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Pulmonary Embolism in Patients with Chronic Obstructive Pulmonary Disease Exacerbation
No full textPulmonary embolism (PE) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are two diseases that share similar symptoms which makes the diagnosis of PE challenging. AECOPD is a risk factor for PE, and PE diagnosed in the context of an exacerbation is associated with an increased risk of mortality. Current available PE diagnostic strategies have not been specifically derived and validated in this population. The overall objective of my research program, which include 6 projects, was to determine the optimal management of patients with a suspicion of PE among patients with AECOPD. Project 1 clarified the epidemiology and the burden of PE in patients with AECOPD in North America. It showed that the prevalence of PE in a Canadian center was 1.1% and that in patients with AECOPD, mortality was higher among those diagnosed with PE compared to those without PE. Project 2 and Project 3 presented the performance of available PE diagnostic strategies in patients with chronic lung disease and AECOPD, respectively. These two studies showed that standard diagnostic algorithms were safe, but a high proportion of patients would need imaging to rule out PE. Project 4 evaluated the association between PE and the type of AECOPD and showed that the risk of PE was clinically lower in patients with purulent AECOPD compared to patients with non-purulent/unknown etiology AECOPD. Project 5 presented the derivation of a new diagnostic strategy specifically for patients with AECOPD. The diagnostic strategy consists of a COPD-specific score (type of AECOPD, alternative diagnosis less likely than PE, and clinical signs of deep venous thrombosis) combined with D-dimer testing. Project 6 focused on the feasibility and challenges of a pilot study evaluating prospectively the prevalence of PE in these patients. The study demonstrated its feasibility and targeted challenges such as recruitment of patients, adequate pre-test probability assessment and consistent PE diagnostic strategy use. All 6 projects helped improve PE diagnostic management in patients with AECOPD and thus, clinical care of patients with chronic obstructive pulmonary disease will certainly be improved with this work
Le Moulin-à-Fleur de Sudbury: Quartier ouvrier, territoire canadien-français
No full textÀ son apogée entre 1945 et 1975, le Moulin-à-Fleur ou la paroisse Saint-Jean-de-Brébeuf se vantait d’être le quartier francophone de Sudbury et de l’Ontario. Il représentait en effet la pierre angulaire pour les autres communautés francophones ainsi que le fondement de la vie culturelle, économique et politique des Franco-Ontariens. Mais l’histoire n’a jamais été racontée de façon détaillée.
Des années de recherches approfondies ont incité les auteurs à se plonger dans de nombreux écrits, articles scientifiques, archives personnelles, articles de journaux et témoignages afin de livrer cette première étude globale.
Divisé en deux volets qui se complètent, ce récit retrace à la fois l’héritage des familles qui se sont battues pour offrir un quotidien et un avenir brillants à leur descendance et la lutte féroce menée par des pionniers, notamment Omer Thériault, Gaétan Gervais et Hélène Gravel, pour la défense culturelle et patrimoniale.
Mais tous ces souvenirs dorment dans les rues de l’ancien quartier ou comme Mme Tregonning-Whissell le disait, «à l’ombre des silos». Ce livre témoigne des origines d’une communauté marquée par le dur labeur des mineurs de l’International Nickel, tout en évoquant le rôle des enseignants qui éveillaient les jeunes générations à un monde de possibilités. Le Moulin-à-Fleur de Sudbury rend hommage aux valeurs de charité et d’entraide qu’incarnait ce quartier qui célèbre au-delà de 120 ans de vie communautaire et culturelle.INTRODUCTION
Pourquoi étudier le Moulin-à-Fleur?
Comment raconter cette histoire
Chapitre 1.
L’émergence d’un quartier ouvrier canadien-français à Sudbury (1902-1945)
Le peuplement du moyen-nord de l’Ontario
Les Canadiens français et Sudbury au tournant du siècle
Le peuplement de la plaine des jésuites
Borgia et Notre-Dame, rues d’affaires canadiennes-françaises
Tableau 1 : Origines des propriétaires d’immeubles au Moulin-à-Fleur (1920, 1934)
Le développement institutionnel franco-catholique
Crise économique et croissance dans les années 1930
Tableau 2 : Migrations entre Saint-Charles et les villes minières de Sudbury (1905-1943
Politique, guerre et syndicalisme
Chapitre 2.
