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Examining the mediating role of cardiovascular disease risk factors on the association between physical activity and global cognitive scores in community-dwelling middle-aged and older females
Get PDFCardiovascular disease (CVD) and cognitive decline are significant contributors to global mortality and morbidity. Physical activity (PA) has emerged as a modifiable factor with positive effects on various aspects of health across different age groups. While many studies has identified direct relationships between PA and cognition, PA and CVD risk factors, and cognition and CVD risk factors, limited research has investigated the potential mediating role of CVD risk factors in the relationship between PA and cognition, particularly among older adults. This thesis aimed to fill this gap by utilizing a cross-sectional study design and secondary analysis of data from the Women’s Advanced Risk-Assessment in Manitoba (WARM) Hearts cardiovascular screening study. The study explored the mediating role of both composite and individual CVD risk factors on the association between PA and cognition in community-dwelling middle-aged and older females. Mediation analysis was conducted using the PROCESS macro (version 4.3) for SPSS. PA and specifically moderate to vigorous PA (MVPA) was associated with cognitive performance through body mass index (BMI) and frailty index (FI), but not through a composite CVD risk factor or other individual CVD risk factors, such as systolic blood pressure (BP), diastolic BP, arterial stiffness, and blood markers. The lack of significant mediating effects of CVD-specific risk factors suggests that the cognitive benefits of PA, particularly MVPA, may be more strongly linked to general health indicators such as BMI and FI rather than through CVD-specific pathways. These results imply that older females may see cognitive benefits through the maintenance of BMI and FI by engaging in PA and specifically MVPA. By investigating these relationships, this thesis provided insights into the mechanisms underlying the association between PA, cognition, and CVD risk factors in middle-aged and older females. The findings may inform interventions aimed at promoting cognitive and overall health in this population, emphasizing the importance of regular engagement in PA.October 202
Will investors’ excitement last? Determinants of investors’ responses to cross-border acquisitions by Chinese firms
No full textPrevious studies have found that in the short term, investors in emerging economies tend to react optimistically to cross-border acquisitions. However, studies in both financial economics and strategic management have acknowledged that there may be short-term abnormal returns in the stock market. As such, based on a behavioral perspective on investor valuation, we examine whether and when investors’ initial reactions are sustained using a sample of cross-border acquisitions by Chinese firms from 1998 to 2018. We find that the investor’s initial positive reactions are more likely to be sustained in the long term when (1) a cash payment is used for the acquisition, (2) the acquiring firm has more international acquisition experience, (3) the target firm’s country has a large economy, and (4) the target firm’s country has a culture of high uncertainty avoidance. Our findings extend the behavioral perspective on market reactions to cross-border acquisitions, and we contend that investors’ market valuations are a complex process that relies on various contextual cues. We contribute to an improved understanding of how investors evaluate a firm’s cross-border acquisitions over time
Geographic and socioeconomic inequalities in the coverage of contraception in Uttar Pradesh, India
No full textBackground
Uttar Pradesh (UP) is the most populous state in India, with a historically lower level of family planning coverage than the national average. In recent decades, family planning coverage in UP has significantly increased, yet there are considerable geographic and socio-economic inequalities.
Methods
The data used for the study is derived from a cross-sectional quantitative survey of 12,200 currently married women conducted during December 2020–February 2021 in UP by the Technical Support Unit. Univariate and bivariate analyses were performed and equiplots were used to make visualizing inequalities easy.
Results
The findings of the study reveal significant variation in family planning coverage indicators amongst currently married women in reproductive ages by administrative divisions in UP. For instance, in the Jhansi division, it was 72.4%, while in Faizabad, it was 39.3%. Jhansi division experienced the highest modern contraceptive coverage with the lowest inequity compared to other divisions. However, the range of coverage within the division by Accredited Social Health Activist (ASHA) areas is 25% to 75%. In fact, for some ASHA areas in the Jhansi division, the family planning demand satisfied for modern contraception ranged from more than 85% to less than 22%. On the other hand, the Gonda division with the lowest coverage and lowest inequity for demand satisfied for modern contraception has some ASHA areas with less than 5% and some with more than 36%. The study also revealed intersectionality of education, wealth, place of residence and geographic divisions in identifying inequity patterns. For instance, in case of Mirzapur and Varanasi, the demand satisfied among the illiterates was 69% and the corresponding percentage for literates was 49%. With respect to place of residence, Basti division, where the coverage for modern contraception is extremely low, demand satisfied for modern contraceptive methods is 16.3% among rural residents compared to 57.9% in the case of urban residents.
