interprofessional client-centered collaborative practice. Collaboration is then discussed as both an outcome and a process. This follows a discussion related to the four approaches that can be adopted to assess competence. The reader is then presented with an in depth discussion of the CIHC Interprofessional Collaboration Competency Framework and of its competency domains and descriptors. A case study is provided within the chapter to present how each of the competencies may be demonstrated within a primary health care …

What Is Competence In Client-Centered Collaborative Practice?, Carole A. Orchard, Lesley Bainbridge

Nursing Publications

The chapter opens with a discussion on the growing impact of chronic disease in populations and the health system pressures to meet demands for ongoing care. In response a focus has shifted to delivery of care through teamwork, advocated because of the burgeoning health human resource shortages. The focus then shifts to how a framework for client-centered collaborative practice can be created in which a partnering relationship develops between clients, their families, and health providers within interprofessional teams. Exploration of this framework begins with a discussion about client engagement and client participation with the role of clients in their self-care …

Evaluation Of Continuing Interprofessional Client-Centered Collaborative Practice Programs, Carole A. Orchard

Nursing Publications

This chapter highlights the value of developing program evaluation approaches that focus on the merit or worth of the learning in relation to the program’s perceived accuracy, utility, feasibility, and propriety. A number of approaches to creating a program evaluation plan are provided. A case is made for the application of program logic models (PLMs) to continuing interprofessional education (CIPE) program evaluation. The argument is raised about the comprehensive nature in its application of an open systems approach that allows the linking back to the reason for the program.A case study is then provided to demonstrate how a manager can …

Assessment Of Learning Within Interprofessional Client-Centered Collaborative Practice -- Challenges And Solutions, Carole A. Orchard

Nursing Publications

The focus in this chapter is on the assessment of learning associated with continuing interprofessional education (CIPE) programs. It presents a case for using a formative approach to learning that is then assessed beyond just the CIPE program. How a participant converts learning gained and how it can be shared with fellow members in an interprofessional team are discussed. Factors that influence and impede knowledge uptake are presented. The chapter then shifts to discussion of assessment of team performance addressing team dynamics, knowledge contributions of members, and the organizational environment within which the team practices. Finally, the author provides examples …

Nfkb1 Activation By The E26 Transformation-Specific Transcription Factors Pu.1 And Spi-B Promotes Toll-Like Receptor-Mediated Splenic B Cell Proliferation, Stephen K.H. Li, Ali K. Abbas, Lauren A. Solomon, Gaëlle M.N. Groux, Rodney P. Dekoter

Paediatrics Publications

Generation of antibodies against T-independent and T-dependent antigens requires Toll-like receptor (TLR) engagement on B cells for efficient responses. However, the regulation of TLR expression and responses in B cells is not well understood. PU.1 and Spi-B (encoded by Sfpi1 and Spib, respectively) are transcription factors of the E26 transformation-specific (ETS) family and are important for B cell development and function. It was found that B cells from mice knocked out for Spi-B and heterozygous for PU.1 (Sfpi1^+/- Spib^-/- [PUB] mice) proliferated poorly in response to TLR ligands compared to wild-type (WT) B cells. The NF-κB family member …

Estimation Of Gfr Using Β-Trace Protein In Children, Samantha H. Witzel, Shih Han S. Huang, Branko Braam, Guido Filler

Paediatrics Publications

Background and objectives Sexmay affect the performance of smallmolecularweight proteins as markers of GFR because of differences in fat mass between the two sexes. The hypothesis was that the diagnostic performance of b-trace protein, a novel marker of GFR, would be significantly better in boys than in girls. Design, setting, participants, & measurements GFR, height, weight, serum creatinine, and β-trace protein were measured in 755 children and adolescents (331 girls) undergoing 99technetium diethylenetriamine penta–acetic acid renal scans from July of 1999 to July of 2006. Boys and girls were separated into formula generation cohorts (284 boys and 220 girls) and …

