Browsing by Subject "Canada"
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Item Open Access Association of maternal depression and hypothyroidism with infant gastroschisis: a population-based cohort study in Canada.(Scientific reports, 2023-05) Liu, Shiliang; Claude, Hughes; Yong, Shin Jie; Chen, DunjinGastroschisis has increased globally over recent decades, and this increase has not been explained by identified risk factors. We conducted a population-based study of infants born in Canada, 2004-2020. We used "winter" months (i.e., September through June) and northern areas of residence as indicators of less sunlight/less active lifestyle, while "summer" (i.e., July and August) and southern areas were considered as reference. Rate of gastroschisis for infants conceived in winter (3.4 per 10,000) was higher than for infants conceived in summer (2.2 per 10,000; p < 0.001). Exposure to winter, and northern area, hypothyroidism, substance or tobacco uses and depressive disorder were initially identified as risk factors for gastroschisis. There was a significant interaction between women < 24 years of age and 2-month conception intervals (rate ratio (RR): 1.42 (95% confidence interval [CI] 1.19-1.70). The association of maternal depression (mean ratio 2.19, 95% CI 0.87-3.50, p = 0.001) with infant gastroschisis was mediated by hypothyroidism (mean ratio 1.04, 95% CI 1.01-1.07, p < 0.001), whereas substance use, hypothyroidism, tobacco smoking and gestational diabetes showed 5.5-, 3.1-, 2.7-, and 1.2-fold associations, respectively, with maternal depression. In contrast to the summer conception interval of low gastroschisis risk, an elevated risk of gastroschisis spans the other ten months in association with higher levels of stress adaptation, thermoregulation and metabolism, reproduction, and growth effector hormones. Our findings suggest that periconception depression with mediation by hypothyroidism, may play a causal role in offspring gastroschisis.Item Open Access Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study.(Spine, 2013-10) Smith, Justin S; Lafage, Virginie; Ryan, Devon J; Shaffrey, Christopher I; Schwab, Frank J; Patel, Alpesh A; Brodke, Darrel S; Arnold, Paul M; Riew, K Daniel; Traynelis, Vincent C; Radcliff, Kris; Vaccaro, Alexander R; Fehlings, Michael G; Ames, Christopher PStudy design
Post hoc analysis of prospectively collected data.Objective
Development of methods to determine in vivo spinal cord dimensions and application to correlate preoperative alignment, myelopathy, and health-related quality-of-life scores in patients with cervical spondylotic myelopathy (CSM).Summary of background data
CSM is the leading cause of spinal cord dysfunction. The association between cervical alignment, sagittal balance, and myelopathy has not been well characterized.Methods
This was a post hoc analysis of the prospective, multicenter AOSpine North America CSM study. Inclusion criteria for this study required preoperative cervical magnetic resonance imaging (MRI) and neutral sagittal cervical radiography. Techniques for MRI assessment of spinal cord dimensions were developed. Correlations between imaging and health-related quality-of-life scores were assessed.Results
Fifty-six patients met inclusion criteria (mean age = 55.4 yr). The modified Japanese Orthopedic Association (mJOA) scores correlated with C2-C7 sagittal vertical axis (SVA) (r = -0.282, P = 0.035). Spinal cord volume correlated with cord length (r = 0.472, P < 0.001) and cord average cross-sectional area (r = 0.957, P < 0.001). For all patients, no correlations were found between MRI measurements of spinal cord length, volume, mean cross-sectional area or surface area, and outcomes. For patients with cervical lordosis, mJOA scores correlated positively with cord volume (r = 0.366, P = 0.022), external cord area (r = 0.399, P = 0.012), and mean cross-sectional cord area (r = 0.345, P = 0.031). In contrast, for patients with cervical kyphosis, mJOA scores correlated negatively with cord volume (r = -0.496, P = 0.043) and mean cross-sectional cord area (r = -0.535, P = 0.027).Conclusion
