8 research outputs found
Oral History Interview with Joseph Sharp, April 27, 2004
No full textThe National Museum of the Pacific War presents an oral interview with Joseph Sharp where he discusses his childhood and education. He describes the process of enlisting in the Navy, the training he had to go through to become a pilot and his experiences in the Pacific Theatre during World War Two
Saved and sanctified: spaces of black youth in two oneness pentecostal storefront churches
No full textThis dissertation examines the spiritual lives of a group of urban youth in two storefront churches in Trenton, NJ. The youth are all members of Oneness Pentecostal churches. In this work, I examine the lives of youth through the prisms of gender, music, and education. My child-centered approach uses qualitative methods and the words and perspectives of the youth themselves in order to capture the experiences and understanding of spirituality. This project also investigates the role that the young Pentecostals in these churches play in the popularity and growth of Pentecostalism in America.Ph.D.Includes bibliographical referencesIncludes vitaby Marcus K. Wood
Martin est en colère by J. Theobald & K. Viala
No full textTheobald, Joeseph and Kévin Viala. Martin est en colère. Toronto: Éditions Scholastic, 2014. Print.This picture book tells a humorous story about a sheep that gets angry very easily when he does not get what he wants. His anger turns him into a nasty and ferocious monster. In the end, he becomes stranded and realizes that it’s not so fun to get mad.I really enjoyed this silly and funny book. I found the pictures to be amusing, colourful and very expressive. The visuals were large and really demonstrated what was happening in the book, to the point where words were not necessarily required to understand the story. The pictures made the story funny, especially when the main character becomes a monster.I loved the fact that all the characters in this book were animals. Animal books are often a great fit for younger students since the character is more easily relatable and does not imply any cultural or ethnic barriers.When it came to the writing, the author used language that was not too complicated or wordy. I especially like this for those students in French Immersion programs since the vocabulary is not too advanced for native English speakers learning French. The text and the images make this a great read for younger students at an intermediate level in the French language.What struck me the most about this book is the open ending. This ending leaves the reader wondering if Martin will make a change in his action this time or whether he will fall back on old habits. Overall this was a feel good, easy to understand and humorous picture book that displays a great message about looking for solutions instead of losing your cool.Highly recommended: 4 out of 4 starsReviewer: Vanessa PesantVanessa Pesant is a grade 2 French immersion teacher in Beaumont. She is currently working on completing her master\u27s degree in Elementary Education
Regional changes in thalamic shape and volume with increasing age
No full textAbstractThe thalamus undergoes significant volume loss and microstructural change with increasing age. Alterations in thalamo-cortical connectivity may contribute to the decline in cognitive ability associated with aging. The aim of this study was to assess changes in thalamic shape and in the volume and diffusivity of thalamic regions parcellated by their connectivity to specific cortical regions in order to test the hypothesis age related thalamic change primarily affects thalamic nuclei connecting to the frontal cortex.Using structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI), we assessed thalamic volume and diffusivity