Les recherches suggèrent que les préjugés envers les personnes d’origine chinoise ont augmenté au cours des premiers mois de la pandémie de la COVID-19. L’étude présentée dans ce mémoire se base sur un premier postulat, selon lequel l’évolution des préjugés n’est pas univoque pour tous les individus. Le second postulat de cette étude établit que le contexte pandémique suscite des mécanismes psychologiques qui peuvent favoriser mais aussi contrer les préjugés. Le premier objectif vise à identifier l’hétérogénéité dans les trajectoires de préjugés. Le deuxième objectif vise à déterminer quelles catégories sociodémographiques sont associées aux différents groupes de trajectoires de préjugés (âge, genre, province de résidence, affiliation politique). Le troisième objectif vise à déterminer si les participants assignés aux différents groupes de trajectoires de préjugés diffèrent selon la menace économique et le statut identitaire. Une étude longitudinale a été conduite d’avril à décembre 2020 auprès d’un échantillon adulte représentatif de la population canadienne en vertu de l’âge, du genre et de la province de résidence (N = 3617). Les résultats suggèrent des trajectoires élevées et stables de préjugés ainsi que des trajectoires faibles et instables de préjugés. Les participants appartenant aux trajectoires élevées et stables rapportent une plus grande affiliation politique « de droite » et s’identifient à des groupes plus locaux. Les participants appartenant aux trajectoires faibles et instables rapportent une plus grande affiliation politique « de gauche » et s’identifient de manière plus globale et inclusive. Les résultats sont mitigés concernant l’âge et non significatifs concernant le genre, la province de résidence et la menace économique. Les implications théoriques et pratiques sont discutées. / Research suggests that prejudice against Chinese people has increased in the early months of the COVID-19 pandemic. The study presented in this master’s thesis is based on a first premise that the evolution of prejudice is not unequivocal for all individuals. The second postulate of this study establishes that the pandemic context gives rise to psychological mechanisms which can promote but also counter prejudice. The first objective is to identify heterogeneity in the trajectories of prejudice. The second objective aims to determine which socio-demographic categories are associated with the different groups of prejudice trajectories (age, gender, province of residence, political affiliation). The third objective aims to determine whether the participants assigned to the different groups of prejudice trajectories differ according to economic threat and identity status. A longitudinal study was conducted from April 2020 to December 2020 within a representative adult sample of the Canadian population by age, gender and province of residence (N = 3617). The results suggest high and stable trajectories of prejudice as well as low and unstable trajectories of prejudice. Participants belonging to high and stable trajectories report greater “right-wing” political affiliation and identify with more local groups. Participants belonging to low and unstable trajectories report greater “left-wing” political affiliation and identify more globally and inclusively. Results are mixed for age and are non-significant for gender, province of residence, and economic threat. Theoretical and practical implications are discussed.

