Master of Science

thesisPremature infants are exposed to stressful events in the newborn intensive care unit (NICU). Neonatal stress is associated with increased adipose distribution to visceral depots (VAT). Adipose tissue, particularly VAT, produces two major cytokines associated with reducing insulin sensitivity, TNF-­?? and IL-­?6. Timed pregnant dams delivered at term (E21). Litters were culled to 10 pups (5 M, 5 F) and divided into three groups: control (CTL; maternal separation), neonatal stress (NS; maternal separation + injection + hypoxia/hyperoxia) and NS + MTS (10 min of stroking and limb movement). Treatments were given from D6-­?10 and tissue was harvested on D120. VAT and subcutaneous (SAT) depots measures were detected using MRI and DXA. Serum levels of insulin, TNF-­?? and IL-­?6 were measured with ELISA, and cytokine mRNA levels in VAT and SAT were measured by real-­?time PCR. Protein expression was determined through western blotting

Development and implementation of the Ontario Stroke System: the use of evidence

<b>Introduction</b><br> The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. <br><b>Research Objective</b> <br> To identify the role evidence played in the development and implementation of the Ontario Stroke System. <br><b><title>Methods</b> This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery.<br> <b>Results</b><br> Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1) informing system development; 2) mobilizing governmental support; 3) getting the system up and running; and 4) integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1) human capacity and 2) mechanisms to share evidence. <br> <b>Conclusion</b><br> This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery

“Get back on the horse and start over again”: Long-Term Effects of a Diabetes Self-Management Education (DSME) Program in an Underserved Population

Purpose: The purpose of this retrospective, mixed methods study is to examine the relationship between participation in an interdisciplinary diabetes self-management education (DSME) program at an urban primary health care center and patients’ perceived knowledge and skills, as well as clinical markers, on four cohorts of patients over a two-year period. Methods: Participants, mainly African-American females, responded to survey questions including self-care behaviors, perceived knowledge, and self-efficacy. The researchers also reviewed the participants’ clinical records for glycosylated hemoglobin (HbA 1c) and body mass index (BMI) data and compared these to similar patients in the health center who had not participated in the DSME program. Additional analysis involved a cross comparison of earlier cohorts (2014-15) to later cohorts (2016-17). Results: Quantitative analysis showed strong statistical evidence that those in the DSME program had more control over their BMI as compared to the control group. The results also suggested that those in the program after 2016 had more control over their HbA1c than those in the program before 2016, although this evidence was more limited. Qualitative themes that emerged highlighted the participants’ valuing most what they learned about nutrition, exercise, and disease management. Conclusions: Population specific DSME programs can help produce both quality of life and clinical improvements that persist over time in underserved populations. This study was limited by a small sample size

Strategies for mitigating N2O and N2 emissions from an intensive sugarcane cropping system

In sugarcane cropping systems, high rates of N fertiliser are typically applied as sub-surface bands creating localised zones of high mineral N concentrations. This in combination with high levels of crop residue (trash) retention and a warm and humid climate creates conditions that are known to promote soil denitrification, resulting in high emissions of the potent greenhouse gas N2O. These losses illustrate inefficient use of N fertilisers but total denitrification losses in the form of N2 and N2O remain largely unknown. We used the 15N gas flux method to investigate the effect of cane trash removal and the use of the nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) on N2 and N2O emissions on a commercial sugarcane farm at Bundaberg, Australia. High gaseous N losses were observed under the standard grower practice where cane trash retention and N fertiliser application (145 kg N ha−1 as urea) resulted in N2 and N2O emissions (36.1 kg N ha−1) from the subsurface N fertiliser band, with more than 50% of these losses emitted as N2O. Cane trash removal reduced N2 emission by 34% and N2O emission by 51%, but had no effect on the N2O/(N2 + N2O) ratio. The use of DMPP lowered N2 and N2O emission by 35% and 98%, respectively, reducing the percentage of these losses (N2 + N2O) emitted as N2O to only 4%. We conclude that the use of DMPP is an effective strategy to reduce N losses, minimise N2O emissions, while keeping the benefits of cane trash retention in sugarcane cropping systems.</p

