This study examines accelerometer-based and self-report assessment of sleep disturbance from a larger prospective cohort of youth 5 to 18 years of age with postconcussive injury. Twenty-one participants with self-reported sleep disturbance were evaluated using accelerometers. Participants completed the Pittsburgh Sleep Quality Index (PSQI) every 48 hours and also measured sleep via accelerometry. Correlations were conducted matching PSQI scores to accelerometry assessment. PSQI scores were significantly correlated only with “average number of awakenings” (r = −0.21; P = .049). Accelerometer-measured mean (standard deviation) sleep efficiency was 79.9% (5.20%), with normal sleep defined as >85%. The mean (standard deviation) PSQI global score was 10.5 (3.78) out of 21, where scores of >5 indicate subjective insomnia. Results suggest the PSQI and accelerometers may be measuring different attributes of sleep. Both may be needed as actual sleep is important but so is perception of good sleep. These findings call for further validity testing of objective sleep assessment measures and commonly used self-report tools.

Purpose: Homelessness is one of the most significant social determinants of health, yet it remains difficult to integrate within educational material for pre-clerkship medical students. Current homelessness health curricula are limited and may perpetuate negative stigmas of homelessness. This qualitative study evaluated a Pen-Pal Project curriculum innovation that aimed to facilitate empathy and teaching through letter exchanges, where medical students were paired with community members with a lived experience of homelessness. Method:The researchers explored 10 pre-clerkship medical students' experience in this four-week letter exchange. Semi-structured interviews with medical student participants were conducted in July 2020. Interviews were recorded, transcribed, and coded by two independent coders. Codes were analyzed within code groups for themes, supported by group discussion, and analytic memos.Results: Medical students' impressions of the Pen-Pal Project were overwhelmingly positive and were frequently attributed to developing a genuine and mutually beneficial relationship with a community member. From learning about their pen-pals' emotional experiences with healthcare and homelessness, students partaking in the Pen-pal Project endorsed improved communication, advocacy, and empathy skills. Lastly, although homelessness education was unanimously perceived as important, all students believed that current medical curricula are lacking in this area.Conclusions: These findings contributed to the sparse medical educational efforts on homelessness health and provide a deeper understanding of students' perceptions on an inexpensive and simple tool to facilitate empathy development and community involvement.

Cancer survivors have strong personal desires to resume work to feel productive and meet financial needs. However, they may be faced with physical and psychological challenges. This research aims to: examine cancer survivors' perspectives on supports needed when returning to work; investigate sex and gender differences when returning to work; and explore demographic and employment factors that may influence this process. An exploratory qualitative design was used. The study had two phases: focus groups and one-on-one semi-structured interviews. Inductive thematic analysis was used to analyze the data. The total sample includes 15 participants, 87% female and 13% male. Key themes include: changing perspectives on self and work; managing work and social systems; determining disclosure and accommodation; and the importance of supports for return to work and daily life. This study informs cancer rehabilitation research by developing an understanding of the supports needed to help cancer survivors return to work successfully. Chapter 1: Introduction Purpose of Study In 2017, the Canadian Cancer Society released a report stating that about 1 in 2 Canadians are expected to be diagnosed with cancer in their lifetime (Canadian Cancer Society, 2017). Furthermore, it predicts that nearly 55% of all new cases of cancer will occur in people aged 20-69 years (Canadian Cancer Society, 2017). Given that working age is normally defined as 15 to 64 (Organisation for Economic Cooperation and Development [OECD], 2017), most Canadians who are diagnosed with cancer are likely to be interested in returning to or staying at work as a way to establish normality, social relationships, and enhance quality of life (Peteet, 2000; Steiner, Cavender, Main, & Bradley, 2004). In fact, a literature review by Spelten, Sprangers, and Verbeek (2002) found that, on average, 62% of cancer survivors are able to stay at work or return to work after treatment. Another cohort study found that this number increases to 85% after 4 years, confirming that many cancer survivors are able to remain or stay at work after treatment (Short, Vasey, & Tunceli, 2005). Cancer impacts not only individuals, but also stakeholders throughout the healthcare system and in the workplace (Maunsell,