Master Theses & Projects (FHSCI)

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Characterizing aerobic and anaerobic performance in alpine skiing
(2024-08-01) Cormier, Justin Curtis; Logan-Sprenger, Heather
The purpose of this secondary data analysis was to characterize dryland performance of trained adolescent alpine skiers from the end of season to pre-season, and to assess the longitudinal changes in dryland jump performance over a 26-month period. Skiers between the ages of 15 and 18 volunteered for this study (n = 8; 16.5 ± 1.1 years; 73.3 ± 10.2 kilograms; 175.9 ± 7.2 cm; VO2max 55.5 ± 7.2 ml/kg/min). Clockwise (p = 0.008) and counterclockwise jump performance (p = 0.001) improved from April to September. Peak power and mean power improved from April to September (p < 0.01). Hexagon jump performance improved over 26 months in the clockwise (p < 0.05) and counterclockwise directions (p < 0.01). These results demonstrate the changes in aerobic and anaerobic performance in youth alpine skiers during different seasons and over a 26-month period.
Examining women’s knowledge, health risk perceptions, beliefs and behaviours in relation to toxic chemicals commonly found in personal care and household products: a mixed-methods approach
(2024-08-01) Trifunovski, Adrianna; Barakat, Caroline
Many personal care and household products (PCHP) contain toxic chemicals harmful to health. For instance, parabens, commonly found in shampoos, are endocrine disruptors that increase the risk of hormonal and reproductive disorders among women. Despite safer alternatives, research suggests women are unaware of these risks and options. This research used a mixed-methods approach to examine knowledge, health risk perceptions, beliefs, and avoidance behavior of women regarding toxic chemicals in PCHP. It focused on lead, parabens, bisphenol A (BPA), phthalates, triclosan, and perchloroethylene. A questionnaire was administered to 200 women, and 10 women participated in virtual interviews. Multivariate analysis found positive associations between avoidance of lead, parabens, BPA, and phthalates and knowledge, perceived health risks, and harm beliefs. Higher education and chemical sensitivity diagnoses increased lead avoidance. Factors influencing PCHP purchases included price, social media, effectiveness, and brand preference. The study emphasizes enhancing women’s knowledge about PCHP health risks and the importance of safer alternatives.
Exploring varsity athletes’ sleep characteristics: perspectives and implications of sleep on training, recovery, and athletic performance
(2024-06-01) Belchos, Melissa N.; Papaconstantinou, Efrosini
Introduction High-quality sleep is necessary for sports performance, physical and mental recovery from training, and preventing in-game fatigue. Varsity athletes may face additional challenges. Research Questions 1) What are the sleep characteristics of varsity athletes? 2) What are their experiences, views, expectations, and beliefs regarding the importance of sleep? 3) What can be hypothesized from the results of their sleep characteristics and perspectives? Methods We conducted a systematic review. MEDLINE, Embase, PsycINFO, CINAHL, and SPORTDiscus were systematically searched for primary studies published in English from inception to March 18, 2024. We included quantitative, qualitative, and mixed-methods studies. Results We screened the titles and abstracts of 1555 articles, of which 31 studies were included in this review. Conclusion Findings suggest that sleep quality may be lacking in collegiate athletes and that sleep duration may need improvement. This knowledge helps to identify future targets to improve the athlete's well-being, academics, and performance.
The perspectives of childbearing individuals and their families with reduced local access to maternity services in Canadian rural and remote communities: a qualitative evidence synthesis
(2024-05-01) Magdum, Komal; Brunton, Ginny
The reduction and discontinuation of maternity services in rural and remote communities in Canada has created health accessibility issues for many childbearing individuals. In this study, the perspectives of individuals and their families who lack local access to maternity care will be assessed using a Qualitative Evidence Synthesis (QES). Previous qualitative research has identified several stressors due to closures. By framing the research after the release of a watershed document - the Family Centered Maternity and Newborn Care (FCMNC) guidelines from 2019 - the implementation of the guidelines will be assessed. The objective of this study is to synthesize the existing evidence on perspectives of childbearing individuals and their families living in rural and remote communities who face lack of local access to maternity services after the FCMNC release. Results of this QES show that childbearing individuals continue to experience accessibility issues, which impacts their health and wellbeing.
