26734 research outputs found
Sort by
Awe, Dignity, and the Ethics of Transformational Change: A Meta-Narrative Review of Adventure Therapy Research and Practice
No full textThis thesis explores how power, consent, and relationships shape change within adventure therapy and outdoor behavioural healthcare. Using a meta-narrative review, 79 peer-reviewed studies published over 5 decades were analyzed to trace how the field has moved from control and compliance toward ethical, relational, and client-centred practice. The review followed the RAMESES publication standards for meta-narrative reviews and used Braun and Clarke’s (2020) reflexive analytic approach to interpret and synthesize findings across traditions. Four interrelated narratives were identified. Adventure Therapy (AT) as Psychosocial Catalyst describes how challenge, reflection, and relationship create opportunities for growth through belonging, trust, and identity renewal. Behavioural Containment vs. Mental Health Treatment examines the field’s struggle to separate coercive histories from legitimate therapy, showing that healing depends on consent, safety, and collaboration. Transdiagnostic and Developmentally Sensitive Treatment shows how AT adapts effectively across ages and diagnoses through pacing, attunement, and the use of relational safety. From the Margins to the Mainstream traces the field’s gradual movement from alternative education into professional mental health, where evidence and ethics are now intertwined. A grand narrative of ethical and relational transformation emerges, defined by the presence of awe, the protection of dignity, and the possibility of transformational change. When practitioners meet clients with humility, curiosity, and shared agency, moments of genuine change often follow. The heart of AT lies in relationship, in the awareness of power, trust, and human connection that gives this work its depth and meaning
Considerations for Treating Generalized Pustular Psoriasis (GPP): A Narrative Review
No full textAbstract Generalized pustular psoriasis (GPP) is a rare, chronic dermatological condition characterized by widespread pustulation that may be associated with other cutaneous and systemic manifestations. If left untreated, it may be life-threatening. Therapies developed for plaque psoriasis have been used to treat GPP with limited efficacy; however, these therapies do not target the interleukin (IL)-36 pathway, which is the most common pathway implicated in the pathogenesis of GPP. A systemic biologic targeting the IL-36 receptor for the treatment of GPP is currently the only approved treatment for GPP and allows for an opportunity to improve patient outcomes. This manuscript outlines practical considerations that aim to provide guidance on personalizing the treatment of GPP
Constructing Efficient Mesh-Based Global Grid Systems with Reduced Distortions
No full textRecent advancements in geospatial technologies have expanded geospatial data volume and diversity, enabling innovative applications but demanding novel Geographic Information Systems (GIS) with efficient operations and low-distortion, uniform computational domains. (Discrete) Global Grid Systems (DGGSs) have emerged as a promising solution to provide these capabilities. Current DGGSs employ low-resolution polyhedral approximations of the Earth for efficient operations, but require a projection between the Earth’s surface and the polyhedral faces. Equal-area DGGSs provide a low-distortion computational domain but lack the efficient operations required to fully achieve the objectives. Efficiency-first DGGSs achieve operational efficiency but fail to provide low-distortion, uniform computational domains. This work introduces a novel mesh-based DGGS (MBD) that achieves both. MBD achieves efficient DGGS operations through the use of a novel hash encoding method and an efficient barycentric indexing method (BIM). MBD extends Atlas of Connectivity Maps to the BIM to provide efficient spatial and hierarchical traversal. To provide a low-distortion, uniform computational domain, MBD employs a novel mesh-optimization technique that results in high-resolution base polyhedra with highly uniform faces and low distortion. Their properties are experimentally validated, demonstrating increased uniformity, reduced distortion and highly efficient -- constant-time -- operations. Several polyhedra are identified as candidates for use in DGGS, demonstrating the suitability of MBD to address modern geospatial big data applications
Experiences of the Bereaved: Consulting Alternative Care Providers in a Euro-Western Context
