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Article ; Online: A Novel, Wearable Inertial Measurement Unit for Stroke Survivors: Validity, Acceptability, and Usability.

Bishop, Lauri / Demers, Marika / Rowe, Justin / Zondervan, Daniel / Winstein, Carolee J

Archives of physical medicine and rehabilitation

2024

Abstract: Objective: To establish the concurrent validity, acceptability, and sensor optimization of a consumer-grade, wearable, multi-sensor system to capture quantity and quality metrics of mobility and upper limb movements in stroke survivors.: Design: ... ...

Abstract	Objective: To establish the concurrent validity, acceptability, and sensor optimization of a consumer-grade, wearable, multi-sensor system to capture quantity and quality metrics of mobility and upper limb movements in stroke survivors. Design: Single-session, cross-sectional. Setting: Clinical research laboratory. Participants: Thirty chronic stroke survivors (age 57 (10) years; 33% female) with mild to severe motor impairments participated. Interventions: Not Applicable. Main outcome measures: Participants donned 5 sensors and performed standardized assessments of mobility and upper limb (UL) movement. True/false, positive/negative time in active movement for the UL were calculated and compared to criterion-standards using an accuracy rate. Bland-Altman plots and linear regression models were used to establish concurrent validity of UL movement counts, step counts, and stance time symmetry of MiGo against established criterion-standard measures. Acceptability and sensor optimization were assessed through an end-user survey and decision matrix. Results: Mobility metrics showed excellent association with criterion-standards for step counts (video: r=0.988, P<.001, IMU: r=0.921, P<.001) and stance-time symmetry (r=0.722, P<.001). In the UL, movement counts showed excellent to good agreement (paretic: r=0.849, P<.001, nonparetic: r=0.672, P<.001). Accuracy of active movement time was 85.2% (paretic) and 88.0% (nonparetic) UL. Most participants (63.3%) had difficulty donning/doffing the sensors. Acceptability was high (4.2/5). Conclusions: The sensors demonstrated excellent concurrent validity for mobility metrics and UL movements of stroke survivors. Acceptability of the system was high, but alternative wristbands should be considered.
Language	English
Publishing date	2024-03-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2024.01.020
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Article ; Online: Evaluating a Video-Based Addiction Curriculum at a Safety Net Academic Medical Center.

Peterkin, Alyssa F / Baldwin, Marielle / Demers, Lindsay / Gergen Barnett, Katherine

Substance abuse

2023 Volume 44, Issue 3, Page(s) 241–248

Abstract: Background: Since 2019, the United States (US) has witnessed an unprecedented increase in drug overdose and alcohol-related deaths. Despite this rise in morbidity and mortality, treatment rates for substance use disorder remain inadequate. Insufficient ... ...

Abstract	Background: Since 2019, the United States (US) has witnessed an unprecedented increase in drug overdose and alcohol-related deaths. Despite this rise in morbidity and mortality, treatment rates for substance use disorder remain inadequate. Insufficient training in addiction along with a dearth of addiction providers are key barriers to addressing the current addiction epidemic. Addiction-related clinical experiences can improve trainee knowledge, yet they remain dependent on practice sites and residency training environments. Asynchronous learning, in the form of video-based modules, may serve as a complement to formal, scheduled lectures and clinical experiences. Objectives: To evaluate the educational impact of a video-based addiction curriculum in 2 residency programs at a large safety net academic medical center with a high volume of patients with substance use disorders. Methods: Family Medicine (FM) and Internal Medicine (IM) residency interns (PGY1s) (n = 60) had access to 28 minutes of video content related to opioid use disorder (OUD) and alcohol use disorder (AUD) during the first 2 months of their residency training. Interns were asked to complete voluntary and anonymized pre- and post-surveys in Qualtrics that included knowledge and confidence-based questions about the management of OUD and AUD, in addition to questions about prior exposure to and future interests in addiction training and practice. Data were analyzed with non-parametric sign tests. Results: Twenty-eight interns completed both OUD pre- and post-surveys, and 24 interns completed all AUD survey questions. There was a statistically significant increase in the number of interns who reported increased knowledge of and confidence around diagnosis, management, and ability to provide evidence-based treatment recommendations for both OUD and AUD. Conclusions: Brief addiction focused video-modules can improve confidence and knowledge in managing OUD and AUD among medical trainees.
Language	English
Publishing date	2023-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1458030-5
ISSN	1547-0164 ; 0889-7077
ISSN (online)	1547-0164
ISSN	0889-7077
DOI	10.1177/08897077231195995
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Article ; Online: Project Inclusive Genetics: Protecting reproductive autonomy from bias via prenatal patient-centered counseling.

