Interdisciplinary Health / Santé interdisciplinaire

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Adaptation during a longitudinal integrated clerkship: the lived experiences of third-year medical students at the Northern Ontario School of Medicine.
(Laurentian University of Sudbury, 2013-07-31) Dubé, Tim V.
There are three interrelated concepts of what medical students learn, which include the formal, informal, and hidden curriculum. Several researchers who have investigated notions of the hidden curriculum have demonstrated how the experiences of medical training entrenched in the hidden curriculum can have a profound impact on medical student adaptation. The most influential transitional stage in undergraduate medical education is the third-year clinical clerkship, when medical students transition from classroom learners into clinicians. The Northern Ontario School of Medicine’s (NOSM) clinical clerkship year consists of a mandatory eightmonths of living and working in rural and northern communities throughout Northern Ontario, and learning in the context of rural family practice. Informed by a social constructivist research paradigm, I explored how 12 third-year students described the challenges they had to manage and, in response, the strategies they employed to adapt to their clerkship. I elicited their experiences and perspectives to contribute to a rich understanding of how students at the NOSM describe developing processes of adaptation during the Comprehensive Community Clerkship. Data were collected between August 2011 and April 2012, including: a) pre-clerkship interviews and a demographic questionnaire, b) mobile methods in the form of ‘guided walks’ in the communities, and c) post-clerkship interviews. The quality of the data collection and analysis were enhanced through processes of methodological and interpretive rigour, representativeness and authenticity, rich description and contextual relevance, audit trail, and reflexivity. Through an inductive thematic analysis of the data, the findings provide a rich description of events experienced such as medical training in one’s hometown or a familiar community, iv transitions including adaptation to the clinical setting and to the medical profession, and the influence of the clerkship on career path, personal well-being, and empathy for patients. The findings serve to advance our understanding of how medical students describe developing processes of adaptation throughout a longitudinal integrated clerkship. Implications are considered for medical students, the NOSM, the clerkship communities, and medical schools nationally and internationally. I propose recommendations regarding the suitability of authentic methods in medical education research, and discuss the implications for rural and northern health research.
Building resilience and community capacity: the Sachigo Lake wilderness emergency response education initiative
(Laurentian University of Sudbury, 2014-05-21) Curran, Jeffrey
The Sachigo Lake Wilderness Emergency Response Education Initiative represented a partnership between Sachigo Lake First Nation in northern Ontario Canada, and medical professionals and university researchers from outside the community. This study was one component of a larger community-based participatory research program to develop locally relevant first response training to address the isolation from emergency healthcare in Sachigo Lake. The aim of this qualitative study was to complete a formative evaluation to understand how a five-day comprehensive training course implemented in May 2012: (a) met the local needs of Sachigo Lake; and (b) fostered resilience and community capacity. The results of this study describe the unique features of delivering first aid training in a remote context and illustrate the intrapersonal and interpersonal impacts of the program. Health promotion through community based first aid education is a model with potential to improve emergency care in the absence of formal emergency medical services.
Exploring media representations of overweight & obese women’s dietary and exercise behaviours in the biggest loser: a self-determination theory approach
(Laurentian University of Sudbury, 2014-10-22) Tennant, Melissa
Objective: The purpose of this study was to use self-determination theory (SDT) to gain a better understanding regarding how weight loss practices (i.e., dietary and exercise behaviours) and weight loss strategies for overweight and obese women were portrayed within the reality television show The Biggest Loser (Season 13). The psychological, behavioural and health promotion implications were of interest. Design and Method: An ethnographic content analysis (see Altheide, 1996) of media representations of all 18 episodes within season 13 of The Biggest Loser were undertaken with a specific focus on five female contestants. Results: Analysis revealed that weight loss was portrayed under an over-arching theme: reaching weight loss goals equals success/not reaching weight loss goals equals failure. Multiple meanings of weight loss and implications emerged depending on four distinct sub themes: a) fat women’s lack of self-control; b) weight loss strategies associated with disordered exercise practices; c) weight loss promoted as a privilege; and d) weight loss as a new and improved self. These themes had motivational implications when interpreted within the context of SDT. Conclusion: This study extends the understanding of the ways in which certain forms of media (i.e., reality television) construct and reinforce particular cultural, social and behavioural norms concerning the promotion of weight loss practices in overweight women. This study also extends previous exercise psychology literature seeking to conceptualize and study the promotion and selfregulation of exercise and weight loss practices from a SDT perspective within a cultural context (i.e., the media).
