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Doctors in Late Antiquity: Changes in Status of Medical Practitioners and the Effect of the Rise of Christianity
No full textThe field of medicine in Late Antiquity occupied a complex position between older Graeco-Roman traditions, and the expanding influence of Christianity. At this time, physicians continued to use the medical works of both Hippocrates and Galen, while also trying to adapt their practices to incorporate themselves in the newly Christian-predominant Western Roman Empire, the Roman East, and the later Successor Kingdoms.
This thesis investigates how doctors were represented, what roles they played, how their status changed, how they adapted to survive during this time, and how Christianity played a major role in the reshaping of the medical world. While the legacy of classical medicine is well known and extensively studied, less attention has been given to the doctors themselves as professionals and people of influence at this time, which this thesis will aim to rectify.
The main focus on the thesis is to provide an introduction to the topic of doctors in Late Antiquity through three chapters. The first contains a discussion of the types of sources which have been used and a brief history of doctors in Rome prior to Late Antiquity. The second elaborates on the new role doctors played at this time, being sent on diplomatic missions East to the Sassanians and why they were chosen, a brief section on education followed by some of the doctors about whom we know that have been compiled in the volumes of the PLRE and the trends that can be seen in each volume. The focus of the third chapter is on the influence of Christianity in Late Antique medicine, the foundation of the first hospitals, the rise of miracle culture, and how doctors fit into this restructured world of healing
Unveiling Hidden Assumptions: How Underlying Beliefs Shape Legal Norms and Create Insufficiency in Artificial Intelligence Regulation
No full textThis dissertation argues that unchallenged assumptions embedded in European Union AI law have led to significant regulatory insufficiency. To demonstrate this, the thesis examines the regulation of General Purpose AI (GPAI), manipulative AI systems, and AI companions. In the case of GPAI, it is argued that the initial legal frameworks were shaped by outdated beliefs about the relationship between data, capability, and harm, rendering them inadequate for the novel challenges posed by GPAI. Similarly, the analysis of AI-enabled manipulation reveals that E.U. law is predicated on flawed assumptions about human rationality and free will, resulting in an under-inclusive ban that fails to address a wide range of manipulative practices. Finally, the case study of AI companions illustrates the tangible harms - ranging from emotional distress to severe psychological manipulation - that arise from these regulatory gaps. By uncovering these hidden assumptions, this work demonstrates how they have influenced the development of key legal instruments like the AI Act, the GDPR, and the UCPD, ultimately creating a legal apparatus ill-equipped to protect individuals from the multifaceted risks of advanced AI systems. --
Cette thèse soutient que des présupposés non remis en question, intégrés dans le droit de l'Union européenne en matière d'IA, ont conduit à une insuffisance réglementaire importante. Pour le démontrer, elle examine le droit de l'intelligence artificielle à usage général, des systèmes d'IA manipulatoires et des compagnons virtuels. S'agissant de l'IA à usage général, il est avancé que le cadre juridique initial proposé par l'AI Act a été façonné par des croyances dépassées sur la relation entre données, capacités et préjudices, le rendant inadapté aux défis inédits posés par l'IA à usage général. De même, l'analyse de la manipulation facilitée par l'IA révèle que le droit de l'UE repose sur des hypothèses erronées concernant la rationalité et le libre arbitre humains, aboutissant à une interdiction trop restrictive qui ne couvre pas un large éventail de pratiques manipulatoires. Enfin, l'étude de cas consacrée aux compagnons virtuels illustre les préjudices concrets - allant de la détresse émotionnelle à la manipulation psychologique sévère - qui découlent de ces lacunes réglementaires. En mettant à jour ces présupposés implicites, ce travail montre comment ils ont influencé l'élaboration d'instruments juridiques clés tels que le règlement sur l'IA, le RGPD et la directive sur les pratiques commerciales déloyales, aboutissant à un appareil juridique mal équipé pour protéger les individus contre les risques multiformes des systèmes d'IA avancés
Shared decision-making and behaviour change collide: an analysis of consultations discussing clinical trial recruitment
No full textAbstract Background Recruitment to clinical trials is often challenging, and evidence on effective recruitment strategies remains limited. Framing trial recruitment as a behaviour, amenable to change, enables the application of behavioural science frameworks to better understand and potentially improve recruitment processes. Since trial participation is also a preference-sensitive decision, shared decision-making (SDM) may further enhance ethical recruitment. The present study aimed to explore how behavioural taxonomies and SDM frameworks can be applied to recruitment consultations to identify behaviour change techniques (BCTs) and assess the extent of SDM. Methods A secondary analysis was conducted on 53 audio-recorded consultations; consultations from 3 trials in oncology and gastroenterology were sampled. The action, actor, context, target, and