VictorJuiz/thesis huggingface dataset:
Nursing Students’ Self-efficacy to Care for Older Adults in Acute Care Settings in Ghana: A Mixed Method Study

Self-efficacy has been reported to serve as a motivator for goal achievement and to impact care quality and career development choices. Understanding nursing students’ self-efficacy to care for older adults can provide an opportunity to identify gaps and develop strategies to shape nursing students’ interest in caring for older adults. This study sought to identify the relationship between nursing students’ knowledge about, attitudes towards, and self-efficacy to care for older adults and explored nursing students’ understanding of their self-efficacy to care for older adults. The study also examined stakeholders’ perceptions about nursing students’ self-efficacy to care for older adults and how these views shape gerontological nursing education and practice in Ghana. Bandura’s self-efficacy theory guided this study. Results of this sequential explanatory mixed-method study showed that nursing students’ age and attitudes towards older adults were associated with their self-efficacy to care for older adults. Content knowledge about gerontology was not associated with self-efficacy. Nursing students suggested their self-efficacy to care for older adults was based on their perceived competency in routine procedural nursing care, the impact of the general nursing education program, and the sociocultural norms of caring for older adults in Ghana. Stakeholders indicated that nursing students were well prepared and confident to care for older adults and that the general nursing education program and sociocultural norms of caring for older adults enhanced nursing students’ self-efficacy to care for older adults; however, they also acknowledged the need for gerontological clinical placements for nursing students and the challenges of the gerontology curriculum in the general nursing program. Findings suggest a need for a larger study encompassing different nursing training institutions to determine the extent of revisions needed in gerontological nursing curricula. Findings also indicate a need for gerontological nursing clinical placements to enhance students’ gerontological skills development, for capacity building of faculty, and for the government’s commitment to invest in gerontology education and practice.

Keywords: Attitudes
Gerontological nursing
Knowledge
Nursing students
Older adults
Self-efficacy
Advisor: Cranley, Lisa
Puts, Martine
Causal Inference Methods for Secondary Analysis of Randomized Screening Trials

The primary objective of randomized trials is usually pre-specified in the protocol and typically adheres to the intention-to-treat (ITT) principle, allowing for simple comparisons between intervention arms. However, trials often collect high-quality data that can be utilized for secondary analysis. This thesis is focused on randomized screening trials where asymptomatic individuals are assigned to receive a series of screening examinations or standard care and subsequently followed for a pre-specified period. While the primary analysis in randomized screening trials estimates the effect of intention-to-screen (ITS) on cancer-specific mortality, among the screening-detectable subgroup we might also be interested in the causal effect of early (screening-induced) treatments compared to delayed treatments in the absence of screening. The first objective of this thesis is to develop estimators for the effect of early versus delayed cancer treatments among the screening-detectable subgroup. Using the framework of Rubin’s causal model, we consider two alternative measures, proportional and absolute mortality reductions in the subgroup. We propose estimators for these using the instrumental variable principle as well as outline their identifying assumptions. These estimators generalize existing IV estimators to allow for time-dependent exposure/latent subgroup. The existing models for screening trials, primarily proposed for planning future trials with adequate power for the ITS analysis, are unnecessarily complex for defining and estimating the causal effect of screening-induced early treatments. To address this, we formulate a simplified structural multi-state model, in which the causal effect of early treatments is summarized using a time-invariant, cause-specific structural hazard ratio. For estimating the hazard ratio, we propose two methods, based on an estimating equation and a likelihood expression. Finally, with the aim to generalize the IV methods outside of the trial setting and to allow for covariate-dependent censoring, we introduce covariate adjustment into the estimation. We consider both parametric and non-parametric covariate adjustment using hazard regression models and machine learning algorithms. For the latter, we propose a sub-sampling approach to avoid large-counting process datasets. The performance of all the proposed estimators in this thesis are illustrated through simulation studies and real data examples.

Keywords: Causal inference
Instrumental variable estimator
Multi-state model
Randomized screening trials
Advisor: Saarela, Olli
Standardized Application of Force Plate-based Measures of Standing Balance in the Sub-acute Stage of Stroke Recovery

