Manitoba Heritage Theses
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Contains full text Manitoba-related theses dating from 1902 to the present.
The University of Manitoba Libraries gratefully acknowledges the financial support of the Manitoba Department of Heritage, Culture, Tourism and Sport in the digitization of many of these theses.
The University of Manitoba Libraries gratefully acknowledges the financial support of the Manitoba Department of Heritage, Culture, Tourism and Sport in the digitization of many of these theses.
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- ItemOpen AccessExploring the experiences of physiotherapists who engaged as knowledge users in integrated knowledge translation research partnerships related to balance measurement practices in Canadian hospitals: a qualitative descriptive study(2023-12-07) MOSER, CHERYL ANN; Strachan, Leisha (Kinesiology and Recreation Management); Wittmeier, Kristy (Children's Hospital Research Institute of Manitoba); Sibley, Kathryn; Glazebrook, CherylBackground: Integrated knowledge translation (IKT) is an approach to doing health research that engages academic researchers and knowledge users (KU) as equal partners. IKT intends to increase the chances that resulting research evidence will be useful to those engaged, striving toward improved health system functioning and public health outcomes. With this study, I set out to learn what physiotherapists (PTs) had to say about their experience engaging as KUs in an IKT research partnership related to balance measurement practices in Canadian hospitals. Methods: I used basic qualitative descriptive research methodology, in vivo coding, and conventional content analysis to answer the research questions. Five PTs (n=5) who had engaged as KUs on three balance measurement studies in two provinces were purposefully selected. All five (n=5) participated in online semi-structured interviews. PTs were asked to describe their IKT engagement experience, identify environmental factors that affected their engagement, and discuss how their engagement influenced the research process and evidence use. PTs also characterized themselves using an independently completed pre-interview questionnaire. Results: Participants described their experiences as positive, meaningful, and associated with benefits such as more clinical treatment options, greater sense of personal pride and professional recognition among PTs, increased research capacity for host organizations, and specific contributions to a body of knowledge. PTs said factors conducive to IKT engagement were supportive organizational culture, as well as devoted time, money, material resources, and human resources. PTs described their contributions to research as brokering trusting relationships; providing an insider point-of-view, project management, and resource coordination; and contributing to increased organizational capacity for research. Participants described how evidence-use was impacted by PT career-stage, individual risk perception, usefulness to the profession, organizational culture, treatment environment (especially since COVID-19 introduced pressures to deliver health care online), and third-party endorsement for change. Conclusions: KU engagement in IKT health research partnerships provides researchers with increased clinical access, an insider point-of-view, and stronger research evidence. KU engagement increases the accessibility of resulting research evidence, but sustaining desired outcomes is another issue. The KU engagement experience is greatly affected by organizational culture. KU engagement concepts in IKT research partnerships must include feasibility and resource planning, as well as strategies for organizational change and risk management. PTs described external factors such as professional endorsement as being stronger influences on evidence use outcomes than research engagement. The IKT approach may be strengthened if issues related to change, risk, and resources are addressed early and often throughout the partnership.