Jungels, Apolline / Demers, Lindsay / Ford, Eric / Stevens, Blair K / Sabatello, Maya / Dasgupta, Shoumita

HGG advances

2023 Volume 4, Issue 4, Page(s) 100228

Abstract: Clinician bias negatively impacts the healthcare received by marginalized communities. In this study, we explored factors that influence clinician and trainee bias against individuals with intellectual disabilities and its impact on clinical judgment in ... ...

Abstract	Clinician bias negatively impacts the healthcare received by marginalized communities. In this study, we explored factors that influence clinician and trainee bias against individuals with intellectual disabilities and its impact on clinical judgment in prenatal genetic testing settings. Specifically, we examined bias toward a fetus with a higher chance of developing a disability. We compared genetics specialists with their non-expert counterparts. This web-based study included clinical vignettes, implicit association tests (IATs), and an educational module. 595 participants were recruited via their institution or professional society. We conducted statistical analyses, including regression models controlling for key demographic characteristics, to analyze recommendation patterns and degree of change after the module. Genetics expertise strongly correlated with appropriate testing recommendation when the patient would not consider pregnancy termination (r = 1.784 pre-module, r = 1.502 post-module, p < 0.01). Factors that influenced pre-module recommendation to test include increased age (r = -0.029, p < 0.05), high religiosity (r = 0.525, p < 0.05), and participant personal preference against testing (r = 1.112, p < 0.01). Responses among participants without genetics expertise improved after the educational module (
MeSH term(s)	Female ; Pregnancy ; Humans ; Reproduction ; Educational Status ; Family Planning Services ; Intellectual Disability/genetics ; Patient-Centered Care ; Counseling
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ISSN	2666-2477
ISSN (online)	2666-2477
DOI	10.1016/j.xhgg.2023.100228
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Article ; Online: Reliable, Fast and Stable Contrast Response Function Estimation.

Cortes, Nelson / Demers, Marc / Ady, Visou / Ikan, Lamyae / Casanova, Christian

Vision (Basel, Switzerland)

2022 Volume 6, Issue 4

Abstract: A study was conducted to determine stable cortical contrast response functions (CRFs) accurately and repeatedly in the shortest possible experimentation time. The method consisted of searching for experimental temporal aspects (number and duration of ... ...

Abstract	A study was conducted to determine stable cortical contrast response functions (CRFs) accurately and repeatedly in the shortest possible experimentation time. The method consisted of searching for experimental temporal aspects (number and duration of trials and number and distribution of contrasts used) with a model based on inhomogeneous Poisson spike trains to varying contrast levels. The set of values providing both short experimental duration and maximizing fit of the CRFs were saved, and then tested on cats' visual cortical neurons. Our analysis revealed that 4 sets of parameters with less or equal to 6 experimental visual contrasts satisfied our premise of obtaining good CRFs' performance in a short recording period, in which the number of trials seems to be the experimental condition that stabilizes the fit.
Language	English
Publishing date	2022-10-17
Publishing country	Switzerland
Document type	Journal Article
ISSN	2411-5150
ISSN (online)	2411-5150
DOI	10.3390/vision6040062
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Article ; Online: No place like home: Student and faculty perspectives on the value of house calls in medical education.

Cetrone, Emily / Young, Megan / Demers, Lindsay

Journal of the American Geriatrics Society

2021 Volume 70, Issue 1, Page(s) E1–E4

MeSH term(s)	Attitude of Health Personnel ; Education, Medical/organization & administration ; Faculty, Medical ; Geriatrics/education ; House Calls ; Humans ; Qualitative Research ; Students, Medical
Language	English
Publishing date	2021-10-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.17505
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Article: Wearable technology to capture arm use of stroke survivors in home and community settings: feasibility and early insights on motor performance.

Demers, Marika / Bishop, Lauri / Cain, Amelia / Saba, Joseph / Rowe, Justin / Zondervan, Daniel / Winstein, Carolee

medRxiv : the preprint server for health sciences

2023

Abstract: Objective: To establish short-term feasibility and usability of wrist-worn wearable sensors to capture arm/hand activity of stroke survivors and to explore : Methods: 30 chronic stroke survivors were monitored with wrist-worn wearable sensors during ... ...

