VictorJuiz/thesis huggingface dataset:
Nosocomial Methicillin-resistant Staphylococcus aureus: Acquisition, Infection and Decolonization
Keywords: antibiotic resistance
antibiotic use
colonization pressure
MRSA
nosocomial transmission

Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant bacteria, is often carried asymptomatically, but can cause severe disease. In this thesis, I present three retrospective cohort studies conducted in Toronto, Canada, which examine risk factors for infection or acquisition. In a study of 1,125 adult MRSA carriers at a tertiary hospital, risk factors for subsequent MRSA-positive clinically-indicated specimens were recent identification of carriage, older age, male gender, nosocomial acquisition, carriage detection in ICU, and underlying liver conditions. In a study of pairs of patients at two hospitals who shared a room for ≥48 hours, each pair included a MRSA-index case and a patient at risk of acquisition. Fluoroquinolone receipt by either patient increased the probability of MRSA transmission. Nearly half of identified acquisitions in the year following shared occupancy were unrelated to the MRSA-index case. In a study of 62,552 patient admissions, receipt of fluoroquinolone(s) and exposure to high MRSA colonization pressure in the prior week were significant risk factors for MRSA acquisition. The results of the cohort studies suggest that MRSA control should involve consideration of antibiotic exposures among those colonized and those at risk of acquisition. Antimicrobial stewardship and interventions that identify carriers could reduce disease burden.
Beyond the Present: Risk and Body Stigma in Public Health
Keywords: critical
embodiment
health
qualitative
risk
stigma

Risk is a quotidian concept in public health, but how do individuals make sense of it as an embodied phenomenon? What does a present, embodied stigmatized relationship have to do with risk and health? This research brings together public health, sociology of risk, and sociology of the body theories to answer these overarching research questions. Using a post-structural, interpretive research paradigm, 13 participants sculpted, life-lined, and were interviewed to share their understandings of embodied health risk. Key findings from this research include that sculpting and life-lining are useful in critical qualitative research methods; normality and health identity can be de-stabilized when temporality is introduced to understanding embodied health risk; and there are multiple approaches to understanding risk. There are four risk approaches outlined in this thesis: (1) the ‘shit happens’ approach, (2) the sequelae approach, (3) the risk as heuristic approach, and (4) the knowledge approach. These findings have implications for the fields of qualitative methodologies, physical cultural studies, and public health. Methodologically, absurdity, creativity, imagination and embodiment/tactility are proposed as important characteristics of critical qualitative health research. The innovative methods of sculpting and life-lining in health research can facilitate further research of complex social phenomena, and imagination can be explored as an integral piece of health justice. In physical cultural studies, understandings of the relationship stigma represents between normality and identity is extended by including considerations of risk and temporality to questions of biopedagogy. For public health, this research opens new ways of making sense of risk, and new ideas on how individuals’ everyday experiences relate to population-level health statistics. The findings foster development of a public health ethic that is sociologically informed, and can be used to inform future ideas on health risk communication.
Urban Writing on Disappearing Alleyways and Courtyard Houses, Beijing, 1950-2008
Keywords: Heritage preservation
Urban regeneration
Urban writing
Vernacular architecture

Beijing has transformed tremendously in the recent four decades, and the decline of the signature residential space, alleyways and courtyard houses, is at the center of social and cultural debates. For some, it is an outcome of a profit-driven real estate market that favours international capital rather than local communities. For others, marketization and globalization have otherwise created a niche for the gentrified and commercialized vernacular space as a cultural selling point of Chineseness. This project poses the question differently: what is the role of the cultural intermediaries in this picture of decline with the market and capital on the one hand and the physical changes on the other? This project investigates the cultural intermediaries formed by the architectural trends, planning thoughts, policy tendencies, and heritage system that the capital and market depend on to concretely shape the cityscape. Focusing on multiple genres of texts in urban writing from the 1950s to the 2010s, this project examines them through metaphors. Urban amnesia reveals an architectural forgetting system that marginalizes alleyways and courtyard houses in the fifty years of architectural discourse. City tank provides a cautious approach to housing, land, and demolition and relocation policies that demonstrates how difficult it is for the vernacular space users to cultivate a long-lasting connection with their living environment. The city as organism shed light on the alternative planning practice to preserve vernacular space. Its adaptation into heritage policies in the context of cultural and historical city preservation ironically illuminates on the limitations of organic renewal. The meanings of these metaphors collectively present a complicated picture of how cultural intermediaries promote, oppose to, and negotiate with the erasure of vernacular space in urban redevelopment. To trace these meanings opens up new space to test ideas and practices that emphasize both architectural preservation and social preservation.
A critical analysis of the overrepresentation of First Nations children and families in the Ontario child welfare system and disparities in providing ongoing child welfare services
Keywords: aboriginal
bias
child welfare
decision-making
first nations
overrepresentation