Initial validity and reliability testing of the SGBA-5
(2024-03-01) Putman, Andrew; Dogra, Shilpa
Background: A hurdle to incorporating Sex- and Gender-Based Analysis is a lack of easily implemented measurement tools. To address this, we created the Sex- and Gender-Based Analysis Tool – 5 item [SGBA-5]. Objectives: Assess the validity and reliability of the SGBA-5 for health research where sex or gender are not primary variables. Methods: A Delphi consensus study was conducted with Canadian researchers [n=14]. A 2-arm [students, n=89; older adults, n = 71] test-retest study was then conducted. Results: Agreement was reached for the sex item [93%] and non-agreement for gendered aspect of health items [identity: 64%, expression: 64%, roles: 50%, relations: 57%]. The test-retest study found all items reliable on both arms [sex: κ = 1.00, gendered: ICC(A,1) > .865]. Conclusion: The novel SGBA-5 demonstrated reliability for all items and validity of the sex item; the gendered aspects of health items may be valid. Future research will further assess the SGBA-5.
Heart rate variability (HRV) as a predictor of anemia in premature infants using Artemis
(2024-02-01) Desai, Rachit; McGregor, Carolyn
Premature infants often receive multiple blood transfusions within the first few weeks of life because of their physiological needs. Anemia is a major contributor to the need for transfusions in premature infants, and current detection practices rely on laboratory testing of blood samples. This thesis introduces a Clinical Decision Support System (CDSS) framework that utilizes high frequency streaming physiological data and laboratory information for clinical insights through visual analytics. The framework leverages the Artemis platform, a Big Data and Artificial Intelligence based CDSS, by exploring relationships between blood transfusions and heart rate variability (HRV). Using Artemis, this thesis aimed to identify patterns in HRV to enable non-invasive detection of physiologically significant anemia through data visualization. This work contributes to health informatics by presenting an integrated CDSS framework and to laboratory sciences by demonstrating the potential of laboratory data integration for non-invasive anemia detection.
The relationship between ratings of perceived exertion, training load, and types of deliberate practice in ice hockey training
(2024-04-01) Csiernik, Ben; Wattie, Nick
Ratings of perceived exertion (RPE) are used in team sport settings to measure the perceived exercise intensity of training. Coaches may use measures of RPE as a method to monitor training load to ensure athletes are being sufficiently challenged without overtraining. However, limited published evidence exists evaluating the use of differential RPE (dRPE) in ice hockey. Further, there is a need to understand the impact of practice design on training, and if coaches and athletes perceive the demands of training equally. This study aimed to evaluate multiple domains of training in collegiate women’s ice hockey. Specifically, this study examined the relationship between RPE and dRPE, the impact of practice microstructure on RPE, coach-athlete RPE congruency, and a descriptive approach to training load. Results suggest that dRPE significantly explains the variance seen in RPE, that coaches and players show strong congruence, and that more research is required on practice microstructure.
Synthesizing existing evidence and leveraging expert opinions to develop a university, for-profit, and not-for-profit organization partnership model to address health professions education gaps through simulation-based education
(2023-12-01) Siraj, Samyah; Dubrowski, Adam; Brunton, Ginny
Healthcare providers in rural and remote (R&R) areas of Canada do not have the same access to skills development and maintenance opportunities as those in urban areas. Simulation-based education (SBE) is an optimal technique to allow healthcare providers to develop and maintain skills. However, SBE is mainly limited to universities or hospital-based research laboratories in urban areas. The purpose of this thesis was to develop a partnership model between university research laboratories, for-profit organizations, and not-for-profit organizations to diffuse SBE into R&R communities. Phase A aimed to identify the problem and present a solution through an editorial paper. Phase B consisted of a scoping review to understand the current landscape of literature. Phase C was a qualitative descriptive study interviewing stakeholders to understand their perspective experiencing the partnership process. All three phases were consolidated to create a partnership model to deliver simulation solutions to R&R healthcare settings.