Le sommeil est essentiel à la santé et au bien-être. La littérature suggère que le sommeil s’est prolongé et sa qualité a diminué durant la première vague de COVID-19. Ce phénomène fut associé à divers prédicteurs de la santé. Dû au manque d'études longitudinales et d'échantillons représentatifs, celle-ci visait à (1) examiner les trajectoires de sommeil en début de COVID-19, (2) identifier les prédicteurs de ces trajectoires, et (3) déterminer les associations intertrajectoires. Un échantillon canadien représentatif (N=2246) fut interrogé 6 fois d’avril-juillet 2020. Les participants ont rapporté la durée et qualité de leur sommeil et des prédicteurs de santé. Premièrement, un modèle de croissance à classes latentes a identifié les trajectoires. Deuxièmement, une régression logistique a examiné les relations prédicteurs-trajectoires. Troisièmement, une analyse de trajectoires conjointes multiniveaux a testé les associations entre trajectoires. Quatre trajectoires constantes de qualité du sommeil furent identifiées (M=2,48/10, 6,7 %; M=5,44/10, 37,1%; M=7,83/10, 45,5 %; M=10/10, 10,7%). Deux trajectoires de durée de sommeil furent identifiées, une courte, mais constante (M=369 min, 33.9%), et une longue, mais décroissante (M=486 min, 66.1%, -2.32min/semaine). Le troisième âge, le genre masculin et le respect des recommandations gouvernementales prédisaient une qualité de sommeil élevée. Être plus vieux prédisait un sommeil court, mais constant, tandis que vivre avec un ménage prédisait un sommeil long, mais décroissant. Le sommeil des Canadiens n'a pas significativement changé comme suggéré par la littérature, possiblement due à la méthodologie de l’étude, déterminant les trajectoires de sommeil d’un échantillon pancanadien durant la première vague de COVID-19. / Sleep plays a critical role in maintaining overall health and well-being. During the early days of the COVID-19 pandemic, reports showed a high prevalence of short sleep and poor sleep quality. This was associated with various health predictors. Given the lack of Canadian longitudinal studies and representative samples, our study aimed to (1) examine trajectories of sleep duration and quality during COVID-19, (2) identify predictors associated with these trajectories, and (3) determine inter-trajectory associations. A representative Canadian sample (N=2,246) was surveyed 6 times between April and July 2020. Participants self-reported their sleep duration, sleep quality, and health predictors. First, a Latent Class Growth Analysis identified sleep trajectories. Second, multinomial logistic regression models were used to examine relationships between predictors and trajectory groups. Third, a multilevel joint trajectory analysis tested the associations between trajectories. Four constant sleep quality trajectories were identified (M=2.48/10, 6.7%; M=5.44/10, 37.1%; M=7.83/10, 45.5%; M=10/10, 10.7%). Two sleep duration trajectories were identified, one shorter but constant (M=369min, 33.9%), and one longer but decreasing (M=486min, 66.1%, -2.32 min/week). Being older than 25 years old predicted short but constant sleep duration, while living with a household predicted long but decreasing sleep duration. The sleep of Canadians during early COVID-19 did not meaningfully change, which contradicts earlier reports. Sleep may not be immediately impacted by health crises. This may be explained by the study’s design as the first to provide evidence of trajectories of sleep in a representative pan-Canadian sample during the first COVID-19 wave.

[pt] tese – Ensino Médio em Tempo Integral no Ceará: Um estudo longitudinal sobre o efeito das escolas EEEP – teve por objetivo desenvolver um estudo sobre valor agregado de escolas cearenses de ensino médio, em tempo integral. Para isso, utilizou dados de avaliações do SPAECE, realizadas no período de 2008 a 2011. Nesse intervalo de quatro anos, foi possível realizar um recorte longitudinal, pois foram avaliados o nono EF em 2008, o primeiro EM em 2009, o segundo EM em 2010 e o terceiro EM em 2011. A escolha dessa amostra resultou em mais de 40 mil casos e gerou dados longitudinais apropriados para medir o efeito-escola, permitindo investigar o impacto das escolas na aprendizagem dos alunos. A existência de dados longitudinais permitiu evidenciar que os resultados dos alunos estão relacionados às experiências adquiridas ao longo do Ensino Médio. O efeito-escola atestado foi medido com o auxílio de modelos hierárquicos de regressão – modelos de trajetória, considerando a estruturação temporal e a estrutura multinível dos dados educacionais coletados. / [en] The Thesis Full Time High School in Ceará: A longitudinal study on the effect of EEEP schools, aimed to develop on a study on the value added of Ceará high school, full time. For this, we used data from SPAECE evaluations, carried out from 2008 to 2011. In this four-year interval it was possible to perform a longitudinal cut, as it was evaluated the 9th EF in 2008, the 1st EM in 2009, the 2nd MS in 2010 and the 3rd MS in 2011. The choice of this sample resulted in over 40,000 cases and generated appropriate longitudinal data to measure the school effect, allowing to investigate the impact of schools on student learning. The existence of longitudinal data showed that the students results are related to the experiences acquired during high school. The attested school effect was measured with the help of hierarchical regression models - trajectory models, considering the temporal structure and the multilevel structure of the collected educational data.