First Nations children are chronically overrepresented in the child welfare system in Canada. This is largely a result of the effect that colonization has on Aboriginal peoples, but also evidence of colonialism being reproduced through current discriminatory legislation and practices. This three-paper dissertation employed a secondary analysis of data to examine the extent of the overrepresentation of First Nations children involved with child welfare in Ontario. Moreover, this study critically examines investigations of reported maltreatment to understand what is driving the overrepresentation of First Nations children. The results show that overrepresentation is a predictable outcome in a system predicated on assimilative objectives. In Ontario, First Nations children represent 2.5% of the child population; they represent 7.4% of child maltreatment-related investigations. For every 1,000 First Nations children in Ontario, 160.3 were involved in investigations compared to 54.4 per 1,000 White children. Overrepresentation was most pronounced for investigations of neglect. Rates of substantiation (3.4 times), ongoing services (4.2 times), child welfare court (5.7 times), and child welfare placement (7.5 times) were higher for the First Nations child population and disparities increased as children moved further into the child welfare system. Caregiver concerns were the main drivers of transfers to ongoing services for both First Nations and White children. For investigations involving White children, after controlling for caregiver concerns, workers were more likely to transfer a case for ongoing services when child psychological harm was present. While the proportion of children identified with psychological harm was similar across both groups, workers placed more weight on a White child experiencing psychological harm. The notion that workers might have different standards for decision-making for First Nations children compared to White children is concerning. Overall, the findings indicate that structural risks have not been addressed, putting First Nations families at risk for child welfare involvement. Structural issues such as chronic poverty and systemic racism are indicative of the legacy of the residential school system and produce the conditions that result in children coming to the attention of child protection services. Overrepresentation will continue unabated if the immense social inequities for First Nations children are not addressed.
Pathogenesis and treatments of immune thrombocytopenia: differences between anti-GPIbα and anti-β3 integrin antibody mediated thrombocytopenia
Keywords: Antibody
GPIbα
Hepatocyte
Immune Thrombocytopenia
Platelet
Thrombopoietin

Platelets are anucleate cells in the blood that are critical for the arrest of bleeding. Glycoprotein (GP) Ibα and GPIIbIIIa are two abundant platelet surface receptors that mediate platelet hemostatic plug formation. They are also the major targets for auto- and alloantibodies, which cause several bleeding disorders such as autoimmune thrombocytopenia (ITP). ITP is a disease where one’s immune system mistakenly produces autoantibodies that destroy one’s own platelets, leading to an increased bleeding risk. Currently, potential differences in immune responses (to GPIbα versus GPIIbIIIa) and the consequences following antibody binding to these two antigens in these immune-mediated thrombocytopenias are largely unknown. Antibodies against GPIbα and GPIIbIIIa are hypothesized to have different effects on platelet generation, where and how the platelets are destroyed, and how patients respond to current therapies such as intravenous immunoglobin (IVIG) and thrombopoietin receptor agonists (TPO-RAs). TPO is a glycoprotein hormone produced predominantly in the liver that regulates thrombopoiesis and stimulates the production and differentiation of megakaryocytes. I found that GPIbα-/- mice had decreased circulating TPO. Transfusion of wild-type (WT) platelets but not GPIbα-/- platelets rescued the decreased TPO levels in GPIbα-/- mice. GPIbα-/- mice had lower TPO mRNA levels in hepatocytes than WT, which could also be rescued by WT platelet transfusion. We found that IL4Rα/GPIbα transgenic mice had lower TPO levels than WT mice, indicating that the extracellular domain of GPIbα is important for TPO production. In vitro hepatocyte co-cultures with platelets or GPIbα coupled beads further confirmed the disruption of platelet-mediated hepatic TPO generation in the absence of GPIbα. Furthermore, anti-GPIbα antibodies can disrupt the interaction between platelets and hepatocytes. These findings reveal a novel, non-redundant regulatory role of platelets in hepatic TPO homeostasis. In conclusion, antibodies targeting different platelet antigens delivered different signals to platelets and megakaryocytes. Some antibodies can directly affect the structure and function of these two receptors including the platelet-hepatocyte interaction and TPO production. This study has not only improved our understanding of TPO regulation but also has important implications in diseases related to GPIbα such as BSS and auto- and alloimmune-mediated thrombocytopenias.
River Flowing and Fire Burning: A Narrative Inquiry into a Teacher’s Experience of Learning to Educate for Citizenship — from the Local to the Global — through a Shifting Canada-China Inter-School Reciprocal Professional Learning Landscape
Keywords: Canada-China
Citizenship Education
Global Education
Narrative Inquiry
Professional Learning
Reciprocal Learning

Situated within a Canada-China Reciprocal Learning Partnership project (2013-2020) funded by the Social Sciences and Humanities Research Council of Canada, this four-year study adopts practical narrative inquiry as its theoretical and methodological framework to explore how selected Toronto-based teachers developed their storied experiences and knowledge to educate for citizenship, while teaching in their globalized professional settings shaped by Canada-China Sister School reciprocal learning partnerships. By restorying and inquiring into the curriculum-making experience of one particular teacher, Ann Barton, on her evolving Canada-China Sister School landscape, this study engages the metaphors of river flowing and fire burning to illustrate how a teacher becomes a more globally oriented and informed citizenship educator, through telling and living, and retelling and reliving her stories of building a democratic classroom community on a changing Sister School landscape. It also repositions “narrative inquiry” as an educative and generative Way that could be practiced and engaged to nurture a collaborative professional reciprocal-learning community on a Canada-China inter-school landscape that supports teachers in their effort to retell and relive their cultural and historical narrative of educating for citizenship in the midst of their daily classroom-curriculum making. Such a collaborative reciprocal learning community has the potential to transform teachers’ classroom/school into a space where in-service citizenship professional learning can take place within a global-local dialectics, and where practicing teachers can not only educate for citizenship from the local to the global, but also learn to develop their passion, integrity and identity as citizen-teachers in a globalized, multicultural, still problematic and fragmented world. The study ends with an invitation for educators and learners to rethink and reimagine citizenship teaching and learning using the paired imageries of river flowing and fire burning, and through personal and collective storytelling and reflections, across geographies, boundaries and differences.
Co-Assembled Drug-Silica Materials for Antimicrobial and Antidegradative Dental Applications
Keywords: biomaterials
bodegradation
dental caries
dental implants
drug delivery
nanomaterials

Resin composite dental fillings are exposed to significant challenges in the oral cavity, and fail after 5-7 years. Biodegradation and cariogenic bacteria at the filling-tooth interface weaken this critical region and may cause secondary caries or mechanical failure. Similarly, bacterial colonisation of the dental implant-gingiva interface, both immediately after implant placement or later in the implant service life, may cause implant failure. Systemic antibiotics are frequently prescribed prophylactically before implant surgery, or to treat later infection. However, concerns around antibiotic resistance and allergies have led to calls to reduce antibiotic use, despite their ability to increase implant success by over 200,000 patients/year. Local delivery of antimicrobial agent in a controlled, long-term (decades) manner from a restorative adhesive directly to the filling-tooth interface may reduce bacterial load and extend restoration service life. Antimicrobial delivery directly to the implant-gingiva interface from the implant neck should also reduce bacterial load and improve implant outcome without the negative effects of systemic antibiotics. Traditional mesoporous silica (MS), as particles in restorative adhesive or an implant coating layer, may be an ideal drug reservoir and release vector. However, the post-synthesis loading of drug within MS remains challenging, resulting in low load (
THE "INDIAN" OF FOUR CONTINENTS: READING FOR HORIZONTAL RELATIONS OF VIOLENCE, COMPLICITY, AND THE MAKING OF WHITE SETTLER COLONIALISM
Keywords: complicity
immigration
indentureship
race
settler colonialism
South Asians

This research study asks: How do we theorize the place of non-Black people of colour vis-à-vis Indigenous peoples and Black people in North America? Paying attention to transnational power relations, and colonial entanglements of differential racialization, I particularly inquire into the place of South Asian diaspora in North America. This study draws upon critical Indigenous, Black, anti-caste, and transnational feminist theories to argue for the urgent need to place analyses of white settler colonialism here in conversation with other entangled histories, presented through discrepant spatialities and temporalities, in order to examine what we know and have yet to learn about entanglements of race, Indigeneity, gender, sexuality, caste, and relations of labor. My “unlikely archive” (Lowe, 2015) of complicity consists of a wide array of legal, representational and cultural artifacts. Drawing upon Edward Said’s contrapuntal reading of texts, and Lisa Lowe’s methodology of paying attention to past conditional temporality, this study travels from analyzing lingering coloniality in a series of photographs titled An Indian from India by a contemporary South Asian artist to Bengal of 19th century where I study Neel Darpan, an anti-colonial protest play. In both these chapters, I show how anti-colonial resistance narratives can often replicate the logics of Empire and leave the very people who are the most marginalized subjects of history as subaltern, silent, and vestigial. My chapter on the figure of the wide circulation of the "Indian Queen" in 18th century Europe examines how she is formed at the nexus of race, coloniality, and capitalism but also understudied or suppressed histories of Europe's Crusades against its Muslim Other. This analysis places anti-Muslim sentiments of the Old World into a much- needed conversation with conquest of the New World. In my last chapter, I study "Indian Arrival Day" a national holiday in the Caribbean celebrating the first arrival of Indians as indentured laborers. This chapter adds to the growing scholarship that moves us away from binaries of free versus unfree or coercive labor and towards more complex readings of modern racialized division of labor.
The Public Good: Eugenics and Law in Ontario, 1910 to 1938
Keywords: birth control
eugenics
marriage restrictions
Ontario
public health
sterilization