Conclusions
The findings showed inequality in the modern family planning methods coverage in UP in both best and worst performing divisions. The inequalities exist even in extremely small geographies such as ASHA areas. Within the geographies as well, the socio-economic inequalities persisted. These inequalities at multiple levels are important to consider for effective resource allocation and utilization
Environmental DNA as an ecological monitoring tool for the Canadian Arctic
No full textEnvironmental DNA is a method where DNA shed by organisms into the environment is captured and analysed to give insights into various aspects of the ecosystem. Since detection of organisms is based on capturing theoretically as little as a single strand of shed DNA, the method is highly sensitive, cost-effective, and can be applied to any target organism or groups of organisms. These advantages, among others, have led eDNA methods to become a popular tool in environmental monitoring programs. Recent advances in DNA sequencing technologies have lowered the cost of analysis and allowed for many different applications of eDNA to become viable. Despite its widespread use, there are still a limited number of studies that have been conducted in remote regions such as the Canadian Arctic. This project aims to adapt eDNA methods for use in the Canadian Arctic, specifically in the monitoring of several lakes in the vicinity of established and developing mining sites through metabarcoding. Six of the eight target fish species were detected throughout the project, with the addition of one unanticipated species. The established mine site showed little change, while the developing site showed indications of fish movement that were consistent with the change in affected water bodies. Additional work supported the use of eDNA methods in frozen environments where sampling is required through ice. Overall, eDNA sampling was successfully employed in monitoring for fish presence near an active and developing mine in the Canadian Arctic.October 202
Analyzing the Freedom Convoy through demand and supply-side perspectives in far right literature
No full textThis thesis explores the Freedom Convoy (FC) movement by connecting it to the extensive literature on the recent far-right phenomenon, including extreme, radical, and populist variants. The FC (January 22nd to February 23rd, 2022) involved a number of Canada-wide protests targeting large cities, smaller communities, border-crossing points with the United States (US), and most importantly, the city of Ottawa, where the protest turned into a nearly month-long occupation. The FC, which differs from typical party-based far-right examples, serves as a unique case of far-right mobilization. Although the FC’s connection to the far-right movement has been established through mutual activists and organizations, no comprehensive analysis has previously connected far-right research to the FC. This study will address this gap using far-right literature. Although Eurocentric and party-centered, far-right literature provides valuable insights into protest-based and non-Eurocentric far-right movements, such as the FC. The methodology of this study will thus involve a thematic review of far-right literature, highlighting the importance of studying non-European and protest-based movements within the context of far-right literature. Additionally, this study examines how the FC was shaped by the COVID-19 pandemic and social media.February 202
Barriers to cancer treatment for people experiencing socioeconomic disadvantage in high-income countries: a scoping review
No full textBackground
Despite advances in cancer research and treatment, the burden of cancer is not evenly distributed. People experiencing socioeconomic disadvantage have higher rates of cancer, later stage at diagnoses, and are dying of cancers that are preventable and screen-detectable. However, less is known about barriers to accessing cancer treatment.
Methods
We conducted a scoping review of studies examining barriers to accessing cancer treatment for populations experiencing socioeconomic disadvantage in high-income countries, searched across four biomedical databases. Studies published in English between 2008 and 2021 in high-income countries, as defined by the World Bank, and reporting on barriers to cancer treatment were included.
Results
A total of 20 studies were identified. Most (n = 16) reported data from the United States, and the remaining included publications were from Canada (n = 1), Ireland (n = 1), United Kingdom (n = 1), and a scoping review (n = 1). The majority of studies (n = 9) focused on barriers to breast cancer treatment. The most common barriers included: inadequate insurance and financial constraints (n = 16); unstable housing (n = 5); geographical distribution of services and transportation challenges (n = 4); limited resources for social care needs (n = 7); communication challenges (n = 9); system disintegration (n = 5); implicit bias (n = 4); advanced diagnosis and comorbidities (n = 8); psychosocial dimensions and contexts (n = 6); and limited social support networks (n = 3). The compounding effect of multiple barriers exacerbated poor access to cancer treatment, with relevance across many social locations.
Conclusion
This review highlights barriers to cancer treatment across multiple levels, and underscores the importance of identifying patients at risk for socioeconomic disadvantage to improve access to treatment and cancer outcomes. Findings provide an understanding of barriers that can inform future, equity-oriented policy, practice, and service innovation
Maternal mental health symptom severity, recent stress, and their associations with parenting sensitivity in a treatment-seeking sample
No full textParenting sensitivity refers to a caregiver’s ability to perceive, accurately interpret, and respond appropriately to the needs of a child. For mothers of infants, managing depression can impact sensitive parenting, which can be complicated further by individual mental health symptoms such as anger and sleep disturbance and by contextual life stressors. However, links between parenting sensitivity and depression are scarce in parents of toddlers and have yet to be studied in online assessment contexts (e.g., over Zoom). This study examined links between the severity of mental health symptoms (i.e., depression, sleep disturbance, and anger) and parenting sensitivity for mothers meeting clinical criterion for depression and/or anxiety. Recent stressful experience was hypothesized to moderate the association between depression and parenting sensitivity. A secondary objective was to successfully adapt and administer an in-person measure of sensitivity to meet remote assessment needs. The current sample included 141 mothers and their 2-to-3-year-old toddlers in a secondary analysis of baseline data from an intervention for mothers with mental health challenges: the Building Emotional Awareness and Mental Health (BEAM) program. The results of this study indicated both depression, sleep, and recent stressors as unique contributors to sensitive parenting. No significant associations were found between anger and sensitive parenting in this sample. A unique contribution is the use of an online-observed parenting sensitivity assessment. A clinical implication includes the consideration of targeted intervention that addresses both parental mental health and parenting skills.October 202
Verification of a comprehensive framework for mobility using data from the Canadian Longitudinal Study on Aging: a structural equation modeling analysis
No full textBackground
Mobility within and between life spaces is fundamental for health and well-being. Our objective was to verify a comprehensive framework for mobility.
Methods
This was a cross-sectional study. We used structural equation modeling to estimate associations between latent factors with data from the Canadian Longitudinal Study on Aging for participants 65–85 years of age (65+, n = 11,667) and for adults with osteoarthritis (OA) aged 45–85 (n = 5,560). Latent factors included life space mobility, and physical, psychosocial, environmental, financial, and cognitive elements. Personal variables (age, sex, education) were covariates.
Results
The models demonstrated good fit (65+: CFI = 0.90, RMSEA (90% CI) = 0.025 (0.024, 0.026); OA: CFI = 0.90, RMSEA (90% CI) = 0.032 (0.031, 0.033)). In both models, better psychosocial and physical health, and being less afraid to walk after dark (observed environmental variable) were associated with greater life space mobility. Greater financial status was associated with better psychosocial and physical health. Higher education was related to better cognition and finances. Older age was associated with lower financial status, cognition, and physical health. Cognitive health was positively associated with greater mobility only in the 65 + model. Models generated were equivalent for males and females.
Conclusions
Associations between determinants described in the mobility framework were verified with adults 65–85 years of age and in an OA group when all factors were considered together using SEM. These results have implications for clinicians and researchers in terms of important outcomes when assessing life space mobility; findings support interdisciplinary analyses that include evaluation of cognition, depression, anxiety, environmental factors, and community engagement, as well as physical and financial health. Public policies that influence older adults and their abilities to access communities beyond their homes need to reflect the complexity of factors that influence life space mobility at both individual and societal levels
Preserving a sense of self: young people’s experiences living with food allergy
No full textYoung people with food allergies live with the unpredictable risk of anaphylaxis, which creates a considerable burden including stigma, marginalization, and constant vigilance. We currently lack the knowledge to fully understand ideal management and health needs from the perspective of young people living with food allergy. The purpose of this study was to explore young people’s lived experience of food allergy and analyze its assigned meaning with the intent to inform allergy management and policy. Ten Canadian youth between the ages of 13 to 21 years old with a diagnosis of food-induced anaphylaxis participated in two semi-structured interviews, the first with a focus on lived experience through a phenomenological lens, and the second using photovoice. A focus group helped to provide feedback on early analysis and recommendations. This study used a novel approach in combining van Manen’s phenomenology of practice with photovoice to guide collection and analysis of the resulting data. Analysis used van Manen’s existentials to develop the following subsequent themes: the altered self, home is a safe place, in my shoes, living with possibilities, and the invisible barrier. The resultant overarching theme, preserving a sense of self, concerns how young people living with food allergies must create a sense of holistic safety to maintain their identities. This safety is necessary in the face of perceived limitations and threats experienced as a result of their food allergies. Findings from this study contribute new knowledge of young people’s experiences and assigned meaning when living with food allergy. This study provides new opportunities to expand future food allergy research, policy, education, and clinical practice concerning young people and their health needs.February 202
The validity of electronic health data for measuring smoking status: a systematic review and meta-analysis
No full textBackground
Smoking is a risk factor for many chronic diseases. Multiple smoking status ascertainment algorithms have been developed for population-based electronic health databases such as administrative databases and electronic medical records (EMRs). Evidence syntheses of algorithm validation studies have often focused on chronic diseases rather than risk factors. We conducted a systematic review and meta-analysis of smoking status ascertainment algorithms to describe the characteristics and validity of these algorithms.
Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. We searched articles published from 1990 to 2022 in EMBASE, MEDLINE, Scopus, and Web of Science with key terms such as validity, administrative data, electronic health records, smoking, and tobacco use. The extracted information, including article characteristics, algorithm characteristics, and validity measures, was descriptively analyzed. Sources of heterogeneity in validity measures were estimated using a meta-regression model. Risk of bias (ROB) in the reviewed articles was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
Results
The initial search yielded 2086 articles; 57 were selected for review and 116 algorithms were identified. Almost three-quarters (71.6%) of algorithms were based on EMR data. The algorithms were primarily constructed using diagnosis codes for smoking-related conditions, although prescription medication codes for smoking treatments were also adopted. About half of the algorithms were developed using machine-learning models. The pooled estimates of positive predictive value, sensitivity, and specificity were 0.843, 0.672, and 0.918 respectively. Algorithm sensitivity and specificity were highly variable and ranged from 3 to 100% and 36 to 100%, respectively. Model-based algorithms had significantly greater sensitivity (p = 0.006) than rule-based algorithms. Algorithms for EMR data had higher sensitivity than algorithms for administrative data (p = 0.001). The ROB was low in most of the articles (76.3%) that underwent the assessment.
Conclusions
Multiple algorithms using different data sources and methods have been proposed to ascertain smoking status in electronic health data. Many algorithms had low sensitivity and positive predictive value, but the data source influenced their validity. Algorithms based on machine-learning models for multiple linked data sources have improved validity