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Pediatric occupational therapists' journeys towards culturally safer care through participation in a community of practice: a qualitative study
Get PDFRationale
Indigenous communities have identified cultural safety training (ICST) for healthcare providers as one important approach to address racism and health inequities experienced by Indigenous people in Canada. Cultural safety is not achieved through single educational events; it requires ongoing critical reflexivity and engagement by the healthcare provider. Intentional, co-created learning spaces such as Communities of Practice (CoPs) support the ongoing reflexivity and learning needed to strengthen culturally safer practices among occupational therapists.
Objectives
Using constructivist and Indigenist epistemologies, this narrative inquiry explored the: 1) impact of participation in a cultural safety CoP on the attitudes, beliefs and clinical practices of pediatric occupational therapists and 2) value of CoPs as a model for ICST.
Methods
Participants (n=5) engaged in six facilitated CoP sessions. CoP content was guided by the Cultural Safety Framework (CSF) (Horrill et al., 2021), ICST best practices, and participants’ expressed learning needs. Data collection included audio-recorded individual, semi-structured interviews before and after the CoP series and group reflections gathered during CoP sessions. Recordings were transcribed verbatim, then coded using directed content analysis based on the Cultural Safety Framework. Participants’ journeys were reorganized to reflect a chronological story of their journeys towards culturally safer care and sent to participants for member-checking. Coded data was analysed to explore themes of participants’ journeys.
Findings
Findings are presented in two ways: 1) the re-storied experiences of individual participants, 2) thematically according to the domains of the Cultural Safety Framework: practicing reflexivity, prioritizing relationships and considering context. A fourth theme, becoming unsettled, emerged from the data. Despite varying past experiences, all participants demonstrated changes in attitudes and beliefs, and several expressed early practice changes over the course of the CoP. The CSF offered a helpful structure for the content of the CoP. The CoP structure emphasized relationship-building, a key component in ICST.
Conclusion
CoPs can offer a supportive environment for HCPs to engage in critical reflexivity and anti-racism curriculum. Funders must consider the safety of Indigenous presenters and participants when allocating human and financial resources to ICST programs. Future studies should seek feedback from Indigenous clients to demonstrate clinical impacts of ICST.May 202
Exploring the applicability and reliability of machine learning tools in streamflow forecasting
Get PDFRecent advancements in machine learning, particularly Long Short-Term Memory (LSTM) networks, have demonstrated remarkable success in hydrological modelling, often outperforming traditional hydrological models. This thesis provides a comprehensive analysis of LSTM networks for streamflow forecasting under various conditions. First, the impact of incorporating historical streamflow data as an input was evaluated, demonstrating significant improvements in prediction accuracy across diverse catchments. While LSTM outperformed the persistence for one-day-ahead forecasts, accuracy decreased for longer lead times for both models. The effect of noisy precipitation inputs was subsequently investigated, revealing that while noise generally reduces performance, LSTMs trained with noisy data exhibit resilience. Basin sensitivity to precipitation noise varied and correlated with catchment attributes. Lastly, interpolation and extrapolation under stationary and non-stationary climate scenarios were examined. LSTM performed remarkably well under stationary conditions but showed biases when predicting under changing precipitation regimes, highlighting challenges in extrapolation. In conclusion, the thesis summarizes the key findings, addresses its limitations, and suggests avenues for future research, such as incorporating forecasted forcing data and developing hybrid models to improve the robustness of LSTM-based streamflow forecasting.October 202
We have never forgotten the children: the journey of the Treaty #3 Anishinaabeg as they exercise jurisdiction in relation to their children and families, with consideration of the Act Respecting First Nation, Inuit and Metis Children, Youth and Families
Get PDFThe Anishinaabe Nation in Treaty #3 have profound and distinct laws for raising their children that flow from their sovereignty, miinigoziwin. Their laws have transcended generations through the adisokanaan, the teachings of Nanaboozhoo and through ceremony. Anishinaabe children were nurtured and protected within a web of relationships and taught to understand their interconnectivity to all of Creation, to know their rich history and be immersed in the nuances embedded within the language.
This thesis traces steps that the Treaty #3 Anishinaabe have taken to continuously assert jurisdiction of their children and families, despite colonial policy of dispossession and cultural genocide. The Anishinaabeg have never forgotten the children and have been creative and active in their efforts to displace the child and family services system. This thesis paints a picture from an Anishinaabe perspective purposely utilizing predominantly primary sources to illustrate from both a micro and macro view.