in 86 healthy volunteers, median (range) age 44 (20–74) years. Regional thalamic micro and macro structural changes were assessed by segmenting the thalamus based on connectivity to the frontal, parietal, temporal and occipital cortices and determining the volumes and mean diffusivity of the thalamic projections.Linear regression analysis was performed to test the relationship between increasing age and (i) normalised thalamic volume, (ii) whole thalamus diffusion measures, (iii) mean diffusivity (MD) of the thalamo-cortical projections, and (iv) volumes of the thalamo-cortical projections. We also assessed thalamic shape change using vertex analysis.We observed a significant reduction in the volume and a significant increase in MD of the whole thalamus with increasing age. The volume of the thalamo-frontal projections decreased significantly with increasing age, however there was no significant relationship between the volumes of the thalamo-cortical projections to the parietal, temporal, and occipital cortex and age. Thalamic shape analysis showed that the greatest shape change was in the anterior thalamus, incorporating regions containing the anterior nucleus, the ventroanterior nucleus and the dorsomedial nucleus. To explore these results further we studied two additional groups of subjects (a younger and an older aged group, n=20), which showed that the volume of the thalamo-frontal projections was correlated to executive functions scores, as assessed by the Stroop test. These data suggest that atrophy of the frontal thalamo-cortical unit may explain, at least in part, disorders of attention, working memory and executive function associated with increasing age
Ecological responses to climate extremes in a mesic grassland
No full text2014 Spring.Climate change threatens ecosystems through altered climate means and by increasing the frequency and intensity of extreme climatic events. Such events may have greater impacts on ecosystems than shifting means alone because they can push organisms beyond critical thresholds. Thus, there is an urgent need to assess the response of ecosystems to climate extremes as well as elucidate the mechanisms underlying the observed responses. My dissertation examined the ecological impacts of two years of experimentally imposed climate extremes (heat waves and drought) followed by a recovery year, on a mesic tallgrass prairie grassland ecosystem. The broad objectives of this research were (1) to assess the resistance and resilience of this ecosystem to the individual and combined effects of heat waves and drought, and (2) to identify the ecological mechanisms driving the responses and (3) to evaluate the sensitivities of key carbon cycling process to heat waves and drought. I measured a range of biotic responses to these treatments including: ecophysiology, community dynamics, primary production, and soil respiration in order to gain a comprehensive understanding how this ecosystem responds to such extremes. During the first year of the experiment, I examined the ecophysiological and productivity responses of the dominant C4 grasses to a growing season-long drought and a midsummer, two-week heat wave. Although differential sensitivities were apparent, the independent effects of drought dominated the ecological responses for both species, with only minor direct effects of heat were observed. However, the heat wave treatments had indirect effects via enhanced soil drying, making it difficult to separate the effects of the heat wave and precipitation treatments on biotic responses. Therefore in the second year of the experiment, I controlled for heat-induced water losses during the heat wave and examined the independent effects of heat on net photosynthesis in both grass species under contrasting soil