Health sciences

Objectives/purpose: This study examined the psychosocial health (including resilience, hope, social functioning, mental wellbeing, and stress) of childhood cancer patients attending a recreational oncology camp (ROC).Methods: Childhood cancer patients enrolled for ROC participated in a survey on the first (T1) and last (T2) day of camp, and 3 months post-camp (T3). This survey included the: Child and Youth Resilience Measure (CYRM), Children's Hope Scale (CHS), Social Provisions Scale (SPS-5), and Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Afternoon saliva samples were collected at T1 and T2 to determine cortisol (ELISA). Results: CYRM, SPS-5, and SWEMWBS scores were high but did not differ between timepoints. CHS scores at T3 were lower compared to T1 and T2 (F=9.388, p=0.008). Salivary cortisol levels were within normal ranges. Conclusion/clinical implications: Childhood cancer patients have high levels of positive psychosocial variables and normal stress levels while attending ROC.

Author Keywords: cancer, children, hope, oncology camp, psychosocial health

Cadmium is a toxic metal that has detrimental effects on blood vessel development and function. To examine the effect of varying concentrations of cadmium on angiogenesis, two in vitro assays were used. First, developing yolk sac blood vessels were studied in gestation day 8 mouse embryos exposed to medium alone, 1.25, or 1.75 μM cadmium chloride (CdCl2). Embryos exposed to 1.25 μM cadmium experienced a significant increase in the number of vessels formed; however, they were smaller in size. Vessel morphology and signalling pathways were also investigated using the mouse aortic ring assay, with exposures of 0.0, 0.5, 1.0, 5.0, or 10.0 μM CdCl2. Samples exposed to 10 μM experienced a significant increase in vessel length. However, no significant differences in phosphorylated PTEN and AKT were observed. The results of this study suggest that low levels of cadmium may disrupt angiogenesis, particularly the development of the embryonic vasculature in the yolk sac.

Author Keywords: Angiogenesis, Cadmium, Embryonic Development, Teratogenicity, Vascular Development, Vasculogenesis

Paramedic data has significant potential for research. Paramedics see many patients every year and collect a wide variety of crucial data at each encounter. This data is rarely used for good reason: it's messy and hard to work with. But like theunderdog character in a classic movie, with a little bit of work and a lot of understanding, paramedic data has significant potential to change the world of medical research. Paramedics throughout the world are involved in research every day, but most of this research uses purpose-built data structures and never takes advantage of the existing data that paramedics create as part of their everyday work. Through a project-based approach grounded in developing a better understanding of the opioid crisis, this thesis will examine the quantity and structure of the existing paramedic data, the complexities of its current design, the steps necessary to access it, and the processes necessary to clean existing data to a point where it can be easily modelled. Once we have our dataset, we will explore the challenges of choosing key metrics by examining the effectiveness of metrics currently employed to monitor the opioid crisis and the influences public health programs and changing policies have had on these metrics. Next, we will explore the temporal distributions of opioid and other intoxicant use with an eye to providing data to support public health in their harm reduction efforts. And lastly, we will look at the effect of fixed- and floating-point temporal influences on intoxicant-related calls with an eye to how these temporal points can affect call volumes. By using this exploration of the opioid crisis, this thesis will show that with a more thorough understanding of what paramedic data is, what data points are available, and the processes needed to transform it, paramedic data has the potential to greatly expand the limits of health care data science into a more precise and more all-encompassing discipline.

Author Keywords: Ambulance, Data Science, Opioid, Overdose, Paramedic, Pre-hospital

Objectives/purpose: The current study examined whether attending a 1-month virtual oncology camp (VOC) improved resilience and hope in childhood cancer patients and parental/caregiver stress.

Methods:Childhood cancer patients/survivors and their parent/caregivers enrolled for VOC, participated in an online anonymous survey: before, after and 3-months after VOC. The survey included the Child and Youth Resilience Measure (CYRM) and the Snyder's Children's Hope Scale (CHS) for the childhood cancer patients/survivors and the Pediatric Inventory for Parents (PIP) for parent/caregivers.

Results:CYRM scores increased from T1 to T2 (d=0.86). Compared to T1, at T2 CHS scores also increased (d=1.33). Both CHS and CYRM scores remained higher at T3 compared with T1 (d=1.34; d=0.86). There were no changes in PIP scores between any time points.

Conclusion and significance: Our study demonstrated that participation in a VOC improved children's resilience and hope but did not change parental stress. Highlighting the clinical significance of these VOCs and the impacts they have on childhood cancer patients/survivors.

Author Keywords: cancer, children, hope, parental stress, resilience, virtual oncology camp

A mixed-methods' approach was designed to explore the marital impacts

following weight-loss surgery (WLS). In Phase 1, ten individual interviews with spouses

of five couples were conducted; two of the couples had the wives preparing for WLS, two

of the couples consisted of wives who had WLS, and one couple had both received the

surgery. Interviews were transcribed and analyzed using a combination of interpretive

phenomenological and grounded theory techniques. Findings demonstrated that WLS

does have impacts on marriage regardless of where couples are in their journey. All

couples discussed food as a possible source of conflict in their relationship. Interviews

also reveled that self-esteem is a major factor contributing to their relationship and

support is necessary throughout. In Phase 2 an online survey was developed to

quantitatively explore the important constructs deemed important from the participants in

Phase 1. Relationships between relationship satisfaction, sexual conflict, self-esteem,

depression and body image were examined in 54 participants. Results demonstrate that

higher levels of support and self-esteem and lower sexual conflict relate to a more

satisfactory relationship in individuals post- WLS.