<p>Correlated data with complex association structures arise from longitudinal studies and cluster randomized trials. However, some methodological challenges in the design and analysis of such studies or trials have not been overcome. In this thesis, we address three of the challenges: 1) <em>Power analysis for population based longitudinal study investigating gene-environment interaction effects on chronic disease:</em> For longitudinal studies with interest in investigating the gene-environment interaction in disease susceptibility and progression, rigorous statistical power estimation is crucial to ensure that such studies are scientifically useful and cost-effective since human genome epidemiology is expensive. However conventional sample size calculations for longitudinal study can seriously overestimate the statistical power due to overlooking the measurement error, unmeasured etiological determinants, and competing events that can impede the occurrence of the event of interest. 2) <em>Comparing the performance of different multiple imputation strategies for missing binary outcomes in cluster randomized trials</em>: Though researchers have proposed various strategies to handle missing binary outcome in cluster randomized trials (CRTs), comprehensive guidelines on the selection of the most appropriate or optimal strategy are not available in the literature. 3) <em>Comparison of population-averaged and cluster-specific models for the analysis of cluster randomized trials with missing binary outcome</em>: Both population-averaged and cluster-specific models are commonly used for analyzing binary outcomes in CRTs. However, little attention has been paid to their accuracy and efficiency when analyzing data with missing outcomes. The objective of this thesis is to provide researchers recommendations and guidance for future research in handling the above issues.</p> / Doctor of Philosophy (PhD)

Published Article / In response to the Human Immunodeficiency Virus (HIV) epidemic in the country, the South African Government started with the provisioning of Antiretroviral Therapy (ART) in the public health sector. Monitoring and evaluating the effectiveness of the ART programme is of the utmost importance. The current patient information system could not supply the required information to manage the rollout of the ART programme. A data warehouse, consisting of several data marts, was developed that integrated several disparate systems related to HIV/AIDS/ART into one system. It was, however, not possible to trace a patient across all the data marts in the data warehouse. No unique identifiers existed for the patient records in the different data marts and they also had different structures. Record linkage in conjunction with a mapping process was used to link all the data marts and in so doing identify the same patient in all the data marts. This resulted in a longitudinal patient record of an ART patient that displayed all the treatments received by the patient in all public health care facilities in the province.

Utilising a hermeneutic phenomenological approach twenty women’s experiences of breast cancer were explored through semi-structured interviews at three time points during their healthcare trajectory from recent diagnosis to early follow-up. Phenomenological analysis guided by van Manen’s (1990) principles revealed numerous multifaceted themes some of which were time limited while others spanned the data collection period. Use was made of an adapted life grid approach in order to enhance the implicit meanings to be elicited through interpretation of text. Central themes depicting the medicalisation of breast cancer, perceptions and management of the body and participants’ emotional journey were uncovered. Breast cancer was found to represent a biographical disruption that had a long-term impact on a woman’s body, self, identity and sense of embodiment. Changes to the body, due to breast cancer treatment, and an altered way of being in the world, elicited disruption to the body-self relationship, a separation that was reinforced by the healthcare system. Participants were found to adopt a variety of coping strategies to manage ongoing change and the stress elicited by experiencing breast cancer as a chronic illness. Avoidance, information management, conscious passivity in treatment decision-making and positive cognitive restructuring are examples of such mechanisms. However, women’s experiences of each theme identified and the emergence and maintenance of these themes varied according to women’s biography, diagnosis and prescribed treatment regime, cancer schema, and social support. Accordingly, models of care must address women’s individual experiences and recognise their changing needs throughout the year post diagnosis.

