Background: In Canada, mental health issues disproportionately impact Indigenous peoples. Less than 60% of Indigenous peoples reported having excellent or very good general mental health during 2015 – 2016, compared to 71.9% of non-Indigenous Canadians. Mental health disparities are strongly associated with social determinants of mental health, such as housing, socioeconomic status (e.g. employment, income, and educational attainment), and discrimination. Furthermore, socioeconomic factors contribute to a significant proportion of the disparities in mental health outcomes between non-Indigenous and Indigenous populations in Canada. Objectives: This study aims to summarize and disseminate research findings on socioeconomic inequalities in mental health outcomes among the populations affected. Proposed Methods: A scoping review of the empirical peer-reviewed literature will be conducted, and the methodological framework of Arksey and O’Malley will be employed. Six databases will be used in this study: Bibliography of Native North Americans, Canadian Health Research Collection, Google Scholar, Indigenous Studies Portal, PubMed and Statistics Canada. Citations that do not focus on socioeconomic status and mental health among a Canadian Indigenous population will be excluded. A thematic analysis will be used to analyze qualitative data and papers will be coded using the following categories: Indigenous identity group, geography, age-sex, socioeconomic status, and mental health/emotional well-being. Future Applications: The summary and dissemination of research findings from this study will provide information for policymakers to generate evidence-based decisions when addressing mental health disparities among Indigenous peoples.
Background: All human beings have a fundamental need to belong and to connect meaningfully with others. Unfortunately, youth living with obesity have reported experiencing loneliness, social isolation, weight-based bullying, and discrimination. In addition, research has shown that caregivers of youth with obesity have also expressed feelings of isolation. To date, a relative lack of research attention has been paid to social factors (e.g., connectedness, belonging) - compared to the more frequently evaluated anthropometric outcomes - in the area of pediatric obesity. Objective: Using Baumeister and Leary's Belongingness Theory as the foundation for this study, the primary purpose is to gain a comprehensive understanding of perceptions of belonging and social connectedness, as well as the factors that contribute to these constructs, among teens living with obesity (13-18 years) and their caregivers in London, Ontario. Proposed Methods: Youth-caregiver dyads (n = 10-20) will be recruited from the Pediatric Weight Management Clinic at London Health Sciences Centre. Participants will be invited to take part in a semi-structured interview exploring perceptions of belonging and connectedness, as well as an online survey designed to assess youth social connectedness, anxiety, and quality of life. Thematic analysis will be used to analyze qualitative data, and frequencies and scale-specific calculations will be computed to analyze quantitative data. Future Applications/Directions: Findings from this project will shed light on a vulnerable population whose perspective have yet to be fully understood, and will also provide insights into strategies and approaches for enhancing the care offered to youth with obesity and their caregivers.
Background: Antimicrobial resistance (AMR), which occurs when microbes no longer respond to medications, is one of the top global public health threats facing society. One cause of AMR is the failure to complete a course of treatment, leading to the spread of drug-resistant strains. Forced treatment has been implemented in the past for multi drug-resistant tuberculosis and is legally permitted in some Canadian jurisdictions for certain infectious diseases. However, limited attention has been given to the ethical justification of forced treatment in a context where diseases with AMR become increasingly common. Research that examines the complex ethical considerations of forced treatment as an increasingly important option for infectious diseases with AMR potential is urgently needed. Objectives: (1) Synthesize the current national policy landscape of forced treatment for infectious diseases; (2) explore the perspectives of key stakeholders on the implementation of forced treatment and determine within which contexts it may be ethically justified to issue; and (3) identify the key characteristics of diseases wherein forced treatment can be ethically justified, for policy application to any future disease. Proposed Methods: This qualitative, mixed-methods study will include key informant interviews with Medical Officers of Health across Canada, as well as a content analysis of relevant public health emergency response and infectious disease policy documents from Canada, the United States, and United Kingdom. Future Applications: This research serves to promote the health of populations by preventing the spread of emerging disease threats, and by doing so in a way that is ethically defensible.