Youth With Disabilities Talk About Spirituality: A Qualitative Descriptive Study, Patricia J. Baldwin, Jan Evans, Nicole Etherington, Megan Nichols, Viginia Wright, Janette Mcdougall

Occupational Therapy Publications

There is little known about what spirituality means for youth with disability or about the potential relevance of youths’ spirituality in pediatric rehabilitation. This study explored perceptions of spirituality for youth with disabilities. Using a qualitative descriptive methodology, we examined the lived experiences of eighteen youth ages 11-20 years with disabilities including cerebral palsy, central nervous system disorder or autism spectrum disorder. In individual interviews, followed by a focus group, youth identified key spiritual themes – the importance of their beliefs, personal sources of comfort and strength, finding purpose in helping others, significance of personal connections, and strengths-based perspectives on …

Quality Of Life And Self-Determination: Youth With Chronic Health Conditions Make The Connection, Janette Mcdougall, Patricia Baldwin, Jan Evans, Megan Nichols, Nicole Ehterington, Virginia Wright

Occupational Therapy Publications

While optimizing quality of life(QOL) is a key goal of rehabilitation care,no previous study has reported on what ‘QOL’ means to youth with chronic health conditions. In addition, no qualitative studies have explored the relationship between QOL and self-determination(SD). Objectives of this qualitative study were to examine: what the terms ‘quality of life’ and ‘self-determination’ mean to youth with chronic conditions; the factors these youth think are linked with these concepts; the relationship they see between concepts, the types of future goals youth have and how they view the connection between their SD and these goals. A descriptive methodology was …

Situating Occupation In Social Relations Of Power: Occupational Possibilities, Ageism And The Retirement ‘Choice’, Debbie Laliberte Rudman

Occupational Therapy Publications

Introduction: Research attending to social relations of power can enhance understanding of the mechanisms through which occupational injustices occur and inform socially transformative practice. This study explored how power operates through ageism in ways that shape what people come to take for granted regarding occupation in relation to age, and what occupations are supported through socio- political conditions.

Methods: Narratives were collected using a two-stage interview process with 17 retired Canadians. A critical narrative analysis approach was employed to examine how these narratives revealed the complex ways occupations are negotiated within broader discourses and age relations.

Findings: Ageism mattered for …

Building Trust: A Critical Component Of Global Health, Obidimma Ezezika

Health Studies Publications

Trust is a concept that we often take for granted. But as much as it serves as glue for human relationships, trust lies, albeit subtly or sometimes hidden, at the crux of all global health interventions and is critical to their success or failure.1,2 The recent Ebola pandemic in West Africa shows how distrust among the community, public health officials and government institutions can lead to a massive failure in the delivery of health care and response to a disease outbreak. Media articles and commentaries attributed the slow response to the Ebola crisis to a lack of trust on many …

Invigorating Oral Health Care Using Motivational Interviewing In Clinical Practice, Jennifer Irwin, Clive Friedman, Don Morrow

Health Studies Publications

No abstract provided.

Health Behaviour Outcomes Of Co-Active Coaching Interventions: A Scoping Review, Rebecca Liu, Jennifer Irwin, Don Morrow

Health Studies Publications

The purpose of this paper was to conduct a scoping review on Co-Active (Life) Coaching (CALC) literature related to health behaviour change. The scoping methodological framework developed by Arksey and O’Malley (2005) informed the retrieval of appropriate articles. Six questions provided an in- depth exploration of CALC in the health coaching literature. This paper provides a broad overview of the current status of CALC literature in the area and underscores its utility to help facilitate health behaviour- related outcomes. The CALC approach offers a promising intervention for a variety of health conditions. Future larger-scale studies with increased experimental rigor are …

The Effect Of Motivational Interviewing On Oral Healthcare Knowledge, Attitudes And Behaviour Of Parents And Caregivers Of Preschool Children: An Exploratory Cluster Randomised Controlled Study, Rahul Naidu, Jennifer Irwin