Un quartier et son âge d’or (1946-1967)
Naître et grandir
S’instruire et apprendre
Souffrir et se faire soigner
Travailler et consommer
Tableau 3 : Évolution de l’actif et de sociétaires de quatre caisses sudburoises (1945-1967)
Prospérer et partir
Chapitre 3.
L’agentivité et les rendez-vous manqués (1968-1997)
Recommencer
Créer
Croire
Se mettre en valeur
Échouer
Chapitre 4.
Une revitalisation lente et incertaine (1998-2022)
Se souvenir et abandonner
Résister et oublier
Tableau 4: La construction domiciliaire dans le Grand Sudbury (1991-2010)
S’ouvrir et revenir à la charge
CONCLUSION
Annexe. Renseignements sur le sondage de l’automne 202
"Victim and Vector": The Affective Life of People with HIV Through the Epidemic Eras
No full textThis dissertation explores the criminalization of HIV nondisclosure through the lens of the sociology of health and illness, critical victimology, affect theory, and narrative theory. It situates participants' stories within different historical periods - ranging from the HIV/AIDS crisis era (1981-1995), through the era of treatment and HIV normalization (1996-present) - to demonstrate how these epochs shape the affective life of people living with HIV (PLWH) as they make sense of their diagnosis, disclosure and nondisclosure, and their sense of self in the present. Drawing on the works of Margaret Wetherell, Sara Ahmed, Ann Cvetkovich, Arthur Frank, and Paul Ricoeur it develops the concept of the affective narrative self to understand how individuals construct and make sense of their identities through the interplay of emotions and storytelling. The dissertation explores how the affective narratives of HIV are historically contingent, such that how people feel and narrate their experiences of living with HIV and their sense of self is shaped by the dominant cultural and medical logics of their time. Methodologically, it employs a feminist affective epistemology (Hemmings, 2012) and a theoretical narrative analysis (Riessman, 2008) to analyze semi-structured interviews with 44 participants - 43 PLWH and one HIV-negative person whose partner did not disclose their serostatus prior to sex - as well as lifeline drawings that visually depict their experiences.
There are three substantive analysis chapters which discuss the findings of this study. The analysis reveals that HIV nondisclosure is experienced through competing affective narratives of victimhood. While some participants described nondisclosure as a betrayal that elicited anger and sometimes a desire for legal recognition, others resisted the victim label, citing personal responsibility for sexual health. PLWH articulated their experiences of diagnosis through different registers of grief and as a form of biographical disruption, marked by narratives of the loss of one's sense of self, the loss of one's healthy body, the death of friends and family, and social death. The study further identifies the undetectable self as an affective narrative self, wherein undetectability functions as both an empowering and disciplining force. Ultimately, this research challenges punitive approaches to HIV nondisclosure and advocates for transformative justice frameworks that move beyond legal retribution to address the structural inequalities shaping PLWH's lives
How Do Public Relations Practitioners Experience Technostress? Voices of PR Practitioners in a Hyperconnected World
No full textThis research examined the lived experience of public relations (PR) practitioners who use Information and Communication Technologies (ICTs) such as smartphones and laptops for work purposes, not only during the regular work day but also after hours and on weekends. Through the voices of the practitioners themselves, experiences of stress, work-life balance, satisfaction, and other factors were studied. This research followed a critical approach focused on the hyperconnected, hypermodern society in which everything is socially accelerated. Research questions examined the experience of technostress of public relations practitioners, the strategies practitioners used to resist or emancipate themselves from the constant call of technology for work purposes, and what this means for PR practitioners and the practice of PR. Practitioner views on the right to disconnect were also probed and this research was able to gather reflections from practitioners on their experience of working during the COVID-19 pandemic. Mixed methods consisted of an online survey (N=123) with PR practitioners followed by interviews (N=25) with a sub-set of survey respondents. This study found that PR practitioners appreciated the flexibility that remote and hybrid forms of work have brought to the workplace. However, the range of strategies applied by practitioners to get relief or free themselves from the constant call of connection was limited in many cases. Practitioners felt better resourcing, better support and role modelling from senior leadership, stronger boundaries, as well as a shared understanding of what constituted a crisis needing communications support outside of regular working hours would support practitioners. These findings contribute to public relations scholarship by focusing on the voices of PR practitioners in Canada and the experiences they face with ICTs and their work
Evaluating Patient Selection for Surgery in Older Patients with Non-Metastatic Colorectal Cancer in Ontario: A Population-Based Cohort Study
No full textBACKGROUND:
Surgeons are faced with an increasing number of patients over the age of 80 presenting with non-metastatic colorectal cancer (CRC). Justifying major surgery in a comorbid and frail population requires individualized decision making and remains a challenge for surgeons. Few studies compared survival in these patients with and without surgery, but all had important biases. In addition, no study has evaluated survival from a surgeon's case selection perspective. This study evaluated the quality of patient selection in Ontario octogenarians and nonagenarians with non-metastatic colorectal cancer by comparing survival by surgery status in important patient subgroups.