Background: Personal support workers (PSWs) in long-term care (LTC) homes comprise over half of the workforce responsible for providing care to people living with dementia. Compared to other healthcare professionals, PSWs receive the least education, which fails to equip them with the necessary competencies for quality dementia care. To provide optimal care to people living with dementia, PSWs need to be offered opportunities for continuous education that addresses their specific learning needs. Objective: To identify the self-perceived, dementia-specific learning needs of PSWs in LTC. Methods: Interpretive description guided the secondary qualitative analysis of 22 focus groups with ‘mid-career’ PSWs (n = 39) in LTC. Focus groups were facilitated before, during, and after participants completed a dementia-focused person-centered communication training program in 2020. Preliminary Results: The analysis identified specific learning needs along with ways in which those needs are best met. The learning needs include: 1) addressing responsive behaviours, 2) communication, 3) delirium, 4) person-centered care and attitudes, and 5) dementia as a neurodegenerative condition. Learning needs were most commonly attributed to limited preparation during formal PSW education and a lack of continuous training opportunities. The ways in which learning needs are best met include practical, hands-on, and experiential approaches that involve opportunities for peer learning, feedback, and evaluation, within a supportive environment. Implications: The data generated from this research study will be essential to developing future continuing education for PSWs, contribute to knowledge about dementia care within LTC, and improve the quality of care provided to people living with dementia.
Background Currently, there are many barriers to women seeking diagnosis and treatment for Chronic Obstructive Pulmonary Disease (COPD), including under-diagnosis and fewer consultations. COPD is a chronic disease that causes obstructions in the small airways of the lungs. COPD can cause a persistent cough, breathlessness, and tiredness. There is no cure for COPD; treatments for the disease are used to manage symptoms and prevent exacerbations. As such, the quality of life of a person living with COPD can depend on the care that is being received. In the past decade there has been an increase in the number of COPD cases in women. This increase has not translated into increased care options for women. Objectives Explore the experiences of women during the diagnosis and treatment of their disease. Gain an understanding about what optimal and equitable care looks like to women with COPD. Provide recommendations for better care for women with COPD. Proposed Methods This study will use Van Manen’s hermeneutic phenomenological methodology to explore the lived experiences of women with COPD guided by a critical theory paradigm. This study will be conducted using semi-structured one-on-one interviews to explore the phenomena. Preliminary Results The data collection for this study will begin in the coming weeks. Preliminary results will be available at the time of this conference. Implications By exploring the experiences of women receiving treatment for COPD, this research can be used to help support the development of solutions to allow women to receive equitable care for COPD.
Background: Parental vaccine hesitancy has contributed to reluctant uptake of the COVID-19 vaccine in children, and the re-emergence of vaccine-preventable illnesses in Canada such as measles, meningitis, and varicella. Parental vaccine hesitancy has triggered court cases due to familial conflicts around the COVID-19 vaccine. Discussing vaccination with the child’s primary care practitioner (PCP) is at the root of these cases, necessitating communication strategies for PCPs to describe the importance of vaccination in primary care. How PCPs describe their navigation of the best interests of the child provides a novel and important context to explore approaches to vaccine hesitancy with the use of ethical reasoning and tools. Objectives: 1) explore how primary care practitioners navigated parental COVID-19 vaccine hesitancy during the COVID-19 pandemic, and 2) consider the complexity of ethical tensions, if any, related to navigating children’s best interests that arose when discussing COVID-19 vaccination with parents. Methods: 8-10 PCPs practicing in Ontario are being recruited for semi-structured interviews. Critical realism methodology is guiding methodological approaches. Braun and Clarke’s thematic analysis and NVivo software will support data analysis. Results & Implications (forthcoming): This knowledge will help improve understanding of how ethical considerations related to ‘best interests’ are faced by PCPs when discussing vaccination with hesitant parents. Additionally, a deepening understanding of the reasoning and decision-making tools used by PCPs can enhance vaccine decision-making for future health emergencies. The results have the potential to aid in navigating vaccine hesitancy during future pandemics, as well as alternate contexts such as childhood HPV vaccinations.
Background Alcohol is the most commonly used psychoactive substance among young adults in Canada. Alcohol is the direct cause of over 60 chronic health conditions, including at least seven types of cancer. Two thirds of Canadians are unaware that alcohol is carcinogenic. Other substances with known health risks, including cigarettes, cannabis, and vaping devices are required to have health warnings on their packaging. Aim The absence of health warning labels combined with the social acceptability of alcohol may lead young adults to believe that alcohol is less harmful to health compared to other substances that have health warning labels. A deeper understanding is needed of how young adults think about health warning labels on substance packaging and how health warning labels inform young consumers of health and cancer risks. Proposed Methods A mixed-methods approach was used. Canadian university students, aged 18-28, were recruited through social media. Participants completed a survey designed to investigate perceptions of health and cancer risks of substances that are packaged with a warning label compared to substances without a warning label, and the impact health warning labels have on young consumers. Semi-structured interviews will be conducted to explore student opinions of which substances should come with health warnings, who should be responsible for health warnings, and how health warnings shape their opinions of substances. Future Directions/Implications This research will be used to support future public health education efforts and advocate for federal legislation that would require health warning labels on alcoholic beverages sold in Canada.
Background: The Parkwood Parkinson Education Series (PPES) is a multidisciplinary, group-based, self-management intervention that equips persons with Parkinson's disease (PWPD) and their care partners with strategies to enhance their occupational participation and independence. Due to the global pandemic, the PPES transitioned from an interactive, in-person delivery model to a virtual model. Based on preliminary evaluations, this model may not be effective. In 2024, the intervention is transitioning to a hybrid model. Therefore, it is a critical time to evaluate the feasibility of this intervention. Objectives: The objectives of this pilot trial are to: 1) evaluate the acceptability; 2) practicality; 3) and limited efficacy of the intervention; 4) assess the participants’ intervention experience. Proposed Methods: This study proposes a mixed method, non-experimental pilot trial design, integrating principles of participatory research and integrated knowledge translation 1,.2. Data collection methods include patient reported outcome measures, surveys, document analysis and qualitative semi-structured interviews. Qualitative and quantitative analyses will be conducted. The Practical Reviews in Self-Management Supports (PRISMS) taxonomy and the template for intervention description and replication (TIDieR) checklist will systematically guide how the intervention results are reported. Future Applications: Conducting a small-scale, pilot trial of the PPES will provide a better understanding of the feasibility of the research design, data collection methods, recruitment strategies and the overall logistics of conducting a larger scale study. This research has the potential to inform the development of novel clinical interventions and provide recommendations for program implementation. Ultimately this research strives to improve the QoL and occupational participation of PWPD and their care partners.
Background: Many people with Parkinson's Disease (PwPD;PD) exhibit a shuffling gait characterized by slow velocity and short strides. Cognitive cueing interventions, internally rehearsing verbal instructions, offer a novel mode for gait rehabilitation as they circumvent many limitations of auditory and visual cues. Previous research has shown promising results on the efficacy of cognitive cues in conjunction with video feedback in PwPD. However, more rigorous testing is needed before introduction into clinical practice. [72] Hypotheses/Objectives: 1) Evaluate the effectiveness of cognitive cueing to improve gait and functional mobility in PwPD; 2) Explore the longitudinal efficacy of using cognitive cue-based gait training. [26] Proposed Methods: 25 participants with PD will be recruited from a movement disorders clinic within Southwestern Ontario. Baseline gait and functional mobility will be assessed, and best cue identified for all participants. Gait training videos will be made for each participant containing video clips of cued and non-cued walking with instructions to guide practice. Participants will be assigned to either a cue-only or a cue + video group. Participants will log practice at home for 12 weeks; every other day for 4 weeks, at their own discretion for 8. At 12 weeks gait and functional mobility will be reassessed. [99] Future Applications/Directions: These findings will refinine this innovative approach to managing walking difficulties and may lead to a lower risk of falls and injuries, increased independence, and an overall improvement in quality of life for PwPD. [34]
Background: Physical activity in the early years (<5 years), is essential for ensuring healthy overall development. However, many Canadian post-secondary Early Childhood Education programs, include limited content on national physical activity guidelines or physical education. As a result, many Early Childhood Educators (ECEs) report low knowledge and self-efficacy in leading and promoting active play in early learning settings. Objectives: The TEACH e-Learning course was developed specifically to fill existing gaps in Early Childhood Education curricula related to physical activity. The primary objective of this research is to examine the efficacy of the TEACH-FR e-Learning course on Canadian French-speaking pre-service ECE’s physical activity self-efficacy, knowledge, and intentions. Proposed Methods: I will employ a quasi-experimental design with three data collection time points (baseline, post-intervention, 3-month follow-up). Primary outcome measures of this study (i.e., physical activity-related self-efficacy, knowledge, and intentions) will be gathered via an online survey at each time point. Future Applications/Directions: This study is of critical importance because TEACH-FR is the first study to evaluate the effectiveness of a physical activity training course on French-speaking ECEs’ related self-efficacy, knowledge, and intentions in Canada and will allow us to see how these scores compare to English-speaking pre-service ECEs. Second, as it cannot be presumed that French-language adaptations have the same effects as their English-language counterparts, translating and adopting this course for French and testing the program promptly will allow for equitable access to this training across Canada, and open possibilities for global expansion of this pedagogical tool.