time (AACTT) framework was used to define recruitment behaviours, which were then coded using the Behaviour Change Technique Taxonomy v1 (BCTTv1). SDM was assessed using the 5-item ‘Observing Patient Involvement’ (OPTION5) tool, which evaluates patient involvement in decision-making. Descriptive statistics and frequency counts were used to analyse the data. Results Twenty-one of the 93 BCTs in the BCTTv1 were identified across all consultations. The most frequently coded BCTs were 5.1 (information about health consequences) and 5.3 (information about social and environmental consequences), both present in all consultations. No substantial difference in the total number of BCTs was observed between trial consenters (M = 6.8, SD = 1.5) and decliners (M = 6.4, SD = 2.1). However, some techniques showed variability: BCT 7.1 (prompts and cues) appeared more frequently in consultations with consenters (84%) than decliners (38%), while BCT 1.4 (action planning) was more frequent in decliners (44%) than consenters (27%). SDM, as measured by OPTION5, was low overall, with a mean score of 27.7 (SD = 12.2) out of 100, with no significant differences across trials or participant groups. Conclusions This study demonstrates the feasibility of applying behavioural science and SDM frameworks to analyse trial recruitment consultations. While a range of BCTs were identified, SDM efforts were generally low. Recruitment practices may benefit from more deliberate consideration of these techniques and greater emphasis on shared decision-making to support informed choices
Transforming Chemical Safety Assessment Using Transcriptomics to Define Toxicological Potency and Common Mechanisms of BPA Replacements
No full textHumans are exposed to chemicals that disrupt the function of endocrine tissues through the use of everyday consumer products and other environmental exposures. Bisphenol A (BPA) is used to manufacture polycarbonate plastics and epoxies and is a developing agent in thermal paper. BPA is an endocrine disruptor that acts on several nuclear hormone receptors, including the estrogen receptor. Most people have measurable levels of BPA in their urine, and exposure is associated with several negative health outcomes. In the late 2000s, BPA was regulated in Canada and other jurisdictions worldwide. This has led to the proliferation of chemical alternatives to BPA, sometimes in products labelled 'BPA-free'. Thus, humans are exposed to BPA alternatives, often as mixtures. Unfortunately, most BPA alternatives are data-poor, limiting regulatory toxicology assessment. The goal of my thesis was to use high-throughput transcriptomics to evaluate the potency of data-poor BPA alternative chemicals and characterize mechanisms of action in vitro. I produced global gene expression profiles to derive measures of biological activity and potency of 20 individual BPA alternatives and mixtures of these chemicals. Gene set enrichment analysis was used to identify perturbed biological pathways and upstream regulators. Transcriptomic biomarkers were applied to identify chemicals that activated the estrogen receptor alpha (ERα) and cellular stress response pathways. Bisphenol AF (BPAF) was the most potent chemical tested overall, activating the ERα at the lowest concentration, followed by BPA. Most BPA alternatives activated ERα and related pathways and enriched similar gene sets associated with dysregulated cell cycle control and cancer-related outcomes in vitro. Next, I used a concentration response model to test whether mixtures of BPA alternative chemicals have additive effects in breast cancer cells. Both equimolar and complex mixtures were additive, activated the ERα, and had similar gene expression profiles as their individual components. Lastly, I sought to test BPA alternative chemicals in a more physiologically relevant model. Human mammary epithelial cells (HMECs) from multiple donors were exposed to a subset of BPA alternatives chemicals. These chemicals had similar potency rankings in MCF-7 and HMEC cells, with BPAF exhibiting the highest potency. Some of the BPA alternatives activated cancer-related pathways, while others inhibited the same pathways in HMECs. Overall, my thesis demonstrates that many BPA alternatives have comparable toxicological potencies to BPA, behave additively in mixtures, and have similar mechanisms of action in vitro. Importantly, this research identified BPAF as toxicologically potent BPA alternative chemical. Finally, these data demonstrate a pragmatic approach to the implementation of transcriptomics in regulatory toxicology and decision making
A Deep Learning Pipeline for Impact Event Detection, Head Impact Classification, and Brain Strain Estimation in Youth Ice Hockey Videos
No full textIce hockey poses a significant risk of head impacts, increasing the likelihood of traumatic brain injuries (TBIs), including concussions. Youth players constitute the majority of the ice hockey population, accounting for approximately 69% of all registered players in the United States alone. Notably, 15-25% of all hockey-related injuries in this age group involve head trauma, underscoring the high prevalence of TBIs among youth participants. Younger players face distinct vulnerabilities due to their larger head-to-body ratio, lower skill levels, weaker neck muscles, and less refined motor control, all of which contribute to a playing style that elevates their risk of head impacts. Furthermore, youth leagues often lack access to professional-grade monitoring systems, such as helmet-based sensors or on-site clinical staff, making early detection and response to brain injuries particularly challenging.