No full textThe medicalization of grief through the introduction of Prolonged Grief Disorder (PGD) in the DSM-5-TR reflects a broader Euro-Western trend of defining and treating human experience through diagnostic categories. Such frameworks risk narrowing understandings of grief by privileging a particular grief profile and obscuring alternative meaning-making resources. This study explored how bereaved individuals experience and make sense of engagements with alternative care providers (ACPs)—such as mediums, Reiki practitioners, or energy healers—especially amid Euro-Western medicalizing discourses that may constrain or obscure how grief can be known or expressed. Guided by Interpretative Phenomenological Analysis (IPA) and informed by a critical lens, semi-structured interviews were conducted with five adults who sought ACPs following the death of a loved one. Six interrelated themes emerged: (a) Undertaking an Existential Inquiry, (b) Re-defining Death, (c) Relational Continuity and Ongoing Connection, (d) Negotiating Doubt and Belief, (e) Pathways for Emotional Healing and Release, and (f) Transformation and Personal Growth. Overall, participants described ACP encounters as deeply meaningful experiences that prompted existential upheaval, facilitated ongoing reciprocal relationships with the deceased, and provided emotional release. This study contributes to grief scholarship by illuminating how individuals who seek ACPs may conceptualize and experience grief through ontological and epistemological frameworks that differ from those typically emphasized within mainstream mental health paradigms. The findings invite practitioners and researchers to consider potential areas of experiential obfuscation and attend to and preserve plurality in how grief is understood and supported
Feasibility Assessment of Electro-Thermal Energy Storage Adoption in Alberta’s Steam-Intensive Industries for Industrial Decarbonization
No full textAlberta’s steam-intensive industries, such as oil sands, chemical manufacturing, and pulp and paper, are critical to the province’s economy but contribute significantly to greenhouse gas emissions due to their reliance on fossil fuel-based steam generation. This study investigates the feasibility of adopting Electro-Thermal Energy Storage (ETES) systems to decarbonize these industries and enhance renewable energy integration in Alberta. Through a mixed-methods approach, including literature review, quantitative data analysis, and techno-economic modeling, the research identifies key steam-intensive sectors, assesses their thermal demands, and evaluates the technical and economic viability of ETES.
Findings indicate that commercial ETES technologies, such as molten salt and concrete/rock storage, can meet the high-temperature steam requirements (180–565°C) of Alberta’s industries, offering up to an 80–90% reduction in emissions when powered by renewable electricity. This encompasses a broad range of electrification technologies. However, these estimates are based on modeled best-case scenarios and vendor projections rather than real-world operational data.
Economically, ETES adoption could yield significant carbon cost savings under Alberta’s Technology Innovation and Emissions Reduction (TIER) regulation, with an estimated annual abatement of 33.4 million tonnes of CO2 for the oil sands sector alone. However, high capital costs and substantial electricity requirements highlight the need for robust renewable energy infrastructure and supportive policies. The study proposes a strategic roadmap for ETES deployment, emphasizing pilot projects, policy incentives, and grid enhancements. Despite data limitations and the emerging nature of ETES, this research underscores its potential as a transformative solution for industrial decarbonization, aligning with Alberta’s sustainability goals and the United Nations Sustainable Development Goals (SDGs) for clean energy, climate action, and industry innovation
Deferred Cord Clamping and Long-Term Neurodevelopmental Outcomes in Preterm Infants Born < 29 weeks Gestation in Southern Alberta
No full textImportance: Deferred cord clamping (DCC) is recommended for both term and preterm infants to reduce neonatal complications; however, evidence regarding its association with long-term neurodevelopment remains limited. Primary objective: To examine the impact of DCC compared with immediate cord clamping (ICC) on mortality and any neurodevelopmental impairment (NDI) at 18–24 and 36 months corrected age (CA) in preterm infants born before 29 weeks’ gestation. Design, setting, and participants: This retrospective cohort study included preterm infants (<29 weeks) admitted to neonatal intensive care unit between 1 January 2006, and 31 December 2011, comprised ICC group, and those born between 1 July 2012, and 31 December 2017, comprised DCC group. Neurodevelopmental assessments were conducted at 18–24 and 36 months corrected age. Results: Of 165 infants who received DCC, 153 and 145 had outcome data available at 18–24 and 36 months, respectively. Infants in the DCC group had slightly higher gestational age at birth and a greater proportion were small for gestational age status. Compared with ICC, DCC was associated with lower odds of sepsis, severe retinopathy of prematurity, fewer blood transfusions and shorter oxygen dependence. To obtain equivalent comparison groups, a propensity score–matched analysis was conducted with adjustments for multiple confounding variables. The odds (OR) of death or any NDI at 18–24 months was 1.09 (95% CI: 0.98–1.21, p = .096), and at 36 months CA was 1.18 (95% CI: 1.06–1.32, p = .003). Cognitive assessment was performed using the WPPSI-III during the ICC period and the WPPSI-IV during the DCC period. To maintain consistency by relying on a single assessment tool (WPPSI-IV), an additional analysis was undertaken among preterm infants who received ICC within the DCC period (July 1, 2012–December 31, 2017) and were evaluated at 36 months CA; this analysis yielded a propensity score–adjusted OR was 0.77 (95% CI: 0.64–0.90). Conclusions: In infants born before 29 weeks’ gestation, DCC was not associated with increased odds of death or NDI at 18–24 months, but by 36 months CA, it significantly reduced the risk of death or neurodevelopmental impairment