Long-term care (LTC) homes play a fundamental role supporting the diverse needs of older adults; many of whom face physical and/or cognitive challenges. With thousands of adults currently on a waitlist for a bed, overwhelmed front-line staff, and reports of many residents not having their basic care needs adequately met, Canada’s LTC sector is in crisis. Physical activity and rehabilitation programs in LTC homes have shown effectiveness in improving resident physical and cognitive functions. However, LTC staff often struggle to meet these needs in addition to their core responsibilities. Engaging family/care partners, individuals who provide unpaid support to a resident in LTC, has been proposed as a viable strategy to help address this crisis. However, it is unknown whether family/care partners are: 1) fully cognizant of the benefits associated with physical activity for older adult residents; and 2) willing to actively engage residents in such activities. Therefore, the purpose of this study is to explore family/care partner knowledge, understanding, and beliefs on the role, importance, and effectiveness of physical activity for older adults living in LTC. We aim to recruit 10-15 family/care partners from three LTC homes in Southwestern Ontario. Participants will engage in focus group discussions, exploring a series of questions and prompts carefully devised by our research team. Using thematic analysis (Braun & Clarke 2006), transcribed data will be coded to identify recurring patterns, themes, and insights. This study is a prudent first step towards developing innovative strategies to uplift care quality in Canadian LTC homes.
Background: Graduate students face numerous demands, high stress levels, and associated intra- and inter-personal relationship challenges. Research has shown that high stress levels, reduced self-esteem, and perfectionism among graduate students can negatively impact their self-awareness, interpersonal relationships, and academic self-efficacy; the latter of which is a robust predictor of academic success. One approach to supporting graduate students may be mindfulness training. Mindfulness-Based Stress Reduction (MBSR) is an 8-week evidence-based program focused on reducing stress and managing emotions. Objectives/Hypotheses: To investigate if participation in a MBSR program elicits changes in graduate students’ stress experience (primary outcome), self-esteem, perfectionism, academic self-efficacy, self-awareness, and/or social connectedness. Participants in the MBSR condition are hypothesized to show significant improvements in primary and secondary outcomes. Proposed Methods: A single-blind randomized parallel-group superiority trial will be conducted. Recruitment will begin in the summer of 2024, with the aim of recruiting 156 participants (78 randomized to MBSR and 78 to an active control group using breathing exercises only) via social media and mass email, and the intervention will begin mid-September 2024. Participants will complete five validated tools via online surveys at: baseline, post-intervention completion (8 weeks), 1 month follow-up, 6 months follow-up, and 12 months follow-up. One-way MANOVA will be employed to detect differences between the experimental and active control conditions. Upon completion of data collection, data will be analyzed and manuscript preparation will begin. Future Directions: The findings from this study may be used to inform future studies and mindfulness-based programming for graduate students.