This study is the first to correlate cervical sagittal balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the basis of sagittal alignment. It is interesting to note that sagittal balance but not kyphosis is tied to myelopathy score. Future work will correlate alignment changes to cord morphology changes and myelopathy outcomes. SUMMARY STATEMENTS: This is the first study to correlate sagittal balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the basis of sagittal alignment.Item Open Access Blastomyces helicus, a New Dimorphic Fungus Causing Fatal Pulmonary and Systemic Disease in Humans and Animals in Western Canada and the United States.(Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019-01) Schwartz, Ilan S; Wiederhold, Nathan P; Hanson, Kimberly E; Patterson, Thomas F; Sigler, LynneBackground
Blastomyces helicus (formerly Emmonsia helica) is a dimorphic fungus first isolated from a man with fungal encephalitis in Alberta, Canada. The geographic range, epidemiology, and clinical features of disease are unknown.Methods
We reviewed human and veterinary isolates of B. helicus identified among Blastomyces and Emmonsia isolates at the University of Alberta Microfungus Collection and Herbarium, University of Texas Health San Antonio's Fungus Testing Laboratory, and Associated Regional and University Pathologists Laboratories. Isolates were selected based on low Blastomyces dermatitidis DNA probe values and/or atypical morphology. Species identification was confirmed for most isolates by DNA sequence analysis of the internal transcribed spacer with or without D1/D2 ribosomal RNA regions. Epidemiological and clinical data were analyzed.Results
We identified isolates from 10 human and 5 veterinary cases of B. helicus infection; all were referred from western regions of Canada and the United States. Isolates remained sterile in culture, producing neither conidia nor sexual spores in the mycelial phase, but often producing coiled hyphae. Isolates were most frequently cultured from blood and bronchoalveolar lavage in humans and lungs in animals. Most infected persons were immunocompromised. Histopathological findings included pleomorphic, small or variably sized yeast-like cells, with single or multiple budding, sometimes proliferating to form short, branching, hyphal-like elements. Disease carried a high case-fatality rate.Conclusions
Blastomyces helicus causes fatal pulmonary and systemic disease in humans and companion animals. It differs from B. dermatitidis in morphological presentation in culture and in histopathology, by primarily affecting immunocompromised persons, and in a geographic range that includes western regions of North America.Item Open Access Carbon Sequestration in Canada's Boreal Forests(2012-04-25) Frelinghuysen, TheodoreItem Open Access Dire Straits: The American Canadian Dispute Over the Northwest Passage and a Policy Recommendation to Improve Arctic Security(2014-12-11) Elder, ZacGlobal climate change is thawing the Arctic, opening once impassable northern waterways and presenting new challenges for Canada and the United States as maritime traffic in the region increases. A longstanding legal dispute over the Northwest Passage, the once-frozen strait running through Canada’s Arctic Archipelago, continues to hinder bilateral efforts to curtail rising threats to the environment, human health, and national security. This analysis examines the existing literature on the North American Arctic and incorporates information gathered from various American and Canadian government officials, military personnel, and academics in order to craft a solution to this legal dispute. I argue that Canada and the United States can overcome this dispute by negotiating a bilateral transit agreement, and that this bilateral agreement will catalyze efforts by both nations to implement the infrastructure improvements necessary to safeguard the Arctic.Item Open Access Dreams of a Tropical Canada: Race, Nation, and Canadian Aspirations in the Caribbean Basin, 1883-1919(2010) Hastings, Paula PearsDreams of a "tropical Canada" that included the West Indies occupied the thoughts of many Canadians over a period spanning nearly forty years. From the expansionist fever of the late nineteenth century to the redistribution of German territories immediately following the First World War, Canadians of varying backgrounds campaigned vigorously for Canada-West Indies union. Their efforts generated a transatlantic discourse that raised larger questions about Canada's national trajectory, imperial organization, and the state of Britain's Empire in the twentieth century.
