This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada. Chapter 1 investigates any differences in healthcare utilization patterns between immigrants and non-immigrants. We implement a two-part model, where the first part applies logistic regressions to assess factors associated with visiting a physician, and the second applies zero-truncated negative binomial regression models to capture the frequency of using healthcare services, conditional on having at least one visit. Our results show that the patterns of healthcare utilization are different for immigrants compared to non-immigrants; differences are also observed by gender and age. More specifically, prescription drug insurance coverage and chronic conditions play opposing roles for male and female immigrants compared to their non-immigrants counterparts. Moreover, the number of years since migration is an important factor in increasing the probability of any general practitioner (GP) and specialist (SP) visit for all immigrants. Chapter 2 is to my knowledge, the first research on the causal effects of language proficiency on health outcomes and healthcare utilization of immigrants in Canada. My finding contradicts the idea that immigrants with poor language facilities are less likely to have a regular doctor. I find that good self-reported health is positively associated with language proficiency. However, I find no statistically significant causal effect of language proficiency on reporting ‘good mental health’. In addition, I find strong evidence that the utilization of hospital and mental health care services are positively associated with being English-language proficient even after controlling for many possible sets of factors. Chapter 3 contributes by supporting existing literature, but with a completely different dimension: the medical tax perspective. I am unaware of any previous research that directly compares the claim patterns of the Medical Expense Tax Credit (METC) and/or refundable Medical Expense Supplement (MES) for immigrants with those of non-immigrants in Canada. My results show that there are differences in the proportions of tax filers who claimed the METC and/or MES, and the amounts of a claim for the METC and/or MES for immigrants compared to non-immigrants; differences are also observed by age, years since migration (YSM), province and immigration categories. In both couples and single families, a lower proportion of immigrant tax filers claimed gross immediate family medical expenses (GME), potential METC claims, and METC refunds compared to non-immigrants. In the case of single families, a higher proportion of non-immigrant tax filers claimed MES compared to their immigrant counterparts. / Thesis / Doctor of Philosophy (PhD) / This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada.

Aus historischer Sicht ist Werbung eine bedeutende Quelle zur Alltags- und Mentalitätsgeschichte. Ein besonderer Schatz historischer Anzeigen- und Prospektwerbung der Eisen- und Stahlbranche des ausgehenden 19. und frühen 20. Jahrhunderts hat sich in den Einzelheften der Zeitschrift „Stahl und Eisen“ (Erstausgabe im Juli 1881) erhalten, in dessen Besitz die Universitätsbibliothek 'Georgius Agricola' der TU Bergakademie Freiberg durch die Übernahme der Bibliothek des Vereins Deutscher Eisenhüttenleute (VDEh) - eine der weltweit ältesten metallurgischen Spezialbibliotheken - im Jahr 2020 gekommen ist. Insbesondere die frühen Ausgaben beinhalten sehr informative Anzeigen und lose Prospektbeilagen, die nicht nur Auskunft über Werksprogramme, Produktmaße und -preise, sondern oftmals auch über Produktionszahlen und Anzahl der Arbeiter und Beamten einer Firma/Fabrik geben. Die meist aufwendig gestalteten Werbeprospekte, die jedem Heft in unterschiedlicher Anzahl beilagen, erweiterten das beworbene Produktspektrum um Artikel der Büroausstattung, hochpreisige Konsumgüter und Verlagswerbung. Der Artikel gibt einen Einblick in diesen besonderen Bestand. / From a historical perspective, advertising is an important source for the history of everyday life and mentality. A special treasure of historical advertisements and brochures of the iron and steel industry of the late 19th and early 20th century has been preserved in the single issues of the journal 'Stahl und Eisen' (first issue published in July 1881), which the University Library 'Georgius Agricola' of the TU Bergakademie Freiberg came into possession of by taking over the library of the Verein Deutscher Eisenhüttenleute (VDEh) - one of the world's oldest metallurgical special libraries - in 2020. The early issues in particular contain very informative advertisements and loose brochure inserts, which provide information not only about factory programs, product dimensions and prices, but often also about production figures and the number of workers and officials at a company/factory. The usually elaborately designed advertising brochures, which were enclosed with each issue in varying numbers, expanded the advertised product range to include items of office equipment, high-priced consumer goods and publisher advertising. The article provides an insight into this special collection.

