Research

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  • A multidisciplinary collaborative web site for cardiovascular surgery
    A multidisciplinary collaborative web site for cardiovascular surgery
    Key Points: * Patients, healthcare providers, and students have differing information needs in regard to surgical procedures. * Often, separate information sources are designed for each group, resulting in fragmented information. * Interactive, multidisciplinary, collaborative Web site is being developed to address the needs of all members of the healthcare team. Cardiovascular surgical (CVS) settings encompass shared physical spaces that are accessible to patients, physicians, nurses, residents, and other members of the healthcare team.1 Dynamic, fluid interactions are constantly occurring among various members of the team at any point in time.1 Within these interactions, each member seeks to meet unique information and communication needs. For example, patients require information and support for learning and application of new self-care behavior skills, residents and students require mentorship to guide practice, and nurses and physicians require up-to-date empirical and theoretical information to revise and evaluate existing care endeavors. Traditionally, separate resources have been designed and administered for each member of the healthcare team; however, a single intervention that addresses the needs of each member of a multidisciplinary team has not been designed or evaluated.2,3 We developed an interactive, multidisciplinary, collaborative Web site as an intervention designed to address the needs of all members of the healthcare team, including patients. The Web site addresses the needs of postoperative patients, cardiovascular medical residents, nursing students, and other trainees, as well as nurses and physicians. In doing so, the site mimics the collective functioning of the existing healthcare teams within a shared physical space. The Web site can be accessed by different members of the healthcare team anywhere there is a wireless connection, and so it does not depend on shared physical space. Furthermore, it allows for interactive discussion through online chat rooms and open forums. As a result of this Web site, we anticipate an increase in the quality of patient care that is delivered within the CVS setting., Fredericks, S. (2015). A multidisciplinary collaborative web site for cardiovascular surgery. Computers Informatics Nursing, 33(7), 273-277. DOI: 10.1097/CIN.0000000000000167.
    A new life for Old City Hall
    A new life for Old City Hall
    Possible future uses for Toronto’s iconic Old City Hall with case studies from around town and across the globe. In 2015, City of Toronto staff embarked on a study to determine future uses for Old City Hall, a beloved landmark in the heart of Canada’s largest city. This report does not put forth recommendations, but intends to spark creative thinking and inspire a public discussion., Carter-Shamai, S., & Nelischer, C. (2016). A new life for Old City Hall. Toronto: Ryerson University, City Building Institute, Faculty of Community Services.
    A note on cash-in-advance constraints in continuous time
    A note on cash-in-advance constraints in continuous time
    This paper demonstrates a robust proof of the continuous-time transformations of Stockman's cash-in-advance constraints. When the constraint applies to consumption and capital purchases, monetary growth lowers steady state consumption and capital. When the constraint applies only to consumption purchases, monetary growth is superneutral., Originally published as: Kam, E. (2004). A note on cash-in-advance constraints in continuous time. Economics Bulletin, 5(4), 1-8. Publisher URL: http://www.accessecon.com/pubs/EB/default.aspx?topic=Abstract&PaperID=EB-03E00008
    A novel radiant floor system: detailed characterization and comparison with traditional radiant systems
    A novel radiant floor system: detailed characterization and comparison with traditional radiant systems
    Abstract: Radiant floor systems have the potential to reduce energy consumption and the carbon footprint of buildings. This study analyzed a novel radiant panel configuration comprising a metal plate with small spikes that can be pressed into cement board or wood. The behaviour of this configuration was simulated for different materials for the metal plate, spike dimensions, and varying spacing between spikes. An annual energy simulation model compared the radiant panel configuration with traditional concrete-based system. Simulations were run under heating dominant, cooling dominant, and neutral conditions; significant cost savings and greenhouse gas emission reduction were seen across all scenarios. Keywords: Metal plate with spikes; radiant floor heating and cooling; energy efficiency; thermal comfort; computer simulation; economic optimization, Saunak Shukla, Reza Daneshazarian, Aggrey Mwesigye, Wey H. Leong & Seth B. Dworkin (2020) A novel radiant floor system: Detailed characterization and comparison with traditional radiant systems, International Journal of Green Energy, 17:2, 137-148, DOI: 10.1080/15435075.2019.1708366
    A portrait of school community service programs in Canada
    A portrait of school community service programs in Canada
    Although community service programs are to be found across the Canadian landscape, there have been no national initiatives to standardize programs. Thus, the place and nature of community service in high school curricula vary significantly among the 13 educational jurisdictions in Canada. The greatest differences however, are to be found among individual schools within each jurisdiction. This paper presents findings from interviews with key-informants to provide a more in-depth portrait of the programs in Canadian schools. Community service practices in Canadian schools are then discussed in the context of “best practices” as described in the literature Keywords: CVSS, Centre for Voluntary Sector Studies, Working Paper Series,TRSM, Ted Rogers School of Management Citation:, Meinhard, A. & Brown, S. (2007). A portrait of school community service programs in Canada (Working Paper Series Volume 2007 (1)). Toronto: Ted Rogers School of Management, Centre for Voluntary Sector Studies, Ryerson University.