This dissertation explores the key ideas, tensions, and contradictions that shaped the union discourse over time. Race, nation and empire were central to this discourse. Canadian expansionists' efforts to gain free access to tropical territory, consolidate British possessions in the Western hemisphere, and negotiate the terms under which West Indians of color would enter the Canadian federation reflected and perpetuated logics that were simultaneously racial, national, and imperial.
Canada-West Indies union campaigns raise important questions about the processes at work in the ideological and material formation of the Canadian "nation" in the late nineteenth and early twentieth century. Employing a wide range of public and private manuscript material, diaries, travelogues and newspapers, this dissertation argues that Canadians' expansionist aspirations in the West Indies were inextricably connected to a national vision. To the campaign's advocates, acquiring colonial satellites - particularly in tropical regions - was a defining feature of nation-state formation.
Item Open Access Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest.(Resuscitation, 2016-12) Gaspari, Romolo; Weekes, Anthony; Adhikari, Srikar; Noble, Vicki E; Nomura, Jason T; Theodoro, Daniel; Woo, Michael; Atkinson, Paul; Blehar, David; Brown, Samuel M; Caffery, Terrell; Douglass, Emily; Fraser, Jacqueline; Haines, Christine; Lam, Samuel; Lanspa, Michael; Lewis, Margaret; Liebmann, Otto; Limkakeng, Alexander; Lopez, Fernando; Platz, Elke; Mendoza, Michelle; Minnigan, Hal; Moore, Christopher; Novik, Joseph; Rang, Louise; Scruggs, Will; Raio, ChristopherPoint-of-care ultrasound has been suggested to improve outcomes from advanced cardiac life support (ACLS), but no large studies have explored how it should be incorporated into ACLS. Our aim was to determine whether cardiac activity on ultrasound during ACLS is associated with improved survival.We conducted a non-randomized, prospective, protocol-driven observational study at 20 hospitals across United States and Canada. Patients presenting with out-of-hospital arrest or in-ED arrest with pulseless electrical activity or asystole were included. An ultrasound was performed at the beginning and end of ACLS. The primary outcome was survival to hospital admission. Secondary outcomes included survival to hospital discharge and return of spontaneous circulation.793 patients were enrolled, 208 (26.2%) survived the initial resuscitation, 114 (14.4%) survived to hospital admission, and 13 (1.6%) survived to hospital discharge. Cardiac activity on US was the variable most associated with survival at all time points. On multivariate regression modeling, cardiac activity was associated with increased survival to hospital admission (OR 3.6, 2.2-5.9) and hospital discharge (OR 5.7, 1.5-21.9). No cardiac activity on US was associated with non-survival, but 0.6% (95% CI 0.3-2.3) survived to discharge. Ultrasound identified findings that responded to non-ACLS interventions. Patients with pericardial effusion and pericardiocentesis demonstrated higher survival rates (15.4%) compared to all others (1.3%).Cardiac activity on ultrasound was the variable most associated with survival following cardiac arrest. Ultrasound during cardiac arrest identifies interventions outside of the standard ACLS algorithm.Item Open Access Genomics research: world survey of public funding.(BMC Genomics, 2008-10-10) Pohlhaus, Jennifer Reineke; Cook-Deegan, Robert MBACKGROUND: Over the past two decades, genomics has evolved as a scientific research discipline. Genomics research was fueled initially by government and nonprofit funding sources, later augmented by private research and development (R&D) funding. Citizens and taxpayers of many countries have funded much of the research, and have expectations about access to the resulting information and knowledge. While access to knowledge gained from all publicly funded research is desired, access is especially important for fields that have broad social impact and stimulate public dialogue. Genomics is one such field, where public concerns are raised for reasons such as health care and insurance implications, as well as personal and ancestral identification. Thus, genomics has grown rapidly as a field, and attracts considerable interest. RESULTS: One way to study the growth of a field of research is to examine its funding. This study focuses on public funding of genomics