L’évaluation de la traduction du FOCUS-F
(Laurentian University of Sudbury, 2014-11-25) Pominville, Valérie
Deux études ont été menées afin de vérifier l’évaluation de la traduction du FOCUS-F. La première étude a vérifié la compréhension et la facilité d’utilisation de la traduction de la mesure de progrès FOCUS-F (Focus on Outcomes of Communication Under Six version française) en milieu francophone minoritaire à l’aide de questionnaires. FOCUS-F mesure, chez les enfants d’âge préscolaire, les changements apportés à leur communication quotidienne (à la maison, en garderie, avec les amis) à la suite d’interventions en orthophonie. Notre échantillon comporte 35 répondants ayant des contacts fréquents avec des enfants de moins de 6 ans par exemple des parents, des grands-parents et des voisins. Généralement, les répondants ont jugé les phrases du FOCUS-F comme étant claires et le vocabulaire utilisé facile à comprendre. Quelques énoncés ont été parfois identifiés comme étant plus difficiles à comprendre. La deuxième étude a été effectuée auprès de 10 parents par le biais d’entrevues afin de mieux cerner les difficultés encourues par les participants lors de la première étude. Cette deuxième étude a démontré que les questions inversées du FOCUS-F s’avèrent plus difficiles à comprendre pour les parents. Elle met aussi en lumière la présence de quelques questions pouvant être interprétées différemment selon les parents.
L’accélération du temps psychologique avec l’âge : mythe ou réalité?
(Laurentian University of Sudbury, 2015-04-27) Chenard, Isabelle
La perception du temps au cours de la vie est un objet d’étude plutôt négligé par la science. Jusqu’à récemment, l’étude scientifique de la perception temporelle se limitait surtout aux jugements de durées physiques de l’ordre des millisecondes, des secondes et des minutes. Cependant, depuis le tournant des années 2000, un intérêt scientifique grandissant se manifeste pour des jugements de durées physiques beaucoup plus longues, de l’ordre des années et des décennies. C’est dans ce contexte que des équipes de recherche tentent maintenant de circonscrire un phénomène qui, jusqu’à présent, avait été abordé de manière plutôt marginale : l’accélération subjective du temps avec l’âge. En effet, depuis une cinquantaine d’années, plusieurs chercheurs se sont efforcés, par l’entremise d’expériences pionnières, de mesurer ce phénomène. Cette littérature est revisitée aujourd’hui, dans la mouvance d’une société démographiquement vieillissante. Si bien qu’une nouvelle discipline scientifique se dessine à l’horizon : la chronobiologie, l’étude de l’expérience temporelle subjective au cours de la vie. Le présent mémoire vise à rendre compte des plus récentes avancées empiriques et théoriques sur l’accélération du temps psychologique avec l’âge, le phénomène central qui a présidé à l’émergence de la chronobiologie. La définition du phénomène de l’accélération subjective du temps avec l’âge mène à l’examen de son caractère soit unitaire ou multidimensionnel. Les théories présentées dans la littérature sont variées en valeur explicative, mais semblables en guise de méthodologie, en bout de ligne. Le développement d’une méthodologie propre au domaine importe ainsi qu’un sens de l’application pratique dans nos communautés.
An examination of some theories that address the heavy alcohol consumption of university students
(2015-05-05) Treleaven, Taylor M.
The following paper investigates some of the many theories used to explain underlying reasons contributing to student drinking. Reasons for student drinking include escape from reality, social discomfort, former child abuse and neglect, and specific personality types. After reviewing various theories of addiction, this paper uses a deductive approach to identify the three theories most relevant student binge drinking: the social learning theory, the behavioural theory, and the personality theory. From social reasons to behavioural and personality related reasons, students drink to be more social and to cope with stress, but these rewards do not come without risks. The ability of theory to adapt to address the unique needs of individuals makes it an important, albeit underused, tool. Using theory to inform intervention strategies, then, is essential for developing effective treatment. Future research in this area should focus on methods for integrating theory with addiction treatment.