Background: Health systems worldwide are experiencing problems meeting population health needs. In Canada, key factors contributing to this problem include population aging and issues related to recruiting, training, and retaining an adequate supply of appropriately-skilled and appropriately-distributed health workers. Effective planning, management, and evaluation processes are required to address this problem, as is an occupational science-informed framework to support these processes. Hypotheses/Objectives: The objective of this study is to critically examine a strategically-chosen selection of frameworks that key stakeholders in Canada may consider using to support health systems planning, management, and evaluation in our nation and, by drawing on these frameworks and other literature, create a provisional occupational science-informed framework that aims at a more fulsome and culturally-appropriate occupational perspective. Proposed Methods: In consultation with my advisory committee, three to five relevant frameworks will be chosen for critical examination. To be considered for inclusion, frameworks must exhibit potential to contribute to a holistic occupational perspective. Selected frameworks will be critically examined with respect to what they include and how they were created. Contents that demonstrate promise for supporting health systems planning, management, and evaluation within the Canadian context will be synthesized into a provisional occupational science-informed framework that aims at a more fulsome and culturally-appropriate occupational perspective. Future Applications/Directions: Feedback will be solicited from key stakeholders and used to transform the provisional occupational science-informed framework into an approved framework ready to use to support health systems planning, management, and evaluation in Canada, as well as research on these processes.
Background: Traumatic stress is on the rise, yet psychotherapeutic educational programs offer little to no education on traumatic experiences. Master’s programs prioritize training for short-term, cognitive-focused, and/or solution-oriented approaches, which are not effective for treating trauma as indicated by the literature. Psychotherapeutic research almost exclusively focuses on whether treatments are efficacious in the reduction of trauma symptoms. As a result, therapeutic research frequently neglects whether mental health clinicians’ have the capacity to meaningfully implement psychotherapeutic treatments; the value and importance of the psychotherapist’s own individuation process is often ignored within mainstream clinical training programs and the current trauma literature. The therapeutic relationship is the most important variable for efficacious therapy regardless of one’s therapeutic orientation, and yet this therapeutic alliance is fundamentally built on a therapist’s capacity for connection to themselves and others. Hypothesis: The personal development of the psychotherapist towards their own sense of wholeness is an essential variable in achieving the resolution of a suffering person’s trauma symptoms. Proposed research procedures: (i) philosophically examine the limitations that occur with the “evidence-based” paradigm in psychotherapy; (ii) theoretically reconceptualize trauma as a non-pathological response; (iii) complete a comprehensive literature review around the relationship between a psychotherapist’s personal development and the impact this has on trauma responsive psychotherapy; (iv) facilitate semi-structured qualitative interviews with licensed mental health clinicians who have expertise in treating trauma, and investigate their perspectives on the impact of a therapist’s self-actualization process in trauma healing. Implications: Help psychotherapists help people with trauma more effectively.
Background: The escalating incidence of traffic-related injuries presents a pressing public health challenge, with environmental factors emerging as pivotal contributors to the dynamic landscape of road safety. This study focuses on the identification of hotspots, geographical areas with heightened risk, associated with traffic-related injuries. The intersection of environmental factors and injury patterns is a critical yet underexplored facet that demands attention to enhance preventive strategies. Hypotheses/Objectives: This research aims to investigate the correlation between environmental factors and hotspots in traffic-related injuries. Hypothesizing that specific environmental variables such as traffic density, road conditions, and urban design significantly impact injury occurrences, the study seeks to elucidate patterns and relationships. Objectives include mapping hotspots, identifying key environmental determinants, and understanding their interplay in shaping injury dynamics. Proposed Methods: Utilizing a multidisciplinary approach, this study employs spatial analysis, machine learning algorithms, and comprehensive data integration. Geographic Information Systems (GIS) will be instrumental in pinpointing hotspots, while machine learning models will uncover intricate relationships within the environmental factors. Real-time data from traffic monitoring systems, accident reports, and environmental databases will be amalgamated to provide a comprehensive understanding of the evolving landscape. Future Applications/Directions: The outcomes of this research hold the potential to redefine strategies for injury prevention and intervention. Insights gained from identifying hotspots and understanding environmental determinants will inform policy development, urban planning, and public health initiatives. The study lays the foundation for proactive measures, contributing to the creation of resilient, adaptive systems in response to the ever-changing health landscapes posed by traffic-related injuries.
