About MacSphere

MacSphere is McMaster University's Institutional Repository (IR). The purpose of an IR is to bring together all of a University's research under one umbrella, with an aim to preserve and provide access to that research. The research and scholarly output included in MacSphere has been selected and deposited by the individual university departments and centres on campus.

To contribute to McMaster's Institutional Repository, please sign on to MacSphere with your MAC ID.

If you have any questions, please contact the MacSphere Support Team.

Students wishing to deposit their PhD or Masters thesis, please follow the instructions outlined by the School of Graduate Studies.

Communities in MacSphere

Select a community to browse its collections.

Now showing 1 - 5 of 5

Recent Submissions

AI-Driven Cardiorespiratory Signal Processing: Separation, Clustering, and Anomaly Detection
(2025) Torabi, Yasaman
This thesis applies artificial intelligence (AI) to separate, cluster, and analyze cardiorespiratory sounds. We recorded a new dataset and developed several AI models, including generative AI methods based on large language models (LLMs) for guided separation, explainable AI (XAI) techniques to interpret latent representations, variational autoencoders (VAEs) for waveform separation, a chemistry-inspired non-negative matrix factorization (NMF) algorithm for clustering, and a quantum convolutional neural network (QCNN) designed to detect abnormal physiological patterns. The performance of these AI models depends on the quality of the recorded signals. Therefore, this thesis also reviews the biosensing technologies used to capture biomedical data. Together, these studies show how AI and next-generation sensors can support more intelligent diagnostic systems for future healthcare.
Healthcare utilization and preventive care among social housing residents compared to the general population during the COVID19 pandemic in Ontario, Canada: A population-based cohort study
(Frontiers in Public Health, 2026-01) Gina Agarwal; Homa Keshavarz; Ricardo Angeles; Melissa Pirrie; Francine Marzanek; Francis Nguyen; Jasdeep Brar; Michael Paterson; Christie Koester; Mikayla Plishka; Guneet Mahal; Sahar Popal; Manasvi Vanama
Introduction: To examine disparities in influenza vaccination and screening for breast, cervical, and colorectal cancers among adults living in social housing compared to the general population of Ontario, Canada, before and during the COVID-19 pandemic. Methods: A population-based cohort study was conducted using linked administrative health data from Ontario, Canada. We studied individuals aged 18 and older who were alive on January 1, 2020. Social housing sites were identified using the 2023 cycle of the Social Housing of Ontario Registry. The complement cohort comprised adults not residing in social housing. Receipt of influenza vaccination and screening for cervical (Pap test), breast (mammography), and colorectal [fecal immunochemical test (FIT)/fecal occult blood test (FOBT)/sigmoidoscopy/colonoscopy] cancers were analyzed using data from the Ontario Breast Screening Program (OBSP), Ontario Cancer Registry (OCR), Ontario Health Insurance Plan (OHIP) Database, and Primary Care Population Database (PCPOP). Age-standardized rates and rate differences between the social housing population and complement cohort were compared for the pre-COVID-19 (2018 and 2019) and COVID-19 (2020 and 2021) periods. Results: The social housing cohort included 297,644 individuals, while the complement cohort had 11,386,078 individuals. The social housing cohort had higher proportions of older adults (≥60 years) and females. Age- and sex-standardized disparities in influenza vaccination (≥1 dose in 2-year period) between social housing residents and the complement cohort widened during the COVID-19 pandemic from −0.30 to −1.84%, with the largest gaps observed among adults aged 80 and older. While age- and sex-standardized disparities in breast and cervical cancer screening narrowed, they remained significant. In contrast, the age- and sex-standardized disparity in colorectal cancer screening increased from −7.42 to −9.69%, particularly among males and older adults aged 60–74. Discussion: Disparities in healthcare utilization and preventive care between social housing residents and the complement cohort persisted or widened during the COVID-19 pandemic, most notably for influenza vaccination and colorectal cancer screening. Narrowing of some screening disparities was primarily attributed to overall declines in screening rates rather than improved access. These findings emphasize the need for targeted, equity-focused public health strategies to improve access to preventive healthcare services for socially and economically disadvantaged populations.
Where Low-income Seniors Receive their Heart Health and Diabetes Information: A Cross-Sectional Survey
(BMC Public Health, 2025-12) Pauneez Sadri; Momina Abbas; Christie Koester; Melissa Pirrie; Ricardo Angeles; Francine Marzanek; Mikayla Plishka; Guneet Mahal; Jasdeep Brar; Sahar Popal; Manasvi Vanama; Gina Agarwal
Background: Older adults (> 55 years), in particular low-income older adults, have lower health literacy than the rest of the Canadian population. Lower health literacy is related to several negative health outcomes such as poor diabetes control and other physical and mental health problems. Canada's rising ageing population requires an age-friendly system that reduces the dependency on the Canadian health care system. This study investigated the Health Information Seeking Behaviour of low-income seniors living in social housing across five Ontario regions to determine how to improve healthcare outcomes and the performance of the Ontario healthcare system. Methods: This cross-sectional study included in-person interviews guided by the Health Awareness and Behaviour Tool (HABiT) survey. Interviews were conducted with older adults from 16 social housing buildings in five Ontario communities between May 