Effect of neck muscle vibration on upper limb sensorimotor integration and motor performance
(2022-07-01) Tabbert, Hailey; Murphy, Bernadette
Upper limb control depends on accurate internal models of the position of the limbs relative to the head and neck. The cerebellum is heavily involved in SMI of neck sensory inputs and motor learning; therefore, it is likely that altered neck sensory input will impact cerebellar processing. However, it is unclear whether acute models of altered afferent input from vibration impacts SMI, somatosensory processing, and proprioception. Study one used SEPs to investigate the effects of neck muscle vibration on SMI and motor learning while study two used an elbow repositioning task to investigate its effects on upper limb proprioception. Vibration led to differential changes in SEP peaks associated with cerebellar processing and motor skill acquisition, and changes in upper limb accuracy. This thesis suggests that neck muscle vibration impacts cerebellar processing and motor control, likely due to vibration-induced alterations in body schema leading to neuroplastic adaptations and reduced accuracy.
A descriptive analysis of antipsychotic prescribing patterns for patients admitted to hospital with a primary diagnosis of schizophrenia
(2023-12-01) McTier (Hollingbery), Rachel (Tai); Rudoler, David
Treatment with antipsychotic medication is recognized as the standard treatment for patients with schizophrenia. While evidence-based recommendations have been made on antipsychotic prescribing patterns for patients with schizophrenia, there is still a disconnect between these recommendations and the prescribing patterns that are seen in clinical practice. This study investigates the current antipsychotic prescribing patterns for inpatients with schizophrenia at Ontario Shores, a specialized mental health hospital in Whitby, Ontario. Most sociodemographic variables had no significant effect on the three outcomes variables: whether patients met a target antipsychotic dose by the second week post-admission; were prescribed an LAI; or whether, pending eligibility, patients were prescribed clozapine as a third-line treatment. Length of stay as well as race/ethnicity were associated with an increased likelihood of receiving treatment with an LAI, however there are a number of unobservable confounding variables which make it difficult to draw conclusions from these findings. Overall, the findings of this study suggest that the provider seen may be an influential factor in determining the type of treatment a patient receives. This study provides a baseline on the current antipsychotic prescribing patterns at Ontario Shores and may be used to inform the implementation of an antipsychotic order set as part of bundled care initiatives within the hospital moving forward. Future studies should investigate whether receiving treatment that aligns with evidence based recommendations correlates with improved symptom scale scores and, whether the successful implementation of an antipsychotic order set improves both the standard of care received and symptom scale scores of patients diagnosed with schizophrenia.
Understanding the usage of mental health apps among post-secondary students
(2023-12-01) Karunakaran, Sharveena; Lemonde, Manon
University is a period where adolescents are exposed to novel stressors such as extensive academic overwork, familial pressure, financial concerns, and substantial studying, which can lead to psychological disorders such as anxiety and depression. It is well documented that ethnic and racial students experience a high prevalence of mental disorders yet underutilize health services. Culturally relevant mental health apps that incorporate insights from the targeted population can possibly reduce the mental health disparities that exist among marginalized groups. The study uses a semi-structured interview to explore the experiences of three female Sri Lankan students with mental health apps. The main themes that emerged from the study results included: perceived severity of mental illness; cues to action using the mental health app; self-efficacy and coping strategies; barriers to using mental health apps; benefits of using mental health apps; and recommendations for improving the engagement of mental health apps.
Using the evidence-development-validation-consensus (EDVC) approach to develop an online training program for healthcare professionals and laypeople to provide outside-hospital cardiac arrest care in rural and remote places
(2023-09-01) Gino, Bruno; Dubrowski, Adam
Introduction: The COVID-19 pandemic exacerbated challenges in delivering cardiac arrest (CA) courses in remote and rural (R&R) areas and affected training for laypeople (LP) and healthcare professionals (HCPs). Due to the combined issues, medical education suffered, including the suspension of basic life support and defibrillation (BLSD) training. Materials and Methods: In this study, researchers developed an online training program via evidence-development-validation-consensus (EDVC) approach using a learning management system (LMS) model. Results: A comprehensive online training program should encompass cognitive, affective, and psychomotor learning domains, addressing various skills and knowledge aspects in BLSD training. Conclusion: The study presents the EDVC approach used to develop an online training program, enabling effective out-of-hospital CA care courses in R&R places. The program incorporates expert feedback and improves knowledge and techniques in automated external defibrillator (AED) delivered by drones use.