Background: Joint protection programs (JPP) are a self- management strategy for patients living with arthritis to help preserve joint function and reduce pain. Current JPPs are outdated and not adaptive to the highly variable patient needs. Objective The purpose of this study would be to conduct a structured elicitation of patients’ needs, preferences and priorities in the delivery of a Joint protection Program through a Discreet Choice Experiment Proposed Methods A Discrete Choice Experiment (DCE) is a quantitative method used to elicit patient preferences and evaluate complex choices. It works by presenting respondents with different complex scenarios and asking them to select their preferred choice. We aim to create a total of 4 tasks, with 3 alternative scenarios per task. Our choice sets will present different options on the duration; frequency; interactivity; additional support that will be offered through our video modules. To be eligible, patients will be required to be diagnosed with hand arthritis, have experienced pain symptoms for at least 3 months and be over 45 and years old. Future Directions We will use qualitative research methods (focus groups and semi-structured interviews) to inform the different options for each choice set. We will use a fractional factorial design to generate our choice sets to ensure a balanced and efficient design. We will analyse the choices made by the respondents using multinomial logistic regression models, to estimate the relative importance of each attribute and level and yield estimates of the marginal substitution rate between the attributes.
Background: There is a lack of quality research on the effectiveness of prehabilitation and education on improving outcomes after a shoulder replacement surgery. We designed a program for prehabilitation and education before a shoulder replacement (PREPS) that is based on reviews of relevant literature and is co-designed based on a preference assessment of both patients and clinicians. The PREPS program has the potential to improve postoperative pain, function, and patient-oriented outcomes, while decreasing postoperative opioid use and healthcare costs. Hypotheses/Objectives: Prior to testing the effectiveness of PREPS in a fully powered randomized controlled trial, we aim to complete a pilot randomized controlled trial to test the feasibility of PREPS and the study protocol. Proposed Methods: Participants (n=90) undergoing a shoulder replacement will be randomized into 1) 6-week self-directed online PREPS program, 2) 6-week online PREPS program with a therapist to monitor progression or 3) standard of care group. The PREPS program will be delivered virtually with an online program of modules and a written handbook for participants. Primary outcomes include recruitment rate, adherence, content acceptability, study acceptability, outcome measure completion rates and treatment fidelity. Outcomes will be assessed at baseline and 1 day before surgery, then post-operatively at 6 weeks, 3 months, 6 months, and 12 months. Future Applications/Directions: This project will include the feasibility testing of the PREPS program, and its ability to improve surgical outcomes. Results of this study will provide the foundation for a future fully powered trial.
Background: Dementia-related stigma is known to transmit feelings of shame, embarrassment, and hopelessness. Such prejudices often create barriers to help seeking behaviour, resulting in a delayed diagnosis, caregiver stress, and isolation. The Canadian population is growing older and concurrently becoming more racially diverse. In tandem, dementia-related stigma is profound among racialized groups. Presently, there are no studies that explore stigma in daily conversation between racialized persons living with dementia (PLWD) and their care partners. Objective: Examine dementia-related stigma in conversation between a racialized PLWD and their care partner. Methods: A formal analysis of 22 audio recordings involving naturalistic conversations between racialized Canadians living with dementia and their care partners were performed. This study used conversation data from the Canadian Consortium on Neurodegeneration in Aging. Five racialized groups were observed (Black, Hispanic, South Asian, East Asian, Middle Eastern). Corrigan’s Model of Stigma and the Communication Predicament in Aging model informed the analysis. Conventional content analysis was applied to identify themes related to dementia-related stigma. Results: Overarching themes related to stigmatizing perceptions of dementia include 1) Stereotypes, 2) Prejudice, and 3) Discrimination. Implications: This study is the first to examine naturalistic conversations between racialized PLWD and family care partners. It is also the first to comprehensively represent multiple racialized groups across Canada. Findings demonstrate how stigma is perpetuated in everyday conversation. Recognizing such expressions can/will inform education, training, and awareness efforts of dementia-related stigma.
