Approche bioclimatique et performance énergétique des bâtiments d'habitation au Nunavik

Au Nunavik, les conditions climatiques de froid extrême et sa situation géographique isolée imposent de nombreuses contraintes dans la construction et l'entretien des bâtiments. En plus d'être la cause de coûts élevés, ces contraintes limitent la planification de nouveaux bâtiments dans un contexte de surpopulation des résidences existantes et de crise du logement. Les 14 communautés inuites habitant le territoire ne sont pas connectées au réseau électrique approvisionnant le reste de la province. Elles dépendent donc de systèmes mécaniques alimentés au diesel pour leurs besoins énergétiques à hautes émissions de CO₂. Des modèles de base ont été conçus pour être érigés rapidement pendant les courtes saisons de chantier estivales par les organisations de construction locales. Les bâtiments résultants ne considèrent donc pas entièrement les particularités climatiques du site, mais dépendent plutôt des systèmes mécaniques pour le confort des habitants. Ce mémoire vise à utiliser une approche bioclimatique dans la conception afin d'accroître la résilience des bâtiments d'habitation au Nunavik tout en réduisant leur consommation énergétique. Une revue de littérature a permis de souligner trois principales caractéristiques morphologiques ayant un impact sur les charges thermiques des bâtiments dans un contexte de froid extrême : leur compacité, leur orientation et leur aérodynamisme. Ces trois variables ont été analysées de manière paramétrique à l'aide des outils de la suite Ladybug ainsi que Galapagos et Octopus. Un bâtiment de référence a été utilisé afin de comparer les résultats des simulations. Les résultats montrent que la compacité possède le plus grand potentiel d'améliorer la performance énergétique des bâtiments au Nunavik, suivi de l'aérodynamisme et enfin, de l'orientation. À partir de ces résultats, trois modèles de bâtiments ont été conçus afin de valider l'impact de l'approche bioclimatique sur la performance énergétique. Les résultats montrent que les trois bâtiments permettent de réduire considérablement les charges thermiques tout en augmentant les gains solaires annuels du bâtiment de référence. Le présent mémoire montre que l'approche bioclimatique utilisée dès les premières étapes de conception possède un véritable potentiel pour accroître la résilience des bâtiments d'habitation au Nunavik.In Nunavik, extreme climatic conditions and remoteness of Inuit villages imply many constraints to the construction and maintenance of residential buildings. While being the cause of high costs, those constraints limit the planning of new buildings in a context of housing shortage. The 14 inuit communities living in the territory are not connected to the electric network supplying the rest of the province. They rely instead on high CO₂ emission diesel mechanical systems for their needs in energy. Basic models are designed to be fast constructed during the short construction periods in summer. The resulting buildings do not fully consider the site's climatic particularities, but rely instead on the mechanical systems to provide comfort to the inhabitants. This thesis aims to use a bioclimatic approach in the design process to increase the resilience of housing buildings in Nunavik while reducing their energy consumption. A literature review highlighted three principal shape characteristics having an impact on the heating loads of buildings in northern climates: compactness, orientation and aerodynamism. Those three variables have been parametrically analyzed with the Ladybug Tools, Galapagos and Octopus. A reference building, the J.2.2. model, was used to compare the results of the simulations. The results show that compactness has the higher potential to improve the energy performance of buildings in Nunavik, followed by aerodynamism and finally, orientation. From those results, three building models have been designed to validate the pertinence of a bioclimatic approach on the energy performance. The results show that the three buildings can reduce significantly the heating loads while increasing the solar gains annually in comparison to the reference building. This thesis show that the bioclimatic approach used in the first design phase has a true potential to increase the resilience of housing buildings in Nunavik

Risk Score, Causes, and Clinical Impact of Failure of Transradial Approach for Percutaneous Coronary Interventions

ObjectivesTo study the causes of and to develop a risk score for failure of transradial approach (TRA) for percutaneous coronary intervention (PCI).BackgroundTRA-PCI failure has been reported in 5% to 10% of cases.MethodsTRA-PCI failure was categorized as primary (clinical reasons) or crossover failure. Multivariate analysis was performed to determine independent predictors of TRA-PCI failure, and an integer risk score was developed.ResultsFrom January to June 2010, TRA-PCI was attempted in 1,609 (97.3%) consecutive patients, whereas 45 (2.7%) had primary TRA-PCI failure. Crossover TRA-PCI failure occurred in 30 (1.8%) patients. Causes of primary TRA-PCI failure included chronic radial artery occlusion (11%), previous coronary artery bypass graft (27%), and cardiogenic shock (20%). Causes for crossover TRA-PCI failure included: inadequate puncture in 17 patients (57%); radial artery spasm in 5 (17%); radial loop in 4 (13%); subclavian tortuosity in 2 (7%); and inadequate guide catheter support in 2 (7%) patients. Female sex (odds ratio [OR]: 3.2; 95% confidence interval [CI]: 1.95 to 5.26, p < 0.0001), previous coronary artery bypass graft (OR: 6.1; 95% CI: 3.63 to 10.05, p < 0.0001), and cardiogenic shock (OR: 11.2; 95% CI: 2.78 to 41.2, p = 0.0011) were independent predictors of TRA-PCI failure. Risk score values from 0 to 7 predicted a TRA-PCI failure rate from 2% to 80%.ConclusionsIn a high-volume radial center, 2.7% of patients undergoing PCI are excluded from initial TRA on clinical grounds, whereas crossover to femoral approach is required in only 1.8% of the cases. A new simple clinical risk score is developed to predict TRA-PCI failure

Initial evidence of the effectiveness of a short, online Recovery College Model: a co-learning model to support mental health in the context of the Covid-19 pandemic: Effectiveness of a short, online Recovery College

Introduction. The Covid-19 pandemic (C-19) has a negative impact on the mental health of the general population and in particular, women, people with chronic physical illness or psychiatric conditions, students and health care providers. Targeting these needs, the Recovery College (RC) model offers a new and innovative approach based on co-learning and learner diversity. The model provides a co-learning space where at-risk populations and the general public learn together and collectively equip themselves to better address psychological well-being and mental health issues. Objective. The objective is to present the initial results of the RC co-learning model in a short online format to meet the pressing needs of mental health intervention in the C-19 context. Method. A pre-post research design with repeated measures was used. Results. Results suggest improved knowledge and use of tools to support mental health interventions, self-management strategies, anti-stigma attitudes, and protection against increased anxiety. Conclusion. This RC model allows people from all backgrounds to participate in an innovative co-learning model in which experiential knowledge is central to learning to stimulate reflection and change in attitudes and behaviors