OPUS: Open Ulethbridge Scholarship

Open ULeth Scholarship (OPUS) is the University of Lethbridge's open access research repository. It contains a collection of materials related to research and teaching produced by the academic community.

Self-archiving your research in OPUS is one way to meet Open Access policies of granting agencies. It is important to retain your final, post-peer-reviewed drafts for submission to OPUS, as this is often the only version publishers will allow to be archived. Click here for information on the U of L Open Access Policy.

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Intersectional impacts of sex and gender on employment outcomes in patients with atrial fibrillation: a systematic review and meta-analysis
(Lethbridge, Alta. : University of Lethbridge, Dhillon School of Business, 2025) Okeowo-Grant, Maryam A.; University of Lethbridge. Dhillon School of Business; Runté, Mary
Abstract Background More than 33 million people worldwide suffer from Atrial Fibrillation (AF) (Chugh et al., 2014; Goren et al., 2013). The objective of this systematic review and meta-analysis was to explore the research question: How does sex and gender impact employment outcomes in adult patients with atrial fibrillation? Methods A systematic search was conducted in accordance with the PRISMA 2020 guidelines using keywords and MeSH terms related to atrial fibrillation, employment, sex and gender. Studies were included if they presented sex or gender-specific outcomes or employment outcomes for adults with AF. Data was presented in forest plots and using I² statistics. Data Synthesis and Analysis A fixed-effects meta-analysis was conducted using R software. Results were expressed as Odds Ratios (ORs) and 95% confidence intervals (95% CIs). The I² statistic was used to assess statistical heterogeneity. Forest plots were generated to represent effect sizes and heterogeneity visually Results A total of twenty studies met the inclusion criteria for qualitative synthesis, and eight were included in the quantitative meta-analysis. Pooled data indicated that males with atrial fibrillation (AF) had 24% lower odds of unemployment compared to females (OR = 0.76, 95% CI: 0.65–0.86). Unemployment was associated with a 44% increased risk of AF (OR = 1.44, 95% CI: 1.29–1.59). Shift work was linked to an 11% higher risk of incident AF (OR = 1.11, 95% CI: 1.05–2.17), although heterogeneity was substantial (I² = 90.59%). Many studies conflated sex and gender. Conclusions The findings from this study suggest that structural inequities tied to sex and gender exacerbate employment challenges and health risks for AF patients. Policies that provide flexible scheduling, caregiving support, and equitable labour conditions may reduce the socioeconomic and cardiovascular burdens associated with AF.
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Sociodemographic determinants of mobility decline among community-dwelling older adults: findings from the Canadian longitudinal study on ageing
(SpringerNature, 2025) Onyeso, Ogochukwu K.; Alumona, Chiedozie J.; Odole, Adesola C.; Victor, Janice; Doan, Jon; Awosoga, Olu A.
Background Mobility is fundamental to healthy ageing and quality of life. Mobility decline has been associated with functional impairment, falls, disability, dependency, and death among older adults. We explored the sociodemographic determinants of mobility decline among community-dwelling older Canadians. Methods This study was a secondary analysis of a six-year follow-up of the Canadian Longitudinal Study on Ageing (CLSA). Our analysis was based on 3882 community-dwelling older adults 65 years or older whose mobility was measured using timed-up and go (TUG) and 4-meter walk (4MWT) tests at baseline and follow-ups 1 and 2 after three- and six-year intervals, respectively. We analysed the cross-sectional and longitudinal association, main and interaction effects of the participants’ sociodemographic characteristics on mobility decline using chi-square, Pearson’s correlation, mixed-design repeated measures ANOVA, and bivariate and multivariate linear regression tests. Results At baseline, 52% of the participants were female, 70.4% were married, and the average age was 68.82 ± 2.78 years. Mean TUG and 4MWT scores were 9.59 ± 1.98 s and 4.29 ± 0.95 s, respectively. There was a strong positive longitudinal correlation between TUG and 4MWT (r = 0.65 to 0.75, p < 0.001), indicating concurrent validity of 4MWT. The multivariate linear regression (for TUG) showed that older age (β = 0.088, p < 0.001), being a female (β=-0.035, p < 0.001), retired (β=-0.058, p < 0.001), Canadian born (β=-0.046, p < 0.001), non-Caucasian (β=-0.063, p < 0.001), tenant (β = 0.050, p < 0.001), having no spouse/partner (β=-0.057, p < 0.001), household income of $50,000-$99,999 (β = 0.039, p < 0.001), wealth/investment lower than $50,000 (β=-0.089, p < 0.001), lower social status (β=-0.018,p = 0.025), secondary education and below (β = 0.043, p < 0.001), and living in certain provinces compared to others, were significant predictors of a six-year mobility decline. Conclusion Our study underscored the impact of modifiable and non-modifiable sociodemographic determinants of mobility trajectory. There is a need for nuanced ageing policies that support mobility in older adults, considering sociodemographic inequalities through equitable resource distribution, including people of lower socioeconomic backgrounds.
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Geriatric and gerontological physiotherapy in focus: a cross-sectional survey of education, clinical practice, and service availability across world physiotherapy member nations
(SpringerNature, 2025) Onyeso, Ogochukwu K.; Alumona, Chiedozie J.; Okoh, Augustine C.; Ibekaku, Michael; Shirazi, Soroush; Kalu, Micchael E.