Navigating life with heart failure: the realities of self-care practices for patients and their families following cardiac rehabilitation
(2023-12-01) Doucette, Kristen; Lemonde, Manon
Heart failure (HF) self-care is well-documented in HF management, yet the experiences of patients and family members post-cardiovascular rehabilitation (CR) are less explored. This qualitative study utilized semi-structured interviews to probe into the post-CR self-care experiences among patients with HF and their families. Employing the Health Belief Model (HBM) as a guiding framework and interpretative phenomenological analysis (IPA) for data analysis, the research unveiled 14 interconnected themes rooted in the HBM's core elements: perceived susceptibility, perceived severity, cue to action, perceived benefits, perceived barriers, and self-efficacy. The insights gleaned from this study hold significant implications for clinical practice, policy, and future HF management research. The findings offer a nuanced understanding of intricacies behind behaviour change in patients with HF and their families, guiding targeted interventions and policy adjustments for improved care and support.
Exploring the facilitators of adapted mountain biking based on the lived experiences of adults living with a spinal cord injury
(2023-08-01) Wildish, Sarah K.; Lloyd, Meghann
Research related to adapted mountain biking for people living with spinal cord injuries has primarily focused on the barriers that exist. Facilitators of adapted mountain biking have not been well-researched, and a better understanding of the facilitators that address these barriers is needed. The intention of this study was to understand how adapted mountain biking is facilitated. Ten adults with a spinal cord injury who have participated in adapted mountain biking were recruited as participants. Semi-structured interviews were held to understand the lived experiences of participants regarding the facilitators of their participation in adapted mountain biking. The main themes that emerged from this research were 1) general facilitators related to the physical environment, organizations, human connections, and the individual, along with motivations; 2) equipment as a facilitator. The facilitators described by participants reflect the current actions that enable participation and the suggestions for how to further facilitate the sport.
Characteristics of rapidly manufactured ventilators: a scoping review
(2023-08-01) Mikkelsen, Katie Lynn; Nonoyama, Mika
The mechanical ventilator shortage caused by the Sars-CoV-2 (Covid-19) respiratory virus revealed healthcare systems worldwide were not equipped to handle mass-casualty events. Rapidly manufactured ventilators (RMVs) are low-cost machines made from readily available materials capable of performing the basic requirements of mechanical ventilation and posed a potential solution when intensive care unit ventilators were occupied. In the current literature, a plethora of RMVs exist in a variety of designs and capabilities; however, a lack of universal standards regarding their design and testing procedures restrict their safe introduction into the clinical setting. Standards for medical devices, like the International Organization for Standardization (ISO), help ensure safe, reliable and effective performance while also reducing the risk for recalls or adverse events. This scoping review collected and synthesized all available evidence on RMVs for critically ill patients. In April 2022, a systematic search was completed in numerous databases, resulting in the inclusion of 52 articles (53 RMVs). Four categories (operating, performance, other general features, and engineering components) created based on the information from six RMV guidance documents described the characteristics of the RMV designs and are presented in textual and graphical form. There was a large amount of variability in the characteristics of the RMVs, with some including several design elements and quality testing, while others including very few. Based on the synthesis of the 53 RMVs and six previously published RMV guidance documents, 11 suggestions regarding RMV design, performance and testing are provided. These suggestions may serve as a useful tool for development of universal standards such as those published by the ISO or for teams wishing to design their own RMV.