Health Studies Publications

Background: Motivational Interviewing (MI) has been used across primary healthcare and been shown to be effective in reducing the prevalence of early childhood caries (ECC) in preschool children. This study aimed to compare the effect of MI, in contrast to traditional dental health education (DHE), on oral health knowledge, attitudes, beliefs and behaviours among parents and caregivers of preschool children in Trinidad. Method: The design of this exploratory study included a cluster randomised controlled trial and semi-structured focus groups. Six preschools (79 parents and caregivers) in Eastern Trinidad were randomly assigned to a test or control group (3 preschools in …

Public Health Guidelines For Physical Activity: Is There An App For That? A Review Of Android And Apple App Stores, Emily Knight, Melanie I Stuckey, Harry Prapavessis, Robert Petrella

Family Medicine Publications

BACKGROUND: Physical activity participation is an important behavior for modifying lifestyle-related disease risk. Mobile health apps for chronic disease management and prevention are being developed at a rapid rate. However, it is unclear whether these apps are evidence-based. Current public health recommendations for physical activity participation for adults highlight the importance of engaging in 150 minutes weekly of purposeful exercise, and muscle strengthening activities on at least 2 days of the week.

OBJECTIVE: The aims of the present review were to (1) identify available evidence-based physical activity apps, and (2) identify technological features that could be leveraged to improve health …

Promoting First Nations, Metis, And Inuit Youth Wellbeing Through Culturally-Relevant Programming: The Role Of Cultural Connectedness And Identity, Claire Crooks, Dawn V. Burleigh, Ashley Sisco

Journal Articles

Objectives: Although culturally relevant programming has been identified as a promising practice for promoting resiliency among First Nations, Métis, and Inuit (FNMI) youth, the specific ways in which these programs contribute to wellbeing are unclear. The Fourth R: Uniting Our Nations programs include an array of strengths-based culturally relevant programs for FNMI youth that have been found to increase wellbeing. The purpose of this study was to explore how culturally relevant programming provides a forum for intrapersonal and interpersonal growth.

Methods: In-depth interviews were conducted with 12 adult FNMI community and education stakeholders who have had extensive involvement with the …

A Restorative Approach For Class Ii Resin Composite Restorations: A Two-Year Follow-Up, Maria Jacinta M.C. Santos

Dentistry Publications

This clinical report describes a restorative technique used to replace two Class II resin composite restorations on the upper premolars. A sectional matrix band was used in conjunction with an elastic ring (Composi- Tight) to obtain tight proximal contact. A nanofilled resin composite (Filtek Supreme Ultra) was incrementally applied using oblique layers to reduce the C-factor, each layer being no more than 2 mm thick, and then light cured for 20 seconds with a light-emitting diode lamp (EliparFreeLight 2 LED Curing Light) with a power density of 660 mW/cm2. A centripetal technique was used to restore the lost tooth structure …

Detective Quantum Efficiency Of Photon-Counting X-Ray Detectors., Jesse Tanguay, Seungman Yun, Ho Kyung Kim, Ian A Cunningham

Medical Biophysics Publications

PURPOSE: Single-photon-counting (SPC) x-ray imaging has the potential to improve image quality and enable novel energy-dependent imaging methods. Similar to conventional detectors, optimizing image SPC quality will require systems that produce the highest possible detective quantum efficiency (DQE). This paper builds on the cascaded-systems analysis (CSA) framework to develop a comprehensive description of the DQE of SPC detectors that implement adaptive binning.

METHODS: The DQE of SPC systems can be described using the CSA approach by propagating the probability density function (PDF) of the number of image-forming quanta through simple quantum processes. New relationships are developed to describe PDF transfer …

Pretreatment Of Human Cerebrovascular Endothelial Cells With Co-Releasing Molecule-3 Interferes With Jnk/Ap-1 Signaling And Suppresses Lps-Induced Proadhesive Phenotype., Fukashi Serizawa, Eric Patterson, Richard F Potter, Douglas D Fraser, Gediminas Cepinskas

Medical Biophysics Publications

OBJECTIVE: Exogenously administered CO interferes with PMN recruitment to the inflamed organs. The mechanisms of CO-dependent modulation of vascular proadhesive phenotype, a key step in PMN recruitment, are unclear.