Background: Subacromial Pain Syndrome (SAPS) significantly impacts quality of life and is commonly treated with physiotherapy and corticosteroid injections. Understanding the optimal integration of these treatments is crucial for effective management. Objective: To assess the short and medium-term effects of combined physiotherapy and corticosteroid injection versus physiotherapy alone on pain, disability, quality of life (QoL), and treatment effectiveness in SAPS. Methods: Fifty SAPS patients were randomly assigned to a combined treatment group (n=25) or a physiotherapy-only group (n=25) for this double-blind, parallel-group randomized controlled trial. Visual Analog Scale (VAS) for pain intensity, Quick Disability of the Arm, Shoulder, and Hand (Quick-DASH) and Shoulder Pain and Disability Index (SPADI) for disability, Western Ontario Rotator Cuff (WORC) index for QoL, and Global Rating of Change (GRC) score for treatment effectiveness, were measured at baseline, post-intervention, and at 3- and 6-months follow-up. Results: Analysis of variances showed group-by-time interactions for all outcome measures, indicating potential differences among groups or times. In the medium-term, the combined treatment group demonstrated significantly greater improvements in pain, disability, and QoL mean scores (p<0.01). Moreover, in short-term, despite a greater number of patients stating "completely recovered" in the combined group, there was no difference between groups. The results suggest that effectiveness of physiotherapy plus corticosteroid injection could be more long-lasting than physiotherapy alone in patients with SAPS. Implications: This study underscores the potential benefits of integrating corticosteroid injections with physiotherapy for more sustained medium-term outcomes in SAPS, informing future therapeutic approaches and particularly relevant for developing long-term treatment strategies for SAPS.
Background: Rotator cuff tears greatly impact shoulder quality of life, and while conventional physiotherapy after Arthroscopic Rotator Cuff Repair (ARCR) mainly focuses on the glenohumeral joint, recent research highlights the importance of scapular movement in ARCR recovery, as these injuries disrupt scapular function, impacting strength and movement rhythm. Despite this, the effectiveness of including scapulothoracic joint exercises in post-ARCR rehab is not well-studied. Objective: To evaluate the effects of adding scapulothoracic joint rehabilitation to conventional physiotherapy on pain, range of motion (ROM), function, quality of life (QoL), and treatment effectiveness on patients after ARCR. Methods: In a two-arms, parallel-group, double-blind, randomized controlled trial with concealed allocation, 28 participants were randomly assigned to either the group receiving conventional physiotherapy rehabilitation (n = 14) or conventional plus scapulothoracic joint rehabilitation (n = 14) for 21 sessions over 12 weeks. Pain, ROM, function, QoL, and treatment effectiveness were assessed pre-, post-intervention, and 3-month follow-up. Results: The ANOVA revealed statistically significant group-by-time interaction (p<0.05) for all outcome measures except for active ROMs (p>0.05). Multiple comparison analyses showed statistically significant between-group differences (p<0.05) at 3-month follow-up with a large effect size for almost all outcomes. For the GRC scale, more participants stated "much improved" in the comprehensive group than in the conventional. In conclusion, comprehensive rehabilitation has shown a statistically and clinically significant difference in improving pain, ROM, function, QoL, and treatment effectiveness in patients after ARCR after 3 months. Implications: This study supports integrating scapulothoracic joint rehabilitation in post-ARCR physiotherapy, potentially enhancing rehabilitation protocols and patient outcomes.
Background: Carpal Tunnel Syndrome (CTS) is the most common compression neuropathy in the adult population, with a prevalence of 2.7%-5.8%. CTS is a progressive condition that can lead to weakness and atrophy of the thenar muscle groups in untreated patients. Objectives: To provide a comprehensive analysis of the available evidence on the effectiveness of acupuncture and injection interventions for treating carpal tunnel syndrome (CTS) based on published systematic reviews (SR). Methods: SRs related to acupuncture and injection interventions for treating CTS were collected from various online databases until April 22. Subsequently, two independent researchers screened the titles, abstracts, and full texts and assessed the quality of the SRs using the AMSTAR-2 criteria. We extracted data concerning study characteristics, the efficacy of acupuncture, corticosteroids, platelet-rich-plasma and dextrose for CTS, effect sizes, and intergroup significance. This information was organized based on the intervention type (acupuncture or injection) and the substance and application method for injection treatments. Additionally, we created a citation matrix and calculated corrected covered areas. Results/implication: We found 24 SRs addressing the mentioned interventions. The quality of the SRs was mainly critically low (n = 16) or low (n = 7). The results were mostly in favour of both acupuncture and injection intervention, in the short-term, for reducing pain, improving symptom severity and functional status scales, and some of the electrophysiological parameters compared to placebo and sham therapy. Additionally, the suggested method for injection was ultrasound-guided in-plane method.
