Bien-être spirituel et qualité de vie chez les patients atteints d'un cancer pulmonaire avancé : une étude exploratoire

Objectifs Plusieurs études démontrent une corrélation positive entre bien-être spirituel et qualité́ de vie chez les patients oncologiques. Cependant, celles-ci font défaut chez les patients atteints d’un cancer pulmonaire avancé. Les objectifs principaux de ce travail étaient d’évaluer la faisabilité́ et l’acceptabilité́ d’une étude portant sur le bien-être spirituel et son impact sur la qualité́ de vie chez cette population de patients. Méthodologie Cette étude exploratoire, monocentrique, a été conduite au sein de la clinique THOR du service d’oncologie ambulatoire du CHUV par questionnaires dans le cadre d’entretiens semistructurés. Les patients, atteints de cancer pulmonaire stade III ou IV, ont été recrutés par les médecins assistants du service d’oncologie. Différents facteurs, tels que degré de spiritualité et religiosité, bien-être spirituel, qualité de vie, symptômes physiques, psychologiques et de dépression ont été évalués par questionnaires. La faisabilité (nombre de patients répondant aux critères d’inclusion, nombre de patients enrôlés) ainsi que l’acceptabilité (taux et motifs de refus des participants, satisfaction globale à l’égard de l’entretien, impact émotionnel et temps alloué à l’entretien) ont été analysés. Résultats L’étude s’est déroulée d’avril à août 2018. Onze patients y ont participé, tous recrutés au cours des deux derniers mois et demi de l’étude. Diverses hypothèses peuvent expliquer ce recrutement tardif, telles que la charge de travail des médecins oncologues, le nombre élevé de recherches menées en parallèle dans le service et une information insuffisante sur l’étude. La présence de l’investigatrice principale lors des consultations dès juin 2018 a permis de pallier à ces difficultés de recrutement. Tous les patients à qui l’étude a été proposée ont accepté d’y participer. 90% des patients se sont dits plutôt satisfaits ou très satisfaits de l’entretien. Celui-ci n’a suscité aucun impact émotionnel négatif. Les questions ont été compréhensibles pour la grande majorité d’entre eux et le temps alloué à l’entretien a été jugé adéquat. Conclusion Ce travail démontre la bonne acceptabilité́ d’une étude portant sur le bien-être spirituel et son impact sur la qualité́ de vie des patients atteints d’un cancer pulmonaire avancé et suivis ambulatoirement. Elle révèle également en terme de faisabilité la nécessité d’un coinvestigateur impliqué quotidiennement dans le recrutement de ce type de patients

Validità delle metriche ritmiche: un’analisi e verifica su alcune varietà d’italiano regionale

2012 - 2013Negli ultimi anni, lo studio del ritmo avviene tramite modelli definiti metriche ritmiche (cfr. Ramus et al. 1999, Grabe & Low 2002, Dellwo 2006, Bertinetto & Bertini 2008). La maggior parte degli studi sul ritmo sperimentano queste metriche su parlato letto. La sperimentazione delle metriche su corpora di parlato spontaneo e semi-spontaneo, però, mostra risultati che contrastano con quelli del parlato letto, cioè tali modelli rendono per questi tipi di parlato classificazioni ritmico-tipologiche differenti. Lo scopo di questa ricerca è verificare la capacità classificatoria di alcune metriche ritmiche (cfr. Ramus et al. 1999, Grabe & Low 2002, Dellwo 2006) su un corpus di parlato semi-spontaneo. Il corpus della ricerca è estratto da CLIPS (cfr. Albano Leoni 2006, Savy & Cutugno 2009) ed è composto da otto varietà di italiano regionale. Il parlato, come sopra accennato, è di tipo semi-spontaneo ed è stato acquisito attraverso le tecniche di elicitazione del map task e del test delle differenze. In letteratura, le metriche sopra citate sono sperimentate su unità linguistiche molto eterogenee tra loro per dimensione, struttura e parametri. Questa eterogeneità rappresenta un problema di non facile soluzione per gli studi sul ritmo. Allo scopo di risolvere tale problema, in questa ricerca si definisce un dominio per le analisi ritmiche che, insieme alla verifica della validità classificatoria delle metriche ritmiche, rappresenta un punto saliente della tesi di dottorato. La unità linguistica che in questa ricerca funge da dominio per le analisi ritmiche è la Unità Tonale (T-U). Dalla sperimentazione delle metriche sulle T-U del corpus emergono alcune problematiche che pongono in serio dubbio la utilità di questi modelli. Infatti, la maggior parte delle varietà di italiano che compongono il corpus della ricerca non vengono classificate nelle classi ritmiche tradizionali. La mancata classificazione della maggior parte delle varietà di italiano dipende dai parametri su cui le metriche fondano la classificazione delle lingue naturali: la durata e il numero dei segmenti vocalici. Nel parlato semi-spontaneo, tali parametri sono molto instabili perché, come dimostrano i risultati di questa ricerca, dipendono dai seguenti fattori: velocità di elocuzione, variabilità inter-parlatore e variabilità intra-parlatore. [a cura dell'autore]XII n.s