BACKGROUND: Tobacco use remains the leading cause of morbidity and mortality in the US. Effective tobacco cessation aids are widely available, yet underutilized. Tobacco cessation brief interventions (BIs) increase quit rates. However, BI training has focused on conventional medical providers, overlooking other health practitioners with regular contact with tobacco users. The 2007 National Health Interview Survey found that approximately 20% of those who use provider-based complementary and alternative medicine (CAM) are tobacco users. Thus, CAM practitioners potentially represent a large, untapped community resource for promoting tobacco cessation and use of effective cessation aids. Existing BI training is not well suited for CAM practitioners' background and practice patterns, because it assumes a conventional biomedical foundation of knowledge and philosophical approaches to health, healing and the patient-practitioner relationship. There is a pressing need to develop and test the effectiveness of BI training that is both grounded in Public Health Service (PHS) Guidelines for tobacco dependence treatment and that is relevant and appropriate for CAM practitioners. METHODS/DESIGN: The CAM Reach (CAMR) intervention is a tobacco cessation BI training and office system intervention tailored specifically for chiropractors, acupuncturists and massage therapists. The CAMR study utilizes a single group one-way crossover design to examine the CAMR intervention's impact on CAM practitioners' tobacco-related practice behaviors. Primary outcomes included CAM practitioners' self-reported conduct of tobacco use screening and BIs. Secondary outcomes include tobacco using patients' readiness to quit, quit attempts, use of guideline-based treatments, and quit rates and also non-tobacco-using patients' actions to help someone else quit. DISCUSSION: CAM practitioners provide care to significant numbers of tobacco users. Their practice patterns and philosophical approaches to health and healing are well suited for providing BIs. The CAMR study is examining the impact of the CAMR intervention on practitioners' tobacco-related practice behaviors, CAM patient behaviors, and documenting factors important to the conduct of practice-based research in real-world CAM practices.

Knee osteoarthritis (OA) is the commonest form of lower limb OA with a lifetime risk of over 40%. It is a disease characterised by symptoms such as pain and loss of function. In addition there are typical structural features on both radiographs and MRI. Knee OA represents a spectrum of disease, ranging from early preclinical cartilage change to established full thickness disease. Anteromedial knee OA is a particular phenotype of knee OA where disease is confined to the medial compartment. Whilst end stage arthritis is treated reliably with joint arthroplasty, those with early stage disease are treated with a variety of non- surgical interventions with varying success. This thesis is concerned with understanding the disease of patients that have early radiographic changes but symptoms not controlled by conservative measures. Up to 150 of these patients a year present to the Nuffield Orthopaedic Centre, Oxford. They have been described as being in the “Treatment Gap”. A series of validation studies were performed to determine the optimal method for diagnosing cartilage defects within the knee. The three commonest diagnostic methods were examined for their validity. Arthroscopic assessments of cartilage lesions demonstrated a moderate level of intra and inter observer reliability. In contrast, radiographs and MRI demonstrated high levels of reliability. When using MRI as a criterion standard, both radiographs and arthroscopic assessment were found to have poor accuracy. Based on the work in this thesis a formal definition of the cartilage changes exhibited in early knee OA was proposed. A cross sectional cohort of 100 patients with the symptoms and radiological features of early knee OA were identified. Their pain and function profile was compared to two comparison groups of patients at the end stage of knee OA (defined by the need for partial or total arthroplasty). In up to 78% of individual cases those with early OA had pain and function profiles as bad as those with end stage disease. The cross sectional symptoms of early knee OA demonstrate a marked discordance with their mild radiographic changes. The same cohort was extended to 125 patients. They were followed over one year with monthly PROM assessments to determine how symptoms change over time. 43% of patients experience a clinical improvement over 12 months, 31% experience a clinical deterioration and 26% remain unchanged. The range in OKS variation over 12 months was on average 12 points, with clinically relevant variation occurring on 45% of monthly measurements. Patients with early knee OA can expect to experience considerable variation in their symptoms over 12 months and this must be considered when planning interventions. A number of patients with early knee OA were noticed to demonstrate medial meniscal extrusion. Using data from the Osteo Arthritis Initiative (OAI) a nested case control study was designed to determine how the presence of meniscal extrusion in an otherwise normal knee affects the risk of developing knee OA over the next 48 months. This demonstrated an Odds Ratio of 3.5, suggesting that meniscal extrusion is a considerable risk factor for the development of OA. The presence of a knee injury or operative intervention to the index meniscus was shown to increase this risk. Many phenotypes of OA are known to demonstrate familial aggregation. In an attempt to determine where the earliest structural changes occur in medial compartment knee OA, a cohort of patients selected only for their family history of the disease were developed. This cohort was compared to spouse controls for the presence of knee OA, as well as meniscal extrusion and long leg alignment. In addition, a functional analysis of their cartilage was performed. This cohort was not shown to be at increased risk of disease compared to controls. Discussion of the possible reasons for this finding is presented. Early knee osteoarthritis is a considerable clinical problem. This thesis has aided the understanding of the condition by firstly defining the radiological description of these patients. Secondly, their cross sectional and longitudinal symptom profile have been described for the first time. In addition, the presence of an extruded meniscus has been demonstrated as a substantial risk factor for the disease. Finally, family history has not been demonstrated as a risk factor for the disease within the limits of the study described here. Future work has been proposed.

