VictorJuiz/thesis huggingface dataset:
The quality of care among older adults with diabetes comorbid with other chronic conditions
Keywords: Concordant/discordant comorbidities
Continuity of care
Healthcare utilization
Multimorbidity
Polypharmacy
Quality of care

The management of people with multiple chronic conditions requires understanding the extent to which concurrent chronic conditions contribute and interact to affect the patientâ s health status, as well as assessing the risk and benefits of various strategies for the treatment of complex needs in patients. A single condition focus in both clinical care and research remains and limits the assessment of care for people with multiple chronic conditions. The overall aim of this project was to evaluate the quality of overall care for older adults with selected disease combinations in ambulatory care settings. The first study aimed to identify a set of evidence-based and valid quality indicators for evaluating ambulatory care for older adults with selected chronic conditions, including diabetes, hypertension, chronic ischemic heart disease, major depression and osteoarthritis. The second study aimed to critically appraise the identified quality indicators and select a set of indicators for evaluating the quality of care for older adults with diabetes with comorbid concordant and discordant chronic conditions. The third study aimed to examine the difference in the quality of care between patients with 2 vs. 1 selected concordant vs. discordant comorbid conditions, and to examine associations of quality of care and hospitalizations among older adults with selected disease combinations. The study findings suggest that older adults with diabetes are at risk of suboptimal care with additional selected comorbid conditions, especially those with discordant comorbid conditions. The study findings also support the importance of continuity of care for older diabetes patients with comorbid chronic conditions. The study findings suggest that the likelihood of hospitalizations increases with the number of prescribed drugs among older adults with comorbidities. There is a need for a holistic approach in education and clinical care of older adults with diabetes taking into account concomitant conditions that affect patientâ s health status. Future research is needed for measuring the quality of care in the larger diabetes population and reporting by different stratifications, including age, sex, primary care models to see if there are any patterns in certain groups and target the interventions towards improving practices for specific sub groups.
Characterization of the immunoregulatory roles of IFN-β in T cells and dendritic cells
Keywords: dendritic cell
EAE
Interferon-beta
Th17

Multiple sclerosis (MS) is an autoimmune disease that targets the central nervous system (CNS). Interferon (IFN)-β was the first approved therapy for relapsing-remitting MS more than 20 years ago, however, its mechanism of action remains ill-defined. Using a myelin oligodendrocyte glycoprotein (MOG)-induced murine experimental autoimmune encephalomyelitis (EAE) model for MS, our earlier studies identified that IFN-β-/- mice exhibit an earlier onset and a more rapid progression of disease compared to IFN-β+/+ mice. CD4+ T cells, specifically of the Th17 lineage, are posited to be pathogenic in MS and in EAE, and CD11c+ dendritic cells (DCs) are critical antigen-presenting cells that have the potential to regulate pathogenic T cells in MS and EAE. Accordingly, we investigated the immunoregulatory effects of IFN-β on CD4+ T cells and DCs. Our studies revealed that CD4+ T cells isolated from IFN-β-/- mice are primed to polarize to the Th17 lineage, associated with expression of Th17-associated cytokine receptors. Stimulation with a cocktail of Th17-inducing cytokines led to increased expression of Th17-associated genes in IFN-β-/- Th17 cells compared to IFN-β+/+ Th17 cells, suggestive of a regulatory role for IFN-β in determining the Th17 cell transcriptome. Consistent with these findings, we observed a greater proportion of Th17 cells in the LNs of IFN-β-/- mice compared with IFN-β+/+ mice during EAE, with increased numbers of CD4+ T cells in the CNS of IFN-β-/- mice, regardless of stage of disease. We identified that IFN-β exerts immunoregulatory effects on DCs, associated with determining cytokine production and expression of co-stimulatory activation markers. IFN-β-/- DCs drive increased proliferation of MOG-transgenic CD4+ T cells, and produce more IL-6 and IL-23, critical for induction of Th17 cells. Finally, we provide evidence that IFN-β regulates the migration of DCs into the CNS during EAE, by modulating STAT1-dependent CCR7 expression. Taken together, our data indicate immunoregulatory roles for IFN-β in suppression of Th17 cells and in limiting the activation and trafficking of DCs during EAE.
Investigating the Role of Tumour-Stroma interaction in Head and Neck Squamous Cell Carcinoma
Keywords: fibroblasts
head and neck cancer
stroma
tumour microenvironment