moisture regimes. Under low soil moisture, heat had no effect on net photosynthesis, while increasing temperatures moderately reduced photosynthesis under high soil moisture. Next I examined the resistance and resilience in ecosystem function (aboveground primary production) of this tallgrass prairie to the two years of extreme treatments and for one subsequent recovery year. I observed high resistance to heat but not drought, as aboveground production dropped below historic levels during the second year of the drought. Despite this extreme ecological response, productivity fully recovered in just one year post-drought due to rapid demographic compensation by the dominant grass offsetting the loss of the dominant forb. Finally, I examined the response of soil respiration to heat and drought across the three years of the experiment. As with aboveground net primary production, soil respiration was more sensitive to drought than heat, but it was less sensitive overall to drought than production. There are three main conclusions from my dissertation research. First, this tallgrass prairie ecosystem has low resistance but high resilience to extreme short-term drought, which may be an important characteristic for long-term stability in ecosystems with histories of drought. Secondly, the two most abundant species governed both community and ecosystem-level dynamics across this three-year experiment, providing evidence for the central role of dominant species during these short-term events. Finally, my results suggest that three key carbon cycling processes in this mesic grassland - photosynthesis, plant productivity and soil respiration - are all significantly more sensitive to the independent effects of an extreme drought than heat waves and there were little to no combined effects of heat waves and drought. Overall, these results suggest that in a future with more frequent and extreme heat waves and drought, this mesic grassland will be most vulnerable to water stress, either directly through precipitation deficits or indirectly through warming-induced drying, while the direct ecological effects of midsummer heat waves will be minor
Pore water exchange‐driven inorganic carbon export from intertidal salt marshes
No full text© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Tamborski, J. J., Eagle, M., Kurylyk, B. L., Kroeger, K. D., Wang, Z. A., Henderson, P., & Charette: 1774-1792, https://doi.org/10.1002/lno.11721.Respiration in intertidal salt marshes generates dissolved inorganic carbon (DIC) that is exported to the coastal ocean by tidal exchange with the marsh platform. Understanding the link between physical drivers of water exchange and chemical flux is a key to constraining coastal wetland contributions to regional carbon budgets. The spatial and temporal (seasonal, annual) variability of marsh pore water exchange and DIC export was assessed from a microtidal salt marsh (Sage Lot Pond, Massachusetts). Spatial variability was constrained from 224Ra : 228Th disequilibria across two hydrologic units within the marsh sediments. Disequilibrium between the more soluble 224Ra and its sediment-bound parent 228Th reveals significant pore water exchange in the upper 5 cm of the marsh surface (0–36 L m−2 d−1) that is most intense in low marsh elevation zones, driven by tidal overtopping. Surficial sediment DIC transport ranges from 0.0 to 0.7 g C m−2 d−1. The sub-surface sediment horizon intersected by mean low tide was disproportionately impacted by tidal pumping (20–80 L m−2 d−1) and supplied a seasonal DIC flux of 1.7–5.4 g C m−2 d−1. Export exceeded 10 g C m−2 d−1 for another marsh unit, demonstrating that fluxes can vary substantially across salt marshes under similar conditions within the same estuary. Seasonal and annual variability in marsh pore water exchange, constrained from tidal time-series of radium isotopes, was driven in part by variability in mean sea level. Rising sea levels will further inundate high marsh elevation zones, which may lead to greater DIC export.This research was undertaken thanks in part to funding from the Canada First Research Excellence Fund, through the Ocean Frontier Institute. Additional funding was provided by the U.S. Geological Survey (USGS) Coastal & Marine Geology Program and the USGS Land Change Science Program's LandCarbon program
