CROSH research
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Item Inhalation of Nebulized Diesel Particulate Matter: A Safety Trial in Healthy Humans(2014-02-14) Dorman, SandraDiesel particulate matter (DPM) has adverse health effects. Examining the underlying pathophysiological mechanisms would be facilitated by the introduction of an exposure method that is safe, portable, and cost-effective. The purpose of this study was to establish a novel method to study DPM exposure via nebulization and an inhalation dose that was safe, yet capable of eliciting an inflammatory response. Ten participants enrolled in this nonblinded, nonrandomized study. Subjects inhaled nebulized 0.9% saline and increasing doses of DPM suspended in 0.9% saline (75, 150, and 300 𝜇g) in a sequential manner. FEV1 was measured repeatedly during the first 2 h after exposure and blood, oximetry, sputum, and heart rate were taken before, 2 h, and 24 h after inhalation challenge. DPM inhalation was well-tolerated at all doses. A decrease in FEV1 was observed after each inhalation challenge (including saline). Inhalation of 300 𝜇g DPM produced a significantly different FEV1 response curve. An increase in particle inclusion-positive sputum macrophages for all DPM doses confirmed that the nebulized particles were reaching the lower airways. SerumGM-CSF was elevated after exposures to 150 and 300 𝜇gDPM.No other inflammatory changes were detected.DPM inhalation via nebulizer is a safe method of delivering low doses of DPMs in healthy people.Item Smoke Exposure Has Transient Pulmonary and Systemic Effects in Wildland Firefighters(2014-01-30) Dorman, SandraRespiratory exposure to air pollutants is associated with cardiovascular morbidity and mortality and firefighters have been shown to be at an increased risk of work-related cardiovascular events. Wildland firefighters experience intermittent, intense exposure to biomass smoke. The aim of this study was to characterize the respiratory and systemic effects of smoke exposure in wildland firefighters. Seventeen seasonal firefighters from a northeastern Ontario community were recruited at the beginning of the fire season and baseline measurements obtained; postexposure measurements were made at various times within 16 d of firefighting. Spirometric measurements showed a transient decline in forced vital capacity within 7 d of fire exposure, not evident by 8–16 d. Induced sputum showed a significant increase in macrophages and epithelial cells within 7 d, with evidence that macrophages had internalized particles; such changes were not evident in the second week following exposure. Likewise, peripheral blood analysis revealed significant increases in erythrocytes, hemoglobin, monocytes, and platelets within the first week after fire exposure, which were diminished 8–16 d in postexposure group.We conclude that acute exposure to forest-fire smoke elicits transient inflammatory responses, both in the airways and systemically.Whether these changes contribute to the observed increased risk of cardiovascular events requires further study.Item Evaluating the Reliability of Assessing Home-Packed Food Items Using Digital Photographs and Dietary Log Sheets(2013-11) Dorman, SandraObjective: To assess the reliability of manual data entry for home-packed food items by using digital photographs and dietary log sheets. Methods: Data from 60 lunches were entered by researcher A and B independently. Researcher B re-entered researcher A’s items within 1 week. Researcher B then re-entered her items 4 weeks from the initial entry point. Results: The inter-rater reliability intraclass correlation coefficient (ICC) was 0.83 for total kilocalories and ranged from 0.75–0.87 for macronutrients. The intra-rater reliability ICC was 0.92 for total kcal and ranged from 0.90–0.92 for macronutrients. The inter-rater ICCs for the 5 selected micronutrients ranged from 0.33–0.83, whereas the intra-rater ICCs for these micronutrients ranged from 0.65–0.98. Conclusions and Implications: This method of data entry is feasible and its reliability is promising for macronutrient investigations. Continued assessment of this method for investigations related to micronutrient content is recommended.Item Community-Based Emergency Care: An Open Report for Nishnawbe Aski Nation(2014) Ritchie, Stephen; Orkin, Aaron; VanderBurgh, Dave; Fortune, MelanieThis report summarizes the learnings of the Community-Based Emergency Care Roundtable, a two-day multi-jurisdictional meeting held in October 2013 in Sioux Lookout, Ontario. The purpose of this meeting was to discuss and address pre-nursing station emergency care needs in remote and isolated First Nation communities in Ontario. Representatives of First Nations’ governance and community organizations, Ontario Provincial and Canadian Federal governments, nursing and paramedical services, and non-governmental organizations joined together to develop shared understandings and a vision for the future of emergency care in remote and isolated settings. This report offers a Vision, Key Recommendations and Guiding Principles with which to improve emergency care for all injured and ill people in remote and isolated First Nation communities in Nishnawbe Aski Nation.Item Leadership status congruency and cohesion in outdoor adventure groups(2008-08) Ritchie, Stephen; Eys, Mark; Oddson, Bruce; Little, Jim; Slade, HeatherThe general purpose of the present study was to examine the relationship between status congruency and group cohesion in an outdoor expedition setting. Specifically, three aspects of status congruency were assessed in relation to group cohesion in four adventure canoe groups. These groups were participating in two week expeditions in the northern areas of the Canadian provinces of Ontario and Quebec. The participants were 32 upper year undergraduate students enrolled in a central Canadian university (Mage = 8 22.41 + 2.43 years). Results indicated that (a) individuals who ranked themselves higher in the group’s status hierarchy compared to where their peers ranked them had decreased attractions to social aspects of the group; (b) perceptions of group cohesion were greater when individuals occupying formal leadership positions were higher in the group’s status ranking (i.e., greater congruency between formal and informal status hierarchies); and (c) individuals who were members of groups that had some level of consensus regarding status rankings perceived their groups to be more cohesive than those who were members of a group that had no consensus.Item Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community(2014-04-15) Ritchie, Stephen; VanderBurgh, Dave; Jamieson, R; Beardy, Jackson; Orkin, AaronCommunity-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive five-day first aid courses. Sachigo Lake First Nation is a remote aboriginal community of 450 people in northern Ontario, Canada with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Issue. Most first aid training programs rely on standardized curriculum developed for urban & rural contexts with established emergency response systems. Delivering effective community-based first aid training in remote aboriginal communities required specific adaptations to conventional first aid educational content and pedagogy. Lessons Learned. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum. (1) 15 Standard algorithmic approaches may not be relevant nor appropriate. Relationships between course participants and the people they help are relevant and important. Curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.