Patients, Caregivers, and Illness Uncertainty: Influences on Coping and Quality of Life

Illness uncertainty is defined as “the inability of a person to determine the meaning of illness-related events”. Patients’ and caregivers’ individual experiences of illness uncertainty adversely affect their quality of life (QOL). The relationship between uncertainty and QOL have been examined extensively for either the patient or caregiver, but not among the patient-caregiver dyads. This three-paper dissertation fills gaps in the literature by examining the independent and interdependent relationships between illness uncertainty and QOL using the patient-caregiver dyad as a unit of analysis. The first paper presented a systematic review and meta-analysis of 21 articles that reported correlates of illness uncertainty in patients with cancer and caregivers. Notable effect sizes were observed in the correlations between illness uncertainty and social support, QOL, depression, and anxiety among patients with cancer. Insufficient data precluded examining the effect size of correlates of illness uncertainty among caregivers. The second paper using the actor -partner interdependence model, examined the independent and interdependent relationships between illness uncertainty and QOL among patients with advanced cancer and caregivers and assessed whether these relationships differed according to the patient-caregiver relationship and the type of cancer. Results demonstrated that patients’ and caregivers’ illness uncertainty was negatively associated with their own QOL. Patients’ illness uncertainty was negatively associated with caregivers’ QOL. These independent and interdependent relationships between illness uncertainty and QOL did not differ by patient-caregiver relationship, but did differ by type of cancer. The third paper using actor-partner interdependence mediation model, examined independent and interdependent relationships among patients’ and family caregivers’ illness uncertainty, coping, and QOL. Significant actor and partner effects were present: each person’s illness uncertainty and coping were significantly associated with their own QOL; caregivers’ illness uncertainty was positively associated with patients’ avoidant coping. The mediation effects of active and avoidant coping on the relationships between illness uncertainty and QOL among patients and caregivers were partially verified. Collectively, the findings emphasized the need to support patients and caregivers as one unit of care and underscore the potential value of targeting family-oriented interventions to enhance QOL for patients and caregivers as they manage the stress of cancer.Doctor of Philosoph

Improving Textless Spoken Language Understanding with Discrete Units as Intermediate Target

Spoken Language Understanding (SLU) is a task that aims to extract semantic information from spoken utterances. Previous research has made progress in end-to-end SLU by using paired speech-text data, such as pre-trained Automatic Speech Recognition (ASR) models or paired text as intermediate targets. However, acquiring paired transcripts is expensive and impractical for unwritten languages. On the other hand, Textless SLU extracts semantic information from speech without utilizing paired transcripts. However, the absence of intermediate targets and training guidance for textless SLU often results in suboptimal performance. In this work, inspired by the content-disentangled discrete units from self-supervised speech models, we proposed to use discrete units as intermediate guidance to improve textless SLU performance. Our method surpasses the baseline method on five SLU benchmark corpora. Additionally, we find that unit guidance facilitates few-shot learning and enhances the model's ability to handle noise.Comment: Accepted by interspeech 202

Photocatalytic Oxidation of Gaseous Isopropanol Using Visible-Light Active Silver Vanadates/SBA-15 Composite

An environmentally friendly visible-light-driven photocatalyst, silver vanadates/SBA-15, was prepared through an incipient wetness impregnation procedure with silver vanadates (SVO) synthesized under a hydrothermal condition without a high-temperature calcination. The addition of mesoporous SBA-15 improves the formation of nanocrystalline silver vanadates. In situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) confirms the presence of Brønsted and Lewis acids on the SVO/SBA-15 composites. The results of photoluminescence spectra indicated that the electron-hole recombination rate have been effectively inhibited when SVO was loaded with mesoporous SBA-15. All the composites loaded with various amount of SVO inherit the higher adsorption capacity and larger mineralization yield than those of P-25 (commercial TiO2) and pure SVO. The sample loaded with 51% of SVO (51SVO/SBA-15) with mixed phases of Ag4V2O7 and α-Ag3VO4 exhibits the best photocatalytic activity. A favorable crystalline phase combined with high intensities of Brønsted and Lewis acids is considered the main cause of the enhanced adsorption capacity and outstanding photoactivity of the SVO/SBA-15 composites

Learning from Chinatown

In Learning from Las Vegas, Robert Venturi, Denise Scott Brown, and Steven Izenour approach the city without preconceived opinions because they believe there is something to be learned from every aspect of the built environment. Inspired by their research methods, I walked around Toronto’s Chinatown and observed its unique spatial character, paying particular attention to how it was formed by the nature of its bottom-up socio-cultural and economic patterns. Toronto’s Chinatown first emerged 150 years ago as a place of convergence for the Chinese diaspora. In response to the struggles faced by new immigrants in becoming established in a foreign context, kinship systems of support and exchange emerged, bridging old- and new-world cultures. The resilience and tenacity of their desire to establish a foothold in a new city and build for future generations is the foundation for the unique characteristics of today’s Chinatown—both in how it is enmeshed in the local context within the urban core, and also how it is a distinct space with its own internal set of social and economic networks. The core of this study consists of extensive field research, visualized through maps, photographs, diagrams, and illustrations based on personal experience. A key lesson to be learned from Chinatown concerns the intelligence and innovation of immigrants who adapted their cultural habits to a different environment in order to maintain a self-sustainable, affordable, and resilient neighbourhood

AMPK- mediated formation of stress granules is required for dietary restriction- induced longevity in Caenorhabditis elegans

Stress granules (SGs) are nonmembranous organelles that are dynamically assembled and disassembled in response to various stressors. Under stressed conditions, polyadenylated mRNAs and translation factors are sequestrated in SGs to promote global repression of protein synthesis. It has been previously demonstrated that SG formation enhances cell survival and stress resistance. However, the physiological role of SGs in organismal aging and longevity regulation remains unclear. In this study, we used TIAR- 1::GFP and GTBP- 1::GFP as markers to monitor the formation of SGs in Caenorhabditis elegans. We found that, in addition to acute heat stress, SG formation could also be triggered by dietary changes, such as starvation and dietary restriction (DR). We found that HSF- 1 is required for the SG formation in response to acute heat shock and starvation but not DR, whereas the AMPK- eEF2K signaling is required for starvation and DR- induced SG formation but not heat shock. Moreover, our data suggest that this AMPK- eEF2K pathway- mediated SG formation is required for lifespan extension by DR, but dispensable for the longevity by reduced insulin/IGF- 1 signaling. Collectively, our findings unveil a novel role of SG formation in DR- induced longevity.In addition to heat stress, starvation and dietary restriction (DR) can activate stress granule (SG) formation in Caenorhabditis elegans. HSF- 1 and AMPK are two key regulators for the SG formations. HSF- 1 is required for the SG formation in response to acute heat shock and starvation but not DR, whereas the AMPK- eEF2K pathway is required for starvation and DR- induced SG formation but not heat shock. Furthermore, AMPK- mediated SG formation contributes to DR- induced longevity.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/1/acel13157-sup-0008-Figurelegends.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/2/acel13157-sup-0001-FigS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/3/acel13157-sup-0006-TableS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/4/acel13157-sup-0007-TableS2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/5/acel13157-sup-0005-FigS5.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/6/acel13157-sup-0003-FigS3.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/7/acel13157.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/8/acel13157-sup-0002-FigS2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/9/acel13157-sup-0004-FigS4.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155936/10/acel13157_am.pd