- ItemOpen AccessUse of antiseizure medications during pregnancy and adverse neonatal outcomes(2024-04-22) Lavu, Alekhya; Falk, Jamison (Pharmacy); Chelsea, Ruth (Pediatrics and Child Health); De-Vera, Mary (University of British Columbia); Eltonsy, Sherif; Alessi-Severini, SilviaBackground: Epilepsy during pregnancy can lead to various adverse health outcomes in both pregnant people and infants. Furthermore, in-utero exposure to antiseizure medications (ASMs), employed in the management of epilepsy, is also associated with an increased risk of adverse birth outcomes. With the exponential increase in the use of ASMs over the last few decades, it is crucial to understand the safety of in-utero exposure to ASMs. In this thesis we aimed to evaluate the safety of ASMs in all pregnant people, pregnant people with epilepsy (PPWE) and pregnant people without epilepsy (PPWOE), using both evidence synthesis methods and real-world data. Methods: First, we conducted a systematic review and meta-analysis to evaluate the risk of adverse birth weight outcomes due to in-utero exposure to ASMs in the published literature from inception to March 23rd, 2022. (Chapter 2: Protocol & Chapter 3: Report). Second, we conducted two population-based cohort studies utilizing the administrative databases in Manitoba to study the safety of in-utero exposure to ASMs and gabapentin in pregnancy. We included all pregnant people in Manitoba between 1998-2021. In study 1 (Chapter 4: ASMs) we evaluated the ASMs safety and in study 2 (Chapter 5: gabapentin) we evaluated gabapentin safety among all pregnant people, PPWE and PPWOE. Results: In the systematic review, we found a significant association between in-utero exposure to all ASMs in pregnant people and small for gestational age (SGA), with relative risk (RR) 1.33 (95% CI 1.18 to 1.50, I2 74%), low birth weight (LBW) RR 1.54 (95% CI 1.33 to 1.77, I2 67%), and decreased birth weight with a mean difference (MD) of -118.87 (95% CI -161.03 to -76.71, I2 42%) g compared to unexposed pregnant people. We found similar results among PPWE when compared to unexposed pregnant people, but they did not reach statistical significance. In our cohort study, among all pregnant people exposed to ASMs we found a significant increased risk of SGA (adjusted odds ratio [aOR] 1.16, 95% CI 1.04-1.30), LBW (aOR 1.66, 95% CI 1.47-1.88), preterm birth (aOR 1.56, 95% CI 1.41-1.73), neonatal intensive care unit (NICU) admissions (aOR 1.91, 95% CI 1.74-2.10), and length of hospital stay (LOS) infant (aOR 1.68, 95% CI 1.56-1.82) when compared with unexposed pregnant people. We found similar results among PPWOE when compared with unexposed PPWOE. For gabapentin exposure, among all pregnant people we found a significant increased risk of LBW (aOR 1.95, 95% CI 1.58-2.41), preterm birth (aOR 1.68, 95% CI 1.39-2.03), NICU admissions (aOR 2.04, 95% CI 1.71-2.42), pregnant peoples LOS (aOR 1.33, 95% CI 1.15-1.54), infant LOS (aOR 2.09, 95% CI 1.81-2.41) compared to unexposed pregnant people. We found similar results among exposed PPWOE when compared with unexposed PPWOE. Conclusions: Both the choice of ASM use and the underlying condition (epilepsy) contribute to an elevated adverse risk during pregnancy. With the increased risk of adverse neonatal outcomes associated with in-utero exposure to ASMs, including gabapentin, clinicians should carefully assess the risk-benefit ratio before prescribing these medications. Moreover, the use of gabapentin requires caution among pregnant people.
- ItemOpen AccessLes modes substitutifs de résolution des différends en matière de violence à caractère sexuel ou de discrimination chez les institutions postsecondaires au Manitoba(2024-03-23) Lebois, Joel; Kennedy, Gerard (Law); Heckman, Gerald (Federal Court of Appeal); Turnbull, LornaLe règlement des différends en matière de violence à caractère sexuel ou de discrimination dans les établissements postsecondaires du Manitoba, dans sa forme actuelle, ne sert pas de façon optimale les intérêts des établissements ni des membres de leur collectivité. Les processus actuels de règlement des différends, largement inspirés du système de justice pénale, ne cadrent pas avec les missions et les objectifs de ces établissements et ne tiennent pas suffisamment compte du rôle unique que jouent les établissements postsecondaires dans le tissu social manitobain. Le modèle actuel est axé sur une détermination des faits dans un processus d’enquête qui est contradictoire pour les parties – soit où les parties sont des adversaires – et n’offre aucune occasion pour l’apprentissage ou la responsabilisation. De plus, il impose un lourd fardeau à toutes les parties concernées, prenant beaucoup de temps et d’énergie émotionnelle dans un système dichotomisé « tout ou rien » qui laisse souvent au moins une partie insatisfaite du résultat. Nous émettons l’hypothèse que dans le cas de comportements qui ne sont pas à la fois des comportements criminels, un changement vers des modes substitutifs de résolution des différends, avec l’intégration de la participation obligatoire comme partie fondamentale du processus de règlement des différends atténuerait une partie ou la totalité de ces lacunes. La transition permettrait non seulement d’accroître le niveau de satisfaction des participants, mais aussi d’assurer une meilleure harmonisation avec les valeurs fondamentales et la vision des établissements postsecondaires. Les options non décisionnelles offrent le potentiel de meilleurs résultats pour les participants, et s’alignent mieux avec une vision qui cherche à éduquer de jeunes adultes qui commettent des faux pas plutôt que les punir sans présenter une occasion de croissance.
