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Nurturing Métis Youth Wellness: Kehtêyak Perspectives on Identity, Community, Spirituality, and Wholistic Connection
No full textThis research inquiry explores the wisdom of Métis kehtêyak (the one who knows) to understand their thoughts, experiences, and perceptions in promoting wellness for Métis youth. Grounded in Indigenous Research Methodologies, the researcher met with eight Métis kehtêyak throughout the province to gain a deeper understanding of Métis ways of being, knowing, and doing in relation to wellness. Four overarching wellness themes collectively emerged, emphasizing identity, community, spirituality, and wholism. These findings informed the development of the community organization’s Youth Life Promotion Project through participation in the project’s Youth Leadership Kinship Circle to co-create wellness videos for the life promotion modules. This research provides a summary of the work needed to address the gaps in Métis mental wellness and knowledge driven by Métis kehtêyak
HEALTH ECONOMIC EVALUATION OF MICROPROCESSOR AND NON-MICROPROCESSOR CONTROLLED PROSTHETIC KNEES
No full textBACKGROUND: Use of a microprocessor-controlled knee (MPK) compared to a non-microprocessor-controlled knee (NMPK) can lead to improved walking ability, confidence and satisfaction. However, the MPK is more expensive than the NMPK and it is unknown whether the higher costs outweigh the potential benefits.
OBJECTIVE: To evaluate the cost-utility and cost-effectiveness of MPKs and NMPKs from a societal perspective in the Netherlands.
METHODOLOGY: Participants completed the Dutch version of the EuroQol - five dimensions - five levels (EQ-5D-5L) to assess health-related quality of life, three subscales (ambulation, utility and well-being) of the Prosthesis Evaluation Questionnaire (PEQ) to assess prosthesis-related quality of life and a cost-questionnaire from societal perspective. Incremental cost-utility ratio (ICUR) and incremental cost-effectiveness ratio (ICER) were calculated and the ICUR was compared with the Dutch willingness-to-pay threshold. Bootstrapping was used to estimate statistical uncertainty, and multiple imputation was applied to account for missing values.
FINDINGS: In total, 111 participants were included (37 female, 73 male, 1 unknown; 71 transfemoral, 39 knee disarticulation, 1 unknown; age 64 ± 13 years; 49 NMPK users, 62 MPK users). The cost-utility analysis demonstrated that the MPK yielded an increase of 0.032 quality adjusted life years (QALY) but at considerably higher costs. The mean cost difference was € 14,626, resulting in a mean ICUR of € 457,063 per QALY gained. The cost difference was mainly driven by acquisition costs but was partially compensated by lower costs of work absence, health care consumption and household care.
CONCLUSION: The cost-effectiveness analyses demonstrated that the MPK is likely to provide benefits in term of prosthesis-specific quality of life, but at higher costs. However, short-term (6 months) improvement in health-related quality of life was too small to result in substantial QALY gain to offset the higher costs of the MPK and result in an incremental cost-utility ratio below the generally accepted willingness-to-pay thresholds.
This article has an associated Letter to the Editor (https://doi.org/10.33137/cpoj.v8i2.46339) and Author Response (https://doi.org/10.33137/cpoj.v8i2.46486)
Layman\u27s Abstract
In this study, we compared two types of prosthetic knees that are used by people with a lower limb amputation. One is a high-tech version that uses a built-in computer sensor to help control movement (called a microprocessor controlled knee or MPK) and the other is a simpler, mechanical version (called a non-microprocessor controlled knee or NMPK). MPKs can help people walk more easily and feel more confident, but have a much higher acquisition cost. We compared the costs and benefits of both types of knees by studying 111 people who were either using an MPK or NMPK in their daily life. They completed surveys about their health, how they felt about their prosthesis, their healthcare use and work. Results showed that the people using an MPK reported better experiences in terms of mobility and satisfaction with their prosthesis. However, while the MPK did also improve quality of life a little bit, the improvement was small compared to how much more it costs. While the MPK helped reduce some other costs like time of work and healthcare use, the overall benefit wasn’t enough to make it cost-effective by current standards in the Netherlands. In conclusion, while the MPK offers some advantages, they may not be enough to justify the higher price, at least not in the short term (6 months). More research could help us understand whether the benefits grow over time.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/45823/34424
How To Cite: Bosman C.E, van der Sluis C.K, Vrieling A.H, Geertzen J.H.B, Seves B.L, Groen H. Health economic evaluation of microprocessor and non-microprocessor controlled prosthetic knees. Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 2, No. 3. https://doi.org/10.33137/cpoj.v8i2.45823
Corresponding Author: Charlotte E. Bosman, PhDAffiliation: Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.E-Mail: [email protected] ID: https://orcid.org/0000-0001-7950-589
Quantifying Language Tract Damage in Stroke Patients: Utilizing Diffusion Tractography and Streamline Counts to Predict Aphasia Scores
No full textAphasia is a neurological condition that challenges language production and comprehension. It often follows a stroke that damages critical language regions in the brain. While existing research has highlighted the roles of grey matter lesions in aphasia, the potential of white matter damage as a predictive marker remains underexplored. This study investigates the feasibility of using diffusion tractography to assess white matter integrity via interhemispheric streamline count difference and subsequently investigates whether this white matter damage measure can be used to predict aphasia severity over and above existing predictors like grey matter damage. Our findings reveal significant negative correlations between white matter damage, assessed through interhemispheric streamline count differences and mean fractional anisotropy discrepancies, and aphasia severity. Multiple regression analyses subsequently underscored the importance of incorporating streamline count as an additional predictor of Western Aphasia Battery (WAB) scores alongside grey matter lesion volume, highlighting their collective contribution to aphasia severity prediction. By elucidating the relationship between white matter integrity and language deficits, our study offers insights into the development of automated diagnostic tools aiming to improve outcomes for aphasia patients
Excavating the Schreiber Estate Midden: Reflections on Historical Archaeology and Undergraduate Field Training
No full text
The Making of Mas: Archiving Toronto\u27s Caribana
No full textThis year marks the 56th anniversary of Caribana, which was originally supposed to be a one-off event, put together by a group of West Indians for Expo 67’ who wanted to share the beauties of West Indian culture with the City of Toronto. Today, Caribana is the largest cultural festival in North America, bringing in over two million people each year; however, many individuals who have grown up alongside the production of Caribana have witnessed the transformation of the event over the years.
On August 4th, 2023, an article titled “The History and Legacy of Caribana Must Be Preserved” by scholar and writer Camille Hernández-Ramdwar, was published in the Globe and Mail.1 The article vocalizes the growing concerns over the loss of the parade’s connection to Caribbean roots alongside the lack of archival efforts and documentation of the celebration over the last five decades. As discussions regarding the lack of archival efforts and scholarly attention toward Caribana’s history have gained momentum, my thesis endeavors to bridge this gap by advocating for the preservation and deeper understanding of Caribana’s legacy within Toronto’s cultural milieu