Abstract	Objective: To establish short-term feasibility and usability of wrist-worn wearable sensors to capture arm/hand activity of stroke survivors and to explore Methods: 30 chronic stroke survivors were monitored with wrist-worn wearable sensors during 12h/day for a 7-day period. Participants also completed standardized assessments to capture stroke severity, arm motor impairments, self-perceived arm use and self-efficacy. Usability of the wearable sensors was assessed using the adapted System Usability Scale and an exit interview. Associations between motor performance and capacity (arm/hand impairments and activity limitations) were assessed using Spearman's correlations. Results: Minimal technical issues or lack of adherence to the wearing schedule occurred, with 87.6% of days procuring valid data from both sensors. Average sensor wear time was 12.6 (standard deviation: 0.2) h/day. Three participants experienced discomfort with one of the wristbands and three other participants had unrelated adverse events. There were positive self-reported usability scores (mean: 85.4/100) and high user satisfaction. Significant correlations were observed for measures of motor capacity and self-efficacy with paretic arm use in the home and the community (Spearman's correlation ρs: 0.44-0.71). Conclusions: This work demonstrates the feasibility and usability of a consumer-grade wearable sensor to capture paretic arm activity outside the laboratory. It provides early insight into stroke survivors' everyday arm use and related factors such as motor capacity and self-efficacy. Impact: The integration of wearable technologies into clinical practice offers new possibilities to complement in-person clinical assessments and to better understand how each person is moving outside of therapy and throughout the recovery and reintegration phase. Insights gained from monitoring stroke survivors arm/hand use in the home and community is the first step towards informing future research with an emphasis on causal mechanisms with clinical relevance.
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.01.25.23284790
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Article ; Online: Cancer Risks among Emergency Medical Services Workers in Ontario, Canada.

Sritharan, Jeavana / Demers, Paul A / Eros, Fanni R / Berriault, Colin / Dakouo, Mamadou / Kirkham, Tracy L

Prehospital emergency care

2023 , Page(s) 1–6

Abstract: Objectives: Emergency medical services workers, such as paramedics, provide important emergency care and may be exposed to potential carcinogens while working. Few studies have examined the risk of cancer among paramedics demonstrating an important ... ...

Abstract	Objectives: Emergency medical services workers, such as paramedics, provide important emergency care and may be exposed to potential carcinogens while working. Few studies have examined the risk of cancer among paramedics demonstrating an important knowledge gap in existing literature. This study aimed to investigate cancer risks among paramedics in a large cohort of Ontario workers. Methods: Paramedics were identified in the Occupational Disease Surveillance System (ODSS) from 1996 to 2019. The ODSS was established by linking lost-time worker's compensation claims to administrative health data, including the Ontario Cancer Registry to identify incident cases of cancer. Cox-proportional hazard models were used to calculate age and sex-adjusted hazard ratios and 95% confidence intervals to estimate the risk of cancer among paramedics compared to all other workers in the ODSS. Results: A total of 7240 paramedics were identified, with just over half of the paramedics identifying as male similar to the overall ODSS cohort. Paramedics had a statistically significant elevated risk of any cancer (HR 1.19, 95% CI 1.06-1.34), and elevated risks for melanoma (HR 2.18, 95% CI 1.46-3.26) and prostate cancer (HR 1.73, 95% CI 1.34-2.22). Paramedics had a statistically significant reduced risk for lung cancer (HR 0.48, 95% CI 0.28-0.83). Findings were similar to cancer risks identified in firefighters and police in the same cohort. Conclusions: This study contributes valuable findings to understanding cancer risks among paramedics and further supports the existing evidence on the increased risk of cancer among emergency medical services workers. We have observed some similar results for firefighters and police, which may be explained by similar exposures, including vehicle exhaust, shiftwork, and intermittent solar radiation. This can lead to a better understanding of carcinogens and other exposures among paramedics and inform cancer prevention strategies.
Language	English
Publishing date	2023-11-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1461751-1
ISSN	1545-0066 ; 1090-3127
ISSN (online)	1545-0066
ISSN	1090-3127
DOI	10.1080/10903127.2023.2283079
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Article ; Online: Wearable Technology to Capture Arm Use of People With Stroke in Home and Community Settings: Feasibility and Early Insights on Motor Performance.

Demers, Marika / Bishop, Lauri / Cain, Amelia / Saba, Joseph / Rowe, Justin / Zondervan, Daniel K / Winstein, Carolee J

Physical therapy

2024 Volume 104, Issue 2

Abstract: Objective: The objectives of this study were to establish the short-term feasibility and usability of wrist-worn wearable sensors for capturing the arm and hand activity of people with stroke and to explore the association between factors related to the ...