People with stroke have poor balance in standing and moving, and experience frequent falls. Impaired balance is a major risk factor for falls in stroke. Therefore, it is important to objectively investigate balance difficulties to develop effective rehabilitation and falls-prevention strategies. Force plate-based balance measures have previously been used to inform clinicians and researchers about balance impairments in the stroke population; however, little is known about their measurement properties, particularly in sub-acute stroke. The overall goal of this dissertation was to establish reliability, validity, and responsiveness of force plate-based measures in sub-acute stroke, and to determine the measures with the best measurement properties. Study 1 established relative and absolute reliabilities for sixteen balance measures, and demonstrated that directional weight-bearing asymmetry (indicates uneven weight distribution), speeds of centre of pressure (indicates neuromuscular control needed for regulating postural fluctuations), and symmetry index (represents contributions of each lower extremity in controlling balance) had the highest relative reliability and lowest measurement error in sub-acute stroke. Study 2 examined concurrent validity of reliable force plate-based measures, and their ability in discriminating different groups. This study found that speed of centre of pressure along the anterior-posterior axis had the highest concurrent validity, while weight-bearing asymmetry had the best capacity to distinguish between people with and without a history of falls, and also between those at high versus low-moderate risks of falls. In Study 3, responsiveness of reliable force plate-based measures, following a period of routine inpatient rehabilitation, was studied. Speed of centre of pressure along the medial-lateral axis, and weight-bearing asymmetry had the highest responsiveness. Additionally, weight-bearing asymmetry and symmetry index were more responsive in individuals who had higher initial reliance on their non-paretic lower extremity for controlling standing balance. Combined, these findings suggest that weight-bearing asymmetry, and speeds of centre of pressure along the anterior-posterior and medial-lateral directions have the overall best measurement properties, which can be used to precisely study balance in people with sub-acute stroke.

Advisor: Mansfield, Avril
Essays in Environmental and Energy Economics

This thesis contains three chapters associated with the study of environmental and energy economics. The first chapter studies the impact of activism by non-governmental organizations (NGOs) on the stock returns of the firms they target, measured through their cumulative abnormal returns (CARs). I find that campaign events on environmental concerns substantially reduce CARs, and that there is no significant effect on campaigns related to non-environmental issues. I additionally test whether NGOs strategically time their campaigning activities and find evidence that NGOs avoid days with newsworthy events that may shift public attention away from their activity. Taken together, the results of this paper provide comprehensive evidence of the effectiveness of activism by NGOs in impacting firms. The second chapter investigates trends in energy use in Canada, relating them to economic output using a key metric: energy intensity. We first derive the major determinants of energy intensity in Canada between 1997 and 2017 using a traditional decomposition framework, namely the activity and efficiency indices. We then find through a non-parametric estimation framework that energy intensity trends downwards, with an average reduction of 1.5% per year, and improvements in efficiency of roughly 1% per year. Our results demonstrate that non-parametric estimation methods are effective in analyzing improvements in energy intensity. The third chapter models the interaction and strategic decision-making between activist NGOs and the firms they target. Firms respond to pressure from NGOs by choosing "green" or "brown" technologies, or by window-dressing; engaging in costly deception to avoid paying the full cost of complying to green technology. I examine how NGOs and firms interact in a monopolistically competitive environment. I derive an NGO-firm game in which firms can choose their technology in response to NGO activism, and the NGO chooses its monitoring intensity. I find that increases in payoffs to the NGO's arm that monitors the use of brown technology lead to an increase in window-dressing. Meanwhile, increases in payoffs to the arm that monitors window-dressing cause a rise in brown technology adoption.

Keywords: Corporate Social Responsibility
Corporate Sustainability
Energy Economics
Environmental Economics
Event Studies
NGOs
Advisor: Yatchew, Adonis
Mirrors and Reflections: Perceptions of Muslim Immigrant Women in Toronto

This study addresses the perceptions that Muslim immigrant women in Canada have about themselves, as self-perception, while also speaking to how they perceive others’ views that affect their lives. Drawing on the experiences and perceptions of self-identified Muslim immigrant women in Toronto, who are English language learners, this study aims to understand Muslim immigrant women’s self-esteem. The study seeks to understand how they perceive themselves, how they simultaneously perceive how others see them in Canada, and the impact of such a double reflexive process. The study examines the cultural and religious impacts on immigrant Muslim women that lead them to deal with a certain “double consciousness” (Du Bois, 1968) to fit into a dominant Canadian culture shaped by colonialism, patriarchy and anti-Muslim racism. Specifically, the study investigates the challenges and needs encountered by Muslim immigrant women in Canada due to existing Orientalist stereotypes and biases about the Muslim community, and how they navigate these challenges. This study adopts a mixed methodology grounded in autoethnography, interviews and a focus group, reflexivity and poetry expression, and creative imagination and visualization. While the study is based on a limited sample, results revealed that Muslim immigrant women’s response to the racist and patriarchal gaze does not diminish their self-esteem; instead, the key finding is that their sense of themselves as agentic, confident women is strong, and this self-perception is not lowered by the perceptions of others.

