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Building Peace Through National Dialogues: What Role for Civil Society Organisations in Cameroon and in Africa?
No full textIn his quest to define peace, Johan Galtung, one of the pioneers in peace research, distinguishes two types of peace: positive and negative. While negative peace is perceived as the absence of human violence and war, positive peace represents the absence of structural violence. Overtime, Galtung's views have shaped contemporary peacebuilding processes and practices. The distinction between positive and negative peace underscores the need to consider both direct violence (protests, armed attacks, police brutality, etc.) and structural violence (inequalities, social discrimination, marginalization, etc.) in designing sustainable peacebuilding strategies. In recent decades, national dialogues have emerged as viable peacebuilding strategies to address historical, political and socioeconomic disputes. In principle, they should foster social cohesion by engaging various perspectives and ensuring that diverse voices are heard. Yet, most dialogue processes organized across Africa have failed; even a few that have ended with an agreement have suffered from poor implementation, leading to a relapse of violence. Although there is no one-size-fits-all approach to national dialogues, it is essential to consider various factors contributing to their failures. The practical puzzle here is to explore strategies that can be employed to ensure that dialogue processes are successful and achieve their desired outcomes. Faced with this puzzle, this thesis responds to the question: What is the actual and potential role of civil society organizations in national dialogue processes in Cameroon and Africa?
Civil society organizations can potentially play key roles in political processes such as national dialogues. CSOs can engage in discussions and collaborate with governments, policymakers, and other stakeholders to advance the interests of the people they represent. Notwithstanding, elites and parties to conflict sometimes intimidate civil society organizations using different means, including open crackdowns on their activities, unlawful arrests and persecution, and misuse of state instruments such as terrorism laws, to silence them. While a few civil society organizations can overcome these oppressions, in Cameroon and other African countries, such practices have limited the strength and ability of many CSOs to engage in peace processes.
Although the literature on civil society and their role in peacebuilding and national dialogues has grown significantly in recent years, there is still a need for more rigorous research on the impact and effectiveness of CSOs in national dialogues. Much of the existing literature focuses on well-known, often international, civil society organizations, overlooking the roles and contributions of local and grassroots organizations, especially those working in fragile and conflict-affected states. Moreover, while the importance of inclusivity in national dialogues is widely acknowledged, there is a gap in understanding how and why CSOs are often marginalized, particularly by state-based elites, and the different options for addressing power imbalances in peace processes. This thesis contributes to the literature on civil society and peacebuilding by addressing these gaps.
Based on data collected through literature review, interviews, and field observations, the thesis argues that national dialogue processes can be manipulated and rendered unproductive when civil society's role is minimal, or their inclusion is approached superficially. I posit that a social contract between the state and the population and a certain level of social cohesion is necessary to encourage the transparent inclusion of politically marginalized actors in African dialogue processes. Based on primary data from Cameroon, the research findings suggest that elites have deceptively used catchphrases and other false narratives to discredit the legitimate grievances of civil society organizations, intimidating or preventing them from challenging existing power structures. This has often reinforced deeply rooted mistrust and inequalities. The literature on the local turn in peacebuilding emphasizes the significance of employing local agency and contextual knowledge for effective peacebuilding. These normative principles could potentially address Cameroon's Anglophone crisis. However, their application in practice (through national dialogues) has unfortunately reinforced power imbalances and the marginalization of civil society and other non-state actors. This thesis concludes that including CSOs in national dialogues is essential for ensuring transparency, addressing power imbalances, and fostering social cohesion. It provides valuable suggestions on how national dialogue stakeholders in Cameroon and beyond can approach meaningful inclusion
Disrupted Cystine Transport Via xCT Induces Serine Metabolic Reprogramming and Enhances Differentiation in Skeletal Muscle Cells