To address these limitations, this thesis introduces a video-based, artificial intelligence (AI)-powered system designed to automatically detect and analyze head impacts in youth sports, facilitating both large-scale dataset generation and injury assessment.
Chronologically, the first component of this work, referred to as Study 2 in the thesis, focused on head impact detection. This study was conducted using professional hockey footage, which offered consistent lighting, high video resolution, and clear player visibility, allowing for early testing under ideal visual conditions. In this phase, we manually annotated head impact moments by reviewing full-game recordings and cropping video segments to center on and isolate each player involved in the contact. To automate this process and enable future scalability, we also introduced a detection and tracking pipeline tailored to professional players, combining You Only Look Once version 8 (YOLOv8)x for player detection - achieving precision 0.97, recall 0.97, and mean average precision (mAP)50 0.99 (at a 50% intersection over union (IoU) threshold) - with StrongSORT for maintaining player identity across frames. The resulting player-centered clips were used to train a long-term recurrent convolutional network (LRCN), which achieved an accuracy of 0.87 in distinguishing head impacts from non-head impact clips. While this study demonstrated the feasibility of video-based head impact detection, it was limited by a small, manually constructed dataset, which restricted scalability and introduced potential inconsistencies in annotation.
Building on the head impact detection framework, the second phase focused on developing a scalable, youth-specific contact detection pipeline. This shift was motivated by a key limitation of the first phase: head impacts are relatively rare events, especially in youth games, making it difficult to build large training datasets for reliable head impact classification. By broadening the scope to detect all physical contact events, not just head impacts, we were able to substantially increase the pool of relevant video clips and create a more scalable and efficient system for data generation and pre-filtering. A fine-tuned YOLOv8 model demonstrated strong player detection performance across diverse youth age groups and challenging visual environments, achieving precision 0.96, recall 0.97, average precision (AP)0.7 (at a 70% IoU threshold) of 0.94, mAP50 of 0.97, and mAP50-95 (averaged over IoU thresholds from 50% to 95%) of 0.82. For tracking, we evaluated the StrongSORT-based module on 100 benchmark clips characterized by high occlusion and rapid movement. The integration of an IoU-based cost term reduced identity switches from 172 to 53 (a 69% improvement) and improved Multiple Object Tracking Accuracy (MOTA) from 89.0% to 94.5%, confirming the system's robustness under realistic youth hockey conditions. A temporal shift module (TSM) network was then applied to classify physical contact events (e.g., player-to-player, player-to-board), achieving a recall of 0.94 and reducing manual review time from several hours to under 30 minutes per game.
The final study introduced a deep learning model to estimate maximum principal strain (MPS), a validated biomechanical indicator of brain tissue deformation, directly from video-derived features. Using 477 reconstructed youth hockey impacts involving players aged 5-17, four features were extracted from video for each event: impact velocity, surface compliance, impact location, and elevation, with player age group included as an additional non-video input. A fully connected neural network trained on this dataset achieved strong predictive performance, with a test-set coefficient of determination (R2) = 0.89 and mean squared error (MSE) = 0.0015. Permutation importance analysis confirmed that impact velocity was the most influential predictor. These results demonstrate the feasibility of estimating brain strain from video features and basic contextual information, offering a scalable, non-invasive approach for monitoring injury risk in youth sports.