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This paper aims to analyze the important role of the reception of music in Marcel Proust's novel À la recherche du temps perdu. This analysis is founded on a theoretical framework inspired by critical theory and theory of critical ideology, where important theorists are Theodor W. Adorno, Fredric Jameson, and Slavoj Zizek. By drawing on these theorists, the firsts two analytical parts of this study shows how the reception of music in the novel creates supplements that reinforce hegemonic ideological consciousness, and how the reception of music also has a thematic role in revealing how these different ideological consciousnesses permeate social relations to both music and other people. In the final analytical part of the work, the study can further conclude that the Bildung of the novel, which constitutes the basic thematic structure of the whole novel, is based on breaking away from these two ideological consciousnesses, and freeing the music from the supplements that permeate the reception of the music in the novel, by making a sovereign gesture of liberation by exposing this process, so as to be able to take a critical approach to those ideological consciousnesses whose ideological theatricality prevents music, and in the long run involuntary memory, from mediating a true philosophical discovery of the nature of subjectivity

La prise en charge nutritionnelle des patients lors d’une chirurgie cardiaque a fait l’objet d’un nombre limité d’études. Ainsi, les lignes directrices de l’approche ERACS (Enhanced Recovery After Cardiac Surgery) n’incluent pas de recommandations nutritionnelles qui sont appuyées par des données probantes. L’objectif du mémoire est de présenter l’évolution nutritionnelle périopératoire des patients dans un cadre de soins inspiré par l’approche ERAS et les recommandations nutritionnelles d’ESPEN (European Society for Clinical Nutrition and Metabolism). Cet objectif a été poursuivi lors d’une étude observationnelle prospective qui a inclus une collecte de données médicales, notamment l’adhésion à certaines recommandations ERACS, et nutritionnelles, soit une évaluation nutritionnelle préopératoire, l’observation des apports alimentaires postopératoires et l’adhésion aux suppléments nutritionnels oraux. L’évolution clinique de 43 patients de l’Institut de cardiologie de Montréal a été étudiée. Le taux de dénutrition préopératoire, déterminé selon l’Évaluation Globale Subjective, était de 11,6%. L’adhésion à deux recommandations ERACS prédéterminées, soit l’éducation et l’optimisation nutritionnelle préopératoire, était insuffisante pour l’ensemble de l’échantillon. Les apports alimentaires moyens du 1er au 4e jour postopératoire étaient insuffisants comparativement aux recommandations nutritionnelles d’ESPEN. Cependant, 41% des patients avaient des apports en calories et en protéines ≥70% de leurs besoins estimés. La consommation de suppléments nutritionnels oraux a permis d’optimiser les apports nutritionnels. Cette étude est, à notre connaissance, la première à décrire une prise en charge nutritionnelle préopératoire et postopératoire dans le cadre de l’approche ERACS. Les facteurs de risques pouvant expliquer les apports nutritionnels insuffisants, tels que le sexe et les antécédents médicaux, sont explorés. Des suggestions pour optimiser la prise en charge nutritionnelle des patients sont proposées, notamment l’amélioration du dépistage nutritionnel préopératoire et l’enrichissement du menu, ainsi que des pistes de recherche qui pourront être développées dans de futurs travaux. / Nutritional care of cardiac surgery patients has been scarcely studied. Currently, the ERACS (Enhanced Recovery After Cardiac Surgery) guidelines do not include high quality evidence-based nutritional recommendations. The aim of this dissertation is to present patients’ nutritional evolution in a care setting inspired by an ERACS approach and ESPEN (European Society for Clinical Nutrition and Metabolism) nutritional recommendations. This aim was pursued through an observational prospective study that included a collection of medical data, namely adherence to a number of ERACS recommendations, and nutritional information comprising preoperative nutritional status evaluation, observation of postoperative oral intakes and adherence to oral nutritional supplements. The clinical evolution of 43 Montreal Heart Institute patients was investigated. Malnutrition rates prior to surgery, as evaluated by the Subjective Global Assessment, was 11.6%. Adherence to preoperative nutritional education and optimisation, two predetermined ERACS recommendations, was insufficient for the overall sample. Mean oral intakes from postoperative day 1 to 4 were insufficient, compared to ESPEN nutritional recommendations. However, 41% of patients had calorie and protein intakes ≥ 70% of their estimated requirements. Consumption of oral nutritional supplements lead to higher nutritional intakes. To our knowledge, this study is the first to present patients’ preoperative and postoperative nutritional care within an ERACS pathway. Risk factors associated with insufficient nutritional intakes, such as sex and medical history, are discussed. Suggestions to optimize patients’ nutritional care are presented, namely improvement in preoperative nutritional screening and the addition of enriched foods to the menu, as are research topics that should be further investigated.

La malnutrition est identifiée comme l’un des facteurs potentiellement responsables des mortalités élevées de colonies d’abeilles des dernières années au Québec. Pour contrer cela, les apiculteurs donnent des suppléments de pollen à leurs colonies, mais les impacts d’une telle pratique à diverses périodes sont méconnus. Les effets de la disponibilité du pollen sur le développement de colonies d’abeilles ont été mesurés pendant 3 différentes périodes : au printemps, durant la pollinisation de la canneberge et à la fin de l’été. À chacune des périodes correspondait une expérience distincte utilisant 40 colonies. Pour chaque expérience, des conditions d’abondance de supplément de pollen et de restriction de pollen naturel étaient créées chez les colonies pendant un mois selon un plan d’expérience factorielle 2x2. L’élevage du couvain et la récolte de miel ont été mesurés jusqu’à la fin de l’été (début de l’été suivant pour l’expérience de fin d’été). Au printemps, les colonies restreintes en pollen naturel ont élevé 18% moins de couvain (p<0.05) pendant la période de restriction et 11% de moins à la fin de l’été alors que l’utilisation du supplément n’a eu aucun effet (p>0.05). Les colonies supplémentées durant la pollinisation des canneberges ont élevé moins de couvain (p<0.05) à la fin de l’été. Pour l’expérience de fin d’été, les colonies supplémentées ont eut une meilleure reprise printanière (p<0.05) de l’élevage du couvain (60% de plus) alors qu’une restriction en pollen naturel avait un effet négatif (p>0.05). Les récoltes de miel ont été augmentées (p<0.05) de 1,3 kg pendant la pollinisation de la canneberge alors qu’elles ont été diminuées (p<0.05)par une restriction en pollen naturel de 4,2 kg à la fin de l’été et de 15 kg au printemps. / The use of pollen supplement is a countermeasure to honey bee malnutrition which is identified as one of the factors causing high colonies losses over the past few years in Quebec. There is little documentation on the results of using pollen supplement during different periods. The effects of pollen availability and supplementation on the development of honey bee colonies were examined during 3 different periods: in spring, during cranberry pollination and in late summer. Each period was a distinct study using 40 different colonies. In each study, pollen supplemented and pollen restricted conditions were created for one month in 10 colonies per treatment group in a 2x2 factorial design experiment. Brood rearing and honey yield were monitored until the end of summer for the spring and the cranberry pollination studies and until the end of the following spring for the late summer study. In the spring study, pollen restricted colonies reared 18% less brood (p<0.05) during the restriction period and 11% less brood (p<0.05) by the end of summer while pollen supplement had no effect (p>0.05). Colonies supplemented during cranberry pollination study reared less brood (p<0.05) by the end of summer. In the late summer study, supplemented colonies had a greater (p<0.05) spring build-up (60% more brood) and pollen restriction negatively influence (p<0.05) brood rearing. Honey yield was decreased (p<0.05) by 15 kg in colonies exposed to a pollen restriction in spring. It was increased by 1.3 kg (p<0.05) in pollen supplemented colonies during the cranberry pollination study and was reduced by 4.2 kg (p<0.05) in pollen restricted colonies in the late summer study. In conclusion, pollen supplement improved colonies population when fed in late summer and not during spring or in cranberry pollination and was without impact on honey yield.