In the early twentieth century, interest in eugenics swept the world. Seen as a scientific solution to social ills of the day like prostitution, venereal disease and the supposed rise in “feeble-mindedness,” its principles were based on the notion that humanity could be improved through selective breeding, as was already being done with plants and animals. Many jurisdictions, including thirty American states as well as Alberta and British Columbia in Canada, implemented legislation which required certain “unfit” individuals to undergo reproductive sterilization. Others passed legislation requiring pre-marital certificates of medical “fitness.” Surprisingly, Ontario never followed suit. This has led to the assumption that “not too much” of a eugenic nature happened in that province. However, by investigating the relationship between eugenics and law using primary sources relatively unknown to historians of medicine, science and technology, I have found evidence of considerable eugenic activity in Ontario. This dissertation focusses on the period from 1910 to 1938 and three specific legal processes. First, I examine the story of Dr. Forbes Godfrey, MPP, who, between 1910 and 1921, introduced eight private members’ bills in the legislature, four to implement sterilization and four to implement marriage restrictions. All eight failed to pass. Second is the story of three Royal Commissions, established in 1917, 1929, 1938, which all recommended eugenic solutions to the problems they were set up to consider. Once again, none of their proposed eugenic solutions were adopted. Third is the story of industrialist A. R. Kaufman and the Parents’ Information Bureau he incorporated to promote birth control and sterilization. This work led to a 1936 criminal prosecution now known as the Eastview Trial in which the judge determined, partly because of an argument based explicitly on eugenic principles, that distributing birth control information and devices served the “public good.”
Understanding access to HIV-related and gender-affirming healthcare for trans women with HIV in Canada: A mixed methods study
Keywords: gender affirmation
healthcare
HIV
stigma
transgender

Background: Trans women living with HIV (WLWH) have lower access to HIV care compared to cisgender (cis) people living with HIV. US-based research describes barriers (e.g., trans stigma) and facilitators (e.g., integration of gender-affirming and HIV care) to HIV care engagement among trans WLWH. Scant research has explored factors associated with HIV or gender-affirming care access among trans WLWH in Canada. This three-paper dissertation aims to expand an intersectional and social ecological understanding of the experiences of trans WLWH in Canada accessing HIV, gender-affirming, and other types of healthcare. Methods: A transformative, convergent parallel, mixed methods design was used whereby quantitative and qualitative data were rigorously collected and analyzed, then purposefully merged. Quantitative data was drawn from baseline cross-sectional survey data collected 2013-2015 from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) (n=54 trans WLWH/n=1422 participants) and analyzed using descriptive statistics and bivariate analyses. In-depth semi-structured individual interviews (25-100 minutes) were conducted with a purposive sub-set of trans WLWH (n=11) 2017-2018 who completed the baseline CHIWOS survey, analyzed using framework analysis. Qualitative and quantitative results were merged by comparing data and considering how results converged, diverged, or expanded understanding. Inequities were highlighted and recommendations made, consistent with a transformative design. Results: Three empirically-based chapters report on: (1) the HIV care cascade and factors associated with HIV care cascade outcomes (ever accessed HIV care, received any HIV care in the past year, currently use antiretroviral treatment (ART), ART adherence, and virological suppression); (2) transition and gender-affirming healthcare experiences of trans WLWH; and (3) resilience and empowerment exhibited by trans WLWH as they navigate intersecting stigmas in healthcare settings. Conclusions: Findings suggest a need for multi-level interventions to address barriers to accessing care. Intersecting stigmas were a pervasive barrier to accessing multiple types of healthcare. Trans WLWH resist and reduce stigma in healthcare settings; however, widespread stigma-reduction training for providers, administrators, and students is recommended. These findings inform a trajectory of social work research, theory development, and practice at policy, organizational, and individual levels, all of which may further contribute to health equity for trans WLWH in Canada.