    A practical servomotor project: combining the Web with simulation tools to solidify concepts in undergraduate control education
    A practical servomotor project: combining the Web with simulation tools to solidify concepts in undergraduate control education
    Proceedings of the 1998 American Control Conference. 21-26 Jun 1998: Volume 2: 1309-1313.
    A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder
    A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder
    Background: Posttraumatic Stress Disorder (PTSD) is a serious mental health condition with substantial costs to individuals and society. Among military veterans, the lifetime prevalence of PTSD has been estimated to be as high as 20%. Numerous research studies have demonstrated that short-term cognitive-behavioral psychotherapies, such as Cognitive Processing Therapy (CPT), lead to substantial and sustained improvements in PTSD symptoms. Despite known benefits, only a minority of clinicians provide these therapies. Transferring this research knowledge into clinical settings remains one of the largest hurdles to improving the health of veterans with PTSD. Attending a workshop alone is insufficient to promote adequate knowledge transfer and sustained skill; however, relatively little research has been conducted to identify effective post-training support strategies. Methods: The current study investigates whether clinicians receiving post-workshop support (six-month duration) will deliver CPT with greater fidelity (i.e., psychotherapy adherence and competence) and have improved patient outcomes compared with clinicians receiving no formal post-workshop support. The study conditions are: technology-enhanced group tele-consultation; standard group tele-consultation; and fidelity assessment with no consultation. The primary outcome is independent assessment (via audio-recordings) of the clinicians’ adherence and competence in delivering CPT. The secondary outcome is observed changes in patient symptoms during and following treatment as a function of clinician fidelity. Post-consultation interviews with clinicians will help identify facilitators and barriers to psychotherapy skill acquisition. The study results will inform how best to implement and transfer evidence-based psychotherapy (e.g., CPT) to clinical settings to attain comparable outcomes to those observed in research settings. Discussion: Findings will deepen our understanding of how much and what type of support is needed following a workshop to help clinicians become proficient in delivering a new protocol. Several influences on clinician learning and patient outcomes will be discussed. An evidence-based model of clinical consultation will be developed, with the ultimate goal of informing policy and influencing best practice in clinical consultation. Trial registration: ClinicalTrials.gov: NCT01861769, Wiltsey Stirman, S., Shields, N., Deloriea, J., Landy, M. S. H., Belus, J. M., Maslej, M. M., & Monson, C. M. (2013). A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder. Implementation Science : IS, 8, 82.
    A realist review of brief interventions for alcohol misuse delivered in emergency departments
    A realist review of brief interventions for alcohol misuse delivered in emergency departments
    Background: Brief interventions (BIs) involve screening for alcohol misuse and providing feedback to patients about their use, with the aim of reducing alcohol consumption and related consequences. BIs have been implemented in various healthcare settings, including emergency departments (ED), where they have been found to contribute mixed results in their ability to address alcohol misuse among adults. Mechanisms through which BIs work and contextual factors impacting BI effectiveness are not clear. The purpose of this review was to understand how, for whom, and under what circumstances BIs work for adults misusing alcohol and who have been admitted to an ED. A realist review was chosen to answer these questions as realist reviews create context-mechanism-outcome configurations, leading to the development of comprehensive and detailed theories; in this case explaining how and for whom BIs work. Methods: Databases including PsycINFO, Healthstar, CINAHL, Medline, and Nursing and Allied Health were searched for articles published until December 2013. The search strategy focused on studies examining BIs that targeted alcohol misuse among adults admitted into the ED. The search identified 145 relevant abstracts, of which 36 were included in the review. The literature was synthesized qualitatively (immersion/crystallization). Results: Four mechanisms were found within reviewed studies, including engagement in/retention of BI materials, resolving ambivalence, increased awareness/insight into consequences of drinking, and increased self-efficacy/empowerment to use skills for change. The following contexts were found to impact mechanisms: emotional state, injury attributed to alcohol use, severity of alcohol use, and baseline stage of change. Conclusions: This realist review provides advances in theories regarding which mechanisms to target during a BI and which contexts create the most favorable conditions for these mechanisms to occur, ultimately leading to optimal BI outcomes. These results can inform future clinical decision-making when delivering BIs in ED settings. Future research should conduct quantitative examination to confirm these findings. Systematic review registration: PROSPERO CRD42013006549, Davey, C. J., Landy, M. S. H., Pecora, A., Quintero, D., & McShane, K. E. (2015). A realist review of brief interventions for alcohol misuse delivered in emergency departments. Systematic Reviews, 4(1), 45.
    A realistic review of family-based interventions for children of substance abusing parents.
    A realistic review of family-based interventions for children of substance abusing parents.