Head and neck squamous cell carcinoma is the sixth leading cause of cancer-related death worldwide. Although most patients initially respond to treatment, many will eventually recur and die and die of their disease. Understanding the impact of the components of the tumour microenvironment on disease progression is essential to effectively treat HNSCC. The work described in this thesis provides a better understanding of the relationship between tumour cells and fibroblasts and describes novel therapeutic targets for further testing. First, I characterized carcinoma-associated fibroblasts (CAFs) and their effect on tumour cell behaviour in vitro and in vivo. Second, using laser-capture microdissection (LCM), I obtained pure populations of tumour and normal epithelial cells as well as tumour-associated and normal stromal cells. From these cells I obtained transcriptomic profiles and used this data to identify candidate molecular interacting partners utilized by tumour and stromal cells to communicate with each other. Finally, I also use these profiles in combination with publically available data gene expression and clinical data from the The Cancer Genome Atlas (TCGA) to characterize the association between stromal genes and clinical outcomes.
Math fluency development in the early elementary grades and the role of the summer break, inattention, and working memory
Keywords: Inattention
Math fluency
Summer slowdown
Working memory

The current dissertation examined factors thought to influence the developmental dynamics of basic math fluency skill (addition and subtraction). The overarching goal of this research was to examine growth patterns in addition and subtraction fluency across Grades 1 through 4 while taking into account the effects of the non-instructional period over the summer months. This was accomplished using an accelerated longitudinal design within the framework of hierarchical linear modeling. A cumulative pattern of growth was observed over time for each fluency measure. Differences between addition and subtraction growth trajectories were found and are discussed. This dissertation also aimed to examine the respective roles of verbal working memory, visual-spatial working memory, and teacher ratings of classroom inattention in the development of math fluency while controlling for sex and parent level of education. This was done from a piecewise perspective, that is, by considering whether these cognitive and behavioral factors exerted differential effects based on seasonal patterns (i.e., skill growth that occurs within the school year (excluding the summer), and the growth that occurs across grades (including the summer)). Differential seasonal patterns were identified: Visual-spatial working memory was predictive of skill development specific to the school year, whereas teacher-rated inattention was a key longitudinal predictor of weaker math fluency, across the years, including the summer months. Implications for research and educational practice are discussed.
Claiming the Road: Intersectional Mobilities and Unfreedom among Migrant Farmworkers in Canada
Keywords: Agriculture
Canada
Labour Migration
Mobilities
Transportation
Unfree Labour

This study considers the travel patterns, practices and conditions that shape how migrant farmworkers circulate in rural southwestern Ontario. While migrants in Canada’s Seasonal Agricultural Worker Program (SAWP) do not exercise occupational mobility and are housed in employer-provided accommodations, they are otherwise legally entitled to circulate freely in Canada. In practical terms, however, most experience significant mobility barriers. The study investigates the mechanisms by which migrant farmworkers are confined and immobilized to farm spaces on systemic levels, contributing to a vein of research on the immobilities that pervade everyday life for transnational, low-wage labour migrants. I show how localized mobility controls placed around migrants as well as inadequate transportation create a “mobility fix” for farm operators and state actors. Technologies of confinement that immobilize migrant farmworkers are justified through racial and sexual ideologies about migrants being a threatening presence in rural Canada, while permitting high levels of value to be extracted from migrants’ labour. The dissertation is organized as three empirical journal articles which are preceded by a chapter on research methods. In the first article I document how a purported problem with transient farm labour migration to Ontario from Quebec and Atlantic Canada was constructed in the 1960’s and 1970’s. In response, the Canadian government devised the SAWP as an institutional mechanism to undercut transnational migrants’ constitutional and practical mobility rights, rights that transients harnessed. This chapter reveals how enacting controls around migrants’ local mobilities has been crucial to the “making” of migrant agricultural workforces in Canada. In the second article I identify how systemic immobilities for SAWP workers are enacted by Canadian family farm operators. I show how Canadian family farms benefit from high levels of personal and intimate interaction with SAWP employees. I identify how operators impose high limitations and constraints as to when, where, and how migrants can travel beyond formal work hours. Finally, the third article examines how migrants have forged bicycling geographies in rural places and how migrant bicyclists are perceived in Canadian communities. Migrants are more vulnerable as bicyclists, do not bike out of choice, and have become subjects of bike safety education. I argue that racial and economic forms of exploitation as well as socio-spatial exclusions inflect actually existing bicycling geographies.
Kafka: A Blueprint of Desire
Keywords: desire
hypertext
Kafka