Keywords: Islamophobia
Microaggression
Mixed Methodology
Muslim immigrant
Orientalism
Women
Advisor: Bakan, Abigail
Integrated Photonic Functions Using Optically Anisotropic Materials

Integrated photonics is an emerging field within photonics research in which waveguides and optical components can be fabricated as an planar, integrated structure. In particular, silicon photonics based on dielectric nanowires have been established as a platform of choice for processing optical signals largely due to their near-lossless nature. One major constraint associated with dielectric waveguides is that their modes are diffraction limited. Plasmonic waveguides can compliment silicon photonics in a way that they can support modes that are not diffraction limited. Our group has successfully developed a plasmonic platform that can facilitate field-matter interaction, long-range propagation while exhibiting excellent coupling efficiency with silicon photonics. Nonetheless, dielectric and plasmonic waveguides still cannot fulfill the full suites of photonic functions. This is because optical modes supported in these structures are predefined by the design, and lack tunability over their modal properties. In this thesis, we will investigate the prospects of optically anisotropic materials/structures as new emerging integrated platforms for tailoring the modal attributes of the waveguide modes. These concepts have been abundant in the field of metamaterials for free space applications. However, thus far the advantage of anisotropic materials as an integrated platform has been largely overlooked, therefore the demonstrations of integrated devices using anisotropic 2D materials have been limited. In this thesis, we theoretically propose and demonstrate how to leverage material anisotropy of the optical materials/structures to tailor modal properties. First, a birefringent L-slot waveguide architecture will be introduced to serve as the basis for various polarization manipulating devices, allowing for the managements and control of polarization states of the lightwaves. Second, a metamaterial waveguide architecture that can effectively enhance the in-plane components of the modal field for graphene photonics will be presented. Third, the modal and dispersion behaviors of anisotropic 2D plasmonic waveguide will be explored. One striking advantage associated with this platform is that the material absorption inherent in this class of plasmonic material can play favorable roles in achieving intriguing integrated photonic functions, which can facilitate low-loss mode propagation, mode swapping, and diffractionless field canalization by regulating material absorption.

Advisor: Helmy, Amr S
Diversification and Evolution of Leech (Hirudinida) Anticoagulants with Emphasis on Antistasin-like Proteins

Bloodfeeding is a common feeding behavior among animals and it requires several adaptions for individuals to feed efficiently. Molecular mechanisms of hemostasis inhibition are common adaptations of bloodfeeding species, and it is essential to allow the parasite to feed for a longer time. The diversity of anticoagulants secreted by these animals is noticeable by many cases of functional convergence and divergence within and between protein families. Leeches are an ecologically diverse group of annelids that are closely related to earthworms and other clitellates. They are known for their bloodfeeding behavior that has attracted great attention during human history, because of the medical properties attributed to leech saliva.This thesis aims to (1) test previous orthology hypothesis between archetypal anticoagulants (2) identify the origin of main orthologous groups (3) seek for putative anticoagulants in non-bloodfeeding leech species and (4) understand the contribution of gene duplication and alternative splicing in the diversification of leech anticoagulants. The results presented here contribute to the expansion of leech salivary transcriptome sampling and orthology determination of several anticoagulants. Moreover, we identify putative homologs of many anticoagulants in non-leech clitellates, helping to clarify the origin of these proteins, which can be traced back to before the origin of extant leeches. The presence of ii anticoagulants in non-predatory species suggests that many of these anticoagulants may be involved in other functions. Finally, we found several splicing isoforms that may contribute to a local exploration of protein sequence space. These results have a high impact on our understanding of leech anticoagulant evolution and suggest that the ancestral leech was probably capable of inhibiting factor Xa. However, important thrombin inhibitors such as Hirudin, seem to be an innovation of Hirudiniforms.

Keywords: Anticoagulants
Antistasin
Leeches
Phylogenetics
Protein evolution
Advisor: Kvist, Sebastian
Rheology and Microstructure of Aqueous Clay Suspensions

The clay minerals kaolinite and montmorillonite are ubiquitous and abundant and have therefore been the focus of research since the early 20th century when Eugene C. Bingham used aqueous kaolinite suspensions in his seminal work that introduced the concept of yield stress, and Irving Langmuir used aqueous montmorillonite suspensions in his seminal work that laid the foundation of Onsager’s theory of the isotropic–nematic liquid crystal transition. Since then, an enormous amount of work has been carried out on the microstructure and rheological behaviour of these two clay minerals. However, the true microstructure and associated rheological response remain poorly understood. The present work focuses on understanding the microstructure of kaolinite and montmorillonite suspensions and their associated rheological behaviour. The microstructure of kaolinite suspensions was investigated as a function of pH and concentration using scattering and rheology experiments. The microstructure at pH 10—far above the iso-electric point (IEP) of the alumina basal plane—showed the absence of aggregation up to a clay concentration of 55 wt.%. Increasing the concentration further led to aggregation to form entities larger than 20 µm in size. The microstructure at pH values below and above the edge IEP did not change except in terms of attraction strength, signifying that the silica-alumina basal plane interaction was the main mode of aggregation. For montmorillonite, scattering experiments revealed objects in the microstructure that were at least an order larger than individual particles, along with the presence of order. Cryo-electron microscopy complemented the scattering results, showing the presence of domains having strong particle-particle ordering as well as regions of particle-particle aggregation. Thus, the presence of an assembly of particles was confirmed, which refuted a widely accepted model for a purely repulsive nature. The presence of nematic domains refuted a widely accepted model for a purely attractive nature. Rheology experiments revealed a pH-driven aging bifurcation. Furthermore, low ionic strength suspensions at clay concentrations above the sol–gel transition were shown to exhibit features of physical aging and thixotropy, suggesting an out-of-equilibrium behaviour, even within the limit of low ionic strength.