Problèmes de consommation d’alcool et les biais attentionnels : étude de population en traitement
(Laurentian University of Sudbury, 2015-07-20) Flesch, Corie Ann
La présente thèse comprend trois chapitres. Dans le premier chapitre, une revue de théories populaires portant sur les problèmes de consommation d’alcool est présentée dans le but d’en faire un compte rendu pour ensuite se pencher sur une explication spécifique : les biais attentionnels. Les biais attentionnels se produisent lorsque les processus d’attention sélective favorisent systématiquement un stimulus spécifique tout en excluant d’autres stimuli pertinents. De nombreuses études ont montré un lien entre la consommation problématique d’alcool et les biais attentionnels (voir Wiers & Stacy, 2006). Or, ce lien a été établi sur la base de tâches artificielles qui ne permettent pas de généraliser ces observations aux activités quotidiennes. Le deuxième chapitre comprend un article empirique soumis pour publication dans la Revue canadienne des sciences du comportement. Cet article a comme objectif de vérifier la présence de biais attentionnels chez les participants parmi les plus sollicités ces dernières années, c’est-à-dire les consommateurs étudiants binges1 et légers ainsi que les consommateurs en cours de traitement, en se servant d’une tâche naturelle. Pour ce faire, les mouvements oculaires des participants sont enregistrés lorsqu’ils observent des scènes complexes (ex. des scènes de bar comprenant plusieurs individus et objets). Le nombre de saccades, l’orientation initiale, la proportion de temps passé sur les stimuli liés à l’alcool et le temps total d’observation sont mesurés. De plus, les participants ont complété le Khavari Alcohol Test (KAT) pour mesurer leurs comportements de consommation d’alcool dans le but de les regrouper sur la base de la fréquence et du volume de consommations rapportées. Les résultats les plus pertinents révèlent que les participants classés comme consommateurs binges regardent les zones d’intérêt plus rapidement que les deux autres groupes peu importe le contenu de l’image (liée à l’alcool ou neutre). Aussi, les consommateurs en traitement passent significativement plus de temps que les consommateurs légers dans les zones d’intérêt, peu importe le contenu (liée à l’alcool ou non). Il est à noter que l’échantillon est petit et que les participants varient en âge; des variables devant être prises en considération dans l’interprétation des résultats. Finalement, le troisième chapitre se veut une discussion et une conclusion faisant le lien entre des théories populaires expliquant la consommation problématique d’alcool, les résultats de l’étude empirique de l’article soumis et des liens pratiques pouvant en découler.
Human immunodeficiency virus -1 (HIV-1) –Transactivator of transcription protein (Tat) effects on Macrophage polarization
(Laurentian University of Sudbury, 2015-08-10) Sarwan, Sylvia
The human immunodeficiency virus (HIV) relies on its encoded proteins to orchestrate cellular mechanisms for its replication and to induce inflammatory responses that recruit and compromise lymphocytes. Among them is the HIV trans-activator protein (Tat). Tat is required for the viral replication and enhances the infection of HIV in the host organism. Tat may also have an impact on the functions of the macrophage, an important player in pathological changes of AIDS patients. Some evidence exists that may suggest a more M2 like behavior of HIV infected macrophage. Tat has been shown to down-regulate P53 in macrophages. HIV infected macrophage had higher amount of arginase and became a major source of HIV viral load in patients with late stage AIDS. In this study, we investigated the possible role of Tat in the functional polarization of macrophages, a process that switches macrophage function between pro- inflammation (M1) and promotion of tissue repair and healing (M2). Effects of Tat on the macrophage were studied with human monocytic THP-1 cells that have been stably transfected with wild type Tat, or N terminus segment of Tat 1-48 aa or C terminus segment of Tat 37-86aa. Lipopolysaccharide (LPS), an activator of M1 macrophage, was used to activate these THP-1 cells. Exposure to LPS led to significant increase in inducible nitric oxide synthase (iNOS) in un-transfected THP-1 cells, GFP transfected cells, and cells with Tat 37-86 aa. However, THP-1 cells expressing wild type Tat or Tat 1-48aa showed no increase in iNOS whereas a rise in arginase was observed in Tat 1-48aa after LPS exposure. We also studied SOCS 1 and SOCS 3 expression and observed a greater SOCS 1 induction only in clones that had elevated iNOS in response to LPS. Wild-type Tat had no effect on SOCS 1 expression and cells with Tat1-48aa showed a decrease in SOCS 1. Cells expressing Tat 1-48aa displayed reduced HDAC 3 and SOCS 3 levels. Our data demonstrated that wild type Tat and Tat 1-48aa may impair or diminish the response of THP-1 cells to LPS. Our data may also suggest that wild- type Tat and Tat1-48aa have conditioned THP-1 cells towards M2 polarization. This may also suggest that cells expressing wild- type Tat or Tat 1-48aa may exhibit M2 behaviours.