Desire in Kafka has been variously theorized, through the works of Freud, Lacan, Girard, Deleuze, and others. Yet there appears to have been, up to now, no inverse attempt: to extract from within his literature a theoretical model of desire. This dissertation fills this gap in scholarship and reveals Kafka as a great theoretician of desire. Since Kafka never wrote such a theory, my objective becomes to lift its blueprint from within his texts and to formulate an account of desire these works generate. I do so by tracing the author’s incessant experimentation with desire on a handful of key texts between 1912 and 1922. Within these works, desire appears as pure Verkehr, a force that tends towards the subject’s self-realization. His letters, novels and stories, as I demonstrate, entail a series of literary experiments that test the potency of written texts on the one hand and human bodies on the other to be employed as vehicles for desire—as means for this Verkehr towards becoming. In Briefe an Felice and Der Prozess Kafka takes up the former, exploring the possibility of liberating the symbolic self from the body through writing, by passing off written documents as a legitimate proxy of one’s identity. Unconvinced by the results, Kafka reverses the hierarchy of writing over corporeality as a mode of self-realization, shifting the site of desire from text to body in attempts to write (In der Strafkolonie), read (Ein Landarzt), and stage (Ein Hungerküstler) bodies as narrative texts. But this counter experiment reaffirms the supposition of duality between the corporeal and the symbolic selves as alternative modes of self-realization, so that desire remains thwarted by the limitations of the chosen medium. It is in his late novel-project, Das Schloß, that Kafka successfully dismantles this opposition and arrives at a more nuanced understanding of desire as a free multi-directional force of self-becoming. Kafka’s evolving conceptualization of desire has direct implications for the increasingly open narrative structure of his late writings: As the flow of desire ceases to be determined by the choice of a single vehicle (written texts or human bodies) and by its limitations, so too the Schloß-novel escapes the narrow parameters of a linear text and itself becomes multi-directional, culminating in a new literary form: a hypertext.
The Constructive Role of Spatial Context in Event Memory
Keywords: Cognitive Neuroscience
Episodic Memory
Hippocampus
Imagination
Memory
Spatial Memory

Episodic memory and spatial memory are two types of memory that have long been associated with the hippocampus, but the mechanism underlying their joint reliance on the hippocampus is debated. Some have proposed that mentally constructing scenes underlies episodic memory, serving as the foundation for remembered and imagined events. In this dissertation, I present four experimental studies testing questions relating to how spatial context affects, and may underlie, episodic memory, in terms of brain and behaviour. Chapter 2 describes a study in which more familiar contexts elicited more detailed and vivid memories of both scenes and events in young and older adults. The effect of context was comparable across age groups, despite the expected memory decline in older adults, suggesting that spatial context has a pervasive effect on episodic memory throughout the lifespan. Chapter 3 presents a study in which we found that participants spontaneously assigned spatial contexts to events where none was specified, suggesting that it is very difficult to vividly imagine and remember an episode devoid of spatial context. In Chapter 4, we found that individuals with memory loss relating to medial temporal lobe damage showed parallel impairments in memory for scenes and episodes, while retaining preserved schematic spatial memory. In a case of more posterior temporal/parietal damage, we found impairments in scene memory and more subtle deficits in episodic memory. These findings suggest that while the medial temporal lobe is crucial for both episodic and scene memory, other regions also contribute to scene memory and may serve as inputs to the hippocampal memory system. In Chapter 5, we examined the neural representation of imagined events using functional magnetic resonance imaging. Multivariate pattern analyses revealed that the largest network of neural areas represented information about the location of events, as compared to people or objects. These findings demonstrate how the location of an event plays a role in determining the neural representation of memories throughout networks associated with scene and event memory. Together, these studies demonstrate how spatial context affects the behavioural and neural characteristics of episodic memory and imagination, relating to theories of episodic memory and hippocampal function.
Disasters, Settlements and the Homeland: Vietnamese American Experiences of White Supremacy in New Orleans
Keywords: Asian American
Diaspora
Disaster
Transnationalism
Vietnamese American
White Supremacy

Vietnamese Americans in New Orleans became well-known as â a community with miraclesâ after Hurricane Katrina in 2005. Arriving in the United States after the Vietnam War (1975), these Vietnamese refugees learned to adapt to life in Louisiana. After more than 35 years living in the country of settlement, Vietnamese Americans have developed experiences of living with African Americans, the majority population in New Orleans. By engaging in the discussion of the white supremacy ideology, the dissertation points out that Vietnamese Americans in New Orleans are not only victims of both overt and covert racial discriminatory acts, but they are also complicit in it. While they suffer from the minority status in American society, they buy into the racial hierarchy of white supremacy that denigrates low-income African Americans. From the analysis of not only their everyday life experiences but also the aftermath of disasters, such as Hurricane Katrina and BP Oil spill in 2010, the dissertation shows the politics of race in New Orleans as well as in the United States. Vietnamese Americansâ conformity to white supremacy also confirms that the United States has not been color-blind. The last chapter displays the linkages of the Vietnamese Americans in New Orleans with their home villages in Vietnam as well as the government of Vietnam. Engaging in a global perspective in which the nation-state has tried to embrace its overseas population as an essential part of the country, the chapter examines the effectiveness of the deterritorialization policy of the Vietnamese government on Vietnamese Americans. It also shows that while the deterritorialization policy failed to achieve its missions, it unexpectedly became a key factor that renewed the diasporic dimension of Vietnamese Americans. In addition, when fighting against the intrusion of the communist agenda into their diasporic community, Vietnamese American community leaders strategically employed the freedom in American politics to legalize and implement their local anticommunist agenda. In this process, while the diasporic moments were reinforced, the white supremacy remained intact.
Questioning Particles: A Cross-Linguistic Approach to Quebec French Polar Interrogatives
Keywords: Interrogative particles
Negative interrogatives
Quebec French
Yes/no questions