Community Interactions and Impacts of Exotic Plant Species in the Southeastern United States

Native to other regions of the world, exotic species can disrupt the ecology and function of natural areas where they are introduced. Exotic species successfully establish in and dominate natural areas via multiple pathways and ecological processes. Given that many of these interactions remain difficult to measure, it is imperative to properly identify environmental factors that predict exotic species success and quantify the impacts of exotic species dominance on natural communities. Here, I explore the interactions between exotic plant species and communities where they have been introduced in the southeastern United States to address the predictors of invasion, community responses to invasion and subsequent removal of dominant invaders. Chapter 2 considers whether biotic communities predictably incorporate or resist exotic species by examining the relationship between native species richness and exotic species richness at multiple spatial scales across a broad range of environmental conditions. Chapter 3 explores the predictive ability of environmental characteristics concerning exotic species success in a large vegetation database. Chapter 4 quantifies the abiotic and biotic community changes with invasion of a dominant exotic shrub, including assessments of species diversity and the physical structure of the community. Chapter 5 assesses the abiotic community differences resulting from exotic shrub invasion, including abiotic responses to removal of that dominant shrub from the community. Exotic species success generally and predictably responds to changes in the scale of observation and local environmental conditions. Several environmental characteristics correlate with exotic species success, including soil pH, calcium, tree stem density and cover of wetland species. The unique predictive ability of any individual variable remains limited, reflecting the complex interactions driving exotic species success and the differences among exotic species. Invaded communities exhibit several distinct responses to exotic species dominance, including changes in both richness and physical forest structure. Such changes must be considered in context, as invaders of similar structure, function and origin differentially affect the communities they invade. Although shrub invasions, and the subsequent removal of dominant invaders, may cause demonstrable abiotic changes in the community, such as in temperature and light availability, responses in soil moisture and nutrient levels are limited.Doctor of Philosoph

Suspension plasma sprayed alumina-yttria stabilized zirconia nano-composite thermal barrier coatings : formation and roles of the amorphous phase

Thermal barrier coatings have been used for the last half century to protect parts in high-temperature service from premature damage. Thermal barrier coatings are mostly produced by thermal spray techniques, especially plasma spray processes. They are widely used in the aerospace and automotive industries and in power plants, applications in which there is an ever-increasing demand for further improvement of functionality and durability. In the field of material design, use of composite coatings rather than monolithic material, and nano-structure instead of conventional grain sizes, are among the solutions most often considered. Suspension plasma spray is an innovative process for production of nano-structured thermal barrier coatings. This research project was directed toward a superior thermal barrier coating using suspension plasma spray deposition of the alumina-yttria stabilized zirconia composite material with nano-crystalline structure. Crystallization of the amorphous phase is introduced as a new route toward nano-crystallinity in ceramics, as was previously applied in the metals and alloys. The suspension plasma spray process was used in production of coatings with comparatively high amorphous content. The work concentrates on three major aspects of thermal barrier coating improvement. The primary focus of the project is amorphous phase formation and the roles it plays in properties and structure. This phase, which was found beneficial to nano-crystallinity, improves the mechanical properties after heat treatment. The second concentration is the suspension plasma spray process and the versatility of its resulting microstructures, and a comparison of suspension with the conventional plasma spray process. The third aspect is the properties of alumina-YSZ composite material as a choice for thermal barrier coating application. It was found that the material can compete with the present YSZ material in some aspects (e.g. thermal resistivity and hardness), but suffers from some other deficiencies (e.g. brittleness and high erosion rate). This suggests considering some other compositions of the composite, while continuing in microstructural improvement of this material for thermal barrier application