research, identifying and collecting data from major government and nonprofit organizations around the world, and updating previous estimates of world genomics research funding, including information about geographical origins. We initially identified 89 publicly funded organizations; we requested information about each organization's funding of genomics research. Of these organizations, 48 responded and 34 reported genomics research expenditures (of those that responded but did not supply information, some did not fund such research, others could not quantify it). The figures reported here include all the largest funders and we estimate that we have accounted for most of the genomics research funding from government and nonprofit sources. CONCLUSION: Aggregate spending on genomics research from 34 funding sources averaged around $2.9 billion in 2003-2006. The United States spent more than any other country on genomics research, corresponding to 35% of the overall worldwide public funding (compared to 49% US share of public health research funding for all purposes). When adjusted to genomics funding intensity, however, the United States dropped below Ireland, the United Kingdom, and Canada, as measured both by genomics research expenditure per capita and per Gross Domestic Product.Item Open Access Multicultural Cold War: Liberal Anti-Totalitarianism and National Identity in the United States and Canada, 1935-1971(2007-05-03T18:53:45Z) Smolynec, GregoryIn Cold War North America, liberal intellectuals constructed the Canadian and American national identities in contrast to totalitarianism. Theorists of totalitarianism described Nazi Germany and the Soviet Union as monolithic societies marked by absolutism and intolerance toward societal differences. In response, many intellectuals imagined Canada and the United States as pluralistic nations that valued diversity. The ways in which Canadians and Americans imagined their respective national identities also varied with epistemological trends that were based on the ideas of totalitarianism and its correlate, anti-totalitarianism. These trends emphasized particularity and diversity. Using archival sources, interviews with policy-makers, and analysis of key texts, Multicultural Cold War outlines the history of theories of totalitarianism, related trends in epistemology, the genealogy of the social sciences, and the works of Canadian and American proponents of cultural pluralism and multiculturalism. It centers attention on Canada and the United States where the unreflective ideology of anti-totalitarianism was widespread and the postwar enthusiasm for ethnicity and cultural pluralism became especially pronounced. In the U.S.A. this enthusiasm found expression among public intellectuals who defined cultural pluralism in their scholarship and social criticism. In Canada, discourses of multiculturalism originated in the hearings of the Royal Commission on Bilingualism and Biculturalism and the political thought of Pierre Elliot Trudeau. This dissertation shows that enthusiasm for sub-national group particularity, pluralism, and diversity was a transnational North American trend.Item Open Access Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis.(The Lancet. Oncology, 2016-04) Thompson, Eric M; Hielscher, Thomas; Bouffet, Eric; Remke, Marc; Luu, Betty; Gururangan, Sridharan; McLendon, Roger E; Bigner, Darell D; Lipp, Eric S; Perreault, Sebastien; Cho, Yoon-Jae; Grant, Gerald; Kim, Seung-Ki; Lee, Ji Yeoun; Rao, Amulya A Nageswara; Giannini, Caterina; Li, Kay Ka Wai; Ng, Ho-Keung; Yao, Yu; Kumabe, Toshihiro; Tominaga, Teiji; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Low, David CY; Seow, Wan Tew; Chang, Kenneth TE; Mora, Jaume; Pollack, Ian F; Hamilton, Ronald L; Leary, Sarah; Moore, Andrew S; Ingram, Wendy J; Hallahan, Andrew R; Jouvet, Anne; Fèvre-Montange, Michelle; Vasiljevic, Alexandre; Faure-Conter, Cecile; Shofuda, Tomoko; Kagawa, Naoki; Hashimoto, Naoya; Jabado, Nada; Weil, Alexander G; Gayden, Tenzin; Wataya, Takafumi; Shalaby, Tarek; Grotzer, Michael; Zitterbart, Karel; Sterba, Jaroslav; Kren, Leos; Hortobágyi, Tibor; Klekner, Almos; László, Bognár; Pócza, Tímea; Hauser, Peter; Schüller, Ulrich; Jung, Shin; Jang, Woo-Youl; French, Pim J; Kros, Johan M; van Veelen, Marie-Lise C; Massimi, Luca; Leonard, Jeffrey R; Rubin, Joshua B; Vibhakar, Rajeev; Chambless, Lola B; Cooper, Michael K; Thompson, Reid C; Faria, Claudia C; Carvalho, Alice; Nunes, Sofia; Pimentel, José; Fan, Xing; Muraszko, Karin M; López-Aguilar, Enrique; Lyden, David; Garzia, Livia; Shih, David JH; Kijima, Noriyuki; Schneider, Christian; Adamski, Jennifer; Northcott, Paul A; Kool, Marcel; Jones, David TW; Chan, Jennifer A; Nikolic, Ana; Garre, Maria Luisa; Van Meir, Erwin G; Osuka, Satoru; Olson, Jeffrey J; Jahangiri, Arman; Castro, Brandyn A; Gupta, Nalin; Weiss, William A; Moxon-Emre, Iska; Mabbott, Donald J; Lassaletta, Alvaro; Hawkins, Cynthia E; Tabori, Uri; Drake, James; Kulkarni, Abhaya; Dirks, Peter; Rutka, James T; Korshunov, Andrey; Pfister, Stefan M; Packer, Roger J; Ramaswamy, Vijay; Taylor, Michael DBackground
