Le pacte critique postmoderne. De quelques figures énonciatives de la critique littéraire québécoise de l’année 1990.

À titre d'activité interprétante, la critique propose une lecture, plus ou moins subjective, plus ou moins affirmée, mais visant néanmoins l'inscription d'un savoir. Du point de vue énonciatif, elle engage toute une série de rapports - entre le sujet et l'objet, entre le signataire et le lecteur, entre l'œuvre et ses commentaires - ordonnés autour d'une stratégie argumentative centrée et orientée vers un enjeu véridictoire. Qu'en est-il lorsque l'un ou l'autre de ces axes est délibérément mis à mal ? L'examen des figures énonciatives manifestées dans un échantillon de textes critiques parus en 1990 montre une inflexion du pacte critique, qui touche à la fois la conceptualisation du référent, la posture du sujet et sa visée cognitive.As an interpretative activity, the critic suggests a lecture, more or less subjective, more or less affirmative, but always oriented toward the inscription of a knowledge. On enonciative point of view, it suppose series of relations - between the subject and the object, between the enonciator and the lector, between the text and its comments - determined by the rhetoric strategy and the search of veridiction. What happens when either one of these relations is volontarily disturbed ? The study of the enonciative figures who appears in a set of critic text published in 1990 shows an inflexion of the critic pact, who touch the referent's conceptualization, the posture of the subject and his cognitive aim

Les modifications vocales de Kendrick Lamar dans l'album To Pimp a Butterfly et leur apport au texte

Le rap a grandi en popularité depuis quelques années, non seulement du point de vue de la diffusion musicale, mais aussi sur le plan de la recherche. L’intérêt pour le rap dans le monde de la recherche musicologique se sépare en plusieurs branches, par contre, il existe peu de littérature en ce qui concerne les aspects narratifs de la musique rap, en particulier en ce qui a trait aux techniques vocales propres au rap (le flow). Cette recherche a pour but d’analyser les rapports qu’entretiennent le récit et la voix dans la musique rap en prenant pour exemple l’album To Pimp AButterfly (2015 de l’artiste Kendrick Lamar. Cet album par sa parution récente et son récit concis nous semble constituer un bon exemple, notamment en raison de sa richesse sur les plans narratif et vocal. À l’aide de méthodes que nous emprunterons à la narratologie, mais aussi d’outils d’analyse musicale, nous analyserons de plus près la manière dont l’artiste de rap peut utiliser sa voix pour donner vie à une histoire, souvent inspirée de la réalité

An Investigation of Cancer Rates in the Argentia Region, Newfoundland and Labrador: An Ecological Study

Background. The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region. Methods. Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared. Results. Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community. Conclusions. We did not detect an increased burden of cancer in the Argentia region

The Simple Lifestyle Indicator Questionnaire and its association with health-related quality of life and well-being.

A person’s lifestyle may be related to their quality of life and well-being. This cross-sectional survey examined the association between the Simple Lifestyle Indicator Questionnaire, a measure of lifestyle, and health-related quality of life and well-being among a sample of 100 adults living in St John’s, Newfoundland & Labrador. Lifestyle was significantly, positively correlated with well-being (r=0.47, p<0.01), self-perceived health (r=0.59, p <0.01) and mental health-related quality of life (r=0.41, p<0.01), but not physical health-related quality of life (r=0.13, p=0.19). This study benefitted from the use of validated questionnaires but the generalizability of these results is limited by a sample population that was younger, more educated and of higher household income than the general population. Lifestyle appears to be related to well-being and quality of life, and lifestyle factors may predict quality of life in populations similar to the population in this study

Le français écrit par la cohérence du texte rapport de recherche /

La couv. porte en outre: Texte, contexte, progression, non-contradiction, relation, cohérenceÉgalement disponible en version papier.Titre de l'écran-titre (visionné le 28 janv. 2010)Bibliogr.: p. 121-12

Identifying a list of healthcare ‘never events’ to effect system change: a systematic review and narrative synthesis

Background Never events (NEs) are patient safety incidents that are preventable and so serious they should never happen. To reduce NEs, several frameworks have been introduced over the past two decades; however, NEs and their harms continue to occur. These frameworks have varying events, terminology and preventability, which hinders collaboration. This systematic review aims to identify the most serious and preventable events for targeted improvement efforts by answering the following questions: Which patient safety events are most frequently classified as never events? Which ones are most commonly described as entirely preventable?Methods For this narrative synthesis systematic review we searched Medline, Embase, PsycINFO, Cochrane Central and CINAHL for articles published from 1 January 2001 to 27 October 2021. We included papers of any study design or article type (excluding press releases/announcements) that listed NEs or an existing NE framework.Results Our analyses included 367 reports identifying 125 unique NEs. Those most frequently reported were surgery on the wrong body part, wrong surgical procedure, unintentionally retained foreign objects and surgery on the wrong patient. Researchers classified 19.4% of NEs as ‘wholly preventable’. Those most included in this category were surgery on the wrong body part or patient, wrong surgical procedure, improper administration of a potassium-containing solution and wrong-route administration of medication (excluding chemotherapy).Conclusions To improve collaboration and facilitate learning from errors, we need a single list that focuses on the most preventable and serious NEs. Our review shows that surgery on the wrong body part or patient, or the wrong surgical procedure best meet these criteria