- ItemOpen AccessAn examination of Dietary Inflammatory Index scores in a Canadian nationally representative sample(2024-02-09) Fleet, Kristen; Lengyel, Christina (Food and Human Nutritional Sciences); Urquia, Marcelo (Community Health Sciences); Reimer, Raylene (University of Calgary); Eck, Peter; Clara, IanThere is growing recognition that diet can influence an individual’s inflammation level and ultimately, their risk for developing disease (Minihane et al., 2015; Prasad et al., 2012). The Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of an individual’s diet and pro-inflammatory diets have been linked to numerous chronic diseases (Phillips et al., 2019). That said, there is a paucity of research examining the inflammatory nature of diets in Canada. The current project used data from the Canadian Community Health Survey – Nutrition 2015. The study sample consisted of adults aged 18-65, who were not pregnant. 24-hour dietary recalls were used to calculate DII and Health Eating Index – Canada (HEI-C) scores. Adherence to food guide recommendations was assessed using Health Canada’s four-tiered, grading system. The association between DII and HEI-C scores, as well as adherence to the Canadian Food Guide recommendations were measured. The influence of personal and external factors that influence diet and DII scores was examined using a structural equation modelling approach. Results indicated that there was an inverse relationship between adherence to food guide recommendations and DII scores; however, no significant relationship was observed for HEI-C scores. Higher DII scores were noted for individuals who were not married or had lower levels of education or income. The best fitting structural equation model included variables for sex, income, number of foods consumed and length of time since immigration. The findings in this thesis indicated that certain Canadian populations have significantly higher DII scores and this knowledge could lead to the development of effective interventions to promote the consumption of an anti-inflammatory diet.
- ItemOpen AccessAn evaluation of farmer-selected spring wheat genotypes from Canada's first organic participatory breeding program(2024-03-04) Carkner, Michelle; Duncan, Robert (Plant Science); Kumar, Santosh (Plant Science); Schneider, Kimberley (Soil Science); Döring, Thomas (University of Bonn); Entz, MartinDespite organic spring wheat’s (Triticum aestivum L.) economic and cultural importance to Canadian agriculture, breeding for organic production systems remains a challenge. Organic growing environments are different from conventional farms in terms of weed species and abundance, fertility, and soil biology. More specifically, many organic farms where most of the organic wheat in Canada is grown (Alberta, Saskatchewan, and Manitoba), are deficient in soil test phosphorus (P). To address these complex challenges, the unorthodox breeding model, participatory plant breeding (PPB), has been proposed. An organic PPB wheat program has been practiced across Canada over the past decade, providing an unprecedented opportunity to explore the influence that selection environment diversity has on the agronomic performance under organic management. Field trials testing 25 PPB genotypes against 6 check cultivars across 12 environments demonstrated three PPB genotypes and one check cultivar to be top yield performers. A second experiment compared a modern cultivar and a landrace cultivar used as parental material in the PPB program, as well as the product of two farmer-selected PPB genotypes by farmers in different geographic locations from the same cross. The genotypes were tested under P limited and P-amended organic conditions, to investigate resilience against P limited conditions. There were no significant differences in yield among genotypes. Farmer genotypes were similar to the modern parent cultivar for protein concentration and lodging severity, and similar to the landrace parent in plant height and kernel mass. More detailed measurements pertinent to phosphorus use, physiology, and uptake efficiency demonstrated that two different phosphorus uptake and use efficiency mechanisms may be occurring between the farmer genotypes. Overall, this research provides evidence that early generation farmer selection is an effective breeding strategy to create distinct genotypes with phenotypic characteristics that are beneficial for organic production systems in Canada. More research is needed to determine how PPB initiatives can better serve organic production systems with a focus on specific site selection at the early generation phase in combination with parental material that may enhance pest resistance and greater phosphorus uptake efficiency. A proposed model of future PPB breeding schemes with special attention to selection environment is presented.