Papers by Stephanie Mowat (nee Armstrong)
Canadian Journal of Rural Medicine, 2017
International medical graduates (IMGs) seeking licensure in Canada have been recruited to practis... more International medical graduates (IMGs) seeking licensure in Canada have been recruited to practise in medically underserviced areas, but retention of these physicians remains a concern. This study explored retention of IMG family physicians in Manitoba and its predictors. We used data from the University of Manitoba, provincial registries and Manitoba Health. Inclusion criteria were IMGs who completed University of Manitoba IMG training or assessment programs, and their return-of-service. Practice location, certification and licensure status were examined. We used logistic regression to consider the effects of a mentorship program, Manitoba residency at application, IMG program and years since program graduation on retention. A total of 197 IMGs met the inclusion criteria. Most IMGs (63.5%) remained in Manitoba, and 59.2% of this group practised outside of Winnipeg. Of those remaining in Manitoba, most (69.6%) held full provincial licensure and national certification. The regression...
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada, 2017
INTRODUCTION International medical graduates (IMGs) seeking licensure in Canada have been recruit... more INTRODUCTION International medical graduates (IMGs) seeking licensure in Canada have been recruited to practise in medically underserviced areas, but retention of these physicians remains a concern. This study explored retention of IMG family physicians in Manitoba and its predictors. METHODS We used data from the University of Manitoba, provincial registries and Manitoba Health. Inclusion criteria were IMGs who completed University of Manitoba IMG training or assessment programs, and their return-of-service. Practice location, certification and licensure status were examined. We used logistic regression to consider the effects of a mentorship program, Manitoba residency at application, IMG program and years since program graduation on retention. RESULTS A total of 197 IMGs met the inclusion criteria. Most IMGs (63.5%) remained in Manitoba, and 59.2% of this group practised outside of Winnipeg. Of those remaining in Manitoba, most (69.6%) held full provincial licensure and national ...
Few studies have examined a diversity of professionals’ perspectives in providing children’s ment... more Few studies have examined a diversity of professionals’ perspectives in providing children’s mental health (CMH) care, particularly for ongoing-complex problems. Based on interviews with 16 primary...
Annals of Otology, Rhinology & Laryngology
BMC Medical Education
Background: The Manitoba Physician Achievement Review (MPAR) is a 360-degree feedback assessment ... more Background: The Manitoba Physician Achievement Review (MPAR) is a 360-degree feedback assessment that physicians undergo every 7 years to retain licensure. Deliberate reflection on feedback has been demonstrated to encourage practice change. The MPAR Reflection Exercise (RE), a peer-assisted debriefing tool, was developed whereby the physician selects a peer with whom to review and reflect on feedback, committing to change. This qualitative study explores how physicians who had undergone the MPAR used the RE, what areas of change are identified and committed to, and what they perceived as the role of reflection in the MPAR process. Methods: The MPAR RE was piloted out to a cohort of MPAR-reviewed physicians. Thematic analysis was conducted on completed exercises (n = 61). Semi-structured interviews were conducted with individuals (n = 6) who completed the MPAR RE until saturation was reached. Results: Physicians reviewed feedback with a range of peers, including colleagues, staff, and spouses. Many physicians were surprised by feedback, both positive and negative, but interviewees found the RE useful in processing feedback. Areas where physicians committed to change were diverse, covering all CanMEDS roles. Most physicians identified themselves as being successful in implementing change, though time, habit, and structures were cited as barriers. Conclusions: Peer-assisted debriefing can assist reflection of multisource feedback. It is easy to implement, is not resource-intensive, and feedback implies that it is effective at promoting change. Participants, with the aid of peers, identified areas for change, developed approaches for change, and largely thought themselves successful at implementing changes. Areas of change included all seven CanMEDS roles.
BMC Medical Education
Background: To assess the effect of an interprofessional educational activity on professional ski... more Background: To assess the effect of an interprofessional educational activity on professional skills, attitudes, and perceived challenges toward obesity management among front-line healthcare providers. Methods: A one-day interprofessional obesity education activity was organized for healthcare providers across various disciplines. All participants were invited to complete an anonymous survey pre-and post-event, and at sixmonth post-event. The survey was created based on a comprehensive list of perceived skills, professional attitudes and challenges toward obesity intervention compiled from existing literature. Results: Sixty-seven healthcare providers completed the survey pre-and post-event. Participants reported increases in professional skills such as their ability to assess weight (p = 0.04), to address weight management issues (p < 0.001), to teach/motivate patients toward physical activity (p < 0.001) and healthy eating practices (p = 0.001), to use behavior modification techniques (p < 0.001), and to deal with family issues (p < 0.001). Professional attitudes: practitioners felt more educated/competent in obesity management (P < 0.001), learned where to refer patients (p < 0.001), were more comfortable in discussing obesity in managing obesity (p < 0.001), were less likely to avoid the topic (p = 0.004) and felt less frustrated with the low success rate (p = 0.030). Enhancement in professional attitudes remained 6 months after the event. Improvements were mainly associated with male gender, younger age, fewer years of professional practice and healthcare professionals other than physicians. No statistically significant changes in perceived challenges were found after the educational event. Conclusion: Results of this study showed that this interprofessional learning activity contributed to the improvement of professional skills and attitudes of front-line healthcare providers caring for those who are obese or at risk for obesity. The positive results of this interprofessional learning activity aligns with the training needs identified by healthcare practitioners in previous studies, and suggest that this design and content could be used to guide future educational programming in the care of obese people.