Family physicians’ questions about the COVID-19 pandemic: a content analysis of 2,272 helpline calls

Abstract Background During the COVID-19 pandemic, family physicians faced challenges including travel restrictions for patients, lockdowns, diagnostic testing delays, and changing public health guidelines. Given that 95% of Canadian physicians are members of the Canadian Medical Protective Association (CMPA), the CMPA’s telephone helpline — which offers peer-to-peer support — provides valuable insights into family physicians’ experiences during the pandemic. Methods We used a content analysis approach to identify and understand family physicians’ questions and concerns related to the COVID-19 pandemic expressed during calls to the Canadian Medical Protective Association (CMPA) telephone helpline. Calls were classified with preliminary codes and subsequently organized into themes. We collected aggregated data on calls, including province, call date, and whether the physician self-identified having hospital-based activities as part of their practice. Findings from the analysis were explored alongside family physician calls per month (call volume). Results Between 01 and 2020 and 31 December 2021, 2,272 family physician calls related to the pandemic were included for content analysis. We identified six major themes across these calls: challenging patient interactions; COVID-related care; the impact of the pandemic on the healthcare system; virtual care; physician obligations and rights; and public health matters. COVID-related call volumes were highest early in the pandemic especially among physicians without major hospital affiliation when family physicians practiced with little guidance on how to balance patient care and scarce resources in the face of a novel pandemic. Conclusions This research provides unique insight on the effects the COVID-19 pandemic had on family medicine in Canada. These results provide insights on the needs and information gaps of family physicians in a public health crisis and can inform preparedness efforts by public health agencies, professional organizations, educators, and practitioners

Effect of vaginal self-sampling on cervical cancer screening rates: a community-based study in Newfoundland

Background Cervical cancer is highly preventable and treatable if detected early through regular screening. Women in the Canadian province of Newfoundland & Labrador have relatively low rates of cervical cancer screening, with rates of around 40 % between 2007 and 2009. Persistent infection with oncogenic human papillomavirus (HPV) is a necessary cause for the development of cervical cancer, and HPV testing, including self-sampling, has been suggested as an alternative method of cervical cancer screening that may alleviate some barriers to screening. Our objective was to determine whether offering self-collected HPV testing screening increased cervical cancer screening rates in rural communities. Methods During the 2-year study, three community-based cohorts were assigned to receive either i) a cervical cancer education campaign with the option of HPV testing; ii) an educational campaign alone; iii) or no intervention. Self-collection kits were offered to eligible women at family medicine clinics and community centres, and participants were surveyed to determine their acceptance of the HPV self-collection kit. Paired proportions testing for before-after studies was used to determine differences in screening rates from baseline, and Chi Square analysis of three dimensional 2 × 2 × 2 tables compared the change between communities. Results Cervical cancer screening increased by 15.2 % (p < 0.001) to 67.4 % in the community where self-collection was available, versus a 2.9 % increase (p = 0.07) in the community that received educational campaigns and 8.5 % in the community with no intervention (p = 0.193). The difference in change in rates was statistically significant between communities A and B (p < 0.001) but not between communities A and C (p = 0.193). The response rate was low, with only 9.5 % (168/1760) of eligible women opting to self-collect for HPV testing. Of the women who completed self-collection, 15.5 % (26) had not had a Pap smear in the last 3 years, and 88.7 % reported that they were somewhat or very satisfied with self-collection. Conclusions Offering self-collected HPV testing increased the cervical cancer screening rate in a rural NL community. Women who completed self-collection had generally positive feelings about the experience. Offering HPV self-collection may increase screening compliance, particularly among women who do not present for routine Pap smears

Protocol for a randomised controlled trial for Treatment in Thoracic Aortic Aneurysm: Surgery versus Surveillance (TITAN: SvS)

Introduction Ascending thoracic aortic aneurysm (ATAA) is an asymptomatic condition that can lead to catastrophic events of rupture or dissection. Current guidelines are based on limited retrospective data and recommend surgical intervention for ATAA with a diameter of greater or equal to 5.5 cm. Treatment in Thoracic Aortic Aneurysm: Surgery versus Surveillance is the first prospective, multicentre, randomised controlled trial that compares outcomes of patients undergoing early elective ascending aortic surgery to patients undergoing medical surveillance.Methods and analysis Patients between the ages of 18 and 80 with an asymptomatic ATAA between 5.0 cm and 5.4 cm in diameter are eligible for randomisation to early surgery or surveillance. Patients in the surgery group will be followed at 1 month after discharge, then annually for a minimum of 2 years and up to 5 years. Patients in the surveillance group will be followed annually from their index clinic visit for a minimum of 2 years and up to 5 years. The primary outcome is all-cause mortality at follow-up. A sample size of 618 subjects (309 in each group) will achieve an 80% power at a 0.047 significance level.Ethics and dissemination This study has received Ottawa Health Science Network Research Ethics Board approval (Protocol 20180007-01H), which was most recently updated on 25 November 2020. The Research Ethics Board have granted approval to the study at 14 participating institutions, including the Ottawa Health Science Network Research Ethics Board. On completion of data analysis, the result of the trial will be presented at national and international conferences, and published in relevant journals, regardless of the finding of the trial.Trial registration number NCT03536312