METHODS: We assessed the effects/mechanisms of CO liberated from a water-soluble CORM-3 on modulation of the proadhesive phenotype in hCMEC/D3 in an in vitro model of endotoxemia. To this end, hCMEC/D3 were stimulated with LPS (1 μg/mL) for six hours. In some experiments hCMEC/D3 were pretreated with CORM-3 (200 μmol/L) before LPS-stimulation. PMN rolling/adhesion to hCMEC/D3 were assessed under conditions of laminar shear stress (0.7 dyn/cm(2) ). In parallel, expression of …

Hippocampal Volume, Early Cognitive Decline And Gait Variability: Which Association?, Olivier Beauchet, Cyrille P Launay, Cédric Annweiler, Gilles Allali

Medical Biophysics Publications

BACKGROUND: In contrast to its prominent function in cognition, the involvement of the hippocampus in gait control is still a matter of debate. The present study aimed to examine the association of the hippocampal volume with mean values and coefficients of variation (CoV) of spatio-temporal gait parameters among cognitively healthy individuals (CHI) and patients with mild cognitive impairment (MCI).

METHODS: A total of 90 individuals (47 CHI with a mean age of 69.7±3.6years and 48.9% women, and 43 MCI individuals with a mean age of 70.2±3.7years and 62.8% women) were included in this cross-sectional study. The hippocampal volume was quantified …

'Vitamin D And Cognition In Older Adults': Updated International Recommendations., C Annweiler, E Dursun, F Féron, D Gezen-Ak, A V Kalueff, T Littlejohns, D J Llewellyn, P Millet, T Scott, K L Tucker, S Yilmazer, O Beauchet

Medical Biophysics Publications

BACKGROUND: Hypovitaminosis D, a condition that is highly prevalent in older adults aged 65 years and above, is associated with brain changes and dementia. Given the rapidly accumulating and complex contribution of the literature in the field of vitamin D and cognition, clear guidance is needed for researchers and clinicians.

METHODS: International experts met at an invitational summit on 'Vitamin D and Cognition in Older Adults'. Based on previous reports and expert opinion, the task force focused on key questions relating to the role of vitamin D in Alzheimer's disease and related disorders. Each question was discussed and voted using …

Validation Of Volumetric And Single-Slice Mri Adipose Analysis Using A Novel Fully Automated Segmentation Method., Bryan T Addeman, Shelby Kutty, Thomas G Perkins, Abraam S Soliman, Curtis N Wiens, Colin M Mccurdy, Melanie D Beaton, Robert A Hegele, Charles Mckenzie

Medical Biophysics Publications

PURPOSE: To validate a fully automated adipose segmentation method with magnetic resonance imaging (MRI) fat fraction abdominal imaging. We hypothesized that this method is suitable for segmentation of subcutaneous adipose tissue (SAT) and intra-abdominal adipose tissue (IAAT) in a wide population range, easy to use, works with a variety of hardware setups, and is highly repeatable.

MATERIALS AND METHODS: Analysis was performed comparing precision and analysis time of manual and automated segmentation of single-slice imaging, and volumetric imaging (78-88 slices). Volumetric and single-slice data were acquired in a variety of cohorts (body mass index [BMI] 15.6-41.76) including healthy adult volunteers, …

Unified Voxel- And Tensor-Based Morphometry (Uvtbm) Using Registration Confidence., Ali R Khan, Lei Wang, Mirza Faisal Beg

Medical Biophysics Publications

Voxel-based morphometry (VBM) and tensor-based morphometry (TBM) both rely on spatial normalization to a template and yet have different requirements for the level of registration accuracy. VBM requires only global alignment of brain structures, with limited degrees of freedom in transformation, whereas TBM performs best when the registration is highly deformable and can achieve higher registration accuracy. In addition, the registration accuracy varies over the whole brain, with higher accuracy typically observed in subcortical areas and lower accuracy seen in cortical areas. Hence, even the determinant of Jacobian of registration maps is spatially varying in their accuracy, and combining these …