Does exercise-induced inflammation serve a useful purpose across the adult age span?
(2015-08-10) Cartier, Sophie Melanie Louise
Inflammation is a protective biological response involving immune cells, blood vessels and molecular mediators, initiated upon the induction of cell injury (Abbas, Lichtman, & Pillai, 2007). The purpose of nflammation is to both eliminate the cause of the injurious agent (Abbas et al., 2007) as well as remove dead cells and tissues, damaged from the initial assault (Lapointe, Frenette, & Côté, 2002), and to initiate tissue repair (Ricciotti & FitzGerald, 2011). Inflammation as an event is a generic response to any injurious insult, which includes exercise-induced injury (Nehlsen-Cannarella et al., 1997). Exercise-induced muscle damage is defined as an injury from a mechanical force applied externally, causing structural stress or strain, resulting in cellular or tissue responses (Mueller & Maluf, 2002). An acute inflammatory response is sometimes instigated during exercise (Nehlsen-Cannarella et al., 1997); its initiation and magnitude depend upon the degree of physiological stress applied during the exercise bout (McFarlin, Flynn, Stewart, & Timmerman, 2004). Exercise-induced inflammation is typically seen in endurance sports where there is overuse of specific tissues (McFarlin et al., 2004). Physiological stress increases as intensity, duration and internal stimuli (e.g., blood glucose levels) increase (McFarlin et al., 2004). Thus, prolonged and intensive exercises significantly increase the induction of and the magnitude of an inflammatory response (McFarlin et al., 2004). Exercise-induced inflammation also stimulates the activation of the hypothalamic-pituitary adrenocortical (HPA) axis, characterised by elevated levels of cortisol and other mediators, inducing immune suppressive effects and thereby reinstating immune homeostasis (Tsigos & Chrousos, 2002). However, the immunosuppressive effects of the HPA axis may be detrimental to individuals if over-stimulated (Tsigos & Chrousos, 2002).Various methods have been employed in training regimes to counteract this inflammatory response Exercise-Induced Inflammation 7 (Bleakley, McDonough, & MacAuley, 2004; Gleeson, Nieman, & Pedersen, 2004; Quintero, Wright, Fu, & Huard, 2009). Carbohydrate supplementation is one method (Gleeson et al., 2004; McFarlin et al., 2004; Mitchell et al., 1998; Nehlsen-Cannarella et al., 1997; Nieman et al., 2004; Nieman et al., 1998; Scharhag, Myer, Auracher, Gabriel, & Kindermann, 2006). Others, such as cryotherapy (Bleakley et al., 2004) and RICE (rest, ice, compression, and elevation; Quintero et al., 2009), are also commonly used to reduce the exercise-induced inflammatory response under conditions where muscle soreness and/or injuries occur following physical activity (Bleakley et al., 2004; Quintero et al., 2009). The underlying theory is that reducing the inflammation will improve muscle tissue recovery (Bleakley et al., 2004; Quintero et al., 2009). The exercise-induced inflammatory response is necessary for performance adaptation (Kurtz, Loebig, Anderson, DeMeo, & Campbell, 1999), although, it may also lead to injury and is often associated with pain or discomfort by the individual (Abbas et al., 2007). Considering these two, opposing concepts, it would be valuable to understand the appropriate management of exercise-induced inflammation for both injury prevention and performance gains. Further complicating this question are external factors, which can enhance or reduce systemic inflammation (Gomez, Nomellini, Faunce, & Kovacs, 2008; Weiskopf, Weinberger & Grubeck-Loebenstein, 2009). In particular, age has significant impacts on both immune function and underlying inflammatory status (Franceschi et al., 2007; Gomez et al., 2008; Weiskopf et al., 2009). For example, aging impacts immune function by weakening immune responses to infections (Gomez, Boehmer, & Kovacs, 2005). Therefore, the purpose of this paper is to answer two questions: 1) ‘Does Exercise- Induced Inflammation Serve a Useful Purpose?’; and 2) ‘How Does Aging Affect this Process?’ To address these questions, this paper will first: i) review the role of inflammation as part of the Exercise-Induced Inflammation 8 innate immune response; ii) examine the positive and negative consequences of the exercise induced inflammatory response; and iii) outline the age-related effects on both the immune system and underlying inflammatory status.