Author Keywords: marital satsifaction, mixed-methods, qualitative, relationship satisfaction, weight-loss, Weight-loss surgery

The primary research question of this study was to explore the key factors influencing Indigenous health through an investigation of Inuit health in Nunavik.

This research used an exploratory sequential mixed-methods design. The qualitative phase of this project employed interviews with Inuit health experts in Nunavik. The quantitative phase involved an analysis of the regional Inuit health dataset to identify predictors of Inuit self-rated health.

Qualitative results identified a number of key social, cultural, environmental, and individual determinants of health in the region. Analysis of the quantitative data identified significant associations between variables such as age, physical activity, and peacefulness of the community and self-rated health.

Considered in combination, the qualitative and quantitative results of this study indicate the potential value of determinants such as food security, education, and connection to land as important to Indigenous health. The analysis demonstrates that our understanding of health in an Indigenous context has to expand to include determinants beyond physical health.

Author Keywords: determinants of health, Indigenous, Inuit, Nunavik, self-rated health

This thesis examined the applicability of the sexual self-control model to men, which resulted in the creation and analysis of a new two-dimensional sexual double standard scale. In Study 1, a sample of 124 men completed the Self-Control Schedule assessing general learned resourcefulness, the Sexual Resourcefulness Inventory, Sexual Self-efficacy Scale, Reasons for Consenting to Unwanted Sexual Advances Scale, and the Sexual Giving-in Experiences Survey. Contrary to expectations based on female samples, lower sexual resourcefulness was not a unique predictor of consenting to unwanted sexual advances in men. Instead, a mediation model was supported whereby men having more reasons for consenting to unwanted sexual advances were more likely to comply despite having higher levels of sexual resourcefulness skills. Concurrent with Study 1, 11 men were interviewed in Study 2 to further examine their giving-in to unwanted sexual advances, reasons for consenting, and sexual resourcefulness, but men shifted the conversation toward the sexual double standard despite scoring neutral to a quantitative sexual double standard measure in the survey of Study 1. Therefore, a new sexual double standard scale was created based on the content of the interviews. Study 3 examined the new scale's psychometric properties and its association with sexual consenting. The findings revealed that the new scale was best represented by two dimensions: personal attitudes and peer responses. Neither of these two subscales uniquely predicted giving-in to unwanted sexual advances, but were significantly associated with several key variables differentially.

Author Keywords: learned resourcefulness, sexual double standard, sexual health, sexual resourcefulness, sexual script theory, unwanted sex

A consistent provincial approach to capacity planning for rehabilitative care had been

identified as a critical gap in the field of health care in Ontario (Rehabilitative Care

Alliance, 2015a). In response, the rehabilitative care alliance (RCA) developed a needs

based hip fracture capacity planning canvas together with persons and families. This

research utilized computer assisted participation (CAP) to gather additional perspectives

from Virtual Voices via an on-line survey. The results of the Virtual Voices survey were

compared to Ontario's RCA hip fracture patient focus group findings. CAP facilitated

more voices and more ideas through virtual engagement. The survey method required

97% (10.6 hours) less time than the focus group. The Virtual Voices respondents

provided validation of the focus groups' confirmation of the rehabilitative care needs,

locations and most core team members as well as identified new ideas. The results

support the implementation of a needs-based capacity plan that enables individualized

care planning. This research provides a blueprint for the ongoing engagement of

persons and families in the co-creation of a sustainable rehabilitative care system. A

dashboard and e-health app would enable ongoing co-design, monitoring and

evaluation.

Author Keywords: Computer Assisted Participation (CAP), Computer Assisted Survey, Hip Fracture, Rehabilitative Care Needs, Virtual Collaboration, Virtual Engagement

Eating Disorders (ED) are notoriously difficult to treat due, in part, to commonly observed inefficiencies in cognitive flexibility and central coherence, which are believed to maintain disordered cognitions and behaviours and negatively impact prognosis. Cognitive remediation therapy (CRT) has recently been used effectively with adults with ED; however, evidence among adolescents is limited. The present study explored change in flexibility and central coherence in a group of 23 adolescent ED inpatients (M = 16 years, SD = 0.95). All participants received a comparable dose of ED treatment. Participants were split into two groups for comparison: the CRT group (n = 15) received CRT in addition to TAU; and a TAU group for control (TAU; n = 8). Improvements in flexibility and central coherence were superior in the CRT group, suggesting that CRT is a potentially useful treatment for adolescents with AN as part of an overall psychosocial rehabilitation program.

Author Keywords: anorexia nervosa, central coherence, cognitive flexibility, cognitive remediation, eating disorders, set shifting

Cardiovascular disease (CVD) prevention, treatment and outcomes in women remain largely inequitable globally. Unique sex-specific stages of life, including pregnancy conditions, and their influence on cardiac risk is a growing area of research (Norris et al., 2020). For example, preeclampsia is strongly associated with CVD risk. This connection has led to prevention interventions such as postpartum risk clinics. Research to date on pregnancy and chronic disease is rooted in the medical paradigm of risk and lacks women's lived experience. The present study qualitatively explored illness and risk perceptions of women with risky pregnancy conditions. Some participants felt self-blame for their conditions. Consequences and severity were focused on "baby first", while maternal risk was viewed in the distant future. Aspects of the pregnancy experience, including prompt access to mental health support, was viewed as a "blessing in disguise". Risks, such as lack of agency, and benefits of healthcare risk communication and intervention and implications for practice were also explored.

Author Keywords: communication, critical, health care, phenomenology, pregnancy, risk