Hamilton Junior High School Highlights 1990
No full textThe annual publication of the students of Hamilton Junior High School, Lethbridge, Alberta. (Volume. 1989-90)pdfU> ETERNITY S31HU C/) O
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miENDS 3 SPORTaABOVE the crowd[Grade Nine
TYRON ARMFELT
JOLAIN ARNOLD
WENDY
BANKS
LOUISA BENNETT
ANDREW
BENOIT
DARCY
BERNHART
TROY
BERNHART
SEAN
BLAIR
MARSHA
BROME
CHRISTINA
BASCOM
YVETTE
BLACKWATER
MIRANDA
BRUNER
KELLY
BASHFORTH
MICHEAL ANDREWS
ANGEL
CAPLETTE
JANNA
CAREFOOT
KAROLYN
CHANGER
GARRICK
CHOW
LESLIE COLIN
CALDWELL CHRISTIEANITA
DUMONT
JOE TARA LEE KERRI RICHARD
CLARK CLARKE COPELAND COTE
SHERI-LYNN DAUB
ROXANNE DENECKY
PAIGE DESOUZA
DINAH
DESROCHERS
VERONA CURTISS JAMIE
EACLE-PLUME EAGLE-SPEAKER EDWARDS
LEONA-MAE
CREELEY
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NICOLA DUDLEY
JASON
ENTZ
RYAN
FARRIES
NOREEN
FEHR
SUZANNE
FERGUSON
JAMES
FINCH
ERIN
FINCHFIELDKAREN LORI
FISHER FORSYTH
BRETT
FOX
KERRI
GARDENER
SANDRA
GATTO
ERIN CHRIS JENNIFER KEVIN MIRANDA
GIBSON FENDER GLOVER GRAVELAND GRENIER
RICHARD DARREN
GROVER GUENTHER
JAMIE KELLY ROBERT
GUNTER HALKOW HAMILL
SHELLEY
HANSEN
JOLEAN
HARLEY
DAVE
HARRIS
ROBERT
HARRIS
JOSHUA
HASKETTTREVOR CHAD
HAUGEN HEALY
CHRIS
HEALY
MICHELLE WILLIAM
HECKFORD HENINGER
ANDY LANA SUSAN
HENLEY HENESSY HERBIG
ADAM TREVOR
HORNBERGER HUGHES
KELSEY
IRVING
JEFF
IVES
CHRISTINA
KARY
NANCY
JOHNSRUDE
UtKlSTINA
KERCHER
TIMEA
KERITESZ
CINDY
KING
GLENN
KULTGEN
JASON
KUNTZ
LAURA
HUISMAEF
ERIN CAMBEL ERNEST CURTIS WINNIE
LACEY LAI LANGRIDGE LARKO LAU
SCOTT
LAWRENCE
CURTIS
IEJSHMAN
JULIE
LETKEMAN
RAMONA
LIEBAU
JEREMY
LINN
DENISE
LOWEN
KARA JAMES DAWN DANIEL
LISTER MACKAY MAJERAN MANNING
KERRI
MARTIN
ERIK
MASON
KEVIN
MCGEOUGH
ERIN
MCCANN
BRIAN
MCKENNATAMMIE OKA
SANDRA KELLI ROBIN JASON
MCMURRAY MERRILL MERRILL MIKLOS
TROY
MUTTER
BLAIR
NOWICKI
SEAN
OLSEN
DAVE
ORMANDY
AMBER
ORR
DEAN
PALMERCHUK
CAMILLE
MOOK
JEREMY
NEWART
JENNIFER
MOORE
TANNIS NICKOLET
HEIDI
NAPORA
SCOTT
NAY
KIMBERLY
MCMANE
MICHEAL
MILLER
ROBYN
MOODYTRACY RYAN BRENDA RAMIE KATHLEEN
PALMER PARKER PARR PASKUSKI PATERSON
DONAHUE RONDA RANDI AARON JASON
PEARSON PEKKEDER PIERZCHALA POZZI QUIRING
LEISHA
ROBERTS
JENNIFER
RADFORD
KYLE
REED
DENISE
RITCO
JENNIFER
ROBERTS
PAULA
RUSSELL
AMBER
RUTLEDGE
CAMERON
SANDUSKY
KYLE
SAWATSKY
TRACY
SCHOOLERROSALINDE
SCHOW
SHAWNA DAVID
SCULLY SEELY
CHAD LANCE
SELK SEMAK
PETER
TAGG
JOHN
TERRY
JAMIE
TOLLEFSON
CORI LANCE
SOMMERFELDT STENKE
TERESA
STEPPLE
HARVEY
SWEETGRASS
CAREY
THIESSAN
RHONDA
TODERIAN
DEANNA
SENDA
RICHARD
STERLING
DARREN
STEVENSON
ANTHONY
STRAGA
MANDI
STENBACK
MATHEW
STURGEONBRANDON
TOMIYAMA
SHANE
VANDENHOEK
MELANEY
WATSON
JARED
WOLFE
DEBBIE CHRISTINE MATHEW SHAW
T3CHETTER VAN NIEUWENHUIZER VANDENDERGHE VANDENHOEK
JASON DAVID JODY DREW
VERES WAGNER WALKER WALTERS
TINA VINCENT SARAH
WESTON WILLIAMS WINGFIEID
JODY
WELLS
EVAN
WORKMAN
JENNIFER DANA
WYNNYCHENKO ZARETSKI
JEFF
BAKERGREG HENDRICKS CALEB WILDE
OLIVER BARIL STEPHEN BEREZAY
KARLA BLAIR
CHRIS BLAND DEREK HACKSONHAMILTON HIGHLIFE
Mike Andrews — collects bottle caps
Tyron Armfelt -- sesame street is nis show
Jolain Arnold — likes guys 4 to cheer-lead
Amber Auderaert -- likes swimming 4 animals
Jeff Baker - likes hockey & golf
Kenny Bakowski — plays hockey 4 football