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

Palliative care has become an increasingly important public health issue due to the rising acceptance of implementing a health promoting palliative care approach. To explore communication pathways that would facilitate implementation of this approach, we conducted a scoping review examining communication and enactment of care plans for older adults with life-limiting illnesses across health, social and community sectors. We used a scoping review methodology to map the current literature on communication plans between primary care and other sectors (community, health, and social). Five databases were searched MEDLINE (ovid), CINAHL (EBSCO), EMBASE (Elsevier), PsychInfo (EBSCO), and Scopus. The database search identified 5,289 records, after screening and hand-searching a total of 28 articles were extracted. Three major themes were determined through the records: (1) the importance of professional relationships across sectors, (2) the importance of community navigators in sharing the care plan, and (3) and creating comprehensive and multidisciplinary care plans. Findings suggested that enacting quality care plans is important to healthcare providers; the use of an electronic health records system can be useful in ensuring that all healthcare and community systems are in place to aid patients for better community-based care. Community navigators were also key to ensure that plans are communicated properly and efficiently. Further research is needed to determine how having a clear and properly implemented communication system for a healthcare system could facilitate community sector involvement in implementing care plans

Health service experiences and preferences of frail home care clients and their family and friend caregivers during the COVID-19 pandemic

Objective: The COVID-19 pandemic has brought about a major upheaval in the lives of older adults and their family/friend caregivers, including those utilizing home care services. In this article, we focus on results from a qualitative component added to a pragmatic randomized controlled trial that focuses on the experiences of our study participants during COVID-19. A total of 29 participants responded to the COVID-19 related questions focused on their health services experiences and preferences from March-June 2020 including 10 home care clients and 19 family/friend caregivers in the provinces of Ontario and Nova Scotia, Canada. Results: Many participants were affected drastically by the elimination or reduction of access to services, highlighting the vulnerability of home care clients and their caregivers during COVID-19. This took an emotional toll on home care clients and increased the need for family/friend caregiver support. While many participants expressed reduced desire to utilize residential long-term care homes, some caregivers found that passive remote monitoring technology was particularly useful within the COVID-19 context. Our results provide important insights into the ways the older adults and their caregivers have been affected during the COVID-19 context and how to better support them in the future

Atomic Structure and Dynamics of Single Platinum Atom Interactions with Monolayer MoS

We have studied atomic level interactions between single Pt atoms and the surface of monolayer MoS₂ using aberration-corrected annular dark field scanning transmission electron microscopy at an accelerating voltage of 60 kV. Strong contrast from single Pt atoms on the atomically resolved monolayer MoS₂ lattice enables their exact position to be determined with respect to the MoS₂ lattice, revealing stable binding sites. In regions of MoS₂ free from surface contamination, the Pt atoms are localized in S vacancy sites and exhibit dynamic hopping to nearby vacancy sites driven by the energy supplied by the electron beam. However, in areas of MoS₂ contaminated with carbon surface layers, the Pt atoms appear at various positions with respect to the underlying MoS₂ lattice, including on top of Mo and in off-axis positions. These variations are due to the Pt bonding with the surrounding amorphous carbon layer, which disrupts the intrinsic Pt-MoS₂ interactions, leading to more varied positions. Density functional theory (DFT) calculations reveal that Pt atoms on the surface of MoS₂ have a small barrier for migration and are stabilized when bound to either a single or double sulfur vacancies. DFT calculations have been used to understand how the catalytic activity of the MoS₂ basal plane for hydrogen evolution reaction is influenced by Pt dopants by variation of the hydrogen adsorption free energy. This strong dependence of catalytic effect on interfacial configurations is shown to be common for a series of dopants, which may provide a means to create and optimize reaction centers

OMPS Limb Profiler Instrument Performance Assessment

Following the successful launch of the Ozone Mapping and Profiler Suite (OMPS) aboard the Suomi National Polar-orbiting Partnership (SNPP) spacecraft, the NASA OMPS Limb team began an evaluation of instrument and data product performance. The focus of this paper is the instrument performance in relation to the original design criteria. Performance that is closer to expectations increases the likelihood that limb scatter measurements by SNPP OMPS and successor instruments can form the basis for accurate long-term monitoring of ozone vertical profiles. The team finds that the Limb instrument operates mostly as designed and basic performance meets or exceeds the original design criteria. Internally scattered stray light and sensor pointing knowledge are two design challenges with the potential to seriously degrade performance. A thorough prelaunch characterization of stray light supports software corrections that are accurate to within 1% in radiances up to 60 km for the wavelengths used in deriving ozone. Residual stray light errors at 1000nm, which is useful in retrievals of stratospheric aerosols, currently exceed 10%. Height registration errors in the range of 1 km to 2 km have been observed that cannot be fully explained by known error sources. An unexpected thermal sensitivity of the sensor also causes wavelengths and pointing to shift each orbit in the northern hemisphere. Spectral shifts of as much as 0.5nm in the ultraviolet and 5 nm in the visible, and up to 0.3 km shifts in registered height, must be corrected in ground processing