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Background: Cancer is a leading cause of disease burden worldwide and the first cause of mortality in Canada with 30.2% of deaths attributable to cancer. Given aging of the population and the improvement of prevention and treatment protocols, the number of cancer survivors is steadily increasing. These individuals have unique physical and mental health needs some of which can be addressed by integrating physical activity promotion into ongoing and long-term care. Despite the benefits of being active, delivery of PA programs for cancer patients in both clinical and community settings remains challenging. This knowledge-to-action protocol–called Kiné-Onco–aims to develop a practice guideline for the delivery, implementation, and scaling-up of cancer-specific physical activity promotion programs and services in clinical and community settings located in Québec, Canada. Method: The Kiné-Onco project involves knowledge synthesis of scientific and grey literature to establish the benefits and added value of physical activity for cancer patients and survivors, describes current practices in delivering physical activity programs, analyses quantitative data from electronic health records (EHR) of patients participating in a novel hospital-based physical activity program, collects and analyses qualitative data from patients and healthcare providers interviews about lived experience, facilitators, and barriers to physical activity promotion, outlines deliberative workshops among multidisciplinary team members to develop implementation guidelines for physical activity promotion, and summarizes a variety of knowledge transfer and exchange activities to disseminate the practice guidelines. Discussion: This paper describes the protocol for a knowledge-to-action project aimed at producing and sharing actionable evidence. Our aim is that physical activity promotion programs and services be scaled up in such a way as to successfully integrate physical activity promotion throughout cancer treatment and survivorship in order to improve the physical and mental health of the growing population of individuals having received a cancer diagnosis. [ABSTRACT FROM AUTHOR]

Lichen mapping is vital for caribou management plans and sustainable land conservation. Previous studies have used random forest, dense neural network, and convolutional neural network models for mapping lichen coverage. However, to date, it is not clear how these models rank in this task. In this study, these machine learning models were evaluated on their ability to predict lichen percent coverage in Sentinel-2 imagery in Québec and Labrador, Canada. The models were trained on 10-m resolution lichen coverage (%) maps created from 20 drone surveys collected in July 2019 and 2022. The dense neural network achieved a higher accuracy than the other two, with a reported mean absolute error of 5.2% and an R2 of 0.76. By comparison, the random forest model returned a mean absolute error of 5.5% (R2: 0.74) and the convolutional neural network had a mean absolute error of 5.3% (R2: 0.74). A regional lichen map was created using the trained dense neural network and a Sentinel-2 imagery mosaic. There was greater uncertainty on land covers that the model was not exposed to in training, such as mines and deep lakes. While the dense neural network requires more computational effort to train than a random forest model, the 5.9% performance gain in the test pixel comparison renders it the most suitable for lichen mapping. This study represents progress toward determining the appropriate methodology for generating accurate lichen maps from satellite imagery for caribou conservation and sustainable land management. [ABSTRACT FROM AUTHOR]

Background: During major pandemics such as COVID-19, the fear of being infected, uncertain prognoses, and the imposition of restrictions may result in greater odds of emotional and psychological distress. Hence, the present study examines the predictors of psychological distress during the COVID-19 pandemic in Canada, and how they differ by gender. Methods: Data of 2,756 adults aged 18 years and above from a cross-sectional online survey conducted between July and October 2020 was used for this study. A multivariable logistic regression analysis was carried out. The results were presented as adjusted odds ratio (aOR) with their respective confidence interval (CI). Results: Lower odds of psychological distress were found among males compared to females and among individuals aged 45–64 or 65–84 years compared to those aged 18–44. The odds of psychological distress decreased with a rise in income, with individuals whose annual income was greater than or equal to $100,000 being less likely to experience psychological distress compared to those whose income was less than $20,000. The odds of psychological distress were higher among residents of Ontario compared to residents of Quebec. Similarly, the odds of psychological distress were higher among individuals who reported experiencing COVID-19 symptoms compared to those who did not report any COVID-19 symptoms. The disaggregated results by gender showed that age, province, and self-reported COVID-19 symptoms had significant associations with psychological distress in both males and females, but these effects were more pronounced among females compared to males. In addition, income was negatively associated with psychological distress for both males and females, with this effect being stronger among males. Conclusion: Five exposure variables (gender, age, province, experiencing COVID-19 symptoms, and total annual income in 2019) significantly predicted the likelihood of reporting psychological distress during the COVID-19 pandemic in Canada. Clearly, there is an imminent need to provide mental health support services to vulnerable groups. Additionally, interventions and policies aimed at combating psychological distress during pandemics such as COVID-19 should be gender specific. [ABSTRACT FROM AUTHOR]

Background: The Objective Structured Clinical Examination (OSCE) is a commonly used tool internationally to assess clinical competency. Physical therapy (PT) licensure processes vary internationally. The OSCE is the tool used in Canada to assess clinical competency for PT graduates seeking licensure. Previous studies that examined the measurement properties of OSCEs present contradictory results. Objectives: The first objective was to investigate the reliability and validity of OSCEs when administered to PTs during their education or as part of a licensure process. The second objective was to conduct a structured review to report PT educational and licensing components and policies in 17 countries with well-developed PT regulation systems. Methods: An electronic search was performed in four databases from inception to 31st March 2021 to identify relevant articles. Two reviewers performed the critical appraisal of the included studies using a validated quality assessment tool. We deployed a random effects meta-analysis on reliability and validity estimates of OSCEs and examined sources of heterogeneity with univariate meta-regressions. We searched websites of professional regulatory bodies and associations for data on educational and licencing components and policies. Educational and licensing components across countries were synthesized descriptively. Results: A pooled estimate of Cronbach's alpha of 0.55, (95% CI: 0.41, 0.67) was determined for OSCEs. The pooled estimate of Intraclass Correlation Coefficient (ICC) between assessors was 0.77 (95% CI: 0.70, 0.83). The pooled estimate of Pearson Correlation between multiple OSCE stations' scores was 0.27 (95% CI: 0.15, 0.39); and between each station score and the total score was 0.71 (95% CI: 0.61, 0.79). The pooled estimates for kappa Coefficients were 0.75 (95% CI: 0.58, 0.86) and 0.84, (95% CI: 0.72, 0.91) for intra-rater and inter-rater reliability of the standardised patient respectively. From the 17 included countries, Canada (excluding Quebec) was the only country that required both a clinical and written competency exam following graduation from an accredited PT program. Two countries (USA, UAE) required a written competency exam. The remaining 14 countries did not require an additional competency examination after completion of degree requirements from an accredited program. Conclusions: We found weak evidence that OSCE examinations items are internally consistent when used to assess PTs. Canada (excluding Quebec) is the only country out of 17 implementing a national clinical competency examination for their PT graduates to achieve licensure after completing professional degree requirements. [ABSTRACT FROM AUTHOR]

Random population-based surveys to estimate prevalence of SARS-CoV2 infection causing coronavirus disease (COVID-19) are useful to understand distributions and predictors of the infection. In April 2020, the first-ever nationally representative survey in Canada polled 4,240 adults age 18 years and older about self-reported COVID experience in March, early in the epidemic. We examined the levels and predictors of COVID symptoms, defined as fever plus difficulty breathing/shortness of breath, dry cough so severe that it disrupts sleep, and/or loss of sense of smell; and testing for SARS-CoV-2 by respondents and/or household members. About 8% of Canadians reported that they and/or one or more household members experienced COVID symptoms. Symptoms were more common in younger than in older adults, and among visible minorities. Overall, only 3% of respondents and/or household members reported testing for SARS-CoV-2. Being tested was associated with having COVID symptoms, Indigenous identity, and living in Quebec. Periodic nationally representative surveys of symptoms, as well as SARS-CoV-2 antibodies, are required in many countries to understand the pandemic and prepare for the future. [ABSTRACT FROM AUTHOR]

Statistical modeling is commonly used to relate the performance of potato (Solanum tuberosum L.) to fertilizer requirements. Prescribing optimal nutrient doses is challenging because of the involvement of many variables including weather, soils, land management, genotypes, and severity of pests and diseases. Where sufficient data are available, machine learning algorithms can be used to predict crop performance. The objective of this study was to determine an optimal model predicting nitrogen, phosphorus and potassium requirements for high tuber yield and quality (size and specific gravity) as impacted by weather, soils and land management variables. We exploited a data set of 273 field experiments conducted from 1979 to 2017 in Quebec (Canada). We developed, evaluated and compared predictions from a hierarchical Mitscherlich model, k-nearest neighbors, random forest, neural networks and Gaussian processes. Machine learning models returned R2 values of 0.49–0.59 for tuber marketable yield prediction, which were higher than the Mitscherlich model R2 (0.37). The models were more likely to predict medium-size tubers (R2 = 0.60–0.69) and tuber specific gravity (R2 = 0.58–0.67) than large-size tubers (R2 = 0.55–0.64) and marketable yield. Response surfaces from the Mitscherlich model, neural networks and Gaussian processes returned smooth responses that agreed more with actual evidence than discontinuous curves derived from k-nearest neighbors and random forest models. When conditioned to obtain optimal dosages from dose-response surfaces given constant weather, soil and land management conditions, some disagreements occurred between models. Due to their built-in ability to develop recommendations within a probabilistic risk-assessment framework, Gaussian processes stood out as the most promising algorithm to support decisions that minimize economic or agronomic risks. [ABSTRACT FROM AUTHOR]

Old-growth forests play a major role in conserving biodiversity, protecting water resources, and sequestrating carbon, as well as serving as indispensable resources for indigenous societies. Novel silvicultural practices must be developed to emulate the natural dynamics and structural attributes of old-growth forests and preserve the ecosystem services provided by these boreal ecosystems. The success of these forest management strategies depends on developing an accurate understanding of natural regeneration dynamics. Our goal was therefore to identify the main patterns and drivers involved in the regeneration dynamics of old-growth forests with a focus on boreal stands dominated by black spruce (Picea mariana (L.) Mill.) and balsam fir (Abies balsamea (L.) Mill.) in eastern Canada. We sampled 71 stands in a 2 200 km2 study area located within Quebec's boreal region. For each stand, we noted tree regeneration (seedlings and saplings), structural attributes (diameter distribution, deadwood volume, etc.), and abiotic (slope and soil) factors. The presence of seed-trees located nearby and slopes having moderate to high angles most influenced balsam fir regeneration. In contrast, the indirect indices of recent secondary disturbances (e.g., insect outbreaks or windthrows) and topographic constraints (slope and drainage) most influenced black spruce regeneration. We propose that black spruce regeneration dynamics can be separated into distinct phases: (i) layering within the understory, (ii) seedling growth when gaps open in the canopy, (iii) gradual canopy closure, and (iv) production of new layers once the canopy is closed. These dynamics are not observed in paludified stands or stands where balsam fir is more competitive than black spruce. Overall, this research helps explain the complexity of old-growth forest dynamics, where many ecological factors interact at multiple temporal and spatial scales. This study also improves our understanding of ecological processes within primary old-growth forests and identifies the key factors to consider when ensuring the sustainable management of old-growth boreal stands. [ABSTRACT FROM AUTHOR]

Hospitalizations for certain chronic conditions are considered avoidable for adult Canadians given effective and timely primary care management. Individual-level risk factors such as income and health behaviours are not routinely collected in most hospital databases and as a result, are largely uncharacterized for avoidable hospitalization at the national level. The aim of this study was to identify and describe demographic, socioeconomic, and health behavioural risk factors for avoidable hospitalizations in Canada using linked data. A national retrospective cohort study was conducted by pooling eight cycles of the Canadian Community Health Survey (2000/2001-2011) and linking to hospitalization records in the Discharge Abstract Database (1999/2000–2012/2013). Respondents who were younger than 18 years and older than 74 years of age, residing in Quebec, or pregnant at baseline were excluded yielding a final cohort of 389,065 individuals. The primary outcome measure was time-to index avoidable hospitalization. Sex-stratified Cox proportional hazard models were constructed to determine effect sizes adjusted for various factors and their associated 95% confidence intervals. Demographics, socioeconomic status, and health behaviours are associated with risk of avoidable hospitalizations in males and females. In fully adjusted models, health behavioural variables had the largest effect sizes including heavy smoking (Male HR 2.65 (95% CI 2.17–3.23); Female HR 3.41 (2.81–4.13)) and being underweight (Male HR 1.98 (1.14–3.43); Female HR 2.78 (1.61–4.81)). Immigrant status was protective in both sexes (Male HR 0.83 (0.69–0.98); (Female HR 0.69 (0.57–0.84)). Adjustment for behavioural and clinical variables attenuated the effect of individual-level socioeconomic status. This study identified several risk factors for time-to-avoidable hospitalizations by sex, using the largest national database of linked health survey and hospitalization records. The larger effect sizes of several modifiable risk factors highlights the importance of prevention in addressing avoidable hospitalizations in Canada. [ABSTRACT FROM AUTHOR]

Objective: To describe how small animal anaesthesia is performed in French-speaking Eastern Canada, and the variations between practices, in particular based on practice type, veterinarian gender and experience. Design: Observational study, survey. Sample: 156 respondents. Procedure: A questionnaire was designed to assess current small animal anaesthesia practices in French-speaking Eastern Canada, mainly in the province of Quebec. The questionnaire was available through SurveyMonkey, and consisted of four parts: demographic information about the veterinarians surveyed, evaluation and management of anaesthetic risk, anaesthesia procedure, monitoring and safety. Gender, year of graduation, and type of practice were tested as potential risk factors. Chi-square exact test was used to study relations between each risk factor, and the effect of the selected risk factor on each response of the survey. For ordinal data, the Cochran-Mantel-Haenszel test was used to maximize power. Results: Response rate over a period of 3 months was 20.85% (156 respondents). Overall, the way anaesthesia is performed by most respondents does not meet international guidelines, such as patient preparation and evaluation prior to anaesthesia, not using individualised protocols (for 41%), not obtaining intravenous access (12.4% use it for all their anaesthesia in cats, and 30.6% in dogs), lack of patient monitoring at certain intervals for 55% of the responses, and client prompted optional analgesia (for 29% of respondents). Some practices are more compliant than others. Among them, referral centres generally offer better care than general practices. Conclusions and clinical relevance: The level of care in anaesthesia and analgesia in practices in French-speaking Eastern Canada is concerning, highlighting the need for more sustained continuing education. [ABSTRACT FROM AUTHOR]