Wendy Banks — likes Skid Row 4 HJH
Oliver Bari 1 — likes music 4 Nintendo
Christina Bascom - collects dragons
Kelly Bashforth — volleyball and other sports
Louisa Bennett — likes Star Trek
Andy Benoit -- likes to hang out
Steve Berezay -- loves doing slam dunks
Troy Bernhart — hockey 4 football
Yvette Black Hater -- drawing interests her
Karla Blair — likes parties and boys
Sean Blair -- likes sports like football
Chris Bland - Flames are 11
Marsha Brome — likes sports
Mandy Bruner — watching T.Y appeals to her
Leslie Caldwell -- likes arcades, hates school
Angel Caplette -- likes dancing, hates broccoli
Janna Carefoot -- likes cats, dogs and soccer
Kari Chenger -- likes kidding around
Gerrick Chow - likes math and ping-pong
Colin Christie -- likes computer games
Tara Clark — likes most sports
Joe Clark - loves being prez
Kerri Copeland -- enjoys reading
Richard Cote - plays hockey and volleyball
Sheri-Lynn Daub - swimming and shopping
Roxanne Denecky - likes animals and shopping
Paige Desoza - loves hockey players
Oinah Desrochers - likes to watch Sesame Street
Nicola Dudley -- likes Debbi Gibson
Anita Dumont - plays all sports
Verona Eagle Plume - is interested in Guns'n' Rose
Curtiss Eagle-Speaker -- "Nintendo maniac"
Jamie Edwards -- hockey 4 Skid Row rules Jason Entz - likes hockey 4 drawing Ryan Farries - participates in lots of sport Noreen Fehr -- volleyball rules Chris Fender — likes sports 4 watching girls Suzanne Ferguson -- likes listening to the radio Jaime Finch -- enjoys playing drums Erin Finch-Field -- likes animals Karen Fisher - likes swimming Lori Forsyth - likes drama and singing B.J. Fox — enjoys golf 4 violent movies Keri Gardner - listens to music 4 travels Sandra Gatto - likes skating, golf 4 swimming Erin Gibson - dives and cheer leads Jennifer Glover - loves "hard core" rap 4 cows Kevin Graveland - likes to listen to Skid Row Miranda Grenier — is involved in sea cadets Rich Grover - street skater with friends Darren Guenther - hates the Oilers Jamie Gunter - soccer 4 talking on the phone Derek Hackson -- listenes to Tone Loc Kelly Halkow - dislikes country music Rob Hamil! - likes football 4 the guitar Shelley Hansen - ducks rule Jolean Harley -- loves to be lazy
Rob Harris - playing hockey 4 golf
Dave Harris — bike riding and volleyball
Trevor Haugen - plays Nintendo 4 street hockey
Chad Healy - enjoys hockey 4 rugby
Chris Healy -- hobbies-running 4 watching TV
Michelle Heckford - swims, bikes, and hikes
Hilly Heninger - #61 on the football team
Andy Henley -- Pittsburgh rules
Lana Hennessy - likes watching football (guys)
Susan Herbig - drums rule
Adam Hornberger - interested in sports
Trevor Hughes - enjoys being on the PGA tour
Laura Huisman - guys 4 diving interest her
Kelsey Irving - likes oreos 4 the phone
Jeff Ives - favorite music is heavy metal
Nancy Johnsrude - plays her violin a lot
Christina Kary — water-skier 4 baby-sitter
Christina Kercher -- water 4 down hill skier
Tinea Kertesr - loves to party and Metallica
Cindy King - likes shopping 4 music
Jason Kuntz — sleeps a lot
Erin Lacey - is involved in preforming art
Cambel Lai - likes most sports
Ernie Langridge -- raises havic
Curtis Larko - beating on Mr Syme
Blackie Lau -- likes listening to tunage
Scott Lawrence - likes hockey and girls
Curtis Leishman - basketball is his thing
Julie Letkeman -- basketball and having fun
Ramona Liebau - wants to be wealthy
Jeremy Linn - likes BuiIwinkle, math sucks
Kara Lister -- loves to drive
Denise Loewen - walks and sings and swims
Jamie Mackey - loves all sports
Dawn Majeran -- likes soccer 4 cheer leading
Dan Manning -- likes watching T V
Kerri Martin -- likes music 4 skiing
Erik Mason - USA rules
Erin McCann -- likes going to dances
Kevin McGeough — enjoys acting
Brian McKenna - skateboarding etc. etc.