METHODS:
A retrospective population-based cohort study was conducted using population-based health administrative data in Ontario, Canada from 2010 to 2020. We included all patients aged 80 and over with stage I-III colorectal cancer. We first conducted an unadjusted analysis using methods described by Simon and Makuch, then we used a proportional hazards model to measure the association of surgical cancer resection with all-cause survival adjusted for: patient age, sex, and frailty; cancer stage and location; and year. Surgical status was a binary variable expressed as a time-dependent covariate. Interactions between surgical status and all other covariates were included. These results were visualized using heat maps.
RESULTS:
We identified 5782 patients; 4779 underwent elective colorectal surgery and 1003 did not. The surgery group was younger (84.4± 4.5 vs 86.9± 3.6), had more colon/recto-sigmoid cancer (83.7% vs 62.6%) and the difference in frailty between the two groups was small (standardized difference 0.21). Patients selected for surgery had significantly improved survival in almost all subgroups including stage I to II colon and rectal cancer and almost all patients with stage I-III colon cancer. Survival benefit of surgery was greatest in stage 1 disease and progressively decreased with stage 2 and 3 disease. Both male and female patients with stage III rectal cancer having increased levels of frailty undergoing surgery did not have better survival. The most important covariates associated with survival (from most to least important) were surgery, frailty, age, stage, and sex. Tumor type had the smallest independent influence on survival.
CONCLUSION:
Surgeons in Ontario are very good at identifying older patients with colorectal cancer in whom surgery improves survival. Age and frailty alone should not preclude patients from being considered for surgery
Essays on Development Economics in China
No full textThe rapid rise of China in recent decades presents a unique and attractive context for contributing and testing theories in development economics. Beneath the remarkable growth, there seems to be a "helping hand" from the government to direct and facilitate the development. In my doctoral thesis, I employ rigorous applied econometrics methods to investigate topics in development economics from two major events: the Wenchuan earthquake in 2008 and the implementation of the Targeted Poverty Alleviation program in 2015.
Chapters 1 and 2 both study the Wenchuan earthquake in 2008, one of the most destructive earthquakes in modern China. In Chapter 1, I use county-level panel data from 2003 to 2019 to reveal the variation in the earthquake effect over time, as the largest economic setback takes place in 2008. However, the economic recovery in the following years drives severely affected counties to catch up with non-severely affected counties at the end of the sample period. I also find that the average effect of the Wenchuan earthquake causes a decline of 12% in GDP per capita for those severely affected counties, despite that the method tends to ignore the post-earthquake recovery. Consequently, the economic suffering from the earthquake is considered as short-term.
In Chapter 2, I use the exogenous exposure to the 2008 Wenchuan earthquake and the age of students at the time of the disaster to estimate its impact on educational attainment. The findings reveal that students younger than 15 years old in severely affected counties experience a reduction of 0.36 years in schooling, equivalent to a 3.7% decline. I propose one mechanism to explain this outcome: the protective role of compulsory education, which helps prevent early dropouts but ends after junior high school. In summary, this analysis provides insights into how natural disasters can disrupt human capital formation of young students.