Together, these three studies form a comprehensive, video-based pipeline for detecting impactful events, identifying head impacts, and estimating head impact severity in youth ice hockey, advancing injury surveillance in settings where traditional tools are often unavailable
« Sans non, c'est oui, mais... » l’exploration de la définition et des nuances d’interprétation du consentement sexuel auprès de la population universitaire
No full textSachant que le consentement sexuel est au centre des préoccupations sociales et juridiques, il est important de connaitre comment sa définition est mise en pratique lors d’activités sexuelles. Ce projet de thèse explore la compréhension et les nuances d’interprétation de la définition du consentement sexuel auprès de la population universitaire. Pour ce faire, un questionnaire a été créé afin de recueillir les connaissances et les réflexions personnelles des répondant(e)s. Avec l’appui de la théorie des scripts sexuels de Simon et Gagnon (1973), les trois thèmes dominants (la réciprocité, l’autonomie sexuelle et le plaisir) ressortis lors de la recension des écrits ont été mis en relation avec les données recueillies par sondage. L’analyse des données issues des réponses des répondant(e)s nuance la définition juridique du consentement sexuel par le caractère complexe des situations et les multiples variables présentes lors d’interactions à caractère sexuel entre des individus.
As sexual consent is at the center of social and legal concerns, it is important to know how its definition is put into practice during sexual activities. This thesis project explores the understanding and nuances of interpretation of the definition of sexual consent among the university population. To this end, a questionnaire was created to gather respondents' knowledge and personal reflections. Drawing on Simon and Gagnon's (1973) theory of sexual scripts, the three dominant themes (reciprocity, sexual autonomy and pleasure) identified in the literature review were linked to the survey data. Analysis of the data from the respondents' answers qualifies the legal definition of sexual consent in terms of the complex nature of situations and the multiple variables present in sexual interactions between individuals
Place(ing) Relations, Embodying Intentions: A Decolonial Feminist Ethnography of Archival Praxis Among Indigenous and South Asian Artists and Curators in So-Called Canada
No full textWithin escalating conditions of settler colonial violence, Indigenous and South Asian artists and curators in so-called Canada are creating living archives through embodied practices that refuse colonial logics while generating alternative modes of survival and relation. Drawing on autoethnographic reflection and sustained ethnographic engagement between 2022-2024, I argue Indigenous and South Asian diasporic artists and curators enact decolonial feminist archival praxis to create living, embodied counter-archives grounded in place-based accountability that reveals how cultural practice becomes technologies of resistance within ongoing occupation. As a Bengali-Persian refugee-citizen, I offer শুধু নিয়ত| shudho niot (heartfelt intentions) as methodology, rooted in Islamic philosophy and transformed through accountability to Indigenous sovereignty.
I develop key concepts: diasporic mimetic archives, examining Farheen HaQ's transformation of South Asian Muslim wedding rituals into land-based protocols; sovereign ordinariness and archival afterlives, embodied in Christine Toulouse's quillwork practice embracing decay as continuance and asserting Indigenous temporal sovereignty; and cross-cultural-collaborative archival praxis, which informs Naveen Girn and Alanna Edwards' respective place-based curation.
