Hacher menu : recueil de microrécits suivi de Étude de l'extrême brièveté dans le recueil de récits "Troublant" d'Hugues Corriveau

Le présent mémoire a pour objectif principal une double exploration de la pratique de l'extrême brièveté, phénomène représentatif de l'époque contemporaine et de ses enjeux sociaux. Il se divise en deux volets : un recueil de microrécits intitulé Hacher menu et un essai intitulé Étude de l'extrême brièveté dans le recueil de récits Troublant d'Hugues Corriveau . Hacher menu est un recueil constitué de trente-sept microrécits à l'intérieur desquels l'extrême brièveté se donne à lire comme contrainte formelle fondamentale. Comme son titre le suggère, ce recueil accorde une place privilégiée à la fragmentation et aux modalités relatives à la nouvelle contemporaine. Marie-Andrée Gagnon y met en scène une série de protagonistes aux équilibres fragiles, qu'ils soient morcelés ou en voie de l'être, et explore le rapport, trop souvent douloureux, entre corps et nourriture. L'essai s'intéresse aux diverses stratégies narratives et procédés esthétiques déployés par la pratique de l'extrême brièveté. Il consiste essentiellement en une étude de l'interaction entre les deux formes narratives brèves que sont la nouvelle et le fragment, succédée d'une microanalyse de dix récits issus du recueil Troublant d'Hugues Corriveau. Cette partie du mémoire se divise en deux chapitres, Pour une reconnaissance de la forme brève et Les récits fragmentés d'Hugues Corriveau

Exploration des comportements en activité physique chez les personnes ayant vécu un accident vasculaire cérébral : adaptation et faisabilité du programme Fitness and Mobility Exercise par vidéoconférence

Les personnes ayant vécu un accident vasculaire cérébral (AVC) ne sont généralement pas suffisamment actives pour en retirer les bénéfices sur leur santé. Il existe un programme appelé « Fitness and Mobility Exercise (FAME) » reconnu pour améliorer la condition physique post-AVC lorsque donné en centre communautaire. Or, de nombreux obstacles (environnementaux, sociaux, économiques), exacerbés par la pandémie de COVID-19, empêchent les personnes post-AVC d'accéder aux programmes communautaires. Ce présent mémoire se divise en deux phases. La première phase est composée d'un premier objectif qui était de décrire la quantité d'activité physique (AP), les barrières et motivateurs à la pratique d'AP des Québécois post-AVC. Pour ce faire, 30 personnes ont été sondées en ligne. Les résultats démontrent que les participants ne rencontrent pas les recommandations en AP. Certaines similitudes et différences existent entre les barrières des Québécois et celles rapportées dans la littérature, alors que les motivateurs à la pratique d'AP sont similaires. La deuxième phase comprend deux objectifs : a) adapter le programme FAME pour qu'il soit offert par vidéoconférence à la maison et b) évaluer la faisabilité du programme FAME@maison. Pour le premier objectif, deux groupes de discussion ont été réalisés auprès de cinq professionnels de la santé et quatre chercheurs spécialisés en AVC et téléréadaptation. Des recommandations sur les critères d'inclusion, mesures de sécurité, exercices, utilisation de la technologie et autres suggestions ont permis de développer le programme FAME@maison. Pour le deuxième objectif, la faisabilité de FAME@maison a été évaluée auprès de 9 participants post-AVC (trois groupes de trois personnes) (devis avant-après) à raison de 2 séances d'une heure par semaine sur 12 semaines. FAME@maison s'est avéré être faisable (92% de nos critères de faisabilité ont été atteints). FAME@maison est une approche novatrice et faisable qui pourrait aider à combler les besoins en AP des personnes post-AVC.Stroke survivors are commonly not active enough to accrue health benefits. An evidence-based program called, Fitness and Mobility Exercise (FAME), has been shown to improve physical condition and mobility after stroke in community settings. However, stroke survivors often face environmental, social, and economic barriers (exacerbated by the COVID-19 pandemic), to accessing community-based programs. The overall aim of this project was to increase our understanding of physical activity (PA) and barriers for stroke survivors in Quebec, and to explore novel approaches to enhance PA. This study was comprised of two phases. The objective of the first phase was to describe the duration and frequency of PA, and barriers and motivators to PA among stroke survivors in Quebec. Thirty individuals were surveyed online. Results demonstrated that a small sample of stroke survivors living in Quebec did not meet PA recommendations. Some similarities and differences existed between the barriers of stroke survivors in Quebec and the literature, while motivators to PA were similar. The second phase was divided in two specific objectives, which were to: 1) adapt the FAME program for delivery at home using videoconferencing technology, and 2) evaluate the feasibility of the FAME@home program. In objective 1, focus groups were conducted with five healthcare professionals and four researchers with expertise in stroke and telerehabilitation to adapt FAME. Recommendations on inclusion criteria, safety measures, exercise, use of technology, and other issues informed adaptions to the FAME@home program and study protocol. In objective 2, the feasibility of FAME@home was evaluated using a pre-post design with nine post-stroke participants (three groups of three participants). Participants completed two, one-hour sessions each week for 12 weeks. FAME@home was feasible (92% of the feasibility criteria were met). FAME@home is an innovative and feasible approach that may help to meet the PA needs of stroke survivors