Chapter 3 shifts the focus to the government-led Targeted Poverty Alleviation program by evaluating its impact on urban-rural income inequality in China. Income inequality is defined as the ratio of the urban net income to the rural net income, both in per capita form. The main finding suggests that the program leads to a 3.8% reduction in the urban-rural income ratio in poverty counties, compared with non-poverty counties, which implies a discernible convergence in income levels. I discuss that the significant increase in rural income per capita, improved rural employment, and more government spending largely contribute to the narrowing urban-rural inequality in poverty counties
Enhancing Motor Cortex Excitability in Mice Through Optogenetic Intermittent Theta Burst Stimulation
No full textThe motor cortex (MCX) is integral to voluntary movement, sending signals from the brain to spinal motoneurons through the corticospinal tract. Enhancing MCX offers the potential for improving motor function in healthy individuals and aiding recovery post-stroke. Intermittent theta burst stimulation (iTBS) has shown promise in increasing MCX excitability in clinical settings, but its effects are often short-lived and lack spatiotemporal precision. Additionally, the use of invasive tools in animal models to study iTBS presents further challenges to its development. To overcome these limitations, this thesis will use a noninvasive approach that combines transcranial optogenetics with iTBS (opto-iTBS), offering high spatiotemporal precision and aiming to achieve more sustained enhancements in cortical excitability.
We hypothesized that opto-iTBS significantly increases cortical excitability and motor output in naïve mice. Specifically, we designed four noninvasive metrics, including tracking evoked forelimb movement, recording blood flow and epidural EEG signal, and using light-based motor mapping to track changes in the MCX pre- and post-opto-iTBS.
We established an iTBS protocol in mice using transcranial optogenetic stimulation. Using blue light stimulation in ketamine/xylazine anesthetized Thy1-ChR2 mice, we measured the time course of enhanced cortical excitability based on the amplitude of evoked forelimb movements and EEG recordings from the MCX. Stimulation was performed through a transcranial chronic window that provides optical access to the MCX in both hemispheres, thus allowing repeated assessments of iTBS effects. Laser Doppler imaging recorded blue light-evoked hemodynamic changes in the MCX during iTBS. Epidural EEG electrodes collected blue light evoked signals from around the stimulation region.
Our findings demonstrate that opto-iTBS significantly increases the optogenetically evoked contralateral forelimb movement amplitude for at least 85 minutes post-stimulation and expands the size and activation threshold of the motor map for a minimum of 10 minutes. Additionally, a significant increase in blood flow at the stimulation site in the MCX was observed during opto-iTBS induction.
Our noninvasive optogenetic stimulation approach enables longitudinal experiments that allow multi-target assessment, control of stimulation parameters, and within-subject measures of treatment effects. By elucidating optimal parameters and targets for iTBS, this research may identify therapeutic interventions to improve function following MCX stroke
The University of Ottawa Library OER Program: Evaluation Report
No full textLaunched in 2020, the University of Ottawa Library OER Program seeks to raise awareness among faculty members about the cost of commercial course materials and encourage them to choose free, open-access resources, thereby reducing the financial burden on students and promoting access to knowledge. Additionally, given the persistent lack of French-language educational resources adapted to a minority context, the program (particularly its grant component) also aims to encourage the production of OER in this language.