These practices operate through asymmetrical parallelity, acknowledging fundamental differences between racialized settler and Indigenous experiences while creating accountable relations across difference. I advance critiques of Asian settler colonialism by offering models for accountable practice, contribute methodological frameworks that ground decolonial theory in embodied practice, and reveal how intimate refusals maintain cultural sovereignty while navigating institutional demands. This dissertation shows how artists and curators are creating alternatives grounded in place-based accountability and care-centered protocols, demonstrating archives as technologies for collective survival and liberation
Structural Barriers and Equity Considerations in Supporting Immigrant Access to Healthcare: Building Capacity with Local Immigration Partnerships (LIPs) in Ontario
No full textMeeting the healthcare needs of immigrants is crucial to ensuring their wellbeing and successful integration. In the late 2000s, Canada deployed a novel approach to settlement governance and coordination by creating Local Immigration Partnerships (LIPs), starting in Ontario. While evidence exists on LIPs' role and capacity in improving settlement services, more research is needed to understand their contributions within the health sector. This thesis aims to advance knowledge of the LIPs' role in facilitating immigrants' access to primary healthcare services. The study relied on a mixed quantitative-qualitative methodology and applied an integrated Social-Ecological Model and Health Equity/Access to Care framework. A scoping review was undertaken to investigate if and how 'non-medical' settlement coordination organizations support access to healthcare services; a quantitative questionnaire was administered to LIPs in Ontario to examine their capacities to support diversity, equity and inclusion considerations in access to healthcare efforts; and a qualitative case study comprised of interviews, a focus group, and a complementary document analysis was undertaken to uncover the experiences of an established Ontario LIP within the health sector. The findings are presented in an article-format thesis. Our scoping review found 10 publications that revealed local settlement coordination organizations support access to primary healthcare services for immigrants at the individual, relationship and community level. Survey findings suggested that 18 of 22 global health competencies were relevant to LIPs; participants had higher confidence in competencies that involved communication skills, leadership, building coalitions, creating opportunities to access local communities and authorities; they, however, had lower confidence in technical tasks such as analyzing policy, planning, implementing and/or evaluating health programs, and creating opportunities to access higher-level decision-makers. Case study results identified four themes outlining areas where the Ottawa LIP supports healthcare access: cross-sectoral coordination and collaboration; advocacy and policy influence; engaging and empowering communities; and building capacity and informing service delivery. Findings demonstrated the challenges around resource constraints, governance and organizational structure, and relationship management. LIPs support access to primary healthcare services by addressing structural barriers and equity challenges. Including LIPs in collaborative actions towards improving equitable healthcare access may provide more scope to respond to healthcare gaps
Linking Lives Through Care: Two Studies Exploring Care as a Relational Process in Dementia Care
No full textBackground: Dementia is a neurological disorder affecting comprehension, communication and memory, and those living with dementia become progressively dependent on care from others. Despite considerable care needs, however, older adults with dementia are rarely consulted about their own care. The biomedical discourse of deficit and decline has marginalised their voices both in research, where methods mostly rely on verbal conversation and recall, and during care, where caregiving is often perceived as unidirectional. This detracts from understanding dementia care as a relational process. In this dissertation my overall purpose has been to investigate the process of relational care, using research methods that create space for and make visible the participation of older adults with dementia. Objectives: My dissertation is article-based and includes two studies. My first study objective was to critically review the literature on inclusive communication during everyday care routines in long-term care through a qualitative meta-ethnography. My second study objective was to examine how care practices are enacted over time in families living with dementia using a small stories research model of inquiry and multi-modal approach to communication. Ten dyads, each including a participant with dementia and their family member, participated in the study. The interview process included two individual interviews with family member participants, followed by a dyad interview designed as a joint storytelling activity. A further objective of my second study was to qualitatively evaluate the methods used (small stories and objects) to accommodate differences in communication. Tronto's ethic of care served as a theoretical framework for both studies. Findings: In my first study findings I highlight the concept of doing with to represent an approach to care in which both people are actively engaged. This was seen to involve skills in creating space for older adults with dementia to participate during care activities, an orientation towards responsiveness and sensitivity to non-verbal communication. In my second study, I trace the origins, evolution and ongoingness of particular care practices in the lives of six family dyads where symptoms of dementia are advanced. This brought to light the past and present influence of participants with dementia as well as ongoing adaptations by family members to accommodate dementia and sustain connection. During the dyad interviews, the inclusion of objects alongside small stories allowed for an interplay between verbal and non-verbal interactions that opened space for participants with dementia to contribute as co-tellers. The stories that were told - about mutuality, inclusion and food and feeding - highlight the role played by familiar care practices in mediating (maintaining, continuing and repairing) relationship as symptoms of dementia advance. The concepts of doing with, creating space and responsiveness were seen to apply equally to activities of care, storytelling and research. Conclusions and Implications: These findings underline the importance of foregrounding the participation of older adults with dementia in furthering knowledge about care that is relational. They also highlight the importance of an inclusive communication environment to support their participation, whether during care or in conversations about care