No full textSkeletal muscle (SKM) is a remarkable tissue that exerts many important functions such as maintaining posture and mobility, but also plays a major role in metabolism. SKM health is affected by redox homeostasis, which involves electron transfer between molecules driven by redox pairs that interconvert between oxidized and reduced states. The antioxidant glutathione (GSH) and its oxidized disulfide form (GSSG) is one such redox pair that is very abundant in cells, including muscle stem cells (MuSCs), and therefore generally determines cellular redox state. The synthesis of GSH is limited by the availability of cyst(e)ine, which mostly enters cells through the cystine/glutamate plasma membrane antiporter xCT. The goal of this work was to assess the impact of disrupted cystine import on MuSC health and SKM regeneration (myogenesis). Specifically, the understanding of the specific metabolic implications induced by xCT dysfunction, and their consequence on mitochondrial function and myogenesis was sought. MuSCs from mice harboring a mutation in the Slc7a11 gene encoding xCT (Slc7a11ˢᵘᵗᐟˢᵘᵗ) were investigated and findings demonstrated perturbed GSH homeostasis and higher H₂O₂ production compared to WT. Moreover, Slc7a11ˢᵘᵗᐟˢᵘᵗ MuSCs had lower mitochondrial oxidative function and higher Drp1-mediated mitochondrial fission. Metabolomics analyses and [U-¹³C]-glucose stable isotope tracing showed profound metabolic reprogramming in Slc7a11ˢᵘᵗᐟˢᵘᵗ MuSCs, characterized by lower TCA cycle activity and increased glucose flux towards de novo serine and cysteine synthesis. Finally, Slc7a11ˢᵘᵗᐟˢᵘᵗ MuSCs demonstrated higher differentiation and regeneration rates as evidenced by a higher fusion index of myotubes at day 2 of differentiation and increased tissue myofiber cross-sectional area at 21 days post-cardiotoxin injury. Therefore, beyond its established function in redox homeostasis, this work unravels a critical metabolic function of xCT in muscle cells, providing insights that may inform therapeutic strategies for muscular pathologies
Scrambling for Parenthood? Conflicted Hope, Biogenetic Parenthood, and Egg Freezing Among Transgender and Gender Diverse Individuals Taking Testosterone in Ontario
No full textTransgender and gender diverse (TGGD) individuals remain out in the cold when it comes to reproductive healthcare in Ontario. While trans-based organizations continue to promote the importance of providing gender-affirming reproductive healthcare to all TGGD individuals before, during, and after HRT (hormone replacement therapy), many TGGD individuals remain unaware of their fertility options. Using a 31-question survey, in-depth, semi-structured interviews, and a research journal, this thesis explores fertility preservation among 21 TGGD survey respondents and nine TGGD interview participants living in Ontario who are or have used testosterone (HRT). This thesis uses queer theory and is based on themes of biogenetic parenthood, egg freezing, and conflicted hope to demonstrate how TGGD individuals in ON live out queer kinship by delegitimizing the importance of biogenetic connection. Rather, TGGD participants in this thesis turn to family formation such as adoption, fostering, and mentorship for complex reasons. Even those who have used biogenetic forms of reproduction, such as egg freezing and pregnancy, to form their families deprioritize biogenetic parenthood but still have some concerns regarding age-related infertility. Regardless of the pathway to parenthood and family formation taken by participants, concerns regarding transphobia, financial cost, disability, and gender dysphoria remain
Integrated Virtual Care (IVC) - An innovative hybrid model of primary care, combining in-person and virtual care options, in Renfrew County, Ontario.
No full textBackground
Renfrew County is the largest geographic county in Ontario with a dispersed and diverse population. There are insufficient family physicians and other primary care providers to meet the needs of its residents. IVC aims to address this problem by enrolling unattached individuals to a family physician who works predominantly remotely. This enables family physicians from across Ontario to join the program and work a flexible schedule that aligns with their individual professional and personal circumstances.
IVC Structure
The IVC family physicians are embedded within existing, local interdisciplinary primary care teams (IPCTs). Patients receive comprehensive, team-based primary care, through a hybrid of in-person, at-home and virtual care options, depending on their individual needs and preferences. Virtual care options include secure messaging, telephone and video encounters from the patient’s home, and enhanced telemedicine options at a local IPCT. Partnership with the existing community paramedicine program allows a range of at-home and remote care monitoring options for vulnerable, home-bound patients. Other physicians, nurse practitioners and interdisciplinary health professionals in each local group, provide additional in-clinic care options.