Complementary medicine among individuals experiencing homelessness in Switzerland: a quantitative and qualitative descriptive study
No full textAbstract Background People experiencing homelessness (PEH) are disproportionately affected by health issues yet remain underserved by the health care system. Emerging findings suggest that complementary medicine (CM) approaches might help address the low access to earlier treatment and the complex needs of this population. Very little research has explored this topic in Europe. Thus, this study aimed to explore perceptions, experiences, and interests in CM among PEH in Switzerland. Methods Participants (N = 123) were PEH in French-speaking Switzerland who completed a questionnaire assessing their use of and interest in CM. A subsample of the survey participants (n = 18) and 14 professionals working in the homeless-serving sector participated in semi-structured interviews exploring perceived utility of CM for PEH. Descriptive statistics and conventional content analysis were used to analyze quantitative and qualitative data, respectively. Results Quantitative findings showed that despite high levels of interest in CM, less than 30% of participants reported using CM at least once in the previous 6 months. The five CM modalities with the highest interest were osteopathy (61.5% interested or very interested), therapeutic massage (59.2%), nutritional supplements (57.1%), music therapy (50.8%), and acupuncture (49.1%). The qualitative findings reinforced the substantial interest in CM. They revealed that CM approaches were perceived as useful to mitigate some health and social issues frequently encountered in this population, ultimately contributing to improved health and well-being. Participants made recommendations for practices that would help engage and retain PEH in a CM program, such as making it accessible and equitable, and following certain steps to earn the trust of PEH. Finally, a minority of participants questioned the relevance of a CM program for this population, arguing instead that more urgent social and conventional medical needs must be addressed first. Conclusions Taken together, these findings suggest that integrative medicine, which incorporates conventional and complementary approaches to medical and social services may represent a suitable offering for PEH to address their competing bio-psycho-social needs. Using a community-based participatory approach to co-develop such a program might help to ensure effectiveness and thereby increase health equity
Embodying disadvantage: a theoretically-informed analysis of pathways linking socioeconomic position with all-cause and cancer mortality in a nationally representative cohort of adults in Canada
No full textAbstract Background Individuals adopt particular health-related practices according to what is structurally possible for them. Given that many health-related practices and obesity are patterned by socioeconomic position (SEP) and strongly linked with mortality, they may represent mechanisms through which SEP becomes biologically embedded and influences mortality risk. This study quantified whether and to what extent health-related practices (current/former smoking, physical inactivity, low fruit and vegetable intake, excess alcohol intake) and obesity mediate associations between SEP and all-cause and cancer mortality in a nationally representative cohort of adults in Canada. Methods This was a prospective, population-based cohort study of adults (≥ 35 years; n = 308,635) who participated in the cross-sectional Canadian Community Health Survey. Data from eight survey cycles (2000/2001–2011) were linked to mortality records in the Canadian Mortality Database (2000–2013). Household income adequacy and educational attainment were used to generate a latent variable representing SEP at baseline. Participants also self-reported smoking, physical activity, fruit and vegetable intake, alcohol intake and BMI at baseline. Generalized Structural Equation Modeling was performed to evaluate pathways linking SEP with all-cause and cancer mortality mediated by health-related practices (current/former smoking, physical inactivity, low fruit and vegetable intake, excess alcohol intake) and obesity in males and females. Results Health-related practices and obesity did not collectively mediate associations between lower SEP and all-cause