Waking EEG functional connectivity in middle-aged and older adults with obstructive sleep apnea

Objectives: The present study aimed at investigating changes in waking electroencephalography (EEG), most specifically regarding spectral power and functional connectivity, in middle-aged and older adults with OSA. We also explored whether changes in spectral power or functional connectivity are associated with polysomnographic characteristics and/or neuropsychological performance. Methods: 19 OSA subjects (apnea-hypopnea index ≥ 20, age: 63.6 ± 6.4) and 22 controls (apneahypopnea index ≤ 10, age: 63.6 ± 6.7) underwent a full night of in-laboratory polysomnography followed by a waking EEG and a neuropsychological assessment. Waking EEG spectral power and imaginary coherence were compared between groups for all EEG frequency bands and scalp regions. Correlation analyses were performed between selected waking EEG variables, polysomnographic parameters and neuropsychological performance. Results: No group difference was observed for EEG spectral power for any frequency band. Regarding the imaginary coherence, when compared to controls, OSA subjects showed decreased EEG connectivity between frontal and temporal regions in theta and alpha bands as well as increased connectivity between frontal and parietal regions in delta and beta 1 bands. In the OSA group, these changes in connectivity correlated with lower sleep efficiency, lower total sleep time and higher apnea-hypopnea index. No relationship was found with neuropsychological performance. Conclusions: Contrary to spectral power, imaginary coherence was sensitive enough to detect changes in brain function in middle-aged and older subjects with OSA when compared to controls. Whether these changes in cerebral connectivity predict cognitive decline needs to be investigated longitudinally

Altered resting-state functional connectivity patterns in late middle-aged and older adults with obstructive sleep apnea

IntroductionObstructive sleep apnea (OSA) is increasingly recognized as a risk factor for cognitive decline, and has been associated with structural brain alterations in regions relevant to memory processes and Alzheimer’s disease. However, it is unclear whether OSA is associated with disrupted functional connectivity (FC) patterns between these regions in late middle-aged and older populations. Thus, we characterized the associations between OSA severity and resting-state FC between the default mode network (DMN) and medial temporal lobe (MTL) regions. Second, we explored whether significant FC changes differed depending on cognitive status and were associated with cognitive performance.MethodsNinety-four participants [24 women, 65.7 ± 6.9 years old, 41% with Mild Cognitive Impairment (MCI)] underwent a polysomnography, a comprehensive neuropsychological assessment and a resting-state functional magnetic resonance imaging (MRI). General linear models were conducted between OSA severity markers (i.e., the apnea-hypopnea, oxygen desaturation and microarousal indices) and FC values between DMN and MTL regions using CONN toolbox. Partial correlations were then performed between OSA-related FC patterns and (i) OSA severity markers in subgroups stratified by cognitive status (i.e., cognitively unimpaired versus MCI) and (ii) cognitive scores in the whole sample. All analyzes were controlled for age, sex and education, and considered significant at a p < 0.05 threshold corrected for false discovery rate.ResultsIn the whole sample, a higher apnea-hypopnea index was significantly associated with lower FC between (i) the medial prefrontal cortex and bilateral hippocampi, and (ii) the left hippocampus and both the posterior cingulate cortex and precuneus. FC patterns were not associated with the oxygen desaturation index, or micro-arousal index. When stratifying the sample according to cognitive status, all associations remained significant in cognitively unimpaired individuals but not in the MCI group. No significant associations were observed between cognition and OSA severity or OSA-related FC patterns.DiscussionOSA severity was associated with patterns of lower FC in regions relevant to memory processes and Alzheimer’s disease. Since no associations were found with cognitive performance, these FC changes could precede detectable cognitive deficits. Whether these FC patterns predict future cognitive decline over the long-term needs to be investigated

Hacher menu : recueil de microrécits suivi de Étude de l'extrême brièveté dans le recueil de récits "Troublant" d'Hugues Corriveau