Identifying and enrolling unattached residents
The Renfrew County Virtual Triage and Assessment Centre (VTAC) is leveraged to identify unattached patients who are accessing care through VTAC, with the offer of joining the IVC program extended to any additional unattached members of their household. Additional unattached residents are identified through Ontario’s Health Care Connect (HCC) program and offered attachment through IVC. Further potential exists to identify and prioritize specified groups of higher needs, unattached patients. New IVC patients complete an onboarding process that includes digital processes for the collation of their medical history followed by a review of their existing medications by a pharmacist. A medical chart and cumulative patient profile are completed prior to their first encounter with their new family physician. Patients have access to the full suite of services provided by their local IPCT. Additional nurse practitioner time is protected for IVC physicians to request in-person assessment for specific issues as required and on-site group physicians are also available to provide in-person care. Patients book appointments with their family physician by calling the front desk, or through an online appointment booking platform.
Evaluation
IVC aligns with the principles of Ontario's Digital First for Health strategy. As of March 31, 2025, 6804 previously unattached residents are attached to 19 IVC family physicians embedded in three IPCTs. Formal evaluation of patient, clinician and non-clinical staff, showing impressive levels of satisfaction, have been completed and submitted for publication. IVC has contributed significantly to improving cancer screening rates, smoking cessation referrals and evidence-based diabetes care for previously unattached residents.
Conclusion
Integrated Virtual Care (IVC) in Renfrew County demonstrates that a hybrid model of in-person and virtual care can deliver a highly effective and widely accepted approach to primary care in underserved communities. Findings from multiple evaluations highlight high levels of patient satisfaction, trust in IVC physicians, and broad acceptance of virtual care as a viable and effective modality. Patients reported feeling well-supported, engaged in their care decisions, and appreciative of the convenience and accessibility provided by virtual visits, complemented by in-person care when necessary. Most experienced minimal barriers to technology use, and many expressed gratitude for the reduced travel burden in accessing care. The clear ability to foster meaningful patient-provider relationships through this model reinforces the program’s efficiency and reach. All clinicians and non-clinical staff recognized and valued the role of IVC in increasing patient attachment and providing more equitable access to primary care in their communities. Physicians noted strong patient relationships and appreciated the flexibility of remote care delivery. Interdisciplinary Health Professional expressed pride in contributing to a community-focused initiative, even as they adapted to expanded roles and responsibilities. While challenges such as increased workload and integration into existing clinical teams were acknowledged, participants emphasized the importance of team-based care, leadership support, and streamlined communication enabled by technology. As IVC continues to evolve, this innovative hybrid care model may offer a scalable and sustainable solution for addressing healthcare gaps and promoting more equitable access to team-based primary care in remote, rural, and underserved communities
Automated Objective Video Quality Assessment for the Automated Edinburgh Visual Gait Score (EVGS)
No full textThis thesis presents a framework for automated video quality assessment in gait analysis, addressing critical challenges in clinical gait evaluation. The research focuses on developing robust algorithms for detecting multiple persons, plane orientation, zoom artifacts, computing overall video quality score, and generating feedback suitable for automated Edinburgh Visual Gait Score (EVGS) scoring.
The methodology involves extracting skeletal keypoints from video frames using the MoveNet Lightning pose estimation model. The algorithms use these keypoints to detect multiple persons, track the person of interest, detect the plane of motion, identify overlapping people, detect camera zooming, and evaluate video resolution. These components are integrated into a unified quality classification system using a Random Forest classifier.
Results demonstrated exceptional performance across various metrics. The plane detection algorithm achieved excellent classification in both training and validation datasets, ensuring only appropriate videos are used for analysis. Multiple person detection and overlap assessment algorithms show strong performance, with accuracies of 96% and 95% respectively in the validation dataset. The zoom detection algorithm achieved 92% accuracy in identifying sudden zoom events in the video. The overall video quality assessment framework demonstrates a 95% accuracy in categorizing videos as either suitable for immediate analysis or requiring manual editing. This high level of accuracy showcases the effectiveness of the proposed methodology in automating the quality assessment process. The system also provides specific suggestions for improvement when videos fail to meet quality standards, enhancing the overall efficiency of the gait analysis workflow.
In conclusion, this research makes significant contributions to automated gait analysis by addressing the crucial aspect of video quality assessment. The developed framework demonstrates high performance score across various quality metrics, potentially removing the need for manual quality check for automated EVGS scoring in clinical practice
Gifted children: What and how to care?