This thesis examines the syntactic properties of the polar interrogative particle tu in Quebec French. Its goals are to better understand the role of tu in the grammar of Quebec French and to contribute to the study of interrogative particles in general. Three questions are posed which are intended to serve as a guide through the discussion: (i) whether tu is indeed an interrogative particle (or merely a variant of French complex inversion, its source construction), (ii) whether tu is “adapting” to the grammar of Quebec French or vice versa, and (iii) to what extent interrogative particles “retain” properties from their diachronic source element. Interrogative particles are typically either clause-initial or clause-final (Bencini 2003, Dryer 2005b, among others), and often originate from a negative or a disjunctive morpheme. However, tu is clause-internal and it developed from a subject clitic. Yet, it is argued that tu shares properties with interrogative particles in unrelated languages, which it does not share with its source construction. I claim that tu is indeed an interrogative particle, and I conclude that it is “adapting” to the grammar of Quebec French to some extent, for instance in keeping its postverbal position, but that the grammar of Quebec French is also “adapting” to it to some extent, in that the particle is acquiring interrogative particle properties such as an incompatibility with wh-elements and negation. I propose an analysis which reflects this tension, where tu heads a syncretic projection with both C°- and I°-features. The third question is discussed briefly, though answering it will have to await future work. It is predicted that an interrogative particle will develop within a given grammar only if it can occupy a C°-position in the syntactic tree.
Moral and Ethical Leadership: One Principal's Beliefs and Practices
Keywords: ethics
leadership
morals
principal
school
virtues

Abstract Over the past twenty-five years, there has been an increasing body of literature exploring the principal and the teacher as moral agents. Along with a focus on the moral dimensions of teaching and administration, there has been growing emphasis on the ethical nature of schools. This research study considers how one elementary school leader resolves moral and ethical issues and challenges in her daily practice; it further explores the extent of her awareness of such issues and challenges as being moral and ethical in nature. The primary research question is: How does one elementary school principal conceptualize her work in moral terms and engage in ethical practices? The secondary research question is: In what ways does one elementary school principal believe her previous professional experiences and prior life experiences have made her more aware of the moral and ethical dimensions of her role and influenced the way she conceptualizes and deals with ethical situations in her practice? This study is a rich portrayal of who the principal is as a school leader and how she understands the ethical components of her practice as she strives to cultivate an ethical school. Components of her practice that are explored include fostering relationships, encouraging dialogue, formulating decisions that make reference to ethical virtues and moral values, and providing support for purposeful learning. Other dimensions include nurturing a climate of respect and trust, building awareness of the moral implications of words and actions, and fostering a safe and caring community within the school. The principalâ s resolve to conduct her work in an ethical manner is uncovered in a complex array of encounters and interactions with participants in the course of her daily practice.
The Like Button: A Way to Explore Social Interaction in Threaded Discourse
Keywords: Like button
online discussion
online learning
online learning environment design
social interaction
threaded discourse

Recent studies have begun to explore alternative ways to support social interaction in threaded discourse. This dissertation extends this research by exploring how a Like button, much like Facebookâ s, can provide students with a low-cost mechanism to interact with each otherâ s discussion posts. I explore how this ubiquitous social media tool was integrated into an experimental academic online learning environment, Pepper, to support student discussion from multiple perspectives. The research suggests that the Like button was adopted in threaded discourse as an indirect speech act, the meaning of which varies because of how it is used by students. There are four studies that explore how the Like button was used by students enrolled in graduate-level online discussion-based courses at a leading Canadian institute of education. Both quantitative and qualitative data were used to explore student interactivity to better understand the role of the Like button as a social scaffold in threaded discourse. Social constructivism and speech act theory were used as frameworks for the project. Collectively, the findings suggest that the Like button in threaded discourse was an effective social interaction tool used by students to engage in a shared learning experience. Recommendations to expand the Like button into additional low-cost social and learning scaffolds and to provide environment users with integrated support on the availability and function of these tools is provided. The findings of my research act as a starting point for integrating more low-cost mechanisms into threaded discourse by providing thought-provoking ways of integrating and adapting ubiquitous social media tools in academic environments.