or cancer mortality in males or females. However, current/former smoking mediated associations between lower SEP and all-cause (males: HR 1.06, 95% CI 1.01, 1.12; females: HR 0.97, 95% CI 0.95, 0.99) and cancer mortality (males: HR 1.06, 95% CI 1.01, 1.12; females: HR 0.97, 95% CI 0.95, 0.99) in males and females, and physical inactivity mediated associations between lower SEP and all-cause mortality in females (HR 1.12, 95% CI: 1.03, 1.21). Low fruit and vegetable intake, excess alcohol intake and obesity did not mediate associations between lower SEP and mortality. Conclusions Smoking and physical activity may represent mechanisms through which SEP becomes biologically embedded and shapes the risk of mortality among adults in Canada. However, most of the associations between SEP and mortality remained unexplained; thus, additional studies are needed to understand other pathways of biological embedding
Barriers and facilitators to following dietary recommendations for bone health: a qualitative study
No full textAbstract Background An estimated one in two women and one in five men will experience a low-trauma fracture after age 50. Diet is an important mediator of bone health but individuals with or at risk of osteoporosis do not always meet recommended intake of specific nutrients (protein, calcium, vitamin D) and whole foods. We aimed to identify barriers and facilitating factors to following dietary recommendations for bone health among adults with or at risk of osteoporosis. Methods Adults aged ≥ 45 years who had been referred to a specialty osteoporosis clinic were recruited to participate in 4 virtual focus groups exploring barriers and facilitators to following dietary recommendations for bone health. Interest in a practical, bone-health focused Culinary Medicine program was also assessed. Results A total of 29 individuals were enrolled, 26 completed a pre-survey which asked about demographics and dietary habits, and 24 (age range 56–89 years, 21 female) attended one of four virtual focus groups. Principle barriers to following dietary recommendations for bone health highlighted by the focus group participants were: (1) living alone and cooking for one, (2) low motivation to prepare meals, and (3) dietary restrictions. Principal facilitators were: (1) preparing meals in advance, (2) online grocery shopping, and (3) engaging in exercise. Focus group participants expressed enthusiasm about participating in a Culinary Medicine program for bone health. Conclusion Our findings indicate that adults with or at risk of osteoporosis face multiple barriers to adhering with dietary recommendations. Bone-focused Culinary Medicine programming merits further study as a possible method of overcoming these barriers
Investigating The Synthetic Lethality Between PTEN Loss and PNKP Inhibition in Glioma and Sarcoma Models
No full textPhosphatase and tensin homolog deleted on chromosome 10 (PTEN) is one of the most frequently altered tumor suppressors in human cancer and its loss is associated with poor clinical outcomes. PTEN deficiency leads to constitutive activation of the PI3K/AKT/mTOR signaling pathway and consequently dysregulated proliferation. Loss of PTEN also generates chronic oxidative and replication stress, thus heightening a dependence on DNA repair and antioxidant pathways. Among these, polynucleotide kinase phosphatase (PNKP) plays a central role in repairing single strand DNA breaks (SSBs) induced by reactive oxygen species (ROS) and maintaining replication fork stability. Building on prior evidence of synthetic lethality caused by combined losses of PTEN and PNKP activity, in this study I aimed to determine whether PNKP inhibition would selectively sensitize PTEN-deficient glioma and sarcoma cell lines, and whether such vulnerability could be amplified therapeutically by inhibiting oxidative or replication stress responses. Using a set of human brain tumor initiating cells (BTICs), two murine glioma cell lines, and three murine sarcoma cell lines with defined PTEN status, I found that inhibition of PNKP with the specific small-molecule inhibitor A12B4C3 produced a PTEN-dependent reduction in cell viability and clonogenic survival, while PTEN-wildtype cells remained largely resistant. While PNKP inhibition in sarcoma cell lines may have induced a partial ‘synthetic sickness’ phenotype, the combination of the specific PNKP inhibitor A12B4C3 with an NRF2 inhibitor (targeting antioxidant defenses pathways) or a CDK4/6 inhibitor (inducing replication stress), increased the moderate vulnerability observed with A12B4C3 alone into overt synthetic lethality. The synergistic cytotoxicity observed in the sarcoma cells was accompanied by increased γH2AX foci formation, likely reflecting the accumulation of oxidative and replication-associated DNA damage that was not resolved due to the absence of PNKP. Together, these findings establish a mechanistic framework in which PTEN-deficient cells rely on PNKP-mediated DNA repair, as well as a novel vulnerability that can be further exploited via the augmentation of oxidative and replicative stress