This thesis considers why some crimes persist beyond the moment of newsworthiness and how they are able to transcend this period of intense reporting to become a feature of popular memory. The central argument is that the popular memory of a crime is built up over time through a synthesis of public discourses, which are predominantly developed in news reporting, people s everyday experience and the normative social frameworks of everyday life. A temporally sensitive analysis of two case studies, the murder of James Bulger and the murder of Sarah Payne, tests this hypothesis by exploring the connections and disconnections between the ongoing reporting of these crimes and the remembering of them. The study finds that the personal past and public discourse intertwine in remembered accounts of these crimes and considers that this is evidence of the ways audiences utilise crime news as an imaginative resource for understanding crime and criminality more broadly. It can thus be said that audiences use the news to frame, but not define their understandings of the world around us.

Puberty is the process of becoming sexually mature and it has fundamental somatic and psychosocial implications. The focus of this dissertation was the short and long term developmental significance, concerning both soma et psyche, of female pubertal timing. Four studies were designed to accomplish these aims. Six samples of different ages from different countries and from different time points, comprising several thousand females some of which were followed longitudinally, were used. Age at menarche was used as the primary measure of pubertal maturation. The first main aim of this dissertation was to explore the mechanisms that might explain the well-established link between female pubertal timing and problem behavior, and to identify contextual conditions at which associations are stronger or weaker. Existing explanations are unsatisfactory and little is known about conditions that might affect the strength of the associations. In Paper I, we tested and confirmed a peer socialization hypothesis as a satisfactory explanation for the link between early puberty and problematic adjustment. In short, this hypothesis posits that early developing girls associate with older peers and boyfriends because they feel more mature than their same age peers, and through these peers and boyfriends the early developed girls are channeled into more socially advanced behaviors, including normbreaking. This should be particularly true in contexts where heterosexual relationships are sanctioned and where there is an abundance of deviant youth. In Paper II, I used a biopsychosocial approach and studied pubertal timing along with self-perceptions of maturity and early romantic relationships. The findings revealed that early puberty had very different implications depending on the psychological and social contexts in which it was embedded. For instance, when early puberty was coupled with feeling mature and having early romantic relationships, it was associated with adjustment problems. When early puberty was coupled with neither, it was not linked to particularly high levels of problem behavior. In stark contrast to the vast literature on the role of female pubertal timing in adolescence, the literature on long-term implications is remarkably limited. For this reason, the second main aim of this dissertation was to study the adult implications of female pubertal timing. In Papers III and IV, we examined long term implications of pubertal timing, particularly as it relates to somatic development. The findings suggested that pubertal timing does have future implications for women’s body perception and composition, with early developing females having higher body mass indexes in adulthood, but only under certain circumstances. The findings of this dissertation help further understanding of the soma et psyche implications of female pubertal timing. They indicate that pubertal timing has concurrent and future implications. It seems, however, that timing is not everything. The developmental significance of female pubertal timing appears to be very different under different contextual conditions. Thus, it is only when girls’ psychological and social contexts are considered that fruitful predictions can be made. As such, the findings have important implications for prevention, policy, and practice.