INTRODUÇÃO: Metionina (Met), cisteína (Cys), homocisteína (Hcy) e taurina (Tau) são os quatro aminoácidos sulfurados (AAS), mas apenas a Met e Cys são incorporadas em proteínas. Os três principais produtos doS AAS, glutationa, (GSH), Hcy e Tau influenciam, principalmente, as respostas inflamatória e imune. A Tau e GSH diminuem a inflamação, enquanto que a Hcy apresenta efeito oposto. Os pacientes HIV+ apresentam baixos níveis de GSH e outros nutrientes antioxidantes, mostrando relação direta entre Cys (e GSH) com células CD4+. Não se conhece o mecanismo pelo qual as mudanças na ingestão dos AAS influenciam este fenômeno. Paralelamente, as relações entre Hcy, doenças inflamatórias e alterações in vitro no comportamento das células imunes levantou ressalvas sobre a suplementação de dietas com AAS. OBJETIVOS : investigar as vias dos AAS em pacientes HIV+ nas condições de jejum e pós-sobrecarga de Met frente à dieta habitual (OH) isolada ou acompanhada da suplementação de Cys (NAC) ou glutamina (Gln). MÉTODOS : 12 pacientes HIV+ (6 M e 6 F, de 25 a 36 anos), sob tratamento anti-retroviral pelo esquema tríplice, sem infecções secundárias e 20 controles saudáveis (10M e 10F, 23-28 anos) foram randomicamente distribuídos para suplementação com NAC (N-acetilcisteína, 1g/d) ou Gln (20 g/d) em estudo cruzado com 7 dias de dieta separados por uma semana de washout (Wo com DH). Amostras de sangue após jejum noturno de 10 a 12 horas foram coletadas antes (MO) e após (M1) cada regime dietético. A seguir, os indivíduos ingeriram metionina (100 mg/kg), com coletas de sangue após 2 e 4 horas para a determinação da área abaixo da curva (AAC). No MO, ambos os grupos foram avaliados quanto à antropometria (IMC, kg/m2), funções glomerular (uréia, creatinina) e hepatocelular (&#947;-GT), estados nutricional (albumina, cálcio, ácido fólico e vitamina 812) e antioxidante (ácido úrico, GSH, GSSG, Hcy), glicose, lipídios (triacilgliceróis e frações de colesterol) e AAS, serina (Ser), glicina (Gly), glutamato (Glu) e Gln. O grupo HIV também foi caracterizado pela carga viral e contagem de CD4+ e CD8+. As comparações estatísticas entre os grupos e entre as dietas mostraram homogeneidade para IMC, albumina, cálcio, vitamina 812, Hcy, HDL-colesterol, uréia e creatinina. Os pacientes apresentaram valores maiores de glicose, triacilgliceróis, &#947;-GT, LDL-colesterol e GSSG paralelalemente às menores concentrações de ácido úrico, GSH e todos os AAS, exceto Hcy. A sobrecarga de metionina igualou (pelos valores de delta) os grupos para Met, Hcy, Tau e Gln. As suplementações de NAC e Gln levaram o grupo HIV+ a concentrações maiores de GSH (NAC > Gln), atuando diferentemente em seus precursores: G/y (Gln > NAC) e Cys (NAC > Gln) e resultando em consumo similar de Ser e produção de Tau. Ambas as dietas reduziram GSSG/GSH (NAC > Gln) e apenas NAC aumentou (6 x) a Hcy. Esta última foi piorada pela sobrecarga de Mel. Assim, HIV+ resulta em deficiências múltiplas de vitaminas e aminoácidos levando a menores níveis de GSH e GSSG/GSH mais elevada. Os principais problemas de menor formação de Cys e menor incorporação de Cys em GSH foram resolvidos dando-se Met, NAC e Gln aos pacientes, ainda permanecendo a desvantagem do aumento da Hcy com Met ou suplementação de NAC. / BACKGROUNO: Methionine (Met), cysteine (Cys), homocysteine (Hcy), and, taurine (Tau) are the 4 sulfur-containing amino acids (SAA), but only Met and Cys are incorporated into proteins. The 3 major products of SAA, glutathione (GSH), Hcy and Tau influence, mainly, inflammatory and of immune responses. Tau and GSH ameliorate inflammation whereas Hcy has the opposite effect. HIV+ patients present low levelis of GSH and other antioxidants nutrients, showing a direct relationship between Cys (and GSH) with CD4+/ cells. How changes in SAA intake influence this phenomenon is unknown and the relationships among Hcy, inflammatory diseases, and in vitro alterations in immune cell behavior create a cautionary note about supplementation of diets with SAA. OBJECTIVE: To investigate SAA pathways in HIV+ patients on fast and Met-overload (Met-DL) states after taken diet habitual without (HD) or with supplements of Cys (NAC) or glutamine (Gln). METHOOS: 12 HIV+ (6M and 6F, 25-36 yrs old) patients under HAART without secondary infections and 20 healthy (10M and 10F, 23-28 yrs old) controls were randomly assigned to either NAC (N-acetylcysteine, 1g/d) or Gln (20g/d) diets, in a 7-day diet crossover design, separated by a 7-day washout (with HD) period. Blood samples were drawn after overnight fast before (MO) and after each dietary treatments (M1) for the resting measurements. Immediately after blood sampling ali subjects started the Met-DL by ingesting at once 100 mg Met/kg BW and having the blood draw after 2 and 4 hours for the area under the curve (AUC) determination. At MO both groups were assessed for anthropometry (BMI, kg/m2), glomerular (plasma urea and creatinina) and hepatocellular (plasma &#947;GT activity) funetions, nutritional (albumin, calcium, folic acid and vitamin B12) and antioxidant (uric acid, GSH, GSSG, Hey) states, glucose, lipids (triglycerides and cholesterol fractions) and SAA, serine (Ser), glyeine (Gly), glutamate (Glu) and Gln. The HIV+ group was characterized also by viral load, CD4+ and CD8+ counts. The statistical comparisons between groups and among diets showed group homogeneity for 8MI, albumin, calcium, vitamin B12, Hey, HDL-cholesterol, urea and creatinine. The patients presented higher values of glucose, triglycerides, &#947;-GT, LDL-cholesterol, and GSSG along with lower concentrations of uric acid, GSH and all but Hcy amino acids. The Met-OL equalized (&#916; values) the groups for Met, Hcy, Tau and Gln. NAC and Gln diets led the HIV+ group to a higher concentrations of GSH (NAC > Gln) by acting differently on its precursors: Gly (Gln > NAC) and Cys (NAC > Gln), resulting similar consumption of Ser and production of Tau. Both diets reduced GSSG/GSH (NAC > Gln) and only NAC increased (6 x) Hey. The later was worsened by Met-OL. Thus HIV+ results in multiple deficiencies of vitamins and amino acids leading to lower levels of GSH and higher GSSG/GSH ration. The main problems of lower formation of Cys and low ineorporation of Cys and Gly into GSH were greatly solved by giving Met, NAC and Gln to the patients, hence remaining the drawback of increasing Hcy with Met or NAC supplements.

SYFTE: Syftet är att belysa patienternas upplevelse av läkemedelsfri smärtlindring med stöd av grindteorin. DESIGN: Litteraturstudie BAKGRUND: Kunskap om hur patienterna upplever läkemedelsfri smärtbehandling baserad på grindteorin, kan göra det lättare för den enskilda sjuksköterskan att fatta beslut om användande av dessa metoder. URVAL: Vetenskapliga artiklar med empiriska studier på vuxna publicerade mellan åren 2000-2012. METOD: Databassökningar och manuella sökningar RESULTAT: 14 studier med sammanlagt 1771 deltagarevisar att smärtlindringsmetoderna med stöd av grindteorin hade avsedd effekt på smärta. De gav även patienterna lindring vad avser oro och rädsla. Några av studierna tar även upp att patienterna fick en känsla av att själv kunna påverka smärtan. Metoderna som användes var såväl hudstimulerande, som kognitiva. SLUTSATS: Smärtlindring baserad på grindteorin, såväl hudstimulering som kognitiva metoder, är något som sjuksköterskan bör ha kunskap om och använda för att lindra smärta och oro/rädsla. Metoderna är även ett sätt att låta patienten känna sig delaktig, då speciellt de kognitiva metoderna. / PURPOSE: The aim is to illuminate the patients experience of non-pharmacological pain relief with support of the gate-control theory. DESIGN: Literature review/over-view BACKGROUND: Knowledge of how the patients experience non-pharmacological pain treatment based on the gate-control theory can make it easier for the individual nurse to make decisions on the use of these methods. SAMPLE: Scientific studies with empirical studies on adults, published in articles between 2000-2012 METHOD: Database- and manual searches FINDINGS: 14 studies with in total 1771 participants show that the pain relief methods with support of the gate-control theory had the intended effect on pain. They also gave the patients relief with regard to anxiety. Some of the studies also mention that the patients got a feeling of being able to affect the pain themselves. The methods used were skin-stimulating as well as cognitive. CONCLUSIONS: Pain relief based on the gate-control theory, skin-stimulating as well as cognitive methods, is something that the nurse should have knowledge about and use to relieve pain and anxiety. The methods are also a way of letting the patient feel involved, especially the cognitive methods.

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