The Effects Of Nonvascularized Versus Vascularized Bone Grafting On Calvarial Defect Healing., Stephanie M Power, Damir B Matic, David W Holdsworth

Medical Biophysics Publications

It remains unknown whether bone graft vascularity influences calvarial healing. The purposes of this study were (1) to develop a model to study nonvascularized and vascularized calvarial grafts as well as (2) to compare effects of bone graft vascularity on calvarial healing. Bilateral calvarial defects were created in 26 Wistar rats. The defects were left empty within 1 parietal region. On the contralateral side, the defects were partially closed with native parietal bone (control group, n = 6), nonvascularized (N-V, n = 10), or vascularized bone grafts (VAS, n = 10). The vascularized grafts were supplied by perforating dural arterioles. …

Tracking The Fate Of Stem Cell Implants With Fluorine-19 Mri., Jeffrey M Gaudet, Emeline J Ribot, Yuhua Chen, Kyle M Gilbert, Paula J Foster

Medical Biophysics Publications

BACKGROUND: In this study we used cellular magnetic resonance imaging (MRI) to detect mesenchymal stem cells (MSC) labeled with a Fluorine-19 (19F) agent. 19F-MRI offers unambiguous detection and in vivo quantification of labeled cells.

METHODS: We investigated two common stem cell transplant mouse models: an immune competent, syngeneic transplant model and an immune compromised, xenograft transplant model. 19F labelled stem cells were implanted intramuscularly into the hindlimb of healthy mice. The transplant was then monitored for up to 17 days using 19F-MRI, after which the tissue was excised for fluorescence microscopy and immunohistochemisty.

RESULTS: Immediately following transplantation, 19F-MRI quantification correlated …

Human Severe Sepsis Cytokine Mixture Increases Β2-Integrin-Dependent Polymorphonuclear Leukocyte Adhesion To Cerebral Microvascular Endothelial Cells In Vitro., Chris Blom, Brittany L Deller, Douglas D Fraser, Eric K Patterson, Claudio M Martin, Bryan Young, Patricia C Liaw, Payam Yazdan-Ashoori, Angelica Ortiz, Brian Webb, Greg Kilmer, David E Carter, Gediminas Cepinskas

Medical Biophysics Publications

INTRODUCTION: Sepsis-associated encephalopathy (SAE) is a state of acute brain dysfunction in response to a systemic infection. We propose that systemic inflammation during sepsis causes increased adhesion of leukocytes to the brain microvasculature, resulting in blood-brain barrier dysfunction. Thus, our objectives were to measure inflammatory analytes in plasma of severe sepsis patients to create an experimental cytokine mixture (CM), and to use this CM to investigate the activation and interactions of polymorphonuclear leukocytes (PMN) and human cerebrovascular endothelial cells (hCMEC/D3) in vitro.

METHODS: The concentrations of 41 inflammatory analytes were quantified in plasma obtained from 20 severe sepsis patients and …

Face And Content Validity Of A Novel, Web-Based Otoscopy Simulator For Medical Education., Brandon Wickens, Jordan Lewis, David P Morris, Murad Husein, Hanif M Ladak, Sumit K Agrawal

Medical Biophysics Publications

BACKGROUND: Despite the fact that otoscopy is a widely used and taught diagnostic tool during medical training, errors in diagnosis are common. Physical otoscopy simulators have high fidelity, but they can be expensive and only a limited number of students can use them at a given time.

OBJECTIVES: 1) To develop a purely web-based otoscopy simulator that can easily be distributed to students over the internet. 2) To assess face and content validity of the simulator by surveying experts in otoscopy.