Kim McMane - likes movies and music Sandra McMurray -- likes Nintendo and cars Kelli Merrill -- likes skiing 4 music Robin Merrill - California is a good place Jason Miklos - likes surfing 4 snowboarding Mike Millar - likes volleyball 4 basketball Todd Mills - playes basketball Robyn Moody - likes punk music Camille Mock - likes acting 4 hiking Jen Moore -- playes badminton Jennifer Moore - volleyball is her fave sport Troy Mutter - motorcycles (Honda)
Heidi Napora - likes skiing 4 running
Scott Nay -- eats, sleeps, and thinks
Anders Neu - wants to make money
Jeremy Newart - loves to party
Tanis Nickolet -- sports and guys
Blair Nowicki - enjoys sports and Run DMC
Tammie Oka - outdoor fun is great
Sean Olsen - shootin' hoops is his thing
David Ormandy - beats on Mr Syme with Curtis
Amber Orr - likes hanging out 4 reading
Dean Palmarchuk - hanging out and playing hockey
Tracy Palmer - hanging around with friends
Ryan Parker — hopes to play in the NFL
Brenda Parr - score keeper for sports
Ramie Paskuski -- hockey and badminton
Kathy Paterson - listens to music
Rhonda Pelletier - likes New Kids 4 Bon Jovi
Randi Pierzchala - she dances and skies
Aaron Pozzi - is interested in wrest ing
Jason Quiring -- likes to program computers
Jennifer Radford -- enjoys her position in mafia
Kyle Reed - enjoys judo 4 football
Corey Ried -- likes Lego 4 Nintendo
Denise Ritco - loves animals
Jeny Roberts - hates her picture
Leisha Roberts - likes basketball and movies
Paula Russell -- likes sports
Amber Rutledge - loves guys especia ly Bon Jovi
Cam Sandusky -- music 4 drawing are good
Kyle Sawatsky - eats, sleeps, 4 watches T V
Tracy Schooler - reads and swims
Rosalinde Schow - loves hockey 4 guys
Shawna Scully - likes volleyball 4 golf
David Seely - likes Nintendo 4 Sega
Chad Selk - best game is duck duck goose
Lance Semak -- likes knitting 4 eating weeds
Deanna Senda -- likes talking on the phone
Cori Sommerfeldt - likes reading and acting
Bonnie Stabs Down — listenes to Mill Vanilli
Lance Steinke -- Flames are awesome
Mandi Stenbeck - hates swim training
Teresa Stepple -- lifts weights 4 plays pool
Rick Sterling - watches football on the T V
Darren Stevenson - enjoys golf 4 gocarts
Anthony Straga - plays the piano and skis
Matthew Sturgeon -- likes floor hockey
Harvey Sweetgrass - favorite sport is football
Peter Tagg -- air and speed is what he likes
John Terry - loves arcades
Carey Thiessen -- loves being with friends
Rhonda Toderian - likes social class
Jamie Tollefson - in spare time he plays drums
Brandon Tomiyama -- likes to play hockey
Debbi Tschetter - runs and runs and runs
Mathew Vandenberghe - participates in many sports
Darryel Vandenhock -- likes Basketbal 4 drawing
Shayne Vandenhoek -- plays football
Shawn Vandenhoek -- fishes 4 hikes in spare time
Chris VanNeiwenhuizen - life after grade 9.