Keeping girls in the gym : an examination of the reasons why females choose not to participate in high school physical education
(2015-09-16) Zapalski, Brady
With the changes of removal of mandatory participation in physical education (PE) classes and topics taught in these classes, there has been a decline in the participation rate across the board, but most specifically in the female population (Dwyer et al., 2006). With concerns of obesity, inactivity, and mental health issues on the rise, it is necessary to look at why these individuals are not participating. The purpose of this paper is to understand why female high school students do not enroll in senior elective PE classes. An extensive review of current PE literature, combined with a survey/focus group pilot project in Sudbury, Ontario was completed to help determine these reasons. The results of this paper indicate that there are three overarching themes as to why females are not continuing after the mandatory grade 9 class: 1) body image, 2) confidence in athletic abilities, and 3) curriculum and teaching styles. Within these themes, female students feel they should be comfortable and confident with themselves before immersing themselves into PE classes. Additionally, students believe that the content of classes should be adapted to suit current needs of students and promote lifelong health and activity participation. Students are not necessarily finding satisfaction and usefulness in the basketball, soccer and volleyball based gym classes, so it is important that schools consider implementing more individual and everyday activities such as hiking, yoga, swimming, etc. These may be the very activities that allow students to feel successful in the classroom and develop habits for necessary participation as they leave high school and move towards adulthood.
Surviving to thriving terminology and family reactions to disability a literature review
(2015-09-24) Gray, Meghan L
This literature review examined the theories and models surrounding the topic of family reaction to disability. Five models were assessed in terms of their structure and their terminology. An historical review has been provided to give context for the models under examination. Concerns with terminology used include the application of the words adjustment and coping within Patterson’s (1988) Family Adjustment and Adaptation Response model (FAAR), as well as the applicability of the construct of resilience to the FAAR (Patterson, 2002). The relationship between theories was also discussed with the FAAR and Scorgie, Wilgosh and Sobsey’s (2004) Transformational Outcomes model found to be the most complementary.
Social anxiety disorder in adolescence and implications for school settings
(2015-10-31) Hunda, Angie L.
Social anxiety disorder (SAD), sometimes referred to as social phobia, is a disorder in which an individual experiences fear of negative evaluation in social situations. The disorder has an early age of onset with approximately 60% of individuals retrospectively reporting symptom onset prior to 17 years of age (Rosellini et al., 2013). SAD is also common with a prevalence rate of 7% in community samples of children and adolescents (Beesdo-Baum, Knappe & Pine, 2009). Although SAD can be effectively treated, many adolescents do not seek help. As a result, they experience impaired functioning in a number of life domains such as academics and relationships that persist into adulthood and impact their quality of life. The education system has the potential to address the promotion, prevention, and intervention of mental health problems such as SAD at the classroom, school, and/or community level. Suggestions for policy and practice are discussed.
Les étudiantes finissantes francophones d’un programme de baccalauréat en sciences infirmières: une étude de leur expérience avec la clientèle des personnes âgées dans le nord de l’Ontario.
(2016-04-19) Aubuchon, Lynn
Le but de cette thèse est de comprendre l’expérience des étudiantes francophones du nord de l’Ontario finissant un programme de baccalauréat en sciences infirmières avec la clientèle des personnes âgées pour saisir ce qui les retient à s’investir auprès de cette clientèle dans le milieu des soins de longue durée à la fin de leur formation. Le contexte actuel ne semble pas propice à y attirer les futures infirmières autorisées. Une approche phénoménologique, de type Giorgi, est utilisée pour analyser les propos recueillis lors d’entrevues individuelles semi-structurées auprès de six participantes. L’analyse des entrevues fait ressortir que les futures infirmières autorisées ayant participé à l’étude ont vécu une expérience majoritairement positive relativement à la clientèle des personnes âgées. Elles les affectionnent mais elles ne se sentent pas prêtes à travailler dans le milieu des soins de longue durée. Elles ne se sentent pas assez compétentes et expérimentées pour s’y aventurer.