METHODS: An otoscopy simulator, OtoTrain™, was developed at Western University using web-based programming and Unity 3D. Eleven experts from …

Respective And Combined Effects Of Impairments In Sensorimotor Systems And Cognition On Gait Performance: A Population-Based Cross-Sectional Study., Olivier Beauchet, Cyrille P Launay, Bruno Fantino, Gilles Allali, Cédric Annweiler

Medical Biophysics Publications

BACKGROUND: Respective and combined effects of impairments in sensorimotor systems and cognition on gait performance have not been fully studied. This study aims to describe the respective effects of impairments in muscle strength, distance vision, lower-limb proprioception and cognition on the Timed Up & Go (TUG) scores (i.e., performed TUG [pTUG], imagined TUG [iTUG] and the time difference between these two tests [delta TUG]) in older community-dwellers; and to examine their combined effects on TUG scores.

METHODS: Based on a cross-sectional design, 1792 community-dwellers (70.2±4.8 years; 53.6% female) were recruited. Gait performance was assessed using pTUG, iTUG and delta TUG. …

A Method For 3d Histopathology Reconstruction Supporting Mouse Microvasculature Analysis., Yiwen Xu, J Geoffrey Pickering, Zengxuan Nong, Eli Gibson, John-Michael Arpino, Hao Yin, Aaron D Ward

Medical Biophysics Publications

Structural abnormalities of the microvasculature can impair perfusion and function. Conventional histology provides good spatial resolution with which to evaluate the microvascular structure but affords no 3-dimensional information; this limitation could lead to misinterpretations of the complex microvessel network in health and disease. The objective of this study was to develop and evaluate an accurate, fully automated 3D histology reconstruction method to visualize the arterioles and venules within the mouse hind-limb. Sections of the tibialis anterior muscle from C57BL/J6 mice (both normal and subjected to femoral artery excision) were reconstructed using pairwise rigid and affine registrations of 5 µm-thick, paraffin-embedded …

Magnetic Resonance Imaging Biomarkers Of Chronic Obstructive Pulmonary Disease Prior To Radiation Therapy For Non-Small Cell Lung Cancer., Khadija Sheikh, Dante P I Capaldi, Douglas A Hoover, David A Palma, Brian P Yaremko, Grace Parraga

Medical Biophysics Publications

OBJECTIVE: In this prospectively planned interim-analysis, the prevalence of chronic obstructive lung disease (COPD) phenotypes was determined using magnetic resonance imaging (MRI) and X-ray computed tomography (CT) in non-small-cell-lung-cancer (NSCLC) patients.

MATERIALS AND METHODS: Stage-III-NSCLC patients provided written informed consent for pulmonary function tests, imaging and the 6-min-walk-test. Ventilation defect percent (VDP) and CT lung density (relative-of-CT-density-histogram

RESULTS: Seventeen stage-III NSCLC patients were evaluated (68 ± 7 years, 7 M/10 F, mean FEV1 = 77%pred) including seven current and 10 ex-smokers and eight patients with a prior lung disease diagnosis. There was a significant difference for smoking history (p = …

Diagnostic Accuracy Of Ultrasonography, Mri And Mr Arthrography In The Characterisation Of Rotator Cuff Disorders: A Systematic Review And Meta-Analysis, Jean Sébastien Roy, Caroline Braãn, Jean Leblond, François Desmeules, Clermont E. Dionne, Joy C. Macdermid, Nathalie J. Bureau, Pierre Frémont

Bone and Joint Institute

Background Different diagnostic imaging modalities, such as ultrasonography (US), MRI, MR arthrography (MRA) are commonly used for the characterisation of rotator cuff (RC) disorders. Since the most recent systematic reviews on medical imaging, multiple diagnostic studies have been published, most using more advanced technological characteristics. The first objective was to perform a meta-analysis on the diagnostic accuracy of medical imaging for characterisation of RC disorders. Since US is used at the point of care in environments such as sports medicine, a secondary analysis assessed accuracy by radiologists and nonradiologists. Methods A systematic search in three databases was conducted. Two raters …