Patients with incomplete surgical resection of medulloblastoma are controversially regarded as having a marker of high-risk disease, which leads to patients undergoing aggressive surgical resections, so-called second-look surgeries, and intensified chemoradiotherapy. All previous studies assessing the clinical importance of extent of resection have not accounted for molecular subgroup. We analysed the prognostic value of extent of resection in a subgroup-specific manner.Methods
We retrospectively identified patients who had a histological diagnosis of medulloblastoma and complete data about extent of resection and survival from centres participating in the Medulloblastoma Advanced Genomics International Consortium. We collected from resections done between April, 1997, and February, 2013, at 35 international institutions. We established medulloblastoma subgroup affiliation by gene expression profiling on frozen or formalin-fixed paraffin-embedded tissues. We classified extent of resection on the basis of postoperative imaging as gross total resection (no residual tumour), near-total resection (<1·5 cm(2) tumour remaining), or sub-total resection (≥1·5 cm(2) tumour remaining). We did multivariable analyses of overall survival and progression-free survival using the variables molecular subgroup (WNT, SHH, group 4, and group 3), age (<3 vs ≥3 years old), metastatic status (metastases vs no metastases), geographical location of therapy (North America/Australia vs rest of the world), receipt of chemotherapy (yes vs no) and receipt of craniospinal irradiation (<30 Gy or >30 Gy vs no craniospinal irradiation). The primary analysis outcome was the effect of extent of resection by molecular subgroup and the effects of other clinical variables on overall and progression-free survival.Findings
We included 787 patients with medulloblastoma (86 with WNT tumours, 242 with SHH tumours, 163 with group 3 tumours, and 296 with group 4 tumours) in our multivariable Cox models of progression-free and overall survival. We found that the prognostic benefit of increased extent of resection for patients with medulloblastoma is attenuated after molecular subgroup affiliation is taken into account. We identified a progression-free survival benefit for gross total resection over sub-total resection (hazard ratio [HR] 1·45, 95% CI 1·07-1·96, p=0·16) but no overall survival benefit (HR 1·23, 0·87-1·72, p=0·24). We saw no progression-free survival or overall survival benefit for gross total resection compared with near-total resection (HR 1·05, 0·71-1·53, p=0·8158 for progression-free survival and HR 1·14, 0·75-1·72, p=0·55 for overall survival). No significant survival benefit existed for greater extent of resection for patients with WNT, SHH, or group 3 tumours (HR 1·03, 0·67-1·58, p=0·89 for sub-total resection vs gross total resection). For patients with group 4 tumours, gross total resection conferred a benefit to progression-free survival compared with sub-total resection (HR 1·97, 1·22-3·17, p=0·0056), especially for those with metastatic disease (HR 2·22, 1·00-4·93, p=0·050). However, gross total resection had no effect on overall survival compared with sub-total resection in patients with group 4 tumours (HR 1·67, 0·93-2·99, p=0·084).Interpretation
The prognostic benefit of increased extent of resection for patients with medulloblastoma is attenuated after molecular subgroup affiliation is taken into account. Although maximum safe surgical resection should remain the standard of care, surgical removal of small residual portions of medulloblastoma is not recommended when the likelihood of neurological morbidity is high because there is no definitive benefit to gross total resection compared with near-total resection.Funding