The influence of social determinants of health on child physical health in Greater Sudbury neighbourhoods
(2016-04-27) Cox, Kent
There is increasing awareness that social determinants of health are associated with growing health inequities, or avoidable differences, among many populations. The City of Greater Sudbury is experiencing these health inequities, including inequities in child physical health and wellbeing. This study will examine the relationship between specific social determinants of health and child physical health and wellbeing in Greater Sudbury neighbourhoods. The goals of this research are 1) to explore the relationships between specific social determinants of health and child physical health and wellbeing in Greater Sudbury neighbourhoods, 2) explore the collective influence of social determinants of health on child physical health and wellbeing, and 3) examine unique relationships that may exist between the social determinants of health and children physical health in neighbourhoods for the City of Greater Sudbury. The complexity, nature, and interactions of the social determinants of health within society makes observing them quantitatively difficult. This requires many different social determinants of health to be studied separately from one another, as well as together, in order to understand how they influence child physical health and wellbeing. In order to better understand these interactions, the social ecological model of health promotion presents an ideal theoretical framework for examining multiple variables and their correlations and, therefore, is used in this study. This study is an ecological crosssectional study using secondary data analysis of the 2011 National Household Survey (Statistics Canada) and the Early Development Instrument which was developed by the Offord Centre for Child Studies. This study involves a multi-variate analysis with the dependent variable of child physical health being represented by a composite measure of child physical health and wellbeing, and multiple independent variables including different measures of neighbourhood income, education, unemployment, lone-parent families and poverty. Child physical health and wellbeing is represented by the Early Development Instrument (EDI) - a questionnaire completed by the teacher or an Early Child Educator (ECE) when the child is in senior kindergarten. The EDI is a comprehensive measure of child physical health and wellbeing because it includes gross/fine motor skills, physical readiness for the school day, and physical independence. The social determinants of health are represented by the National Household Survey – a voluntary sample survey using a random sample collected by Statistics Canada, which the federal government uses to collect social and economic data about the Canadian population (Statistics Canada, 2011). IV Descriptive statistics address the assumptions of linear regression as well as examine the nature and normalcy of the independent and dependent variables. Then the presence of outliers are tested using univariate, bivariate, and multivariate detection methods. Linear and multiple regression tests are then used to analyze the influences of the social determinants of health on child physical health and wellbeing. The results of this study demonstrate the challenges of exploring geographical differences in the health of a population, and how those differences in health may be socially produced. Furthermore, this study provides insight into better understanding how child physical health and wellbeing in Greater Sudbury neighbourhoods may be influenced by socially produced health disparities.
An exploration of accident/failure at attribution and the potential implications for future research in occupational health psychology with psychiatric nurses
(2016-05-24) Desroches, Justin C.
The current review of the literature provides an overview of Attribution Theory (AT) and the themes, trends and gaps that have emerged for this construct within the field of occupational health psychology. AT is a widely published area of research and has served as a theoretical framework to investigate how individuals interpret accidents and their causes. Within this framework, researchers have investigated cognitive biases such as the selfserving bias, the false consensus effect, the actorobserver bias, the fundamental attribution error, the ultimate attribution error, Fischoff’s hindsight bias, the hedonic relevance bias, the optimism bias, and defensive attribution theory. Themes and trends of this review include subjective attribution tendencies, the types of attributions and their relation to safety behaviours, controversies regarding the assumptions of responsibility and the importance of accurate accident appraisals. Current gaps in the literature include somewhat dated research and only partial use of Weiner’s AT model (1985; 2010). In addition, there seems to be a paucity of research on AT as it applies to occupations with a high prevalence of accidents such as psychiatric nursing. The review further describes the extent to which the theory may be useful for occupational health and safety, accident prevention and in psychiatric nursing where practitioners face not only the common risks inherent to the profession but also the significant and unique risks in mental health facilities such as patient aggression and violence. This paper concludes by suggesting avenues of possible research as it applies to this profession, methodological challenges and the implications for future studies.
Factors that impact opioid agonist therapy in Northern and Rural Ontario
(2016-09-06) Franklyn, Alexandra Michelle
Opioid agonist therapy is the gold standard of care for opioid dependence. However, the efficacy of treatment may be hindered by concurrent drug use, including cocaine and benzodiazepines. This thesis examines the impact of concurrent drug use on treatment retention, and whether it is differentially impacted by geographic region. We conducted a retrospective cohort study using electronic medical records from 58 opioid agonist therapy clinics in Ontario. One-year treatment retention was the primary outcome of interest. Both baseline cocaine and benzodiazepine users experienced decreased retention rates than non-users. Patients who used concurrent drugs at higher frequencies experienced decreased retention rates compared to those who used less often. Northern and urban patients were more likely to be baseline cocaine users, and Southern urban patients were more likely to be benzodiazepine users. Both baseline and continued concurrent drug use is predictive of treatment drop out in Northern and Southern patients.