Keywords: Clays
Neutron Scattering
Physical Aging
Rheology
Scattering
Thixotropy
Advisor: Bobicki, Erin R
Essays on Monetary Policy Transmission

In my dissertation, I study how financial frictions and market power in the banking sector affect the transmission of monetary policy shocks to mortgage rates and the real economy. The first chapter investigates how banking market concentration and its reliance on wholesale funding can affect the transmission of monetary policy shocks to mortgage rates. Using US bank- and loan-level data, I find that banks at the 90th percentile of the wholesale funding reliance in concentrated markets transmit 61 basis points (bps) to mortgage rates, in response to a monetary policy shock that raises the policy rate by 100 bps. Banks at the 10th percentile of the wholesale funding reliance in competitive markets transmit 108 bps to mortgage rates. I find that for unconventional monetary policy shocks, such as an increase in 10-year Treasury yield by 3.85 bps, high market power banks transmit 0.15 to 0.69 bps less to mortgage rates, whereas high market power FinTech lenders pass-through 2 to 3.36 bp more relative to their counterparts. The second chapter focuses on the macroeconomic implications of imperfect monetary policy transmission to mortgage rates. I build a quantitative New Keynesian model with monopolistically competitive banks that have costly access to wholesale funding. In contrast to assuming a perfectly competitive banking sector, my model exhibits a dampened transmission of monetary policy on output, consumption, and housing prices. I then study monetary policy transmission under the Basel III Liquidity Coverage Ratio rule that limits excessive reliance on wholesale funding. I find that higher market power banks with greater reliance on wholesale funding respond strongly to monetary tightening on mortgage rates. The third chapter analyzes cross-country monetary policy transmission on mortgage and deposit rates via the bank market power channel. My results show that when the policy rate increases by 100 bps, banks with high market power transmit a 49 bps lower deposit rate and a 20 bps higher mortgage rate relative to banks with low market power. Monetary policy decisions are transmitted to mortgage and deposit rates mainly through banks with low market power.

Advisor: Ozkan, Serdar
Magneto-centrifugal Wind with Applications to Astrophysical Accretion Disks

We calculate the structure of radially self-similar magneto-centrifugal winds with a wide range of magnetic flux distribution, mass loading, and injection speed at the base of the wind. A variety of wind structures is obtained, including winds driven by magneto-centrifugal and magnetic pressure gradient forces. The critical magnetic tilt needed to achieve an Alfven transition is sensitive to the wind properties, especially the magnetic flux distribution and injection speed, and generally exceeds the 30 degrees minimum for a magneto-centrifugal slingshot. A connection between magnetic tilt and minimization of the specific wind energy is conjectured. The least tilted wind solution is shown to approach the potential solution at low mass loading. Gaseous disks in star-forming galaxies and active galactic nuclei may contain dynamically important magnetic fields and significant flux of cosmic rays. In contrast with radiation-pressure dominated disks, a much weaker energy input in cosmic rays is required to support the disk against vertical gravity, and to drive a magneto-centrifugal outflow. Taking into account cosmic ray ionization, streaming, injection from massive stars and energy losses, we calculate the transition from a hydrostatic disk to an outflowing wind. The solutions are constrained by the slow-magnetosonic critical point associated with cosmic ray streaming; the wind is initially driven by the cosmic ray pressure gradient rather than the magneto-centrifugal force, with the magneto-centrifugal force dominating at larger heights above the disk. The specific example that is explored in quantitative detail involves a near Eddington accretion flow onto a supermassive black hole, at a distance from the hole where a viscous disk tends to be gravitationally unstable. We find that the disk magnetization is around unity, which optimally fixes the fraction of the radial mass flow returned to the wind at order 0.01. Radial scalings in a constant Q disk are worked out.

Keywords: Accretion Disk
Active Galactic Nuclei
Cosmic Ray
Magneto-centrifugal Wind
MHD
Starburst Galaxy
Advisor: Thompson, Christopher