Jason Verces -- rap and girls are good for him Dave Hagner — listening to Metallica Jody Walker - hero is Mr Rogers Drew Halters -- leap-frog 4 tiddley winks Melaney Hatson - piano is what she does Jodie Hells -- plays volleyball 4 basketball Caleb Hilde - hates his name said wrong Vince Hilliams — checking out "chicks"
Sarah Hingfield - listenes to the radio Jared Holfe - does papers 4 likes Petra Evan Horkman - enjoys track 4 field Jennifer Hynnychenko - loves talking on the phcre Dana Zargtski -- enjoys hanging outOre of the goals at Hamilton is to help the students to think for themselves and to assert themselves in
a positive manner.This year the students at Hamilton walked out on Thursday October 19,1989,to protest the departure of a favorite teacher,Mr.Myndio.The students went to the board office and protested for about an hour then Mr.D.Lacey took 20 students inside to debate the issue at hand.The students made their point very clear and the protest was very well organized.Among the organizers were Erik Mason,Ryan Parker,Mike Andrews,and Jeremy Linn.
We would like to thank Mr.Myndio and best to you always!
Students of HamiltonI
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Grade Eight
TIM ALEXANDER SHAHINA ALI KIMBER AMES MICHELLE ANDERSON
RANDALL ARCHIBALL MIKE ARMENER ROSS ASSOON CORDELLE BADARM
MELLISSA BAIN GARMAIN BEAURIVE
CHAD BECK TERA BENTLY
TARA BLAIR RHETT BORTON
JANAY BOURASSA ANGELA BRANNON
CRAIG BROWER WENDY BUCKINGHAM
MARILYN BUDD
SHARON BUDD
RANDAL BULLOCK
TYLER CARLSON LEANNE CARPENTER
JASON CHINNGREG CHRISTIE ANGELA CLEMENTS LYNETTE COURT TREVOR COURT
ALICIA CRAWFORD DARREN CYR LINDSAY DEAL DOUGLAS DENECKY
KELLIE DIETZEN PHILIPPE DOIRON PAUL DOUGHTY KYLE DUNCAN
EVAN DUPUIS
RUSTON EDWARDS
RILEY ELLIS- TODDINGTON AMANDA ENTZ
GILLIAN EPP JEANA ERB DAVID EVANS RYAN EWING
TERRA FARRIES CHRIS FORGET MATTHEW FOSTER DENTON FREDRICKSONLADELL FRIESEN
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CORY GAETZ ROBIN GAGNON DEAN GASKARTH
SCOTT GIBBONEY AMBER GILMAR JAYMES GOING LINDSAY GORDON
ETHAN GORNER STEPHEN GOTH JOHN GRANZOW KELLY GRAY
ANGELA GREEN CHRISTOPHER GREGG AARON GRONEMEYER ROD HAITEL
JACK HALL NIKI HALL HEATHER HAMILTON JODIE HANNA
KELLY HEALY GLORIA HEAVY HEAD NOAH HEBERT JEREMY HILLMERSTACEY HIRSCHE LINDSAY HORNBERGER MICHAEL HOVAN RONI HUDEMKA
JESSIE HUGHES JASON HUIE MEGAN HUSTON KIM. HUTCHEON
SUSAN HUTCHEON SPENCER IVES CLAY JACOBSON CRAIG JAMES
CANDACE JOHNSON HEATHER JONES ERIN HASINOF TRISHA KANE
JODY KARY MICHELLE KEIM RICHARD KELLY ADRIAN KENT
JENNIFER KENZIE NADIA KHATTAK DEAN KLASSEN DENISE KNORRJASON KORINETZ RYAN KURTZ CARA LACEY KEVIN LARUE
ANDREW LEE NIP LY LING LY