2014 and January 2015. Questionnaire responses were analyzed using descriptive statistics and simple logistics regressions. Results: 625 individuals completed the HABiT survey. The majority of participants sought out health information at the doctor's office; 515 participants received health information from a doctor or nurse about keeping their heart healthy and 471 about preventing diabetes. Females were more than twice as likely to receive health information about heart health from family members, media sources, and pharmacists than males. Those aged > 84 years were the least likely to use media sources and were almost three times as likely to contact a doctor or nurse for heart health information compared to middle-aged participants. Adults with higher post-secondary education were more likely to use the Internet as a source of health information compared to high school graduates. Conclusions: Family physicians with older adult patients could better supplement their health assessments by promoting and explaining educational brochures, and ensuring that they address these health topics to better communicate chronic disease prevention.
Perceptions of Primary Care Patients Attending a Legal Health Clinic: A Qualitative Descriptive Study
(BMC Health Services Research, 2025-12) Gina Agarwal; Andrea Ziesmann; Aarani Paramalingam; Kalpana Nair; Bethany Delleman; Dan Edwards; Sharon Crowe; Hugh Tye; Francine Marzanek; Ricardo Angeles; Melissa Pirrie; Christie Koester; Mikayla Plishka; Guneet Mahal; Jasdeep Brar; Sahar Popal; Manasvi Vanama
Background: There has been increasing recognition of the relationship between social determinants of health and unmet legal needs, with those living in poverty experiencing higher rates of poor health. Medical-legal partnerships (MLPs) are programs that have been developed to offer legal services within a clinical setting to patients who may typically not be able to access these types of services. The Legal Health Check-Up Clinic was initiated to screen and offer legal supports to patients from a Canadian primary care clinic, situated in a diverse, urban medium-sized city. Previous quantitative analyses found significant changes in overall health status as well as income, housing, and food security. The aim of this study was to evaluate participants’ experiences and satisfaction with the Legal Health Check-Up Clinic. Methods: A qualitative descriptive approach was used and participants from the Legal Health Check-Up Clinic were invited to take part in a one-time, individual interview. Using a thematic analysis approach, each interview was independently coded and then discussed by three researchers, with any differences reconciled by consensus. Coding was iterative with new codes added as relevant ideas emerged from the interviews. Results: Sixteen interviews were conducted. There were two primary themes: Personal Benefits and Challenges experienced by participants, and Program Structural Elements that fostered or impeded program success. Participants welcomed accessing legal support within the primary care environment and became more aware of their rights and options. Some learned they were not eligible for the program and felt provision of other resources would have been helpful. Participants appreciated the program philosophy of recognizing the relationship between health and social needs and offered constructive feedback for areas of improvement, such as provision of translation services and more time with clients. Conclusions: The Legal Health Check-Up Clinic was helpful for participants in providing referrals, resources, and concrete direction regarding their legal issue. Clarity in screening potential participant eligibility was suggested. Future work related to interprofessional education of legal and health professionals could support the implementation of a stronger patient-centred approach.
SARS-CoV-2 Testing, Test Positivity, and Vaccination in Social Housing Residents Compared to the General Population: A Retrospective Population-Based Cohort Study
(Journal of Epidemiology and Community Health, 2025-03) Gina Agarwal, Homa Keshavarz, Ricardo Angeles, Melissa Pirrie, Francine Marzanek, Francis Nguyen, Jasdeep Brar, Michael Paterson, Christie Koester, Mikayla Plishka, Guneet Mahal, Sahar Popal, Manasvi Vanama
Background: The consideration of unique social housing needs has largely been absent from the COVID-19 response, particularly in tailoring strategies to improve access to testing and vaccine uptake among vulnerable and high-risk populations in Ontario. Given the growing population of social housing residents, this study aimed to compare SARS-CoV-2 testing, positivity, and vaccination rates in a social housing population with those in a general population cohort in Ontario, Canada. Methods: This population-based cohort study used administrative health data from Ontario to examine SARS-CoV-2 testing, positivity and vaccination rates in social housing residents compared with the general population from 1 January 2020 to 31 December 2021. All comparisons were unadjusted, stratified by sex and age and evaluated using standardised differences. Results: The rates of SARS-CoV-2 PCR testing were lower among younger age groups and higher among older adults within the social housing cohort, compared with the general population cohort. SARS-CoV-2 test positivity was higher in social housing than in the general population among individuals aged 60-79 years (7.9% vs 5.3%, respectively) and 80 years and older (12.0% vs 7.9%, respectively). Overall, 34.3% of social housing residents were fully vaccinated, compared with 29.6% of the general population cohort. However, a smaller proportion of social housing residents had received a booster vaccine (36.7%) compared with the general population (52.4%). Conclusion: Improved and targeted outreach strategies are needed to increase the uptake of COVID-19 booster vaccines among social housing residents.

About MacSphere

Discover

Communities in MacSphere

Recent Submissions