No full textGifted children may have a greater risk of experiencing mental health and socio-behavioural issues than the general child population. The present study investigates the protective and risk factors for the mental health and sleep patterns of gifted children and aims to determine if Meaning Mindset (MM), Mental Wellbeing (MWB), Sleep Patterns, Social Support, and Strengths and Challenges among gifted children are interrelated. Participants (N=17, 12 boys, 5 girls, Mage = 11.50 years, SD = 3.78 years) are gifted children (IQ ≥130) recruited through 25 Facebook pages for parents of gifted children across Canada, Association for Bright Children branches across Ontario, and an association for Gifted Education. Primary caregivers provided ratings of child sleep patterns and disruptions using a sleep log and descriptions of their children’s Gifted Strengths and Challenges (GSC). Demographic questions were also asked. Gifted children provided ratings of their MM and their MWB. Results from this study indicated that children’s IQ scores were significantly inversely associated with MM, positively associated with frequency of nighttime awakenings and with GSC, but, notably, do not suggest any significant relationships with total sleep duration and MWB. Further, GSC was inversely associated with MWB and MM, as well as positively associated with IQ score and night awakenings. Notably, the findings from this study also highlight the moderating role of GSC not only in the relationship between child sleep duration and MM but also in the relationship between total sleep duration and child-reported MWB. Additionally, a mediation analysis revealed the mediating role of MM in the relationship between GSC and MWB. These results provide valuable insights into both the protective and risk factors that could potentially influence the well-being of gifted children
Essays on Incentives, Justice, and Mechanism Design
No full textChapter 1 develops an axiomatic foundation for the classical problem of paying workers in settings where their actions are not observed by the employer. The latter observes the distribution of workers' abilities, has precise or imprecise information on the level of output, and demands fairness. We first characterize workers' pay thanks to a set of axioms developed under conditions of uncertainty and information asymmetry, assuming the employer is Bayesian. This characterization leads to a closed-form reward rule called the informational Bayesian value (IBV). Then, we analyze worker disappointment under the IBV and find that average disappointment is equal to zero for each worker. This latter result is robust to considering all inputs-based types of disappointment, including ex-post, interim, and ex-ante disappointment. The analysis implies that a worker is never disappointed in the long run when the pay rule utilized in an organization under information asymmetry is fair.
Chapter 2 analyzes agents' incentives in a production economy where there are both incomplete information and fairness considerations in the allocation of the economy's surplus. Agents hold private information (type or productivity), with each type profile defining a state of the economy. They choose between remaining inactive and participating in production by selecting from a finite set of available actions. This environment defines a new class of Bayesian economies. I show the existence of a pure-strategy Bayesian Nash equilibrium. Additionally, I uncover conditions that guarantee the efficiency and uniqueness of the equilibrium. Importantly, in the absence of fairness principles, an equilibrium may not exist. The findings are robust to several extensions of the basic model. I develop an application to mechanism design. When incentives are aligned with fairness, I uncover a mechanism that is always Pareto-efficient, and that is incentive-compatible and individually rational under certain conditions. This finding has implications for the design of mechanisms in production economies that are compatible with fairness and efficiency while providing incentives for truthful reporting of private information.