Journal of Archaeological Science
ABSTRACT The use of cultigens and wild plants by pre-contact populations is well established in a... more ABSTRACT The use of cultigens and wild plants by pre-contact populations is well established in all regions of the circum-Caribbean and Greater Antilles except for Cuba, the largest island in the Caribbean. We examine a population traditionally understood by Cuban archaeologists as &quot; fisheregatherers &quot; from the shell-matrix site of Canímar Abajo, Cuba to examine subsistence practices using a combination of starch evidence from dental calculus, aided by human bone collagen carbon and nitrogen isotope based probability analyses (Stable Isotope Analysis in R; SIAR). This dual analysis suggests that two chronologically distinct &quot; fisheregatherer &quot; Cuban populations (11 adult skeletons from the older cemetery component, 1380e800 BCE; 23 adult skeletons from the younger cemetery component, 360e950 CE) from Canímar Abajo used at least two species of cultigens (beans and maize and/or sweet potatoes) along with wild plant species and various readily available estuarine, marine and terrestrial animal resources.
The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology, 2011
Using high resolution X-ray computed tomography data we examined the relationship between cochlea... more Using high resolution X-ray computed tomography data we examined the relationship between cochlear labyrinth volume and body mass in extant, non-primate euarchontoglirans, and in two fossils, to allow for comparison with the results of Kirk and Gosselin-Ildari (2009). Modern primates have significantly higher cochlear labyrinth volumes relative to body mass than other euarchontoglirans, which may be related to a downward shift in the highest and lowest audible frequencies over the course of primate evolution, and to the relative increase in brain size observed in Euprimates. Anat Rec, 294:263-266, 2011. V V C 2010 Wiley-Liss, Inc.
Twelve accelerator mass spectrometry (AMS) radiocarbon dates from the shell-matrix site of Caníma... more Twelve accelerator mass spectrometry (AMS) radiocarbon dates from the shell-matrix site of Canímar Abajo (Matanzas, Cuba) are reported. Eleven were obtained directly from human bone collagen in burials and one was obtained from charcoal recovered from a burial context. The site stratigraphy presents two episodes of burial activity separated by a shell midden layer. The AMS dates fall into two compact clusters that correlate remarkably well with the stratigraphy. The older burial dates to between 1380–800 cal BC (2σ) and the younger one to between cal AD 360–950 (2σ). The AMS dates are compared to eight conventional 14C dates previously obtained on shell and charcoal. One of the conventional dates on charcoal (5480–5380 cal BC; 2σ) has been reported as the oldest 14C date in the Caribbean region; its context and reliability are clarified. The suite of AMS dates provides one of the most reliable chronometric dating of a cultural context during this timeframe in Cuba. The correlation of 14C and stratigraphy establishes a solid chronology for investigating the important economic and ritual features of Canímar Abajo.
DOI: 10.2458/azu_rc.57.18313
Journal of Archaeological Science, May 1, 2015
The use of cultigens and wild plants by pre-contact populations is well established in all region... more The use of cultigens and wild plants by pre-contact populations is well established in all regions of the
circum-Caribbean and Greater Antilles except for Cuba, the largest island in the Caribbean.We examine a
population traditionally understood by Cuban archaeologists as “fisheregatherers” from the shell-matrix
site of Canímar Abajo, Cuba to examine subsistence practices using a combination of starch evidence
from dental calculus, aided by human bone collagen carbon and nitrogen isotope based probability
analyses (Stable Isotope Analysis in R; SIAR). This dual analysis suggests that two chronologically distinct
“fisheregatherer” Cuban populations (11 adult skeletons from the older cemetery component, 1380e800
BCE; 23 adult skeletons from the younger cemetery component, 360e950 CE) from Canímar Abajo used
at least two species of cultigens (beans and maize and/or sweet potatoes) along with wild plant species
and various readily available estuarine, marine and terrestrial animal resources.
© 2015 Elsevier Ltd. All rights reserved
International Journal of Paleopathology, Mar 2013
A holistic approach is necessary to investigate health in archeological populations. Molecular te... more A holistic approach is necessary to investigate health in archeological populations. Molecular techniques, particularly multiplex PCR and SNaPshot minisequencing, can be combined with paleopathology and dietary analysis (stable isotope, starch, zooarchaeological analyses) to understand aspects of population health. This article demonstrates how spina bifida, a multi-factorial disease characterized by the midline failure to complete vertebral neural arch formation, can be investigated holistically.
