YorkSpace
YorkSpace is York University's Institutional Repository. It supports York University's Senate Policy on Open Access by providing York community members with a place to preserve their research online in an institutional context.
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- Previously Faculty of Environmental Studies (FES)
- The Global Labour Research Centre (GLRC) engages in the study of work, employment and labour in the context of a constantly changing global economy.
- Lives Outside the Lines: a Symposium in Honour of Marlene Kadar
- Used only for SWORD Deposit by Adminstrator
- Welcome to WILAA, a gathering place for materials related to research projects that explore work-integrated learning and disability-related accessibility and accommodations.
Recent Submissions
Comparative Literature Off-Kilter
(2025) Mathieu-Lessard, Jeanne
Pour son premier colloque à l’extérieur du Congrès de la fédération des sciences
humaines, l’Association canadienne de littérature comparée (ACLC-CCLA) propose
de penser le décalage, qu’il soit institutionnel, temporel ou spatial, que permet le
comparatisme. In 2025, we are bringing our annual Canadian Comparative
Literature Association to Trent University, in PeterboroughNogojiwanong, dedicating three days to sharing our work and our thoughts on
our often off-kilter positionality in (and out of) academia.
The precarious balancing act of comparison entails a constant movement on the
part of the researcher/teacher/creator, a movement that does not settle well within
the institutional structures of the article, the grant proposal, the course, the
conference. This event will be an opportunity to revel in the cracks, the bugs, une
occasion de rajouter du sable dans l’engrenage ; non seulement en pointant les failles
mais surtout en mettant en œuvre les décalages, accrochages, jeux et autres bogues.
Dans la lignée du féminiSpunk conçu par Aventin comme « une extermination des
normes et des pouvoirs […] qui s’offre telle une envie contagieuse – une invitation
totale et permanente au plus jouissif des fuck off » (Aventin 25)1 et de l’éloge du bug
de Vitali-Rosati,2 nous proposons de penser le comparatisme comme ce qui détourne
le « bon fonctionnement » de la machine (académique; capitaliste), and to conceive
this event as a playground on which marginal practices, thoughts, works and
formats can form revolutionary friendship
ANNUAL GENERAL MEETING MINUTES 2025
(2025) Gleibman, Shlomo
Cardiac Rehabilitation Quality Improvement: A Narrative Review
(Lippincott, Williams & Wilkins, 2019-07) Moghei, Mahshid; Chessex, Caroline; Oh, Paul; Grace, Sherry
Purpose:
Despite evidence of the effectiveness of cardiac rehabilitation (CR), there is wide variability in programs, which may impact their quality. The objectives of this review were to (1) evaluate the ways in which we measure CR quality internationally; (2) summarize what we know about CR quality and quality improvement; and (3) recommend potential ways to improve quality.
Methods:
For this narrative review, the literature was searched for CR quality indicators (QIs) available internationally and experts were also consulted. For the second objective, literature on CR quality was reviewed and data on available QIs were obtained from the Canadian Cardiac Rehabilitation Registry (CCRR). For the last objective, literature on health care quality improvement strategies that might apply in CR settings was reviewed.
Results:
CR QIs have been developed by American, Canadian, European, Australian, and Japanese CR associations. CR quality has only been audited across the United Kingdom, the Netherlands, and Canada. Twenty-seven QIs are assessed in the CCRR. CR quality was high for the following indicators: promoting physical activity post-program, assessing blood pressure, and communicating with primary care. Areas of low quality included provision of stress management, smoking cessation, incorporating the recommended elements in discharge summaries, and assessment of blood glucose. Recommended approaches to improve quality include patient and provider education, reminder systems, organizational change, and advocacy for improved CR reimbursement. An audit and feedback strategy alone is not successful.
Conclusions:
Although not a lot is known about CR quality, gaps were identified. The quality improvement initiatives recommended herein require testing to ascertain whether quality can be improved.
Exercise rehabilitation in ventricular assist device recipients: a meta-analysis of effects on physiological and clinical outcomes
(Springer, 2018-04-06) Grosman-Rimon, Liza; Lalonde, Spencer; Sieh, Nina; Pakosh, Maureen; Rao, Vivek; Oh, P.; Grace, Sherry
Background:
Exercise rehabilitation in heart failure patients has been shown to improve quality of life (QoL) and survival. It is also recommended in clinical practice guidelines for ventricular assist device (VAD) recipients. However, there have only been 2 meta-analyses on the effects of exercise rehabilitation in VAD patients, on only 2 outcomes. The objective of the review was to quantitatively evaluate the effect of exercise rehabilitation in VAD recipients on functional capacity, exercise physiology parameters, chronotropic responses, inflammatory biomarkers and neurohormones, heart structure and function, as well as clinical outcomes.
Methods:
The following databases were systematically searched: CCTR, CDSR, CINAHL, EMBASE, PsycInfo, and Medline through to November 2015, for studies reporting on VAD recipients receiving ≥2 sessions of aerobic training. Citations were considered for inclusion, and data were extracted in included studies as well as quality assessed, each by 2 investigators independently. Random-effects meta-analyses were performed where possible.
Results:
The meta-analysis showed that compared to usual care, exercise rehabilitation significantly improved peak VO2 (n=74, mean difference=1.94 mL·kg−1·min−1, 95% CI 0.633.26, p=0.004) and 6-minute walk test distance (n=52, mean difference=42.46 meters, 95% CI 8.45-76.46, p=0.01). No significant differences were found for the ventilatory equivalent slope (VE/VCO2) or ventilatory anaerobic threshold (VAT). In the 6 studies which reported QoL, exercise rehabilitation was beneficial in 4, with no difference observed in 2 studies.
Conclusion:
Exercise rehabilitation is associated with improved outcomes in VAD recipients, and therefore should be more systematically delivered in this population.
Health Care Use and Associated Time and Out of Pocket Expenditures for Patients With Cardiovascular Disease in a Publicly Funded Health Care System
(Elsevier, 2017-10-06) Ali, Saba; Moghei, Mahshid; Krahn, Murray; Chessex, Caroline; Grace, Sherry
Background
The objectives of this study were to describe (1) health care use and associated patient time and out of pocket (OOP) costs over 2 years after a cardiac diagnosis, (2) the sociodemographic and clinical drivers of these costs, and (3) patient costs related to cardiac rehabilitation (CR) participation.
Methods
Secondary analysis was conducted in an observational prospective CR program evaluation cohort in Ontario, which has a publicly funded health care system. A convenience sample of patients from 1 of 3 CR programs was approached at the first visit, and consenting participants completed a survey. Participants were e-mailed surveys again 6 months and 1 and 2 years later; these later surveys assessed their cardiac care and medications and the time and OOP costs associated with care visits. Patient time was valued based on average wages in Ontario.
Results
Of 411 consenting patients, 240 (58.3%) completed CR, and 192 (46.7%) were retained at 2 years. Patients most often visited a general practitioner and had electrocardiography and treatment for angina. The total cost to patients over 2 years was CAD$73.70 ± $275.84 for time and $377.01 ± $321.72 for OOP costs ($525.93 ± $467.08 overall). With adjustment, there were significantly higher OOP costs for women (P < 0.001) and less educated (P < 0.001) patients. Participants spent considerable money that was relatively OOP on CR visits alone ($384.78 ± $269.67), with time costs at $379.07 ± $1035.49 ($939.43 ± $1333.29 overall; 1.6% share of 1 year's income).
Conclusions
In conclusion, time and OOP costs are modest for patients with cardiac conditions, except for CR. Alternative delivery models are needed, in particular for low-income patients.