First Nations will each have to determine how best to shift the child welfare paradigm for their children and their future. Seeking and implementing Anishinaabe truths with the guidance of Anishinaabe knowledge keepers offers the best hope. The federal Act Respecting First Nation, Inuit and Metis Children, Youth and Families has potential as a further step on the pathway to exercising full unencumbered jurisdiction of children and families.May 202
Identification and characterization of novel antivirals for seasonal influenza A virus
Get PDFSeasonal influenza viruses cause approximately 3-5 million cases of illness and 250,000-500,000 deaths globally annually, burdening the healthcare system. Currently, the best intervention against seasonal influenza is the annual vaccine, which protects against Influenza Type A subtypes H1N1, H3N2, and Type B viruses, all of which are endemic in humans. However, vaccine strains must be decided one year before the season, as the dominant seasonal strains may change year to year, which can lead to reduced efficacy. Typically, the first line of post-exposure defense for severe or complicated influenza infection is antivirals such as Oseltamivir. However, influenza quickly gains resistance against antivirals, limiting their value for sustained use during outbreaks. By utilizing DiscoveryProbe pre-aliquoted drug panels from ApexBio against a seasonal strain of H1N1 influenza, I aimed to discover novel antivirals to identify more options for emergency antiviral use in the case of future severe cases or seasonal IAV infection. In vitro screening of FDA-approved drug panel from ApexBio identified two compounds that provided protection against A/Canada/RV733/2007 H1N1 with limited cytotoxicity in MDCK and A549 cells. Screening of the Natural Product library panel from ApexBio identified 12 compounds that provided protection with limited cytotoxicity. Testing these compounds against seasonal and pandemic H1N1, A/Hong Kong/1/68 H3N2, a recombinant VSV, and a seasonal Rhinovirus showed that several of the compounds were effective against a wide range of infectious agents. Testing in both MDCK and A549 cell lines showed that the effectiveness of the compounds occasionally differed between cell lines. Further characterization using immunofluorescent assays to track viral proteins during infection in the presence of the compounds of interest showed that sodium aescinate, calycosin-7-glucoside, oridonin, dioscin, and kinetin reduced viral protein fluorescence 24 hours post-infection. Hemagglutination inhibition assays, attachment and penetration blockades, and attachment immunofluorescent assays suggested that oridonin and dioscin may be inhibiting on IAV attachment, while sodium aescinate and calycosin-7-glucoside may be having a negative effect on IAV penetration. These novel antivirals could provide new possibilities for treatment of influenza infections, and provide additional options for the management of inevitable future IAV outbreaks.October 202
Reliable Tire Recycling – development of a playground tile product
Get PDFThe Reliable Tire Recycling (RTR) Playground Tile Project aims to develop an innovative, sustainable, and safe playground surfacing solution made from recycled rubber tires. This project was initiated to repurpose waste rubber into a functional, high-performance product. Playground tiles made of such material are not widely available in Canada which this project aims to address. The project was completed in collaboration with RTR, Manitoba’s leading tire recycling company, to expand their product line. The playground tile is designed to meet ASTM F1292 impact attenuation safety standards, contribute to environmental sustainability, and enhance product innovation in the recycled rubber industry specifically in Canada.
The design process involved extensive research and experimentation in several key areas: material composition, tile shape, connection method, aesthetics, and manufacturing. The final material formula was selected based on performance test results that met the expected safety rating but also ensured durability, impact resistance, and ease of production. The Team developed a unique base design with a channelled, grid structure to improve shock absorption and water drainage, further enhancing the product’s safety and longevity. Additionally, a dowel pin connection system was implemented to facilitate secure and easy tile assembly, improving product usability in playground installations. The tile’s visual appearance was improved with the integration of coloured rubber from recycled shoes to which added a potential avenue for future product development at RTR.
To ensure the tiles met the main design objectives and specifications, various verification procedures were conducted. The Triax Impact Test in accordance with ASTM F1292 confirmed that the material composition and design features achieved the critical fall height desired by the client for playground applications. Additional tests evaluated the tile’s performance under different environmental conditions including extreme temperatures and moisture resistance. These evaluations demonstrated the tile’s durability and suitability for outdoor use, confirming its potential as a marketable product for RTR.
By successfully developing a high-quality playground tile using recycled rubber, this project not only contributes to sustainable waste management but also provides RTR with a viable, eco-friendly addition to their product line. The results validate the potential for further research and commercialization
Crisis and continuity: pandemic benefits and inequality in Canada
Get PDFThis thesis examines the redistributive impact of Canada’s pandemic income support programs, particularly the Canada Emergency Response Benefit (CERB), and situates these findings within a broader political-economic analysis of neoliberal austerity. While these emergency benefits were not designed to reduce inequality, they nonetheless contributed to a temporary but significant decrease in after-tax income inequality across Canadian provinces. Using Gini coefficients and income share data, this study demonstrates that government intervention—especially when structured as near-universal income support—can meaningfully reduce inequality in the short term. However, the reversion to fiscal restraint and limited social spending in the post-pandemic recovery reveals the political and institutional constraints that prevented such redistributive measures from becoming permanent. The thesis argues that although moments of disruption can open space for structural change, the absence of sustained political coalitions and the persistence of neoliberal ideological frameworks ultimately foreclosed the possibility of a more equitable post-pandemic settlement. In doing so, the paper highlights both the possibilities and limits of crisis-induced reform in Canada’s political economy.University of Manitoba Graduate FellowshipOctober 202
Computed tomography perfusion assessment of poor neurological outcome in comatose cardiac arrest patients (CANCCAP): a prospective study
Get PDFAbstract Background Computed tomography perfusion (CTP) of the brain, are increasingly being employed for the assessment of critically ill patients admitted to intensive care units (ICU), including comatose cardiac arrest patients (CCAP). The purpose of our study was to validate the use of CTP in predicting in-hospital mortality in CCAPs. Method This prospective cohort study enrolled newly admitted adult CCAP, with an out of hospital cardiac arrest (OHCA) and were scheduled for admission to the ICU for further management. Just before ICU admission, CCAP underwent a routine CT scan of the head and CTP of whole head. The treating physicians remained blinded to the CTP results and all patients received standard management. The CTP maps were evaluated to determine a binary outcome of non-survivable brain injury (NSBI), by two independent neuroradiologists, blinded to each other’s assessment and to the clinical history of the patients. Results A total of 91 patients were enrolled and 90 (Male-78; mean age-62 years) were included in the final analysis. One patient declined consent. Of these, 42 individuals (47%) had in-hospital mortality. Patients with in-hospital mortality were older; had higher levels of creatinine, blood urea nitrogen, blood CO2 and lower pH, carbonate, and heart rate. In multivariate analysis, PCI was independently associated with reduction in-hospital mortality. CTP demonstrated exceptionally high specificity (100%; 95% CI 92–100%) and positive predictive value (100%; 95%CI 6.3–100%) for the prediction of NSBI. For CTP, Bennet’s S-score showed excellent agreement between the two readers (s = 0.82–0.95). Conclusion CTP was safe and demonstrated very high specificity and positive predictive value and may be used as an additional diagnostic tool for identifying patients at high risk of in-hospital mortality
Regulation of gene expression by growth differentiation factor 15 in the developing mouse and human neocortex
Get PDFThe evolution of the neocortex, specifically its expansion, is the key advancement that made higher cognitive abilities possible. Humans today have a neocortex that constitutes up to two-thirds of their overall brain mass. This expansion reflects increased and prolonged activity of neural progenitor cells (NPCs), which give birth to neurons during fetal cortical development. Growth differentiation factor 15 (GDF15) is a cell-extrinsic signal that has previously been found to promote basal progenitor proliferation, one of the main classes of NPCs critical to human brain development and evolution. Previously, the Xing Lab discovered several potential downstream targets that could be regulated by GDF15 in the fetal human neocortex, including Dachshund Family Transcription Factor 1 (DACH1), Glypican 6 (GPC6), Semaphorin 5A (SEMA5A), and Shroom Family Member 3 (SHROOM3). All of which have been reported to have various roles in neurodevelopment. In this study, we manipulated GDF15 levels in the developing mouse and human neocortex to understand its regulatory effect on the potential downstream targets. My range-finding experiment indicated a concentration-dependent increase in mRNA levels of the downstream targets, with the most increase observed in fetal human neocortical tissue incubated with 100ng/ml recombinant human GDF15 protein. Knockout of the GDF15 gene in embryonic mice revealed decreased mRNA levels of all the downstream targets. Furthermore, adult GDF15 knockout transgenic mice exhibited a decrease in interneuron and deep-layer neuron numbers. My findings are consistent with the notion that GDF15 regulates NPC proliferation through these downstream targets, contributing to long-term effects on neuron abundance in the adult brain
Healthcare providers' perspectives on the Canadian Caries Risk Assessment Tool implementation in Indigenous pediatric primary care: a qualitative study
Get PDFAbstract Background Early childhood caries remains a significant public health concern among Indigenous children in Canada. Integrating caries risk assessment (CRA) into primary care settings could improve early detection and intervention. Objectives This qualitative study explored the barriers to implementing and integrating the Canadian CRA tool into the primary care of First Nations and Métis children in Manitoba, based on the perspectives of non-dental primary care providers (NDPCPs). Methods Fifty NDPCPs providing care to Indigenous children under six years of age were purposefully selected from ten Indigenous communities in Manitoba, including Winnipeg, Selkirk, St. Laurent, Swan River, Pine Creek, Camperville, and Pine Falls. The study employed an exploratory design, with data collected through eight focus groups and twelve in-depth key informant interviews conducted between April 2023 and September 2024. All interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis with NVivo software. Results Participants included pediatricians, family physicians, public health nurses, nurse practitioners, physician assistants, dietitians, and child development workers, with an average age of 41 years (range: 24–61) and 13 years of practice experience (range: 1–40). Thematic analysis identified four major barriers to integrating the CRA tool: (1) Service provider level – time constraint, scope of practice, documentation/referral pathways, and funding; (2) Community level – oral care not priority, separation of dental and general health, lack of transportation, and healthcare distrust; (3) Caregiver and child level – lack of dental insurance, parental willingness, substituting CRA for dental visit; and (4) Provider training and skills – lack of training on fluoride varnish application and dental screening. Despite these challenges, participants expressed a positive attitude toward receiving training on early childhood caries prevention, fluoride application, and the use of the Canadian CRA tool. Conclusion This study highlights that NDPCPs in Manitoba recognize the Canadian CRA tool as a valuable resource for improving access to early preventive dental care for First Nations and Métis children. The identified barriers provide critical insights for dental, medical, and allied healthcare providers, offering a foundation for developing strategies, guidelines, and policies to enhance preventive oral health services for Indigenous children in Manitoba
Investigating sex-related differences in renal tissues from prohibitin-1 knock-in mouse models
No full textBiological sex-related differences are present in many aspects of renal biology and pathobiology. However, our knowledge of the underlying mechanisms is currently limited. Prohibitin-1 (PHB1) is an evolutionarily conserved pleiotropic protein. Transgenic mouse models of PHB1 have revealed its role in sex differences in adipose and immune functions. However, it is not known whether PHB1 plays a role in sex differences in other cell and tissue types. To explore this at the systemic level, we focused on two key conserved post-translational modification sites in PHB1 (i.e., the Cys69 and Tyr114 residues) and developed Phb1C69A and Phb1Y114F knock-in mouse models (together referred to as the Phb1-Ki mice, unless specified separately). The Phb1-Ki mice displayed both similarities and dissimilarities in sex differences in their immunometabolic phenotypes, signifying the importance of Cys69- and Tyr114-linked functions in the sexually dimorphic features of PHB1. Interestingly, an increase in kidney mass was found in the Phb1-Ki mice. The Phb1-KiY114F mice had significantly larger kidneys than the Phb1-KiC69A mice and wild-type mice. Further analysis of kidney samples from the Phb1-Ki mice showed structural differences in renal tubules and glomeruli. Particularly, a dysregulation of mitochondrial structure in tubular epithelial cells and increase in glomerular size was observed, which were more pronounced in the male Phb1-KiY114F mice. Moreover, lipid droplets were frequently encountered in tubular epithelial cells from the male Phb1-KiC69A mice, whereas an accumulation of damaged mitochondria and immune cell infiltration were more apparent in the male Phb1-KiY114F mice. Notably, sex differences in ubiquitin proteasome activity was apparent between the wild-type male and female mice, which was differently affected in renal tissues from the male and female Phb1-Ki mice and inversely correlated with the accumulation of the damaged mitochondria in tubular epithelial cells. In addition, sex-related differences in IGF1 receptor-mTOR singling and in the markers of mitochondrial dynamics were found in the Phb1-Ki mice, which were differently altered in the Phb1-KiC69A mice and Phb1-KiY114F mice. These cellular and molecular changes correlated with the observed changes at the organ level, including sex-related differences. Collectively, the research findings herein suggest that PHB1’s Cys69- and Tyr114-linked functions play a role in sex differences in renal biology, which was previously unknown. The Phb1-Ki mouse models have created new opportunities to advance our understanding in this field. A better understanding of sex differences in renal biology and pathobiology may open opportunities for better management and treatment of renal diseases, which is a prevalent health problem worldwide.October 202