Are nurses protected? Observing the risk of skin contamination when donning and doffing personal protective equipment, using a Canadian protocol.
(2017-03-30) Desrochers, Chelsie
This study aimed to determine whether the Public Services Health and Safety Association’s donning and doffing protocol for Ebola are effective in the prevention of skin and clothing contamination. Ten third-year nursing students performed a donning and doffing simulation, which included donning personal protective equipment (PPE), being sprayed with GloGerm, performing eight simulated movements, and doffing PPE. Fluorescent stains were observed using an ultraviolet scan and were documented by their location and size. Four participants (N=4) experienced at least one contamination event following the doffing of PPE. Contaminations were observed on: the left dorsal lower leg (41.3mm; 64.0mm); the right dorsal lower leg (77.9mm); the left plantar (9.5mm); the left index finger (2.8mm); the right middle finger (1.6mm); the left scapula (38.1mm); and the right buttock (57.2mm). Areas of difficulty in the protocol included donning and doffing: the gown, N95 respirator, and the outer footwear. Failures with the equipment, including breaches and punctures, also contributed to the documented contamination. Near-miss incidents were observed in nine of the twenty-four steps in the protocols and occurred a total of twenty times. Revisions to the protocols were completed and included additional information for the following protocol steps: hang hygiene, N95 respirator, gown, outer footwear, verification process.
Social network development of the Stay on Your Feet (SOYF) implementation in the Greater Sudbury Region: A case study
(2017-06-19) Labbé, Amanda Paulean
The aging of the Canadian population is a serious concern. There are calls for innovation, integration, and collaboration among health and social systems to address older adult care needs. The rate of falls among older adults is high and will increase as the older adult population expands and progresses through the later life course. Stay on Your Feet (SOYF), an evidencebased falls prevention initiative, has been implemented in northeastern Ontario. Social Network Analysis (SNA) and semi-structured interviews were used to examine the implementation of SOYF in the Greater Sudbury region. The network was consisted predominantly of informal collaborations among health-related organizations, had low density and high centrality. Furthering community recognition and engagement of older adults were indicated as necessary to achieve sustainability of SOYF. The SOYF implementation network could use more collaboration among health and social organizations.
Developing dementia health promotion materials for Indigenous people in an urban Northern Ontario community
(2017-06-26) Webkamigad, Sharlene
This thesis considers health promotion materials on dementia for Indigenous people using health literacy and cultural safety as guiding frameworks. The author examined the question “How can we develop health promotion materials about dementia to meet the needs of Indigenous peoples living in urban Northern Ontario?” using two decolonized approaches to community-based participatory action research. Two-eyed seeing combines biomedical information with Indigenous knowledge to develop fact sheets. An understanding of local tribal teachings guided the research locally. Methods involved qualitative data analysis of two focus groups and five one-on-one interviews exploring the fact sheets’ appropriateness. Results suggest the need for a shared understanding of Indigenous and Western cultures; improved cross-cultural communication; the importance of grounding health promotion materials in culture; and, strategies for dementia awareness in Indigenous health literacy. These research findings can be translated to inform policy and practice through key recommendations regarding the development of health promotional materials.
L’effet de la durée, l’intensité et la dépense énergétique de l’exercice sur la consommation d’oxygène post-exercice (EPOC) chez les adolescentes sédentaires
(2017-08-08) Roy, Renée
Les taux d’obésité au Canada continuent à s’accroitre. Cette tendance est particulièrement inquiétante chez les adolescentes étant donné les conséquences médicales, sociales et psychologiques associées à l’obésité. Bien qu’il existe un nombre de traitements pour la perte de poids, l’impact de l’excès de consommation d’oxygène post-exercice (EPOC) sur le bilan énergétique n’a jamais été étudié auprès des adolescentes. L’objectif de cette étude est de déterminer l’effet de la durée, l’intensité et la dépense énergétique de l’exercice sur l’EPOC chez les adolescentes sédentaires. Huit adolescentes (15-17ans) ont complété 3 sessions expérimentales (30min à 61% du VO2max; 60min à 62% du VO2max; 36min à 76% du VO2max), suivies par 80 minutes de repos. L’EPOC n’a pas été influencé par la durée, l’intensité ou la dépense énergétique de l’exercice. Les adolescentes devraient donc être encouragées de participer à l’activité physique, peu importe les paramètres de l’exercice.

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