Le présent mémoire a pour objectif principal une double exploration de la pratique de l'extrême brièveté, phénomène représentatif de l'époque contemporaine et de ses enjeux sociaux. Il se divise en deux volets : un recueil de microrécits intitulé Hacher menu et un essai intitulé Étude de l'extrême brièveté dans le recueil de récits Troublant d'Hugues Corriveau . Hacher menu est un recueil constitué de trente-sept microrécits à l'intérieur desquels l'extrême brièveté se donne à lire comme contrainte formelle fondamentale. Comme son titre le suggère, ce recueil accorde une place privilégiée à la fragmentation et aux modalités relatives à la nouvelle contemporaine. Marie-Andrée Gagnon y met en scène une série de protagonistes aux équilibres fragiles, qu'ils soient morcelés ou en voie de l'être, et explore le rapport, trop souvent douloureux, entre corps et nourriture. L'essai s'intéresse aux diverses stratégies narratives et procédés esthétiques déployés par la pratique de l'extrême brièveté. Il consiste essentiellement en une étude de l'interaction entre les deux formes narratives brèves que sont la nouvelle et le fragment, succédée d'une microanalyse de dix récits issus du recueil Troublant d'Hugues Corriveau. Cette partie du mémoire se divise en deux chapitres, Pour une reconnaissance de la forme brève et Les récits fragmentés d'Hugues Corriveau

Cartography of Emergency Department Visits for Asthma – Targeting High-Morbidity Populations

BACKGROUND: Asthma education should be offered with priority to populations with the highest asthma-related morbidity. In the present study, the aim was to identify populations with high-morbidity for asthma from the Quebec Health Insurance Board Registry, a large administrative database, to help the Quebec Asthma and Chronic Obstructive Pulmonary Disease Network target its interventions

Housing, Transportation and Quality of Life among People with Mobility Limitations: A Critical Review of Relationships and Issues Related to Access to Home- and Community-Based Services

Anecdotal reports suggest that adequate housing and transportation could be fundamental elements required to ensure quality of life (QOL) for people with mobility limitations. Certain home- and community-based services (HCBS) are also necessary to ensure that housing and transportation needs are met. Understanding QOL as it relates to housing and transportation is critical for people with mobility limitations but requires appropriate assessment of these constructs. The aims of this research were to explore the relationships between housing and transportation on QOL for people with mobility limitations, to describe the current conceptual measurement issues and to propose dimensions of access that could facilitate assessment of QOL as it relates to housing, transportation and HCBS. A critical review of the literature was conducted by experts in disability, QOL and access theory. While evidence indicated a potential influence of housing and transportation on QOL for people with mobility limitations, the relationships between these concepts were weak and inconclusive. Moreover, the measurement tools used lacked appropriateness to specifically measure these constructs. Approaching these measurement issues within an access theory may better position future research to address the housing, transportation and HSBS needs of people with mobility limitations. Future research may consider elements of availability, accessibility, accommodation, affordability, acceptability and awareness to ensure access for people with mobility limitations. A better understanding of QOL as it relates to housing, transportation and HCBS will improve the quality of research, which may in turn improve access of adequate services for people with mobility limitations

Housing, Transportation and Quality of Life among People with Mobility Limitations: A Critical Review of Relationships and Issues Related to Access to Home- and Community-Based Services

Anecdotal reports suggest that adequate housing and transportation could be fundamental elements required to ensure quality of life (QOL) for people with mobility limitations. Certain home- and community-based services (HCBS) are also necessary to ensure that housing and transportation needs are met. Understanding QOL as it relates to housing and transportation is critical for people with mobility limitations but requires appropriate assessment of these constructs. The aims of this research were to explore the relationships between housing and transportation on QOL for people with mobility limitations, to describe the current conceptual measurement issues and to propose dimensions of access that could facilitate assessment of QOL as it relates to housing, transportation and HCBS. A critical review of the literature was conducted by experts in disability, QOL and access theory. While evidence indicated a potential influence of housing and transportation on QOL for people with mobility limitations, the relationships between these concepts were weak and inconclusive. Moreover, the measurement tools used lacked appropriateness to specifically measure these constructs. Approaching these measurement issues within an access theory may better position future research to address the housing, transportation and HSBS needs of people with mobility limitations. Future research may consider elements of availability, accessibility, accommodation, affordability, acceptability and awareness to ensure access for people with mobility limitations. A better understanding of QOL as it relates to housing, transportation and HCBS will improve the quality of research, which may in turn improve access of adequate services for people with mobility limitations