Based on skeletal evidence, this disease was prevalent in a pre-Columbian Cuban population from the archeological site of Canimar Abajo (3000-1250 BP). Molecular paleopathological techniques were employed to examine disease potential in this preliminary study, examining 18 individuals (including two individuals with evidence of mild spina bifida, and 16 without such evidence) for four single nucleotide polymorphisms and one insertion sequence associated with spina bifida. The combined effect of these polymorphisms, as well as dietary factors, determines the risk of the population for spina bifida, and these factors united to create the observed high disease prevalence.
We demonstrate how molecular paleopathology, corroborated by dietary analyses, can be used within a paleoepidemiological framework to understand population health and disease.
Applied Geochemistry
This preliminary study investigates the diet of a population of humans (n = 28) recovered from a ... more This preliminary study investigates the diet of a population of humans (n = 28) recovered from a shell matrix site of Canimar Abajo on the Canimar River, Matanzas Province, Cuba. The site is characterized by two cemetery levels separated by a layer of occupation/ritual/midden activity that lasted 1.5 ka. Stable C (d13C) and N (d15N) isotope analysis of human bone collagen samples obtained from individuals (7 infant/juveniles, and 21 adults) from both cemetery levels was conducted in order to reconstruct the diet of these two populations, investigate the relative importance of marine vs. terrestrial resources, and reveal any sex- and age-related distinctions in their food sources. Initial indications suggest that individuals from both cemetery levels consumed diets that were marine resource intensive but also supplemented with varied additions of terrestrial (mostly plant) resources. This supplementation is particularly evident in the later cemetery population. Though there are no significant differences in diet according to sex, there is a trophic level and terrestrial-based shift for breastfed and weaning infant/juveniles. The infant/juveniles showed evidence of being weaned through distinct d15N enrichments and d13C depletions over adult females.
American Journal of Physical …
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Papers by Stephanie Mowat (nee Armstrong)
DOI: 10.2458/azu_rc.57.18313
circum-Caribbean and Greater Antilles except for Cuba, the largest island in the Caribbean.We examine a
population traditionally understood by Cuban archaeologists as “fisheregatherers” from the shell-matrix
site of Canímar Abajo, Cuba to examine subsistence practices using a combination of starch evidence
from dental calculus, aided by human bone collagen carbon and nitrogen isotope based probability
analyses (Stable Isotope Analysis in R; SIAR). This dual analysis suggests that two chronologically distinct
“fisheregatherer” Cuban populations (11 adult skeletons from the older cemetery component, 1380e800
BCE; 23 adult skeletons from the younger cemetery component, 360e950 CE) from Canímar Abajo used
at least two species of cultigens (beans and maize and/or sweet potatoes) along with wild plant species
and various readily available estuarine, marine and terrestrial animal resources.
© 2015 Elsevier Ltd. All rights reserved
Based on skeletal evidence, this disease was prevalent in a pre-Columbian Cuban population from the archeological site of Canimar Abajo (3000-1250 BP). Molecular paleopathological techniques were employed to examine disease potential in this preliminary study, examining 18 individuals (including two individuals with evidence of mild spina bifida, and 16 without such evidence) for four single nucleotide polymorphisms and one insertion sequence associated with spina bifida. The combined effect of these polymorphisms, as well as dietary factors, determines the risk of the population for spina bifida, and these factors united to create the observed high disease prevalence.
We demonstrate how molecular paleopathology, corroborated by dietary analyses, can be used within a paleoepidemiological framework to understand population health and disease.
DOI: 10.2458/azu_rc.57.18313
circum-Caribbean and Greater Antilles except for Cuba, the largest island in the Caribbean.We examine a
population traditionally understood by Cuban archaeologists as “fisheregatherers” from the shell-matrix
site of Canímar Abajo, Cuba to examine subsistence practices using a combination of starch evidence
from dental calculus, aided by human bone collagen carbon and nitrogen isotope based probability
analyses (Stable Isotope Analysis in R; SIAR). This dual analysis suggests that two chronologically distinct
“fisheregatherer” Cuban populations (11 adult skeletons from the older cemetery component, 1380e800
BCE; 23 adult skeletons from the younger cemetery component, 360e950 CE) from Canímar Abajo used
at least two species of cultigens (beans and maize and/or sweet potatoes) along with wild plant species
and various readily available estuarine, marine and terrestrial animal resources.
© 2015 Elsevier Ltd. All rights reserved
Based on skeletal evidence, this disease was prevalent in a pre-Columbian Cuban population from the archeological site of Canimar Abajo (3000-1250 BP). Molecular paleopathological techniques were employed to examine disease potential in this preliminary study, examining 18 individuals (including two individuals with evidence of mild spina bifida, and 16 without such evidence) for four single nucleotide polymorphisms and one insertion sequence associated with spina bifida. The combined effect of these polymorphisms, as well as dietary factors, determines the risk of the population for spina bifida, and these factors united to create the observed high disease prevalence.
We demonstrate how molecular paleopathology, corroborated by dietary analyses, can be used within a paleoepidemiological framework to understand population health and disease.