Chapter 3 considers the problem of evaluating the utility of participating in organizations that involve multiple interacting agents and are characterized by imperfect information in the sense that agents' types are uncertain ex-ante. We show that this problem admits a unique solution along the lines of expected utility theory, and that this solution is fully characterized by a natural extension of the notions of neutrality to ordinary risk and strategic risk introduced by Roth (1977). In addition, we analyze the implications of Roth's risk neutrality for incentives and equilibrium behaviors. We show the existence of rationalizable organizations, wherein uncertainty over agents' actions arises as an equilibrium play. We develop an application to the firm, showing that, under Roth's risk neutrality, workers' equilibrium behaviors do not depend on whether or not the firm possesses information on individual costs. Our second application is to two-sided assignment markets involving sellers and buyers of indivisible goods. We show that, under Roth's risk neutrality, there exists a pricing mechanism that achieves the expected utility of all agents when the optimal matching is unique, and that only achieves the expected utility of sellers when there is more than one optimal matching
The Experiences of Five Turkish Internationally Educated Teacher Refugees As They Transition to Ontario, Canada
No full textThis research addresses two major questions: What are the lived professional journeys of internationally educated teachers (IETs) who arrived in Ontario, Canada as refugees following their forced departure from their country of origin? In what ways can Yosso’s community cultural wealth theory help us to understand how IETs navigate their life journeys? I used this framework to draw attention to experiences the participants encounter and how they navigate these as they transition from Turkey to Ontario. Through individual semi-structured interviews, participants expressed their passion and the high value of nurturing future generations as the primary reasons they chose the field of teaching. They experience various challenges in their efforts to reestablish themselves in the education system in Ontario, Canada which led some to pursue other professional fields. Language barriers, confusing bureaucratic processes, and lack of adequate governmental support including financial incentives to complete the assessment and recertification process were highlighted as the main barriers. Several implications emerged. Policy needs to be streamlined regarding credential recognition processes. Cultural biases in the hiring practices need to be addressed. Successfully advocating for policy shifts requires a multi-faceted approach. Finally, the integration of IETs into the Canadian educational space should be prioritized because of its beneficial outcome to deepening the learning for all students, colleagues, and the broader education system
Co-occurrence of myositis and neuropathy after anti-CD30 therapy in a late-adolescent Hodgkin lymphoma patient
No full textAbstract Objective Immune-related adverse events (irAEs) are recognized in oncology, particularly with immune checkpoint inhibitors and other targeted therapies. Brentuximab Vedotin (BV), is an anti-CD30 antibody–drug conjugate- its association with immune-mediated myositis remains unexplored. We report a case of an adolescent with Hodgkin lymphoma (HL) who developed neuropathy and myositis following BV therapy. Materials & methods The diagnostic work-up included MRI as well as microscopic analyses (histology, electron microscopy, and immunostainings including CD30 and MxA) of a gastrocnemius muscle biopsy. Proteomic analysis was also performed on the same biopsy, and paradigmatic protein dysregulations were validated through immunostaining. Serum NCAM1 levels were measured using ELISA. Results The patient, diagnosed with HL at 15 years, developed neuropathy after Vincristine treatment and was switched to BV. During BV therapy, she experienced progressive muscle weakness and foot drop, leading to discontinuation. MRI confirmed myositis, and biopsy revealed neurogenic and inflammatory changes with complement deposition and mitochondrial dysfunction. Proteomics showed upregulation of inflammatory relevant proteins, with HPRT1 (749.43-fold) being the most increased one. Intravenous immunoglobulin (IVIG) therapy improved muscle strength. Discussion Myositis following BV therapy has not been reported. Findings suggest an immune-mediated mechanism with B-cell involvement. Given the response to IVIG, B-cell-directed therapies may be beneficial. This case identifies BV-induced myositis as a novel irAE
Impact of a standardized emergency department asthma care pathway on health services utilization
No full textAbstract Background An evidence-based standardized ED asthma care pathway (EDACP) was developed and implemented in Ontario, Canada. Objective To determine the impact of EDACP implementation and access to ED asthma management resources and specialists on return ED visits. Methods All 173 Ontario hospitals were surveyed regarding their access to community and ED asthma specialists and ED asthma management resources, including EDACP implementation date and status as of August 2017. Survey data were linked to provincial health administrative data to quantify acute health services utilization. A Poisson regression interrupted time series analysis was conducted. Results Of the 123 hospitals responding to the survey, 44 (35.8%) had approved the EDACP. Data were analyzed for the 5 years preceding (30,028 asthma visits) and 17 months following (7,916 asthma visits) implementation, with a 3-month implementation black-out period. After controlling for auto-regressive factors, EDACP implementation was associated with a 2% reduction in the absolute rate of return ED visits within 72 h (p = 0.0124), and within 7 days (p = 0.0295) at teaching hospitals. The same effect was not seen at community hospitals. Peak expiratory flow testing (available at 77% of sites) and spirometry (available at 45% of sites) were associated with 34% (p = 0.0071) and 23% (p = 0.028) reductions in the odds of return ED visits within 72 h, respectively. Conclusion The positive results from this large-scale effort to implement an evidence-based knowledge translation initiative in diverse settings, suggests there is merit in continuing to invest time and resources to overcome barriers to adoption and implementation of this EDACP