    Background Millions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field. Methods Realist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data. Results Programs originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Conclusions This review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed., Usher, A. M., McShane, K. E., & Dwyer, C. (2015). A realist review of family-based interventions for children of substance abusing parents. Systemic Reviews, 4, 177. doi:10.1186/s13643-015-0158-4
    A regional spatial-retrofitting approach to geovisualise regional urban growth: An application to the Golden Horseshoe in Canada
    A regional spatial-retrofitting approach to geovisualise regional urban growth: An application to the Golden Horseshoe in Canada
    Understanding urban change in particular for larger regions has been a great demur in both regional planning and geography. One of the main challenges has been linked to the potential of modelling urban change. The absence of spatial data and size of areas of study limit the traditional urban monitoring approaches, which also do not take into account visualization techniques that share information with the community. This is the case of the Golden Horseshoe in southern Ontario in Canada, one of the fastest growing regions in North America. An unprecedented change on the urban environment has been witnessed, leading to an increased importance of awareness for future planning in the region. With a population greater than 8 million, the Golden Horseshoe is steadily showing symptoms of becoming a mega-urban region, joining surrounding cities into a single and diversified urban landscape. However, little effort has been done to understand these changes, nor to share information with policy makers, stakeholders and investors. These players are in need of the most diverse information on urban land use, which is seldom available from a single source. The spatio-temporal effect of the growth of this urban region could very well be the birth of yet another North American megacity. Therefore, from a spatial perspective there is demand for joint collaboration and adoption of a regional science perspective including land use and spatio-temporal configurations. This calls forth a novel technique that allows for assessment of urban and regional change, and supports decision-making without having the usual concerns of locational data availability. It is this sense, that we present a spatial-retrofitting model, with the objective of (i) retrofitting spatial land use based on current land use and land cover, and assessing proportional change in the past, leading to four spatial timestamps of the Golden Horseshoe’s land use, while (ii) integrating this in a multi-user open source web environment to facilitate synergies for decision-making. This combined approach is referred to as a regional-spatial-retrofitting approach (RSRA), where the conclusions permit accurate assessment of land use in past time frames based on Landsat imagery. The RSRA also allows for a collective vision of regional urban growth supporting local governance through a decision-making process adhering to Volunteered Geographic Information Systems. Urban land use change can be refined by means of contribution from end-users through a web environment, leading to a constant understanding and monitoring of urban land use and urban land use change.
    A regression  model explaining predisposition to collaborate
    A regression model explaining predisposition to collaborate
    [First paragraph of Introduction]: In Canada the last two decades of the 20th century have been characterized by government policies that focus on stimulating the economy as a strategy for improving overall quality of life. This Ahard right turn@ has made tax cuts a priority over social program expenditures, and private sector efficiencies have been promoted as the most effective response to financial challenges (Jeffrey, 1999; McBride & Shields, 1997; Tester, 1996). Voluntary organizations in Canada have had to adapt to this new environment. Both federal and provincial governments have been withdrawing from direct service provision in several areas of social welfare with the expectation that the voluntary sector will fill any resulting gaps in the social safety net. At the same time, a decrease in government support for the voluntary sector has limited its capacity to respond to an increased demand for its services (Hall & Banting, 2000). In Canada, on average 64% of revenues for voluntary organizations have come from government grants and payments (Hall & Macpherson, 1997). The federal government limited transfer payments for various social programs (Tester, 1996), and as a result, the provinces began a systematic retrenchment of these programs (Torjman, 1996). With such intense dependence on the government, any change in transfer payments is bound to have a noticeable impact on the sector (Rice & Prince, 2000). This paper focuses on interorganizational activities among voluntary organizations as a response to the funding changes being experienced by the sector. Specifically, we develop a model that presents collaborative behaviour as a function of organizational characteristics, environmental pressures and organizational attitudes. Keywords: CVSS, Centre for Voluntary Sector Studies, Working Paper Series,TRSM, Ted Rogers School of Management Citation:, Foster, M. K. & Meinhard, A.G. (2001). A Regression Model Explaining Predisposition to Collaboration. (Working Paper Series 2001 (2)). Toronto : Ted Rogers School of Management, Centre for Volunteer Sector Studies, Ryerson University.
    A review of mathematical models of influenza A infections within a host or cell culture: lessons learned and challenges ahead
    A review of mathematical models of influenza A infections within a host or cell culture: lessons learned and challenges ahead
    Most mathematical models used to study the dynamics of influenza A have thus far focused on the between-host population level, with the aim to inform public health decisions regarding issues such as drug and social distancing intervention strategies, antiviral stockpiling or vaccine distribution. Here, we investigate mathematical modeling of influenza infection spread at a different scale; namely that occurring within an individual host or a cell culture. We review the models that have been developed in the last decades and discuss their contributions to our understanding of the dynamics of influenza infections. We review kinetic parameters (e.g., viral clearance rate, lifespan of infected cells) and values obtained through fitting mathematical models, and contrast them with values obtained directly from experiments. We explore the symbiotic role of mathematical models and experimental assays in improving our quantitative understanding of influenza infection dynamics. We also discuss the challenges in developing better, more comprehensive models for the course of influenza infections within a host or cell culture. Finally, we explain the contributions of such modeling efforts to important public health issues, and suggest future modeling studies that can help to address additional questions relevant to public health., Beauchemin, C. A. A., & Handel, A. (2011). A review of mathematical models of influenza A infections within a host or cell culture: Lessons learned and challenges ahead. BMC Public Health, 11 Suppl 1(Suppl 1), S7-S7. doi:10.1186/1471-2458-11-S1-S7