Background: Post-secondary students are an at-risk population for poor mental health and high levels of stress—both of which might directly influence their resilience and health-related quality of life (HRQOL). Additional demands experienced by post-secondary students who are also parents may result in further challenges to their resilience and HRQOL. However, current literature is scant regarding the resilience and health-related outcomes among parents pursuing post-secondary education. Objective: The purpose of this study was to explore the resilience and HRQOL of parents (with children/youth aged 0-18 years) pursuing post-secondary education in Ontario compared to non-parent post-secondary students. Methods: Via an online survey, data was collected from 86 parent-students (Mage = 34.69 years; SD = 7.07) and 288 non-parent-students (Mage = 22.41 years; SD = 5.00). Results: By independent groups t-tests, there were no statistical differences in the self-reported resilience between groups. Compared to non-parents, parents reported significantly more physical health problems, role limitations due to physical health, and bodily pain, while also reporting less favourable changes in their health over the past year. No statistically significant differences were reported between groups on the HRQOL domains of role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, or general health perceptions. While parent-students reported more physical health challenges compared to non-parent students, their levels of resilience were alike. Implications: Results from this study offer important insights on some unique challenges that parent-students experience and provides the first understanding of Ontario parent-students' levels of resilience. Additional research on the physical health challenges of parent-students is warranted.
Background: Firefighters are routinely exposed to significant work-related musculoskeletal disorders (WRMSDs), which can sometimes be career-ending due to workplace stressors and the physical demands of the job. Shoulder disorders are the third most frequent WRMSDs that cause pain, disability, and morbidity in the general population. However, little is known about the task-specific causes and risk factors for work-related shoulder disorders (WSDs) among firefighters (FFs). Objectives: To explore the perspectives of firefighters who experienced WSDs with respect to the following: a) Causative factors of WSDs. b) Risk factors for WSDs Methods: The research involved one-on-one semi-structured interviews with 12 firefighters (8 males, 4 females) from Canada and the USA, aged between 26-63 years, who had shoulder disorders. Thematic analysis with an interpretive descriptive approach was used for data analysis. Results: The WSDs reported by FFs included rotator cuff tears, labral tears and muscle sprains or strains. Firefighters identified three main themes as the causes of WSDs: 1) Traumatic incidents of slips and falls during firefighting, 2) Maneuvering heavy equipment in awkward positions and 3) Cumulative repetitive and overhead firefighting tasks. Secondly, five themes were identified as risk factors for WSDs: 1) Unpredictable hazards or environmental conditions, 2) Operational factors like fire-call nature and staffing capacity 3) Lifestyle factors like secondary jobs and variable fitness routines 4) Age and professional experience, and 5) Sex and gender considerations Implications: Our findings highlight the multifaceted nature of the causes and risk factors of WSDs among firefighters, underscoring the need for tailored intervention programs.
Background Mobile devices and social media are ubiquitous, but at the same time create many concerns – especially for those with mental health disorders or those in vulnerable situations. Taking these considerations into account, the London Health Sciences Centre explored staff and patient perspectives on the impact of personal electronic devices. Hypotheses Staff and patients feel differently about the benefits and risks for patients having access to personal electronic devices(PED). Objectives 1. To understand perspectives on PED access and use in mental health 2. To articulate the benefits and risks of PED’s in acute hospital settings 3. To ensure policy changes are informed by patient and provider perspectives 4. To explore ethical areas of concern when using PED’s in the hospital including autonomy, privacy, and liability Proposed Methods A mixed methods approach was used to inform this program evaluation project. Data from this intervention will be further analyzed for educational purposes to integrate simple quantitative survey data with qualitative reports from patients and frontline providers. Results/ Implications Data collected from this project demonstrated a measurable difference between patient and staff perspectives. Reports also demonstrated both similar (access to support networks, apps for mediation, music, stressors from social media) and distinctly different (risk of liability, privacy of providers, privacy of other patients) values around the benefit and risk of access to PED’s. Future Applications This work has been used to inform policy developments and practice standards for device use in LHSC’s adult mental health units.
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