Community Interactions and Impacts of Exotic Plant Species in the Southeastern United States

Native to other regions of the world, exotic species can disrupt the ecology and function of natural areas where they are introduced. Exotic species successfully establish in and dominate natural areas via multiple pathways and ecological processes. Given that many of these interactions remain difficult to measure, it is imperative to properly identify environmental factors that predict exotic species success and quantify the impacts of exotic species dominance on natural communities. Here, I explore the interactions between exotic plant species and communities where they have been introduced in the southeastern United States to address the predictors of invasion, community responses to invasion and subsequent removal of dominant invaders. Chapter 2 considers whether biotic communities predictably incorporate or resist exotic species by examining the relationship between native species richness and exotic species richness at multiple spatial scales across a broad range of environmental conditions. Chapter 3 explores the predictive ability of environmental characteristics concerning exotic species success in a large vegetation database. Chapter 4 quantifies the abiotic and biotic community changes with invasion of a dominant exotic shrub, including assessments of species diversity and the physical structure of the community. Chapter 5 assesses the abiotic community differences resulting from exotic shrub invasion, including abiotic responses to removal of that dominant shrub from the community. Exotic species success generally and predictably responds to changes in the scale of observation and local environmental conditions. Several environmental characteristics correlate with exotic species success, including soil pH, calcium, tree stem density and cover of wetland species. The unique predictive ability of any individual variable remains limited, reflecting the complex interactions driving exotic species success and the differences among exotic species. Invaded communities exhibit several distinct responses to exotic species dominance, including changes in both richness and physical forest structure. Such changes must be considered in context, as invaders of similar structure, function and origin differentially affect the communities they invade. Although shrub invasions, and the subsequent removal of dominant invaders, may cause demonstrable abiotic changes in the community, such as in temperature and light availability, responses in soil moisture and nutrient levels are limited.Doctor of Philosoph

An Exploration of the Experiences of LGBTQ International Students: The Case of the University of Pittsburgh

This doctoral dissertation aimed to explore the unique experiences of a very specific, yet quite diverse segment of the student body population in higher education: International students who also identify as Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning (LGBTQ). The experiences of this subset of the student population have not been extensively examined in scholarly research (Rankin, 2006). Oba and Pope (2013) indicate that these students might confront many difficulties in their academic and personal lives on American campuses as they grapple with factors related to their multiple identities. In light of these findings, this dissertation strove to explore the experiences of these students on one college campus in a city in the United States, the University of Pittsburgh. Sixty-nine students completed a survey which was created specifically for this study. Thirteen of the survey respondents also participated in individual interviews. Results indicated that students’ experiences were quite varied whereby some students reported more positive experiences than others. Furthermore, many participants indicated that they were not open about their LGBTQ identities to others on campus. Negative encounters with homophobia and racism were also reported by various participants. Recommendations are presented for higher education professionals regarding implementing services to assist this diverse student population with a myriad of potential difficulties in their new surroundings

Cigarette smoking during pregnancy and adverse perinatal outcomes: a cross-sectional study over 10 years.

