Sound, Deindustrialization, and Gentrification: The Changing Aural Landscape of Pointe-Saint-Charles

The development of the Grand Trunk Railway of Canada during the 1850s established Pointe-Saint-Charles as a critical rail hub and positioned Montreal as the nexus for Canada’s growing railway system. The rail yards and surrounding industries attracted thousands of workers and their families. The sounds of engines, factory whistles, and the shunting noises of train cars being latched together formed a distinctive new soundscape that would come to define Pointe-Saint-Charles. This blue-collar community would continue to thrive as a seat of industrial activity in Montreal until the Saint Lawrence Seaway opened in 1959, which allowed much commercial traffic to bypass Pointe-Saint-Charles. The ensuing years were a time of change in this area as the neighborhood transitioned from an almost exclusively working-class enclave to a mixed, low-income and middle-class population. In 2015, in response to perceived demands from local residents, the Agence métropolitaine de transport announced that it would build a sound berm along rue de Sébastopol to dampen the sound of train traffic. This proposal was met with confusion by many long-time residents who felt that the train sounds were a vestige of Pointe-Saint-Charles’ working-class past and a defining part of the neighborhood. The berm, a large and imposing physical barrier, has profoundly altered the landscape of rue de Sébastopol. Its physical presence is in conflict with the existing architecture and cultural landscape of the street and the neighborhood. In this thesis, I explore the spatial, sensorial (the importance of engaging the senses within a broad consideration of a place), and symbolic effect of the berm on the community and aural landscape of Pointe-Saint-Charles as a window into the profound impact of the aural landscape on its environment

Love and incomprehensibility: The hermeneutic labour of caring for and understanding a loved one with psychosis

Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers’ perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one’s psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers’ effortful quest to understand their loved one’s experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic ‘mooring points’, making sense of their loved one’s unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful – it is hermeneutic labour – done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems

Love and Incomprehensibility:The hermeneutic labour of caring for and understanding a loved one with psychosis

Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers’ perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one’s psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers’ effortful quest to understand their loved one’s experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic ‘mooring points’, making sense of their loved one’s unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful – it is hermeneutic labour – done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems

Surgical excision of a large, verrucous, scrotal mass in a patient with HSV-2 and HIV-1 co-infection

Genital herpes simplex virus (HSV) infection in HIV-positive individuals can result in a unique presentation of symptoms. Instead of small papules or vesicles that recur and heal periodically, certain individuals present with large, chronic, verrucous lesions. We report a case in which a 45 year old male with acyclovir-resistant HSV-2 and positive HIV-1 serology underwent surgical excision of a verrucous mass on his left hemiscrotum. Keywords: HSV, HIV, Verrucous lesion, Scrotal mas

Can a community-led intervention offering social support and health education improve maternal health? A repeated measures evaluation of the pact project run in a socially deprived london borough

Social adversity can significantly influence the wellbeing of mothers and their children. Maternal health may be improved through strengthened support networks and better health literacy. Health improvement at the population level requires optimizing of the collaboration between statutory health services, civic organizations (e.g., churches, schools), as well as community groups and parents. Two key elements in improving community engagement are co-production and community control. This study evaluated a co-produced and community-led project, PACT (Parents and Communities Together), for mothers in a deprived south London borough. The project offered social support and health education. Intended effects were improvements in mental health, health literacy, and social support, assessed by standardized measures in a pre-post design. Sixty-one mothers consented to take part in the evaluation. Significant improvements were found in mental health measures, in health literacy, for those with low literacy at baseline, and in overall and some specific aspects of social support. Satisfaction with the project was high. We found that the project engaged local populations that access statutory health services relatively less. We conclude that community-organized and community-led interventions in collaboration with statutory health services can increase accessibility and can improve mothers’ mental health and other health-related outcomes

Evaluation of a community-led intervention in South London:How much standardization is possible?

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, the inconsistency of the intervention across sites and, second, the absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy, and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames, and methodologies. In one, the sampling frame and methodology were under community control, permitting a comparison of change in outcomes before and after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results, however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, the measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis