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How will Kingston Care? Designing for better health outcomes
No full textSeniors have outnumbered children in Kingston, Ontario, since 2008. The Community Foundation for Kingston & Area 2017 Vital Signs report projected that the 65+ age cohort would rise to 27% of Kingston’s population by 2026. (CFKA, 2017) Among the many implications that Kingston’s aging population brings is an increased need for health care services. (Statistics Canada, 2024) The demand comes amidst a nation-wide staffing crisis in the healthcare sector that has already impacted the ability of Kingston to meet the needs of its population. Both public and private long-term care facilities have lengthy waitlists, and the city’s two main hospitals are sometimes forced to accommodate individuals waiting for long-term care in acute-care settings. (Schliesmann, 2016) While a wealth of research has made the connection between exposure to nature and mental wellbeing (Cameron et. al., 2020; Grinde, 2009; Hunt, 2022; Verderber, 1987), Ulrich (1984) identified its potential physical benefits when he found that post-operative patients who had views of nature required less potent pain management and recovered more quickly. As it becomes increasingly necessary for Kingston to invest in expanding its health-care infrastructure, the city is presented with an opportunity to create environments of care that incorporate holistic approaches to health through every stage of life, enhance patient care experiences and promote community wellbeing. By exploring global innovations in health architecture that use evidence based design, this paper seeks to build a frame of reference for a future of better care in the city of Kingston
Adaptation and Diegesis of Pre-Existing Music in Historically-Based Video Games
No full textThe modern state of gaming has seen a variety of interactive narratives play out in a variety of worlds. A major setting of video games is ‘the past’, including historically-set games which are meant to mimic real epochs and places, all with varying degrees of accuracy to their factual counterparts.
Interestingly, a pattern emerges within the soundtracks of these games: the use of pre-existing, diegetic music. As observed by scholars such as William Gibbons and Andra Ivǎnescu, such music is frequently chosen to make use of an audience’s prior musical associations within the context of the gameworld (Gibbons 2018, 43; Ivǎnescu 2019, 18-19). However, pre-existing music comes with the risk of misaligning with the player’s expectations for a given piece. Additionally, using diegetic music creates an additional risk of misalignment between the observed action and the heard sound (Neumeyer 2009, 31). Combining these two modalities could initially seem to be not worth the collective risks, but games like the historically-based Pentiment (2022) successfully integrate their audio with game narratives through careful curation of pre-existing musical works. What purpose does pre-existing music serve to warrant its widespread inclusion in historically-based games? A comparison of two works from Pentiment, the non-diegetic “Pierro’s Pride” and the diegetic “Rüdeger’s Rehearsal,” will demonstrate how diegetic music is bound by the depicted action, thereby musically reinforcing it, while non-diegetic music takes more liberties in its historical accuracy
Stories Worth Preserving : Continuity and Change in West Centretown’s Proposed Heritage Conservation District
No full textAs students in Carleton University’s History department, in the Fall of 2023, we were invited to collaborate on historical projects around Ottawa. Our group was tasked to create a report for the Centretown Community Association as part of the process to petition the City of Ottawa for a Heritage Conservation District in West Centretown. In this report, we detail three stories within the proposed district boundaries which argue for the protection of historical locations. This article aims to condense this research to share West Centretown\u27s history with a broader audience. These three stories include the beginnings of the area, beloved community locations, and character profiles of West Centretown residents. Our research includes an oral interview, use of newspaper archives, and existing local knowledge to demonstrate the significance of preserving vibrant communities within the broader Ottawa context. Our findings were that a Heritage Conservation District would be entirely beneficial for preserving the buildings responsible for the rich culture and history of West Centretown
Applying a One Health Lens to Mitigating Vehicular Impacts on Marine Mammals
No full textMarine vehicles play an important role in Newfoundland and Labrador’s (NL) economy, transportation, and essential services. However, they also pose significant threats to humans, marine mammals, and the environment via collisions, noise and/or light pollution, habitat destruction, emissions, and water contamination. These impacts are deeply interconnected, contributing to a complex and evolving wicked problem. Conservation efforts in NL, including grassroots initiatives and government regulations, reflect strong community interest but often lack enforcement mechanisms, long-term support, and measurable outcomes. Applying the One Health perspective highlights the value of community-informed, interdisciplinary approaches that address the complex and overlapping impacts of marine traffic, guiding the development of sustainable solutions for humans, marine mammals, and the environment