It has been shown that active exposure to tobacco is associated with adverse pregnancy outcomes including, but not limited to, intrauterine fetal death, reduced fetal weight, and higher risk of preterm birth. We want to investigate these effects in a high-income country. This cross-sectional study examined 20,843 pregnant women who delivered over 10 years at the Maternity Hospital of the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland. The objective was to evaluate a dose-response relationship between daily cigarette use during pregnancy and possible adverse perinatal outcomes. The social and clinical characteristics as well as obstetric and neonatal outcomes were compared between the smoking and the non-smoking groups. Adjusted odds ratios (aOR) and trend analyses (p <sub>trend</sub> ) were calculated. Nineteen thousand five hundred fifty-four pregnant women met the inclusion criteria and 2,714 (13.9%) of them were smokers. Even after adjusting for confounding factors, smoking during pregnancy was associated with preterm birth, birthweight < 2500 g, intrauterine growth restriction, neonatal respiratory and gastrointestinal diseases, transfer to the neonatal intensive care unit, and neonatal intensive care unit admissions > 7 days. Intrauterine death and neonatal infection were associated with heavy smoking (≥ 20 cigarettes/day). Smoking appeared to be a protective factor for pre-eclampsia and umbilical cord arterial pH below 7.1. A significant trend (p <sub>trend</sub> < 0.05) was identified for preterm birth, intrauterine growth restriction, birthweight < 2500 g, umbilical cord arterial pH below 7.1, transfers to our neonatal intensive care unit, and neonatal intensive care unit admissions more than 7 days. Cigarette smoking is associated with several adverse perinatal outcomes of pregnancy with a dose-dependent effect

Bottom-up vs. top-down connectivity imbalance in individuals with high-autistic traits: An electroencephalographic study

Brain connectivity is often altered in autism spectrum disorder (ASD). However, there is little consensus on the nature of these alterations, with studies pointing to either increased or decreased connectivity strength across the broad autism spectrum. An important confound in the interpretation of these contradictory results is the lack of information about the directionality of the tested connections. Here, we aimed at disambiguating these confounds by measuring differences in directed connectivity using EEG resting-state recordings in individuals with low and high autistic traits. Brain connectivity was estimated using temporal Granger Causality applied to cortical signals reconstructed from EEG. Between-group differences were summarized using centrality indices taken from graph theory (in degree, out degree, authority, and hubness). Results demonstrate that individuals with higher autistic traits exhibited a significant increase in authority and in degree in frontal regions involved in high-level mechanisms (emotional regulation, decision-making, and social cognition), suggesting that anterior areas mostly receive information from more posterior areas. Moreover, the same individuals exhibited a significant increase in the hubness and out degree over occipital regions (especially the left and right pericalcarine regions, where the primary visual cortex is located), suggesting that these areas mostly send information to more anterior regions. Hubness and authority appeared to be more sensitive indices than the in degree and out degree. The observed brain connectivity differences suggest that, in individual with higher autistic traits, bottom-up signaling overcomes top-down channeled flow. This imbalance may contribute to some behavioral alterations observed in ASD

Rhythmic TMS as a Feasible Tool to Uncover the Oscillatory Signatures of Audiovisual Integration

Multisensory integration is quintessential to adaptive behavior, with clinical populations showing significant impairments in this domain, most notably hallucinatory reports. Interestingly, altered cross-modal interactions have also been reported in healthy individuals when engaged in tasks such as the Sound-Induced Flash-Illusion (SIFI). The temporal dynamics of the SIFI have been recently tied to the speed of occipital alpha rhythms (IAF), with faster oscillations entailing reduced temporal windows within which the illusion is experienced. In this regard, entrainment-based protocols have not yet implemented rhythmic transcranial magnetic stimulation (rhTMS) to causally test for this relationship. It thus remains to be evaluated whether rhTMS-induced acoustic and somatosensory sensations may not specifically interfere with the illusion. Here, we addressed this issue by asking 27 volunteers to perform a SIFI paradigm under different Sham and active rhTMS protocols, delivered over the occipital pole at the IAF. Although TMS has been proven to act upon brain tissues excitability, results show that the SIFI occurred for both Sham and active rhTMS, with the illusory rate not being significantly different between baseline and stimulation conditions. This aligns with the discrete sampling hypothesis, for which alpha amplitude modulation, known to reflect changes in cortical excitability, should not account for changes in the illusory rate. Moreover, these findings highlight the viability of rhTMS-based interventions as a means to probe the neuroelectric signatures of illusory and hallucinatory audiovisual experiences, in healthy and neuropsychiatric populations