Canadian Cancer Society Research Institute, Terry Fox Research Institute, Canadian Institutes of Health Research, National Institutes of Health, Pediatric Brain Tumor Foundation, and the Garron Family Chair in Childhood Cancer Research.Item Open Access Radiographical and Implant-Related Complications in Adult Spinal Deformity Surgery: Incidence, Patient Risk Factors, and Impact on Health-Related Quality of Life.(Spine, 2015-09) Soroceanu, Alexandra; Diebo, Bassel G; Burton, Douglas; Smith, Justin S; Deviren, Vedat; Shaffrey, Christopher; Kim, Han Jo; Mundis, Gregory; Ames, Christopher; Errico, Thomas; Bess, Shay; Hostin, Richard; Hart, Robert; Schwab, Frank; Lafage, Virginie; International Spine Study GroupStudy design
A multicenter, prospective review of surgical patients with adult spine deformity.Objective
Assessment of the incidence, risk factor, and impact of radiographical and implant-related complications (RIC) on health-related quality of life measures.Summary of background data
This study provides assessment of the incidence of RIC in adult spinal deformity surgery and impact of these complications on need for reoperation. Risk factors for development of RIC are also assessed, as well as the impact of these complications on health-related quality of life (HRQOL) outcomes measures.Methods
A multicenter, prospective database of surgical patients with adult spinal deformity was reviewed. All patients with complete 2-year follow-up were included. HRQOL was measured using the Oswestry Disability Index, General Health Survey (36-Item Short Form Health Survey [SF-36]), and Scoliosis Research Society-22 (SRS-22r) at baseline, 6 weeks, 1 year, and 2 years postoperatively. Univariate testing was performed as appropriate. Multivariate logistic regression modeling was used to determine independent predictors of RIC. Multivariate repeated-measures mixed models were used to examine HRQOL, accounting for confounders.Results
A total of 245 patients met inclusion criteria. The incidence of RIC was 31.7% and 52.6% of those patients required reoperation. Rod breakage accounted for 47% of the implant-related complications, and proximal junctional kyphosis accounted for 54.5% of radiographical complications. Univariate analysis identified the following potential risk factors for RIC: weight, American Society of Anesthesiologists score, revision, stopping the fusion in the lower thoracic spine, worse SRS-Schwab classification modifiers (pelvic tilt++, pelvic incidence minus lumbar lordosis++, sagittal vertical axis++), higher T1 spinopelvic inclination, and higher T1 slope. Independent predictors of RIC as identified on multivariate logistic regression included American Society of Anesthesiologists (odds ratio: 1.75, P = 0.029) and sagittal vertical axis modifier ++ (odds ratio 3.43, P = 0.0001). The RIC and no RIC groups each experienced significant improvement over time, as measured on the Oswestry Disability Index (P = 0.0001), SF-36 (P = 0.0001), and SRS-22r (P = 0.0001). However, the rate of improvement over time was less for patients with RIC (SRS-22r P = 0.043, SF-36 P = 0.0001).Conclusion
This study identified that nearly one-third of patients undergoing adult spinal deformity surgery experienced a radiographical or implant-related complication, and that just more than one-half of these patients experiencing complication required a reoperation within 2 years of surgery. These complications significantly affected HRQOL measures. Baseline patient characteristics and parameters of the SRS-Schwab classification can be used to help identify those patients at greater risk.Level of evidence
3.Item Open Access The Barriers Facing the Adoption of Compostable Biopolymers in the Canadian Food and Beverage Industry(2020-11-22) Ferreira, EugenioThe food and beverage industry in Canada, generates large volumes of single-use plastic waste as a result of its packaging materials. Utilizing compostable bioplastics in food and beverage packaging can provide an improved environmental performance alternative to conventional fossil-based plastics. Recycling efforts across Canada have historically placed effort on conventional plastics recycling to capture and manage the ubiquitous single-use plastics. However, through industry research and policy review, this report shows that the conventional recycling approach fails to effectively manage this stream. The report supports the adoption of compostable bioplastics as a practical alternative, but understands that its success requires more coordinated and adopted standardized terminology, government regulations and policy incentives to provide the impetus for food and beverage manufacturers to shift towards the adoption of compostable bioplastics as a practical solution to addressing the environmental performance issues associated with fossil-based, single-use plastics.Item Open Access The Wesselhoefts: A medical dynasty from the age of Goethe to the era of nuclear medicine.