BLAIN MACDONALD
CHRISTIE MACKENZIE JENNIFER MACLACHLAN CRYSTAL MAJERAN JEAN MATHISON
AMANDA MATTHEWS JACKIE MAY JENNIFER MC ARTHUR MIKE MC LEAN
SCOTT MCCLAIN JAIME MCDOWALL KYLE MCKINNEY JIM MCLAREN
PAM MEADOWS ROXANNE MELVIN KEVIN MERTZ
JULIA MITTONJAMES MORRIS SHAWN MULLEN TAMMY MARSHALL ANGELA NELSON
DANNY O'CONNOR LISA PALMER CARRIE PENNER CHRIS PETERSON
DESNEIGES PETERSON ROY PHELPS TROY PRICE ALEXIS PUFFER-ROSS
MIKE PYSKA SHELLY PINDER ED QUAN
KRISTIN REEVES
LANCEA REID KATHERINE RIVERS CLINTON ROBERTS SANDRA ROBERTS
BRAD ROELOFS HEATHER ROSS SUSAN RUSSELL JOEL SANDTIM SAUNDERS MARCO SCHEIWILLER KAREEN SCHWARTZ JEREMY SCOTT
MICHAEL SCULLEN KRISTY SEAMAN DAVE SHACKLEFORD RYAN SHANNON
LACEY SHEEN LEAH SHEER TROY SITTER STEVEN SOMMERFELDT
JENNY SPEELMAN CHRISTINE SPIERS LISA SPRING BARBARA STARR
JAMES STEELE TROY STEPENOFF KARLY STOFFER AARON STURGEON
ROBYN SYMONS JEFF SKRETTING TERRI TALERICO JENNIFER TAMURAGRAHAM TAYLOR JENNIFER TAYLOR MEGAN THOMAS SARAH THOMAS
JODY TOLLEFSON TIM TOLLESTRUP TRACY TOLLEY JENNIFER TOMOMITSU
RACHELLE TOTH TENILLE UNRUH JORDAN VALGARDSON JENNIFER VARZARI
MATT VENABLES CARKlE WEBSTER
DANA WELLS SALLY WENNING
DEANNA WEST TIARA WESTOBY BILLY WIEHLER JAMIE WIELER
CAMILLE WILDE CLINTON WILLIAMS TERESA WILLIAMSON MARK WILLISi Grade Seven
JASON ADAMS JENNIFER AITAI ROBERTA ALLAN MELISSA ANDERSON
STEVEN ANDREWS MIRIAM ARMENER JON ASHMEAD DEBBY BALES
CARA BALL SARHA BARON SCOTT BASCOM LISA BASCOM
SADIE BELL BEN BENNETT KERRY BERESNAK JENIFER BIERNASKIE
FRIC BJORDAN CORRINA BLANKLEY
NAVRAJ BOORA
GINA BORGGARD
NIRAVANH BOUNSOMBATH JARRETT mZZl KELLY BRIILIA BUXTON KEVIN CHAMBERS
JENNIFER CHRISTENSEN SCOTT COPELAND
KYLER COUTTS
JONATHAN CREELEY
RICHARD CRONKHITE JEREMY CRUMP
JANICE DAIGLE
ANGELA DONISON KRISTEY DORRELL
KELSEY DROZDOWSKI
CAMILLE DUTHIE BILLY JOE DYCK LAURA ENTZ TORI ERICKSON
TYLER FALLWELL SCOTT FEDERKEIL JODY FERGUSON JONATHAN FESSLER
NEIL FISHER JUSTIN FLETCHER CHRIS FORD WADE FORSYTHEVA FOTHERGILL SHIRLEY FRIERBG
DANA GAGNON
RYAN GLOVER
AARON GOING DAVID GORNER REBECCA GOTH JENNIFER GRAHAM
DAVTD GRAVELAND BRADLY GRAY CARRIE GREEN
KATHFRN GROVER
AMBER GRUNINGER
TRINIDY HALL
JENNIFER HARKER TARA HAWKINS
SUSAN HEALY KRISTIN HEGLAND JENNIFER HEITMAN MEGAN HENDRY
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Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial
No full textBackground:
Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor.
Methods:
The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population).
Findings:
Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI.
Interpretation:
In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk
