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<p>Introduction</p> <p>Canadian health and social service systems need to adapt to new challenges posed by the unique primary health care (PHC) needs of recent immigrant families. Community-based service providers are the first to experience changing responsibilities. Providers in communities with limited experience in working with immigrants may benefit from shared skills and modeled cultural competencies when working with new arrivals.</p> <p>Purpose</p> <p>This case study describes how a set of community-based service organizations addressed the PHC needs of recent immigrant families with young children living within a mid-sized urban centre in Atlantic Canada. The roles of organizational brokers and of <em>competence trust</em> among service providers were examined to determine their influence on the capacities of the service network overall.</p> <p>Methods</p> <p>Methods from social network analysis and descriptive qualitative inquiry were applied in this study. Organizational ecology contructs framed the research questions and propositions. An intersectoral approach to PHC was adopted to define the services network. Results derived from the network survey and key informant interviews were triangulated to develop a final interpretation.</p> <p>Results</p> <p>The study network constituted a relatively cohesive group of service providers. Network participation became more selective depending on the issue experienced by families. Network interactions were facilitated by broker organizations; some brokers actively engaged in the development of cultural competency capacities among network members. Trust in the other provider organization’s cultural competencies (<em>competence trust</em>) with recent immigrant families positively influenced the quality of working relationships.</p> <p>Conclusions</p> <p>Broker organizations can play a significant role in network capacity development through the promotion of cultural competencies in partnering organizations and by making connections across service sectors. The cultural competence of partnering organizations is an important pre-condition of trust for service providers committed to the needs of recent immigrant families. Having trusting relationships among providers can facilitate exchange and enable access to services. Nurses have the potential to participate in the advancement of culturally competent service systems.</p> / Doctor of Philosophy (PhD)

Pseudomonas syringae is a common foliar plant pathogenic bacterium that causes diseases on many crop plants. We hypothesized that today's highly virulent P. syringae crop pathogens with narrow host range might have evolved after the advent of agriculture from ancestral P. syringae strains with wide host range that were adapted to mixed plant communities. The model tomato and Arabidopsis pathogen P. syringae pv. tomato (Pto) DC3000 and its close relatives isolated from crop plants were thus selected to unravel basic principles of host range evolution by applying molecular evolutionary analysis and comparative genomics approaches. Phylogenetic analysis was combined with host range tests to reconstruct the host range of the most recent common ancestor of all analyzed strains isolated from crop plants. Even though reconstruction of host range of the most recent common ancestor of all analyzed strains was not conclusive, support for this hypothesis was found in some sub-groups of strains. The focus of my studies then turned to Pto T1, which was found to represent the most common P. syringae lineage causing bacterial speck disease on tomato world-wide. Five genomes were sequenced and compared to each other. Identical genotypes were found in North America and Europe suggesting frequent pathogen movement between these continents. Moreover, the type III-secreted effector gene hopM1 was found to be under strong selection for loss of function and non-synonymous mutations in the fliC gene allowed to identify a region that triggers plant immunity. Finally, Pto T1 was compared to closely related bacteria isolated from snow pack and surface water in the French Alps. Recombination between alpine strains and crop strains was inferred and virulence gene repertoires of alpine strains and crop strains were found to overlap. Alpine strains cause disease on tomato and have relatively wider host ranges than Pto T1. The conclusion from these studies is that Pto T1 and other crop pathogens may have evolved from ancestors similar to the characterized environmental strains isolated in the French Alps by adapting their effector repertoire to individual crops becoming more virulent on these crops but losing virulence on other plants. / Ph. D.

The purpose of the study was to improve the understanding of the present situation and the key problems regarding the conservation of designed landscapes of the recent past. Another aim was to investigate roles and initiatives undertaken by key stakeholders and recommend key areas for measures and action to enhance the conservation and protection of designed landscapes of the recent past. The emphasis of the research was on the United Kingdom but relevant findings and actions from an international context were included. A qualitative method was applied using the between-method triangulation research methodology, which combined two methods of investigation, namely data triangulation and theory triangulation. Theory triangulation allowed for an investigation of the wider context or ‘the general’ and a comparison of findings from published sources and records, including an examination of the existing inventories and the roles and initiatives of key stakeholders. The data triangulation used a case study survey, with questionnaires and interviews, to enable the collection and analysis of data from different categories of stakeholders from a site-specific perspective or ‘the particular’ context. The case study survey investigated eleven case study sites using questionnaires and interviews. A total of 146 respondents were contacted and 103 completed responses were received. The results revealed that several recommendations for actions to improve the conservation and protection of heritage of the recent past exist, and that general conservation principles and methodologies exist for the conservation of designed landscapes, but that a lack of recognition and awareness for the significance of designed landscapes of the recent past results in poor implementation of such principles, and the continuing destruction and disfigurement of significant sites. The findings of the study led in the conclusions to the preparation of recommendations for measures and actions by stakeholders, to improve the protection and conservation of landscapes of the recent past.

Dans les cas de lymphopénie, les lymphocytes T résiduels prolifèrent exagérément dans un phénomène appelé «expansion homéostatique périphérique» (HPE), qui est efficace pour la régénération des T CD8+, mais inefficace pour les T CD4+. L’interleukine-7 (IL7) est une cytokine homéostatique utilisée afin d’augmenter les comptes lymphocytaires T des patients lymphopéniques. Toutefois, la raison de l’expansion préférentielle des lymphocytes T CD8+ par l’IL7 demeure toujours inconnue. Nous montrons que cette expansion est due au fait que l’IL7 induit une prolifération efficace des T CD8+ périphériques (CD8+PERI) ainsi que des émigrants thymiques CD8+ (CD8+RTEs). Par contre, l’effet prolifératif de l’IL7 est restreint presqu’uniquement aux CD4+RTEs même si les CD4+PERI survivent mieux que les CD4+RTEs. De plus faibles doses d’IL7 sont nécessaires aux CD4+RTEs afin de phosphoryler STAT5 ou de proliférer comparativement aux CD4+PERI et nous démontrons que les contacts TCR/CMHII sont nécessaires à la prolifération induite par l’IL7 des CD4+RTEs en périphérie. De fait, augmenter au Flt3 ligand le nombre de cellules dendritiques périphériques d’une souris donneuse, avant de transférer ses TPERI dans des souris receveuses traitées à l’IL7 induit une prolifération significative des CD4+PERI. Nos résultats indiquent donc que l’abondance des contacts TCR/CMHII reçus dans le thymus semble contrôler la sensibilité à l’IL7 des CD4+RTEs. Finalement, l’observation que les CD8+PERI et CD8+RTEs prolifèrent pareillement pendant la thérapie à l’IL7, alors que la prolifération des T CD4+ est largement restreinte aux RTEs expliquerait pourquoi, dans les cas de lymphopénie, la régénération des T CD4+ est aussi dépendante de la thymopoïèse. / In lymphopenic settings, residual T lymphocytes typically undergo exaggerated proliferation via homeostatic peripheral expansion (HPE). While HPE efficiently regenerates CD8+ T cells, it is unable to normalize CD4+ T-cell counts. Interleukin-7 (IL7) is a homeostatic cytokine, currently used in trials in order to increase T-cell counts in lymphopenic humans. Nowadays, it is still not known why IL7 therapy is more effective toward the expansion of CD8+ T cells rather than CD4+ T cells. Here we show that CD8+ T cells preferential expansion is due to IL7-induced efficient proliferation of peripheral CD8+ T cells (CD8+PERI) and CD8+ recent thymic emigrants (CD8+RTEs). In contrast, the proliferative action of IL7 is largely restricted to CD4+RTEs although CD4+PERI survive better than CD4+RTEs. Interestingly, CD4+RTEs require lower concentrations of IL7 in order to phosphorylate STAT5 or proliferate when compared to CD4+PERI, and we demonstrate the requirement for TCR/MHCII contacts to support the IL7-induced HPE of CD4+RTEs in the periphery. Furthermore, augmenting the number of MHCII expressing cells in the periphery of donor mice by treating them with Flt3 ligand (Flt3L) prior transferring their TPERI cells in IL7 therapy-treated recipients, significantly enhances the IL7-induced proliferation of CD4+PERI. Our results indicate so far that the abundance of TCR triggering occurring inside the thymus drives IL7 responsiveness of CD4+RTEs. Moreover, the observation that CD8+PERI and CD8+RTE proliferate similarly during IL7 therapy, while proliferation of CD4+ T cells is largely restricted to RTEs, may explain why CD4+ T cells regeneration in lymphopenic settings is highly dependent on thymopoiesis.

Chaque année, un nombre considérable d’élèves récemment immigrés intègrent les écoles du Québec. Pour ces jeunes, les risques de faire face à des difficultés socioscolaires sont potentiellement élevés, en particulier chez ceux pour qui des facteurs tels que l’allophonie et la défavorisation s’additionnent. De nombreuses recherches soulignent la réussite de l’adaptation socioscolaire de plusieurs de ces élèves, mais il demeure que d’autres jeunes éprouvent des difficultés et il est capital de chercher à mieux comprendre comment les accompagner à travers ce processus. L’objectif général de cette recherche est de décrire le phénomène de la résilience scolaire chez des jeunes allophones du primaire récemment immigrés dans le but de savoir comment mieux soutenir leur intégration sociale ainsi que leur réussite scolaire. Le concept de la résilience a été employé comme cadre théorique afin de capter le caractère systémique de l’intégration socioscolaire de ces élèves immigrants qui, à leur arrivée, ne maîtrisent pas le français. Les résultats de l’analyse de nos données révèlent que les caractéristiques qui ont soutenu l’adaptation socioscolaire des jeunes que nous avons rencontrés appartiennent à quatre catégories : l’élève (motivation scolaire et importance accordée aux études en général, volonté d’apprentissage du français), son environnement familial (intérêt porté par les parents à l’éducation de l’enfant, discours positif du parent quant à l’éducation), son environnement extra-familial (lieux de culte et espaces d’épanouissement socioculturel pour le jeune, organismes communautaires, adultes significatifs qui peuvent soutenir la résilience du jeune) et son vécu scolaire (enseignants engagés, disponibles, qui inspirent confiance et qui sont outillés, climat psychosocial positif en classe et à l’école). / Every year a considerable number of recently immigrated students attend the schools of Quebec. For these students, the risk of facing socio-educational difficulties is potentially high, particularly for those who are allophones and living in deprivation. Several studies highlight success of socio-educational adaptation of numerous students, but it still remains that others have difficulties and it is capital to look into better understanding how to best support them through this journey. The general objective of this research is to describe the phenomenon of educational resilience in young allophones in elementary schools who have recently immigrated in order to know how to better foster and support their social integration and educational success. The concept of resilience was used as the theoretical framework in order to capture the systemic character of socio-educational integration of these immigrant students, who at their arrival do not master the French language. The results of the data analysis show that the characteristics that have supported the socio-educational adaptation of the students we have met with, can be organized in four categories: the student (educational motivation and the importance placed on education in general, the will to learn French), his/her family environment (parents’ interest in the child’s education, parents’ positive discourse in regards to education), his/her environment outside the family (places of worship and spaces for socio-cultural development, community organisations, significant adults who can support the child’s resilience) and his/her school experience (involved and available teachers, who inspire trust and are appropriately equipped, positive psychosocial climate in class and in school).

Falling among older adults is a leading cause of concern due to the known impacts including physical injury, loss of independence, increased health care costs, and mortality. In efforts to decrease the numbers of falls experienced by older adults, healthcare providers assess individuals’ fall risks and provide corresponding fall prevention recommendations. The effectiveness however, of these recommendations, is only as strong as the level of adherence to those recommendations; which has proven low in recent research. Using the theoretical foundation of the Health Belief Model, this study quantified adherence to environmental fall prevention recommendations. Twenty-two community-dwelling older adults participated in this randomized control group study that took place across three home visits, scheduled approximately 30 days apart. Participants were interviewed regarding their recent falls and perceived susceptibility to future falls; then a home evaluation was conducted. Treatment group participants were provided personalized education explaining how and why environmental fall prevention recommendations were important to decrease their risk of falls while control group participants were provided general recommendations. A two-sample t-test for independent groups determined a statistically significant relationship: participants who received personalized education intervention were more likely to follow recommendations than those who received general education intervention. Multiple regressions were conducted to review relationships between an individual’s recent falls, and their perceived susceptibility to future falls, with their extent of adherence with fall prevention recommendations. No statistically significant relationship was found. This study suggests that providing personalized education for community-dwelling older adults regarding environmental fall prevention recommendations increases their extent of adherence with such recommendations.

Summary: This master's thesis focuses on the actualization and compiling of a detailed engineering geological map in scale 1 : 5 000. The thesis deals with the area defined by four points in the coordinate system JTSK - Křovák: : x1= -749 300, y1= -1 043 400; x2= -745 900, y2= -1 043 400; x3= -749 300, y3= -1 044 500; x4= -745 900, y4= -1 044 500. In the first background research part, the geomorphologic, climatic, geologic, hydrogeological and geodynamic conditions of the mapped area are presented. The second practical part of the thesis consists of four major parts: the engineering geological conditions map, the height of recent sediments map, the hydrogeological map and the map of documentation points. Further, the master's thesis contains geological cross-section. The actualization of engineering geological condition map provides new information about recent sedimentation areas and anthropogenic sediments, especially about landfills and landslides.

Summary: This master's thesis focuses on the actualization and compiling of a detailed engineering geological map in scale 1 : 5 000. The thesis deals with the area defined by four points in the coordinate system JTSK - Křovák: : x1= -749 300, y1= -1 043 400; x2= -745 900, y2= -1 043 400; x3= -749 300, y3= -1 044 500; x4= -745 900, y4= -1 044 500. In the first background research part, the geomorphologic, climatic, geologic, hydrogeological and geodynamic conditions of the mapped area are presented. The second practical part of the thesis consists of four major parts: the engineering geological conditions map, the height of recent sediments map, the hydrogeological map and the map of documentation points. Further, the master's thesis contains geological cross-section. The actualization of engineering geological condition map provides new information about recent sedimentation areas and anthropogenic sediments, especially about landfills and landslides.

Mit zunehmendem Alter verringert sich die Fähigkeit des menschlichen Organismus Infektionen erfolgreich zu bekämpfen und, z.B. nach Impfung, einen protektiven Schutz aufzubauen. Es wird vermutet, dass die Alterung des Immunsystems eine Rolle dabei spielt. Wichtige Ergebnisse liefern dazu vor allem tierexperimentelle Studien, welche jedoch die Komplexität menschlicher Immunität nur bedingt abbilden. Nur ansatzweise erforscht ist der Einfluss immunologischer Alterungsprozesse auf die primäre Immunantwort im Menschen. Um ein besseres Verständnis über primäre Immunantworten im Alter zu erlangen, haben wir junge (n=11, Med=26 Jahre) und ältere (n=12, Med=60 Jahre) Erwachsene mit einem viralen Erreger experimentell infiziert und die akute Immunreaktion und Entwicklung langlebiger Protektion eingehend untersucht. Dafür verwendeten wir den attenuierten Lebendimpfstoff gegen Gelbfieber, der ein hervorragendes Modelsystem darstellt um anti-virale Primärantworten im Menschen zu erforschen. Wir konnten zeigen, dass ältere Impflinge weniger Gelbfiebervirus-(GFV)-neutralisierende Antikörper produzierten, schwächere GFV-spezifische CD8+ T-Zellantworten erzeugten und quantitativ als auch qualitativ veränderte GFV-spezifische CD4+ T-Zellantworten generierten. Zudem wiesen ältere Impflinge häufiger eine vergleichsweise späte Virämie auf. Unsere systembiologische Untersuchungen zeigten, dass die niedrige Zahl von frisch aus dem Thymus ausgewanderten naiven CD4+ T Zellen, sogenannten CD4+ Recent thymic emigrants, sowie der Mangel an dendritischen Zellen vor bzw. am Beginn der Infektion ausschlaggebend für die schlechtere Immunreaktion und niedrigere Langzeit-Immunität bei Älteren war. Daraus schließen wir, dass in älteren Menschen die Verfügbarkeit eines breiten Repertoires naiver CD4+ T-Zellen und eine effektive Induktion des angeborenen Immunsystems in der frühen Phase einer primären Infektion kritisch für die akute Abwehr viraler Erreger und die Ausbildung protektiver Immunität ist. / The immunological competence to fight infections and to generate protective immunity, for example upon vaccination, progressively declines with advancing age. Although the aged immune system has been extensively studied at steady state and in aged animal models, there is only rudimentary understanding on how aging affects the immune response to a primary infection in humans. Involving complex individual systemic immune properties, such investigations have been very challenging particularly with the given restrictions of experimental infections in humans. In our study, we explored age-related changes in human immunity during experimental, primary immunization with live-attenuated yellow fever (YF) vaccine. In 11 young (median age: 26 years) and 12 elderly (median age: 60 years) vaccinees, we assessed individual viral burden and compared humoral and cellular immunity by advanced flow cytometric analysis over the entire course of the acute infection and up to 3 years after it. We discovered that aged subjects developed fewer neutralizing antibodies, mounted diminished YF-specific CD8+ T-cell responses and showed quantitatively and qualitatively altered YF-specific CD4+ T-cell immunity. A comparatively late peak in YF viremia suggested impaired infection control and viral clearance in the elderly. Among numerous immune signatures, low in vivo numbers of naive CD4+ recent thymic emigrants (CD4+ RTE) prior immunization and peripheral dendritic cells (DCs) in the early phase of the innate response phase were indicative for reduced acute responsiveness and altered long-term persistence of human cellular immunity to YF vaccination in the elderly. Thus, we reveal by this study that essential elements of immune responses such as CD4+ RTEs and DCs affect productive immunity in the elderly, explaining conclusively diminished responsiveness to vaccination with neo-antigens and infection with de novo pathogens in aged people.