Background The ageing global population necessitates specialised geriatric/gerontological physiotherapy services (GPTS) to address age-related conditions. We explored the current state of geriatric/gerontological physiotherapy (GPT) academic programmes and clinical practice among World Physiotherapy member nations (WPMNs) and identified factors, including socioeconomic indicators, that predicted the GPTS globally. Methods We conducted an online cross-sectional survey between April 1 and September 19, 2024, inviting official representatives of the 128 WPMNs to answer questions relating to GPT academic programmes and clinical services and practices. We also extracted the Human Development Index (HDI), life expectancy, and Gross National Income (GNI) per capita for each WPMN from the United Nations Development and World Bank databases. Data was analysed using descriptive statistics, a map, bubble charts, and logistic regression models. Results Sixty-seven countries (67/128, 52.3% response rate) completed the survey. Among them, 34 (50.7%) and 19 (28.4%) reported having geriatric/gerontology modules in their entry-level and graduate-level physiotherapy programmes, respectively. Additionally, 20 (29.9%) and 13 (19.4%) reported having entry-level geriatric/gerontology clinical placement and graduate-level clinical training, respectively. Physiotherapists were members of interdisciplinary geriatric/gerontological teams in Africa (9/11, 81.8%), Asia Western Pacific (10/16, 62.5%), Europe (15/27, 55.6%), North America Caribbean (4/7, 57.1%), and South America (5/6, 83.3%), but they can only lead the teams in few countries: Africa (1/11, 9.1%), Asia Western Pacific (4/16, 25.0%), Europe (5/27, 18.5%), North America Caribbean (2/7, 28.6%), and South America (2/6, 33.3%). GPTS were more common in countries with graduate-level geriatric physiotherapy academic programmes (OR = 33.47, 95% CI: 1.36, 822.39, p = 0.032) GPT Availability in Practice Act (OR = 41.93, 95% CI: 1.66, 1059.78, p = 0.023), and higher HDI (OR = 5.32e + 07, 95% CI: 49.78, 5.67e + 12, p = 0.003). Europe and North America Caribbean regions had lower older-adult-to-physiotherapist ratios and a higher life expectancy, HDI, and GPTS availability than other World Physiotherapy regions. Conclusion Geriatric/gerontological PT education and clinical practice are evolving, especially at the entry-level training across WPMNs; however, extra effort is required to enhance graduate specialization to cater to the emerging ageing population.
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Good grief?: The impact of Medical Assistance in Dying (MAiD) on grieving experiences in rural Southern Alberta
(Lethbridge, Alta. : University of Lethbridge, Faculty of Health Sciences, 2025) Trottier, Maegan Gisela; University of Lethbridge. Faculty of Health Sciences; Brassolotto, Julia
Medical Assistance in Dying (MAiD) has introduced new ethical, clinical, and social considerations in Canada’s healthcare system since its legalization in 2016. While research has explored the legal, policy, and practical implications of MAiD, less is known about the grief experiences of those closely involved in the process—particularly within rural communities. This thesis explores the grief experiences of patients, family members, and healthcare professionals involved in MAiD within a rural Southern Alberta context. Using a reflexive thematic analysis of qualitative interview data, this study investigates how participants described grief and what factors influenced their experiences. Through this analysis, I generated three primary themes: (1) MAiD as a means to avoid a ‘bad death’; (2) bureaucratic processes and institutional policies that complicate the MAiD experience and related grief; and (3) the role of stigma and secrecy in shaping grief and limiting access to support. While many participants identified MAiD as enabling a more dignified and controlled end-of-life experience, the grief that followed was not always straightforward. Experiences were shaped by personal and professional relationships, the perceived legitimacy of MAiD within communities, and systemic barriers—including final consent policies and restrictions in faith-based facilities. This research contributes to growing evidence that grief related to MAiD can be multifaceted and influenced by more than the nature of death itself. Findings underscore the importance of considering how rurality, cultural context, and stigma intersect to shape bereavement. The thesis concludes with recommendations for improving policy, support services, and future research, especially regarding the role of rural social norms and institutional restrictions in the experience of MAiD-related grief.
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Correlates of changes in children's independent mobility during the COVID-19 pandemic: a Canadian national longitudinal study
(Lethbridge, Alta. : University of Lethbridge, Faculty of Health Sciences, 2025) Roy, Sudipta; University of Lethbridge. Faculty of Health Sciences; Larouche, Richard
Children's independent mobility (CIM) is linked to higher physical activity in cross-sectional research, but studies describing factors influencing changes in CIM are lacking. The objective of this study was to examine the social-ecological correlates of changes in CIM and whether correlates differ by gender. Every six months between December 2020 and 2021, Canadian parents of 7- to 12-year-olds (n=2291 at baseline) were surveyed to assess mobility licenses (children's permission to do certain activities independently). Linear regression models adjusted for child age, gender, and household income were conducted. Average CIM increased (0.65±1.30 licenses) throughout the follow-up period. Boys experienced a smaller increase in CIM compared to girls (β: -0.60; 95%CI: -1.13, -0.06). Child age (β: 0.08; 95%CI: 0.03, 0.14) and each unit increase in the parental Tolerance of Risk in Play Scale (β: 0.02; 95%CI: 0.00, 0.04) were associated with increased CIM whereas parental crime safety concerns (β: -0.19; 95%CI: -0.37, -0.02) were negatively associated. Children whose parents were neither employed full-time nor homemakers had lower CIM than those of full-time working parents (β: -0.40; 95%CI: -0.74, -0.06). Child gender interacted with parent employment: boys whose parent did not work full-time had a greater increase in CIM (β: 0.52; 95%CI: 0.08, 0.95). In gender-stratified models, boys with a disability (β: 0.49; 95%CI: 0.08, 0.89) and from middle- vs. high-income households (β: 0.34; 95%CI: 0.05, 0.63) had greater increases in CIM. Findings show that correlates of changes in CIM span multiple levels of influence, and these correlates differ significantly between boys and girls, highlighting the importance of examining gender-specific factors when examining changes in CIM. Future interventions to increase CIM could target modifiable variables, including parental risk tolerance and perceived crime safety.