The perceived effectiveness of various forms of feedback on the acquisition of technical skills by advanced learners in simulation-based health professions education
(2023-08-01) Micallef, Julia; Dubrowski, Adam
Simulation-based health professions education is valuable for healthcare professionals to develop technical skills. However, little research has explored the effectiveness of augmented versus intrinsic feedback for advanced learners. This thesis aimed to determine what feedback type is perceived to be most effective by advanced care paramedics airing intraosseous access skills using simulation. Following the Design- Based Research framework, design-thinking and Delphi methods were used to generate a list of augmented feedback. In the test phase, paramedics received the augmented feedback and compared it to their intrinsic feedback while using the simulator, and in the evaluate phase, they ranked the feedback types. The results indicate that knowledge of performance was perceived as most effective, followed by intrinsic, and knowledge of results was perceived as least effective. This research provides insights into augmented and intrinsic feedback in simulation-based health professions education, but further work is needed to assess their actual learning effects.
Examining the effects of embodiment on performance and learning of drilling actions using pseudo-haptics and standard computer equipment
(2023-08-01) Abdo, Sandy; Kapralos, Bill
Psychomotor skills training within virtual learning environments are limited due to the need for expensive haptic devices to simulate haptic cues. While pseudo-haptics presents an accessible and cost-effective alternative to haptic devices, no empirical data support the notion of coupling it with embodiment which is crucial for psychomotor skill development. This thesis explored the effect of embodiment, represented by a virtual hand, coupled with pseudo-haptics on the performance and learning of a virtual drilling task. Using a mixed methods approach, 40 participants performed a virtual drilling task using a developed specifically for this purpose. The results show that when coupled with pseudo-haptics, embodiment significantly improves the speed of acquisition of the task indicating the need for a virtual hand in a virtual psychomotor-based simulation when coupled with pseudo-haptics. Although greater work is required, these results may lead to a convenient cost-effective virtual psychomotor-based simulation using standard computer equipment.
How the COVID-19 pandemic has influenced women’s employment and their health: an inquiry into their lived experiences
(2023-08-01) Veitch, Alanna C.; Bryant, Toba
The COVID-19 pandemic accentuated employment vulnerabilities among women working in the Canadian services sector. Research shows how poverty, precarious employment, and crisis are gendered and racialized. Few studies, however, critically explore women’s employment in Canada and how neoliberalism drives inequality. A Feminist political economy framework was used to examine the lived experiences of ten racialized women who work in the services sector in the GTA. Comparative thematic analysis of online interviews revealed intensified impoverishment, persisting inequalities, intersectional oppression, a deterioration of women’s mental health, and the inadequacy of existing public policies to address the cycle of neoliberal austerity and poor health experienced by racialized women in Canada. This research makes explicit how gender, race, and social class interact and shape women’s health. Governments must strengthen public provisions to address longstanding intersectional inequalities.
Substance use disorder education for emergency registered nurses
(2023-08-14) Shillington, Kelly; Lemonde, Manon
Patients with substance use disorders (SUD) constitute up to 1 in 11 emergency department (ED) visits in North America and this number increasing throughout the COVID-19 pandemic (Morin et al., 2017). The ED presents an excellent opportunity to intervene and improve care for patients with SUDs, however there is currently no required or expected level of competency in managing SUDs for registered nurses (RNs) working in an emergency setting. To inform an educational intervention for improving nursing care for patients with SUDs, this project aimed to leverage nursing leadership opportunities to understand the current competency and confidence amongst ED RNs and identify gaps to be ameliorated through continuing education and policy implementation.
Health care provider’s perceptions of a newly revised eHealth breastfeeding resource for use in clinical practice to increase breastfeeding health literacy
(2023-08-01) Azam, Sidra; Abbass Dick, Jennifer; Lemonde, Manon
Global breastfeeding rates are low, despite the World Health Organization’s breastfeeding recommendations. Health care providers are encouraged to provide education and support. Ehealth resources are increasingly being used to provide breastfeeding information to patients. The purpose of this project was to determine health care providers’ perceptions of a newly revised eHealth breastfeeding resource. This project followed a program evaluation approach and addressed the resources component of the logic model framework. Healthcare providers in Ontario were surveyed to determine their perceptions of the content, design and usability of a breastfeeding eHealth resource for use in clinical practice to increase breastfeeding health literacy and rates. The findings suggest that minimal revisions are needed to the resource and indicate that healthcare professionals found it acceptable for use in their clinical practice.

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