The OER Program was evaluated to assess its relevance, effectiveness, and efficiency. This exercise coincides with the fifth and final year of the program and aims to determine whether the human and financial resources invested have led to the desired short-term and intermediate outcomes and to suggest improvements for the implementation of other OER initiatives at the University
Whose Worship? An Examination of Women’s Gendered Experiences in the Contemporary Worship Music Industry
No full textFor Evangelical Christians in North America, the contemporary worship music industry is the primary source of music for radio play, private devotion, and Sunday morning worship services (Ingalls 2018). As the industry has developed, it has become increasingly difficult for women to pursue musical leadership (Loepp Thiessen 2022). This dissertation examines women's gendered experiences in the contemporary worship music ecosystem. Though they face spiritualized limitations, women in the industry contribute through a range of both public facing and concealed roles. Through 22 qualitative interviews with women songwriters, worship leaders, and industry professionals, I examine the factors that dictate their experiences both of limitation and of finding empowerment. The concept of “gendered stages” (McCusker 2017) is used to organize the different facets of women’s experiences: setting the stage (Chapter 3) by exploring their leadership in the early days of the industry; “on stage” (Chapter 4) as worship leaders, instrumentalists, or background vocalists, “off stage” (Chapter 5) as songwriters, producers, or audio/visual supports; and when they have been monitored on stage (Chapter 6) for their gender and sexuality, sometimes resulting in exclusion from the industry. I present case studies of women in each of these stages, interrogating how Evangelical values intertwine with women's careers and personal lives. Ultimately, this project builds upon literature which interrogates questions of agency and empowerment in conservative religious contexts (Avishai 2008, Burke 2012), and explores how women in the Christian music industry thrive in spaces that present limitations
L1 and L2 Processing of Filler-Gap Dependencies in Mandarin Chinese Speakers: Evidence from Self-Paced Reading Times and Event-Related Potentials
No full textLanguage processing is a complex task requiring our brain to rapidly integrate various linguistic information from strings of unfolding words and quickly build comprehension. While previous studies have shown that native speakers (L1) employ both incremental and predictive processing in real time (e.g., Clifton & Frazier, 1989; Altmann & Kamide, 1999), debates persist regarding how second language speakers (L2) process sentences in real time and whether their processing mechanisms align with or differ from those of native speakers. In the field of L2 processing, some scholars believe that L1 and L2 processing share qualitatively similar mechanisms, and differences in L2 processing profiles arise from individual factors or language features (e.g., Dallas et al., 2023; Sabourin et al., 2014; Sabourin & Stowe, 2008; Berghoff, 2022; Grüter & Rohde, 2021). Others argue for qualitative differences between L1 and L2 processing (e.g., Clahsen & Felser, 2006; Pakulak & Neville, 2011), and these differences are especially apparent when the sentence structure includes filler-gap dependencies, a non-local syntactic structure requiring parsers to establish a connection between a displaced filler and its corresponding syntactic gap over distance (e.g., Marinis et al., 2005; Dong et al., 2023). The primary goal of this dissertation thus is to examine how L1 and L2 speakers process filler-gap dependencies in real time and whether they show qualitatively similar or different processing profiles and underlying neural mechanisms in response to both syntactic and semantic cues.
Three experiments were conducted in the dissertation. Experiment 1 used a self-paced reading paradigm to investigate how L1 English speakers and L2 speakers with L1 Mandarin Chinese process filler-gap dependencies with varying dependency lengths (long vs. short) and filler plausibility (plausible vs. implausible). The results showed that both L1 and L2 groups, regardless of their L2 proficiency and years of immersion, exhibited increased reading times at the verb, the position that indicates a potential syntactic gap, yet their sensitivity to filler-verb mismatches was observed only in the second post-verbal position. These findings indicated active and sequential processing of syntactic and semantic information. Then, using the same paradigm and within-subject factor manipulations, Experiment 2 investigated whether native Mandarin Chinese speakers process Chinese topic structures similarly to how English speakers process filler-gap dependencies. The results revealed that native Mandarin Chinese speakers, like English speakers, actively searched for gaps, evidenced by elevated reading times at the first verb they encountered and sensitivity to semantic mismatches shortly thereafter. Previous research has shown that active gap-filling strategy can be interpreted as a response to the characteristics of wh-dependencies. (Wagers & Phillips, 2009). Thus, the findings lend support to the existence of movement-derived filler-gap dependencies in Mandarin Chinese, despite its wh-in-situ nature. Lastly, Experiment 3 used event-related potentials (ERPs) to examine the brain responses of L1 and L2 speakers with the manipulation of filler plausibility and gap licensor types, which were either a transitive verb or a preposition. The results showed no overall group difference. However, while L2 speakers with high proficiency showed native-like but attenuated and delayed predictive processing, L2 speakers with low proficiency showed no evidence of prediction and experienced syntactic reanalysis.
Overall, this dissertation revealed qualitatively similar processing mechanisms between L1 and L2 speakers, with L2 differences being explained by individual factors. Moreover, the findings lent support to a movement-derived account of Chinese topic structures, despite Chinese being a wh-in-situ language