(Journal of medical biography, 2017-11) Davidson, Jonathan RtFor six generations, members of the Wesselhoeft family have practiced medicine in Germany, Denmark, Switzerland, Canada and/or the USA. In the early decades of the 19th century, two Wesselhoeft brothers left Europe to eventually settle in New England, where they and their progeny gave rise to a regional medical dynasty. The Wesselhoeft doctors became well-known practitioners of homeopathy, hydropathy, conventional medicine and surgery, in academic and general clinical settings. An additional connection was established to the literary worlds of Germany and the USA, either through friendships or as personal physicians.Item Open Access To smoke or to vape? E-cigarette regulation in the US, the UK, and Canada(2018-12-05) Sear, AmandaE-cigarettes are hailed by some as a positive development in the war against smoking and reviled by others as a weapon used to addict a new generation to nicotine. This dichotomy highlights an important debate about e-cigarette risk trade-offs: how can governments strike a balance between promoting e-cigarettes as a smoking cessation aid / reduced harm alternative for adult smokers and ensuring that e-cigarettes don’t act as “gateway drugs” to smoking for adolescents and other non-smokers? To this end, this thesis will specifically examine how the US, the UK, and Canada are regulating e-cigarettes. This thesis will show that policymakers often must grapple with risk trade-offs, even if they do not explicitly say as much. I also show that at least in the case of e-cigarette regulation, policymakers focus more on scientific evidence when business interests are fractured. Due to a lack of explicit risk trade-off analyses, however, their assessments of risks vary based on society-specific concerns, which then contributes to great variations in regulation. These variations thus emphasize the need for better cost-benefit analyses of risk-risk trade-offs.Item Open Access Voices of the seal hunt: communicating our views of animals and ourselves(2006) Sturn, Terra MagdalenThe controversy over the killing of seals on the ice floes off of Atlantic Canada continues to be a very heated, socio-political and moral debate. Sealers’ activities first came under intense public scrutiny in the early 1960s with the broadcast of a television documentary showing graphic footage of seals being clubbed. Since that time, the “seal war” has become an emotional war of words and images fought primarily via media outlets. This paper focuses on analyzing the content of public opinions as published in Canadian news sources. The aim was to elucidate the relevant arguments and delineate the major concerns of each “side” to the conflict. The language used was closely examined. Through this type of inquiry, it is hoped that underlying causes of the disagreement and apparent impasse may be discovered so that a more informed, respectful, and meaningful discourse may someday take place. The results showed that improved communication will be critically important if we are ever to change the status quo which is endless protest, endless backlash, and endless sealing. The paper is divided into three general sections. Section I gives important background information, without which the issue cannot be adequately understood. A synopsis of the pertinent legal and policy framework is also included. Section II establishes theories and perspectives on the human treatment of non-human animals, explores how our conceptions are conditioned both socially and through the very language we employ, and sets the tone for further inquiry by relating these ideas to the Canadian seal hunt. Section III uses content analysis to explore seal hunt opinion. One interpretation regarding the root of this controversy is offered. The central thesis is that human beings ultimately accept varying treatments of “others” in direct relation to how they perceive themselves and their own status in the world around them.