Nutcracker Syndrome, Autonomic Dysfunction, and Dysmotility: A Novel Therapeutic Approach
No full textThis review explores the multifaceted relationship between Nutcracker Syndrome (NCS), autonomic dysfunction, and gastrointestinal dysmotility. Through analysis of literature mediated through elevated norepinephrine (NE) levels. This dysregulation leads to gastrointestinal dysmotility in affected individuals. The evidence strongly suggests that sympathetic nervous system overactivity functions as an intermediary mechanism linking NCS to gastrointestinal symptoms. Conventional constipation treatments frequently prove ineffective in these cases, as they fail to address underlying autonomic components. Drawing from successful therapeutic strategies employed in pheochromocytoma cases, where alpha-adrenergic antagonists have demonstrated efficacy in treating catecholamine-induced constipation, this review presents an innovative therapeutic approach for NCS patients experiencing gastrointestinal symptoms. Specifically, the findings indicate that alpha-adrenergic blockade may provide therapeutic benefits by targeting autonomic dysfunction. This observation emphasizes the fundamental importance of implementing comprehensive diagnostic and therapeutic approaches that simultaneously address all three interconnected conditions. Furthermore, this paper strongly advocates for extensive additional research and the implementation of clinical trials to definitively confirm these proposed associations and evaluate the effectiveness of this novel therapeutic approach
Assessing an 8-Channel Electroencephalogram’s Ability to Evaluate Cue Reactivity in Nicotine Users
No full textWith the increasing popularity of cigarettes, e-cigarettes, and nicotine pouches among youth, novel cessation approaches are needed. Cue-induced cravings occur in response to stimuli that encourage smoking behaviour, like nicotine product promotional material or in media. Such cravings can promote addiction and lead to relapse but responses to such cues are often neglected in nicotine cessation approaches. Cue-reactivity models provide insight into addiction by examining neural responses to stimuli related drugs like nicotine. P300, an event-related potential, can be used as a measure of cue-reactivity, as it correlates with cognitive engagement and craving intensity. Bu et al.’s (2021) study demonstrated the feasibility of a P300-based neurofeedback system to regulate cue-reactivity using a 64-channel EEG. However, these setups are costly and impractical for widespread clinical and commercial applications. Thus, this literature review was conducted to evaluate current literature, looking at an assessment of the ability of an 8-channel portable EEG to measure cue-reactivity and explore its applicability in nicotine cessation.  
Les prix des logements en Colombie-Britannique: quantifier l\u27effet du zonage
No full textBritish Columbia (B.C.)’s housing prices have increased dramatically in recent times, and one potential explanation is municipal zoning bylaws limiting housing supply. However, the effect of zoning on housing prices in aggregate has not yet been studied in B.C. In this study, I use a regression analysis, adapted from an Australian study, to estimate the “zoning effect”: the extent to which zoning controls increase the sale prices of dwellings. I calculate this effect for detached homes in 30 of B.C.’s largest cities and towns, and for apartments in the Metro Vancouver region. I look at how home prices changed between 2016 and 2022, and the extent to which the zoning effect influenced this trend. Finally, I evaluate the potential of government initiatives aimed at decreasing the cost of housing through the lens of the zoning effect, and suggest possible future courses of action.Les prix des logements en Colombie-Britannique (C.-B.) ont augmenté de manière spectaculaire ces derniers temps, et une explication potentielle est que les règlements municipaux de zonage limitent l\u27offre de logements. Cependant, l\u27effet du zonage sur les prix des logements dans l\u27ensemble n\u27a pas encore été étudié en C.-B. Dans cette étude, j\u27utilise une analyse de régression, adaptée d\u27une étude australienne, pour estimer "l\u27effet du zonage": la mesure dans laquelle les contrôles de zonage augmentent les prix de vente des habitations. Je calcule cet effet pour les maisons individuelles dans 30 des plus grandes villes et villages de C.-B., et pour les appartements dans la région de Metro Vancouver. J\u27examine comment les prix des logements ont changé entre 2016 et 2022, et dans quelle mesure l\u27effet du zonage a influencé cette tendance. Enfin, j\u27évalue le potentiel des initiatives gouvernementales visant à réduire le coût du logement à travers le prisme de l\u27effet du zonage, et je suggère des actions possibles pour l\u27avenir
You’ve Gotten Under my Skin: How to Make a Simple, Non-Perishable, Low-Cost Soft Tissue Infection Ultrasound Simulator
No full textWe describe how to make an ultrasound compatible, low-cost, non-perishable, durable skin and soft tissue infection (SSTI) phantom model that simulates multiple pathologies including abscess and necrotizing fasciitis. The SSTI simulator has an extended shelf-life, can be recreated, and can serve as a needle aspiration simulator
Evaluation of an International Point of Care Ultrasound (POCUS) Training Program for Internal Medicine Physicians
No full textBackground: Point of care ultrasound (POCUS) training in internal medicine (IM) training remains largely unavailable in lower-resourced health systems globally. Longitudinal inter-institutional collaboration, based in health equity principles, offers a potential mechanism for more accessible and effective IM POCUS education. Methods: In a partnership between two academic medical centers in Caracas, Venezuela (Luis Razetti School of Medicine at the Universidad Central de Venezuela (UCV)) and New York, USA (New York University (NYU) Grossman School of Medicine), we evaluated the impact of an IM POCUS training program on knowledge and skills of IM physicians at UCV. During 2023-2024, 18 UCV IM physicians participated in the program. The program included online tutorials and quizzes, in-person image interpretation review, and supervised practice. Participants completed a pre-course knowledge assessment, post-course knowledge, skills, and self-confidence assessments, and qualitative feedback regarding course acceptability. Results: Pre-to-post knowledge assessments demonstrated mean score improvement. Post-course knowledge scores were not significantly different between UCV and NYU cohorts (77% vs. 78%, respectively; p =0.82). Skill scores measured by a hands-on test were comparable between groups, with few significant differences. Learners self-rated increases in confidence during the course, and rated the course as locally acceptable and sustainable. Conclusions: A standardized, longitudinal, international IM POCUS training program was successfully implemented with faculty learners in a lower-resourced health system, who demonstrated gains in knowledge and skills, and reported high educational value of the partnership. The results support expanding inter-institutional POCUS training programs founded in health equity principles
Performance of POCUS for Pregnancy Evaluation using a Non-Piezoelectric Ultrasound Device in the Emergency Department
No full textBackground: Confirmation of pregnancy location using point of care ultrasound (POCUS) is an essential component of emergency obstetric care. The accuracy of a non-piezoelectric portable ultrasound device compared to obstetric sonographer-performed ultrasonography remains uncertain. Objective: The objective of this study was to describe the practical utility of a non-piezoelectric POCUS system (Butterfly iQ+) in the emergency department, including characterizing the accuracy of findings relative to obstetric sonographer-performed ultrasound (OB-US) for obstetric and non-pregnant pelvis evaluations in the emergency department. Methods: This retrospective cohort study was conducted at a Level 1 trauma center. Patients who underwent emergency physician-performed transabdominal obstetric or gynecologic POCUS examination using a non-piezoelectric transducer between November 2021 and November 2022 were included. Data from electronic medical records and ultrasound databases were abstracted. POCUS findings such as yolk sac presence, fetal heart motion, and gestational age were recorded alongside patient data including age, body mass index, human chorionic gonadotropin (hCG) levels, and ultrasound results. Descriptive statistics were analyzed using SPSS. Results: Seventy-two obstetric POCUS studies were included with an average maternal age of 29.6 ± 7.8 years. Common indications included positive pregnancy tests, abdominal/pelvic pain, and vaginal bleeding. All first-trimester intrauterine pregnancies (IUPs) diagnosed by POCUS and referred for OB-US were confirmed, with no false positives. POCUS had a sensitivity of 83.3% (95% CI 61.8-94.5) and specificity of 100% (95% CI 71.7-100) for confirmation of an IUP. The lowest hCG levels at which IUP was detected with POCUS were 6,488 without fetal heart motion and 7,098 with heart motion. The agreement between POCUS and OB-US for gestational age measurements was moderate (ICC = 0.83, 95% CI 0.0-0.99). In the second trimester, POCUS accurately detected fetal heart rate, with a strong agreement for gestational age (ICC = 0.96, 95% CI 0.43-0.99) compared to OB-US. Transabdominal POCUS also identified gynecologic conditions such as postpartum hemorrhage, and normal POCUS exams led to alternate diagnoses such as pelvic inflammatory disease and pyelonephritis. Conclusion: POCUS using a non-piezoelectric ultrasound device was able to accurately rule in first trimester IUP in the emergency department at relatively low hCG levels, with no false positive IUPs identified. During the second and third trimesters, POCUS consistently detected fetal heart motion and had good accuracy for gestational age measurements compared to OB-US. These findings suggest that POCUS using a non-piezoelectric ultrasound device is a useful tool for emergency department assessments, though further evaluation is needed