Engaging with natural environments has been shown to reduce stress and improve cognitive performance. Exposure to natural stimuli may refresh our ability to focus by providing a respite from constant demands on our attention. Natural stimuli may also improve emotional and physiological well-being, mitigating the negative effects of stress. This effect has been demonstrated by comparing recordings of natural soundscapes to urban soundscapes. Natural soundscapes often include frequencies that are beyond the range of human hearing (ultrasound). Stimuli with ultrasound appear to increase alpha activity in the brain more than stimuli without ultrasound. Alpha wave activity is associated with a state of relaxed alertness, which may assist with tasks that require focused attention. Relaxation is typically linked to decreased stress levels. To test whether ultrasound is an important component of attention restoration and stress reduction from natural soundscapes, we will conduct a randomized controlled trial comparing the effects of different types of soundscapes (nature or urban) with different levels of bandwidth (audible-only or audible plus ultrasound). We will use backward digit span and n-back tasks to both deplete and assess attention. Participants will complete PANAS questionnaires to assess their stress levels and emotional responses. Both the task blocks and questionnaires will be completed before and after the soundscape intervention. The study will compare the attentional and emotional outcomes of natural and urban soundscapes, with and without ultrasound frequencies, to quantify their effects on attention restoration and stress reduction. Future applications could include urban greenspace enhancements, and new therapeutic sound tools.
Background: In South Asia, as of 2023, the WHO’s minimum recommended antenatal care visits are only met by 50% of women. Reducing the maternal mortality ratio per the Sustainable Development Goals remains a challenge in South Asia with rural regions facing greater health disparity in accessing maternal support. Mobile health (mHealth) solutions, particularly WhatsApp messaging, has demonstrated success in improving maternal healthcare access in similar low-income countries, but no specific studies investigated the South Asian context. Objectives : This study aims to investigate the barriers and facilitators of implementing a WhatsApp messaging intervention for maternal support in rural South Asia, examining expert perspectives. Proposed Methods : The intervention into which expert insight will be collected is a WhatsApp group chat monitored by healthcare workers in maternal health care centers, providing information, appointment reminders, and coordination of care. With a qualitative approach using descriptive phenomenology, 20 experts from health-related fields will be purposively sampled. Data collection involves semi-structured in-depth interviews conducted via Zoom. Ethical considerations will be adhered to through the provision of consent forms, secure storage of the recorded interviews, and anonymization of participant information through unique identifiers. Colaizzi's phenomenological method will guide data analysis, emphasizing formulation of meanings and thematic organization. Future Applications: Findings of the study can inform how the intervention can be successfully implemented to improve maternal healthcare access in rural communities through addressing the barriers and facilitators for a future study. Recommendations for policy and infrastructure changes to support the intervention will also be included.
Background: Developmental Delays (DDs) affect approximately 15% of children ages three to 17 years old and result due to infection, genetic disorders, or premature birth (1, 2). DDs can impact “fine and gross motor development, language and communication skills, problem solving and adaptive behaviour, and personal and social performance” (2, p. 39). It is crucial to identify DDs early to ensure that appropriate interventions are delivered to lessen the risk of lifelong impairment, behavioural problems, and learning difficulties (1, 3). Interventions that may take place include sharing of resources, participation in programs or therapies, or online supports (2). There is limited information available about DD resource type, availability, and usefulness among Canadian parents and little is known about the health literacy of parents using these resources. Objectives: 1. Determine which types of developmental resources are available, being used, and are useful to parents with children ages six months to five years of age with varying risk levels of developing DD. 2. Determine if there are associations and differences between the health literacy rates of the study participants and the developmental health status of their child. Proposed Methods: This survey study will have three components which will collect demographic information, information about developmental resources, responses to the Health Literacy Questionnaire, and responses to the Ages and Stages Questionnaire. Future Applications: The gaps in resource availability, usage, and usefulness identified in this study can provide evidence needed to support the development of future resources and services for parents and children with DDs. References 1. Choo, Y. Y., Agarwal, P., How, C. H., & Yeleswarapu, S. P. (2019). Developmental delay: identification and management at primary care level. Singapore medical journal, 60(3), 119–123. https://doi-org.proxy1.lib.uwo.ca/10.11622/smedj.2019025 2. Vitrikas, K., Savard, D., & Bucaj, M. (2017). Developmental Delay: When and How to Screen. American Family Physician, 96(1), 36-43. https://www-lib-uwo-ca.proxy1.lib.uwo.ca/cgibin/ezpauthn.cgi?url=http://search.proquest.com.proxy1.lib.uwo.ca/scholarly-journals/developmental-delay-when-how-screen/docview/2454236813/se-2 3. Moser, M., Müllner, C., Ferro, P. et al. The role of well-child visits in detecting developmental delay in preschool children. BMC Pediatr 23, 180 (2023). https://doi.org/10.1186/s12887-023-04005-1