Abstract	Objective: The objectives of this study were to establish the short-term feasibility and usability of wrist-worn wearable sensors for capturing the arm and hand activity of people with stroke and to explore the association between factors related to the use of the paretic arm and hand. Methods: Thirty people with chronic stroke were monitored with wrist-worn wearable sensors for 12 hours per day for a 7-day period. Participants also completed standardized assessments to capture stroke severity, arm motor impairments, self-perceived arm use, and self-efficacy. The usability of the wearable sensors was assessed using the adapted System Usability Scale and an exit interview. Associations between motor performance and capacity (arm and hand impairments and activity limitations) were assessed using Spearman correlations. Results: Minimal technical issues or lack of adherence to the wearing schedule occurred, with 87.6% of days procuring valid data from both sensors. The average sensor wear time was 12.6 (standard deviation [SD] = 0.2) hours per day. Three participants experienced discomfort with 1 of the wristbands, and 3 other participants had unrelated adverse events. There were positive self-reported usability scores (mean = 85.4/100) and high user satisfaction. Significant correlations were observed for measures of motor capacity and self-efficacy with paretic arm use in the home and the community (Spearman correlation coefficients = 0.44-0.71). Conclusions: This work demonstrates the feasibility and usability of a consumer-grade wearable sensor for capturing paretic arm activity outside the laboratory. It provides early insight into the everyday arm use of people with stroke and related factors, such as motor capacity and self-efficacy. Impact: The integration of wearable technologies into clinical practice offers new possibilities to complement in-person clinical assessments and to better understand how each person is moving outside of therapy and throughout the recovery and reintegration phase. Insight gained from monitoring the arm and hand use of people with stroke in the home and community is the first step toward informing future research with an emphasis on causal mechanisms with clinical relevance.
MeSH term(s)	Humans ; Arm ; Stroke Rehabilitation ; Feasibility Studies ; Stroke/complications ; Wearable Electronic Devices
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	415886-6
ISSN	1538-6724 ; 0031-9023
ISSN (online)	1538-6724
ISSN	0031-9023
DOI	10.1093/ptj/pzad172
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Article ; Online: Risk of chronic obstructive pulmonary disease in a large cohort of Ontario, Canada workers.

Sritharan, Jeavana / Arrandale, Victoria H / Kirkham, Tracy L / Dakouo, Mamadou / MacLeod, Jill S / Demers, Paul A

Scientific reports

2024 Volume 14, Issue 1, Page(s) 8756

Abstract: Although several occupational exposures have been linked to the risk of COPD; limited data exists on sex-specific differences. This study aimed to identify at-risk occupations and sex differences for COPD risk. Cases were identified in a large ... ...

Abstract	Although several occupational exposures have been linked to the risk of COPD; limited data exists on sex-specific differences. This study aimed to identify at-risk occupations and sex differences for COPD risk. Cases were identified in a large surveillance system established through the linkage of former compensation claimants' data (non-COPD claims) to physician visits, ambulatory care data, and hospital inpatient data (1983-2020). Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CI) for occupation groups (occupation at time of claim), stratified by sex. HRs were indirectly adjusted for cigarette smoking using another population dataset. A total of 29,445 male and 14,693 female incident cases of COPD were identified. Increased risks were observed in both sexes for construction (HR
MeSH term(s)	Humans ; Male ; Female ; Ontario/epidemiology ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Occupations ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/etiology ; Occupational Exposure/adverse effects ; Gases ; Risk Factors
Chemical Substances	Gases
Language	English
Publishing date	2024-04-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-59429-1
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Article ; Online: The Association of Post-COVID-19-Related Symptoms and Preceding Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Fully Vaccinated Paramedics in Canada.

Asamoah-Boaheng, Michael / Grunau, Brian / Karim, Mohammad Ehsanul / Kirkham, Tracy L / Demers, Paul A / MacDonald, Chris / Goldfarb, David M

The Journal of infectious diseases

2023 Volume 229, Issue 4, Page(s) 1019–1025

Abstract: This study investigated the association between previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and risk of symptoms associated with post-COVID conditions among fully vaccinated paramedics in Canada. We included vaccinated ...

Abstract	This study investigated the association between previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and risk of symptoms associated with post-COVID conditions among fully vaccinated paramedics in Canada. We included vaccinated paramedics who provided blood sample and questionnaire data on the same date during the study period. We examined the presence of symptoms associated with post-COVID conditions and depression severity against prior SARS-CoV-2 infection categories. Compared to the "no previous SARS-CoV-2 infection" group, there was no detected association between known prior SARS-CoV-2 infection (odds ratio [OR], 1.42 [95% confidence interval {CI}, 0.96-2.09]), nor unknown prior SARS-CoV-2 infection (OR, 0.54 [95% CI, 0.29-1.00]), and the presence of symptoms associated with post-COVID conditions.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Post-Acute COVID-19 Syndrome ; Paramedics ; SARS-CoV-2 ; Canada/epidemiology
Language	English
Publishing date	2023-11-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiad475
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