Background: Growing numbers of head and neck cancer (HNC) patients are surviving their cancer but living with a myriad of long-term physical and psychosocial consequences. ‘Survivorship care’ has emerged as an approach to meet the needs of cancer survivors. However, without identification of an ideal model of HNC survivorship care, implementation has been limited. Understanding the local context is critical to support successful implementation of evidence-based survivorship care. This project will assemble local evidence to capture the evidence-practice gap related to HNC survivorship care. Objectives: The specific objectives of this work are: 1) to determine the local prevalence of HNC survivorship, and 2) to profile the local HNC population and their survivorship needs. Proposed Methods: Medical chart data will be used to determine the prevalence of HNC survivors, and to profile this population by collecting socio-demographic characteristics (e.g., age, sex, gender, geographic location), health history (e.g., comorbidities), and details of the condition of interest (e.g., HNC). In addition, data related to the survivorship needs of patients will be collected using a checklist tool developed to reflect important elements of survivorship care as described by various international guidelines, and as measured by validated symptom surveys as a first step toward mapping the survivorship evidence-practice gap. Future Applications/Directions: Understanding the local context will inform the process of implementing a formalized survivorship care model, with the ultimate goal of better addressing the consequences of HNC, to enhance functioning and quality of life of survivors.
Background: Spasticity is a debilitating consequence of cerebral palsy (CP) that makes movement and tasks of daily living difficult to complete. Botulinum toxin A (Botox) is effective at treating spasticity and as someone with CP who has undergone Botox treatment, I understand the need for this procedure. Currently, research on Botox in CP largely focuses on the pediatric population. However, CP is a lifelong condition and medical improvements have resulted in individuals with CP living longer and there are now more adults with CP in our communities. The lack of research and the associated knowledge gap has resulted in a disregard for the needs of adults with CP, where the long-term effects of Botox and associated clinical guidelines are unknown. Objective: The objectives of this study are to 1) determine the indications for, and outcomes of Botox treatment in an adult population with CP and 2) explore the accessibility of this service for adults with CP surrounding Southwestern, Ontario seeking transitional care services. Study Methods: Data will be gathered using chart reviews from the Parkwood Institute in London, Ontario. Participants will include those who attend the Botox clinic, have been diagnosed with CP, and are 18 years of age or older. Quantitative methodology will be used to extract and organize variables using a REDCap database, where both descriptive and regression analyses will be conducted. Implications of Findings: Future directions include working towards developing spasticity guidelines for adults with CP in Canada and abroad through publishing in Developmental Medicine and Child Neurology and presenting at conferences.
Background: The World Health Organization has acknowledged that the COVID-19 pandemic affected older adults disproportionately, especially those living in long-term care (LTC) homes. In May 2020, Canada's percentage of COVID-19 related deaths in LTC settings was 81% of total deaths in the general population. High COVID-19 mortality rates as well as infrastructure, quality, and workforce failures call into question policies in place. Investigating how other countries responded to comparable LTC challenges during the pandemic can help draw important policy lessons for the improvement of the Canadian LTC system. Specifically, France and Belgium saw a significantly lower percentage of COVID-19 related deaths in LTC homes (48% and 50%, respectively). LTC policies are being viewed as a priority, thus presenting the timely opportunity for these evidence-based findings to inform policy development. Objectives: This research aims to investigate the similarities and differences in LTC policy changes in Canada, France, and Belgium since the beginning of COVID-19 pandemic. Specifically, the project seeks to understand, synthesize, and disseminate policy innovations in three areas: regulation, service provision, and financial policies. Proposed Methods: A multiple case study method will be used to conduct a comparative policy analysis. The project will encompass an environmental scan of official health organization websites, policy briefs, peer-reviewed literature, and official policy documents. Future Applications: Increasing knowledge on LTC policy changes will improve future health emergency preparedness. My project seeks to critically examine LTC policies to increase policy knowledge and facilitate policy change all with the goal to improve the Canadian LTC system.
Background As their disease progresses, daily living becomes more difficult for patients diagnosed with chronic obstructive pulmonary disease (COPD). Healthcare providers may not be fully aware of how their patients feel about the medical care that has been available to them as they continue to live with their COPD. Patient-reported experience measures, commonly called PREMs, use questionnaires to summarize healthcare experiences of specific patient groups. We’re interested in testing the PREM-C9 that was originally developed for COPD patients who live in the United Kingdom. We want to know if this questionnaire is helpful for providers who treat patients in clinics that are part of the Best Care COPD program in Ontario, Canada. Methods The PREM-C9 comprises nine questions out of a score of five. Higher scores indicate worse experience. We included our own tenth question out of a score of ten, where a higher score indicates a positive experience. We will explore the utility of PREM-C9+ within the context of a chronic disease management program in primary care known as Best Care COPD (BCC). We will use a survey methodology approach guided by a post-positivist paradigm; including interviews with providers involved in the delivery of BCC and participants.Conclusions This study aims to provide insight into the feasibility and usefulness of a patient-reported experience measure to understand what patients consider is important to them and in relation to their care. Our study hopes to aid clinicians to better understand the patient perspective and to form patient-prioritized goals in co-designed management programs. We also hope to improve the use of PREMs across the Canadian healthcare system. Keywords Feasibility, Implementation, patient-reported experience measures, Primary Care, Chronic Obstructive Pulmonary Disease
Background: Early nutrition education for children forms the basis for lifelong healthy behaviors and the acquisition of essential skills and learning capabilities (Cusick et al., 2016). While children can gain food literacy from multiple sources, elementary schools and teachers play a crucial role in shaping children's healthy growth, development, and knowledge of nutrition education (Cotton et al., 2020). However, there is a limited body of research on this topic. Objectives: Examining teachers' perspectives on the influence of curriculum and the school environment on children's food literacy, and the impact it has on them. Proposed Methods: To this end, the study utilizes a qualitative research approach to investigate the experiences of elementary school teachers regarding the delivery of nutrition education and their perceptions of how it affects children. The research involves the conduct and thematic analysis of 13 semi-structured interviews with elementary school teachers from Ontario who possess relevant experience in teaching nutrition, recruited through a purposive and snowball sampling method. Semi-structured interviews were well-suited to generate in-depth understandings of teachers' lived experiences and their perspectives on the influence of nutrition education and the overall school environment on children's food literacy. Future Applications: The study's insights might lead to an educator's guide filled with varied resources like lesson plans, online modules, interactive worksheets, videos, and reading lists. This guide aims to aid teachers in effortlessly integrating nutrition education into their curriculum. Statement on Ethics Approval and Funding: This project has been approved by the Research Ethics Board. This project is currently funded by the SHHRC Canadian Graduate Scholarship
Background: Social-ecological factors (e.g., individual differences, social support, and cultural norms) affect undergraduate students’ resilience. Equity-deserving students are especially vulnerable to social-ecological-related adversities. Exploring equity-deserving undergraduates’ experiences of diversity and inclusion might reflect unique challenges to these students’ resilience and can provide insight into the promotion of health equity in universities. Objectives: The primary purpose of this study is to assess, quantitatively, the relationship between Ontario undergraduate university students’ levels of resilience and their experiences of diversity and inclusion, and to identify demographic factors most associated with these outcomes. The secondary purpose is to explore, qualitatively, undergraduates’ experiences of diversity and inclusion and how they perceive these experiences influence their resilience. Methods: This mixed methods study utilizes demographic questions, the Connor-Davidson Resilience Scale 25, the Interactional Diversity Scale, the Inclusion of Other in the Self Scale, focus groups, and semi-structured interviews. Data analysis involves computing descriptive statistics, Pearson’s correlation, regression analysis, and inductive content analysis. Preliminary Results: Significant positive correlations were found between undergraduates’ (n = 233) levels of resilience and: interactional diversity (p = 0.03); feelings of inclusion with peers at their university (p = 0.002); feelings of inclusion with field-alike peers (p = 0.001); and feelings of inclusion with peers at a university-affiliated student group (p = 0.024). Regression and qualitative (n = 25) analyses are ongoing. Future Directions/Implications: Better understanding the resilience levels of equity-deserving students may inform strategic and tailored institutional approaches to advancing equity, diversity, inclusion, and decolonization practices and the implementation of accessible resources to improve undergraduates’ experiences.
Background: Mental health is a significant topic of discourse worldwide. Canadians aged 15-24 are more likely to experience mental illness compared to other age groups. The Middle East and North Africa (MENA) region has seen a significant rise in mental health disorders, becoming a growing concern in recent years particularly among youth. Individuals living with compromised mental health, experience a complex interplay of cultural, social, and economic factors that influence their overall wellbeing. Exploring the needs and priorities of mental health services offering support for youth is crucial to fostering healthy and resilient communities. Objective: To explore the needs and priorities of youth mental health services in the MENA region and Canada. Methods: Using the Arksey and O'Malley framework for conducting scoping reviews, five databases were searched including Medline, EMBASE, CINAHL, SCOPUS, and PsycINFO. The search terms are categorized within three concepts: mental health, geographic location, and youth. 7763 titles and abstracts were screened and currently 186 articles are undergoing full-text review. Upon completion, the study characteristics and data will be extracted and charted. Highlighted needs and priorities for specified mental health services will be thematically organized and analyzed. Preliminary Results: I expect there to be common themes related to de-stigmatization, improving health literacy, and language accessibility. Future Directions/Implications: Consultations will be scheduled with knowledge-users and experts within the MENA region to provide insight for next steps. This review will provide insight and guidance into the factors that influence the provision and accessibility of mental health services in different contexts while informing future policy and practice.
Background: Traditionally, the physical layout of long-term care (LTC) homes reflects care and life in a hospital setting rather than a warm and welcoming home. Many LTC homes have moved from traditional hospitalized models to ones that emphasize culture change. Culture change is a movement that seeks to transform LTC homes from large, hospital-like settings to environments that prioritize residents’ quality of life, their ability to make personal choices and cultivate a homely atmosphere. Culture change emphasizes respect, empowerment, and providing choices to the residents. Hypotheses/Objectives: Despite efforts to support culture change, there needs to be more evidence to show if this movement is achievable from both the changing physical environment and organizational system. This study aims to identify and analyze the perceived barriers and facilitators LTC homes encounter in adopting culture change. Proposed Methods: The consolidated Framework for Implementation Research (CFIR) is used as a framework to guide the identification of perceived contextual barriers and facilitators to culture change from the perspectives of residents, families, and care providers. The CFIR will inform the focus group discussions, and predefined codes to analyze the data. Future Applications/Directions: An integral part of this study is understanding contextual barriers and facilitators in adopting culture change. This could suggest solutions to optimizing care delivery in the LTC sector and has the potential to significantly bolster person-directed care for residents. Moreover, the knowledge and insights gained from this study can serve as a valuable foundation for further adaptation of culture change on a broader scale in LTC sector.
Background - ‘Aging in place’ is a concept both desired by older adults wanting to maintain their residence and independence, and a necessary one due to problems in long-term care (LTC) (i.e., staffing shortages, capacity and funding limitations) being exaggerated by COVID-19 and a growing population of older adults. However, recent research has suggested the need to gain a deeper conceptualization of ‘place’ to better understand how various forms of inequality impact ‘aging in place’. This is especially important for older adults with disabilities who have routinely been marginalized and yet to be explored post-pandemic. Hypotheses/Objectives - For this reason we must inquire 1) how do older adults with disabilities conceptualize ‘place’? and 2) how do older adults with disabilities ‘age in place’? It is hypothesized that means of social and physical ties contribute to the conceptualization of ‘place’, as well as means of physical access to the home and surrounding community. However, without investigation, our ability to guide and support older adults with disabilities attempting to ‘age in place’, remains limited. Proposed Methods - Narrative inquiry/ interviews are proposed to elicit participant stories explaining how they have come to conceptualize ‘place’ and illuminate potential inequalities faced along the way. Future Applications/Directions - Findings will help guide recommendations specific to older adults with disabilities by informing how and what services should be provided; enabling healthcare legislators to make more educated and inclusive decisions; and encourage future researchers to address applicable inequalities.
Background: For individuals living with chronic pain, exercise has been proven to improve musculoskeletal health, mental health, and physical fitness. However, many veterans and injured military personnel experience chronic pain and posttraumatic stress disorder (PTSD) or other occupation stress injuries (OSI). They face distinct challenges when implementing exercise, as social or physical factors can trigger exercise avoidance or stress responses. Current exercise guidelines and decision support tools have not addressed how exercise prescription should be mediated by mental health conditions. Tailoring strategies are urgently needed for the majority of veterans/injured military personnel who experience chronic pain and OSI. Hypothesis/Objectives: 1) To identify what information is known about the stress responses of veterans and injured military personnel experiencing PTSD/OSI during exercise. 2)Underline the exercise experiences (needs, benefits, triggers, and adaptations) of veterans and injured military personnel living with both chronic pain and OSI) Highlight the best practice guidance for this population from exercise, pain, and mental health experts. 4) Examine usefulness and useability of decision support tool to create useful and useable customized exercise plans for veterans/injured military personnel with OSI. Proposed Methods: To start an integrative review will be conducted, followed be an interpretive description qualitative study, a qualitative interpretive description, and a final Delphi Survey. Future Applications/Directions: This project will be used to develop a new exercise decision support tool, to be broadly shared with veterans/military personnel and clinicians. Aiding in the transition to exercise/activity strategies to accommodate their physical and OSI status while providing a pathway to gain the benefits of an active healthy lifestyle.
Background: Difficulty with language is a hallmark feature for children with hearing impairments, and contributes to difficulty with literacy. Deaf or hard of hearing (DHH) students enrolled in hearing schools often require an adapted curriculum and additional support from educational Speech Language Pathologists (SLPs), Specialist Teachers of the DHH, or both, to reach their full learning potential. Specialist Teachers have additional specialized training and provide regular support to DHH students. Resources for assessment of curriculum-based spoken language skills in DHH students are often limited. Specialist Teachers need to be equipped with the appropriate resources to support these students. Hypotheses/Objectives: Our objective is to develop a bespoke curriculum-based spoken language assessment and intervention tool for use by Specialist Teachers of the DHH. Proposed Methods: Employing a design research approach, an iterative cycle of designing, testing, and revising will take place. Audio recordings from focus groups and interviews will be transcribed verbatim and coded. Analysis of the data and feedback from our partners will direct revisions and further development of the tool. Collaborating with end-users throughout ensures bridging of the gap between research and practice, with immediate implementation. Preliminary Results: Following development of the assessment tool and the initial piloting phase, end-users provided feedback on the tool and its use, leading to iterative cycles of feedback and revisions. Future Application/Directions: Using knowledge gained from the assessment tool, an intervention tool will be developed. This project also provides a framework for collaborative teams to develop bespoke clinical tools and answers important questions about curriculum-based language assessment and intervention for DHH students. Authors Rachel Benninger (University of Western Ontario) Lisa Archibald (University of Western Ontario)
Background: Volunteer firefighters are a specialized subgroup of first responders whose work is not only hazardous but vital to the most isolated communities (Johnson et al., 2019; Wagner & O’Neill, 2012a). In contrast to career firefighters, volunteers have limited access to employee assistance programs (EAPs) which allow career firefighters to receive mental health treatments (Pennington et al, 2022; Yarnal & Dowler, 2022). In essence, the urgency and gravity of life-and-death situations are universal and affect all those dedicated to responding to emergencies, regardless of their income. With the significant dependence on volunteers for firefighting in Canada, the nation cannot afford to overlook the mental well-being of this group (Cowlishaw et al., 2010a; Cramm et al., 2021a). Methodology: This is a qualitative study using interpretive descriptive analysis. Objectives: The overall goal of this study is to identify prevalent themes in the mental health effects and priorities for support of volunteer firefighters. The aim is to provide insights into volunteer firefighters' expectations and provide recommendations that can effectively address their needs. This study is relevant for policymakers, researchers, and mental health practitioners, who are responsible for designing and implementing workplace-based interventions. Findings: The identified themes were that mental health impacts the volunteers, their families, and their jobs. Stigma and support were crucial factors in addressing mental health challenges, and volunteers wanted to know how to prevent mental health issues and access more resources.
Background: Post-COVID condition (PCC) is a term used to describe COVID-19 symptoms persisting for three months or longer post-initial infection. Individuals with PCC present with a variety of symptoms such as fatigue, shortness of breath, and psychosocial symptoms. This review aims to comprehensively map existing rehabilitation interventions for PCC and their associated outcomes. Methods: Searches were conducted in CINAHL, Embase, MEDLINE, PsychINFO, and Scopus.Title and abstract, full-text screening and data extraction were carried out by two reviewers. Experimental or observational studies published between January 1st, 2020 and March 14th, 2023 examining rehabilitation interventions for PCC were included. Studies were excluded if they focused on animal subjects rather than human subjects. There were no limits applied for age of participants, country, or language of publication.Results: 4620 records were identified during the literature search. After full-text screening, 56 studies remained. Several interventions were identified that help to improve fatigue, quality of life, dyspnea, anxiety, and depression in patients with PCC. These included physiotherapy, endurance training, resistance training, and breathing exercises. Discussion: Rehabilitation interventions have resulted in improvements in fatigue, quality of life, anxiety, depression, and dyspnea. Many of the included studies examined multi-faceted interventions, showing improvements for multiple PCC symptoms, and these interventions were in line with the WHO guidelines for managing PCC. Conclusion: Rehabilitation interventions for PCC have shown promise regarding decreases in symptoms such as fatigue, dyspnea, anxiety, and depression, and improvements in quality of life. Ongoing research will be beneficial as the knowledge surrounding PCC continues to evolve.
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