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This paper overviews our recent results of energy market modeling, including The option pricing formula for a mean-reversion asset, variance and volatility swaps on energy markets, applications of weather derivatives on energy markets, pricing crude oil options using the Lévy processes, energy contracts modeling with delayed and jumped volatilities, applications of mean-reverting processes on Alberta energy markets, and alternatives to the Black-76 model for options valuation of futures contracts. We will also consider the clean renewable energy prospective in Canada, and, in particular, in Alberta and Calgary. [ABSTRACT FROM AUTHOR]

This paper uses a large administrative dataset providing 105,149 daily observations on 3,176 youth aged between 18 and 24 years using emergency homeless shelters from January 1, 2014, to December 31, 2019, in Calgary, Alberta, Canada. Using k-mean cluster analysis we classify youth who use emergency homeless shelters by their intensity of shelter use. In Calgary, most youth use homeless shelters as a temporary and infrequent refuge when housing is lost. For these youth, shelters are an effective and relatively inexpensive approach for helping them resolve their homelessness. A significant number, however, rely on shelters for much longer stays. For these youth, shelters are ineffective and expensive responses to their homelessness. To understand how youth are changing their use of shelters over time, we introduce time series measuring first admissions and readmissions to shelters. We show that how youth use shelters, and how that use has changed over time, differs for youth who self-identify as Indigenous, Caucasian and visible minority. [ABSTRACT FROM AUTHOR]

Existing discourse on refugee resettlement in the West is rife with imperialist and neoliberal allusions. Materially, this discourse assumes refugees as passive recipients of resettlement programs in the host country, thereby denying them their subjectivities. Given the amplification of all social and economic inequities during the pandemic, our paper explores how Canada's response to the pandemic visa-vis refugees impacted the everyday of Yazidis in Calgary - a recently arrived refugee group who survived the most horrific genocidal atrocities of our times. Based on interviews with Yazidi families in Calgary and with resettlement staff we unpack Canada's paternalistic response towards refugees during the COVID-19 pandemic. We show how resettlement provisions and social isolation along with pre-migration histories have furthered the conditions of social, economic, and affective inequities for Yazidis. We also show how Yazidi women who were most impacted by the genocide and the subsequent pandemic find ways of asserting their personhood and engage in healing through a land-based resettlement initiative. Adopting a feminist refugee epistemology and a southern moral imaginary as our discursive lenses, we highlight the need to dismantle the existing paternalistic structures and re(orient) resettlement practices and praxis to a social justice framework centering the voices of refugee women and families in their resettlement process. [ABSTRACT FROM AUTHOR]

Participatory action research can be a research methodology that seeks to offer relational processes that develop high touch research relationships, create coempowerment, while fostering resiliency and strength, within the HIV community. The Calgary HIV Social Society (CHSS) in Calgary, Alberta, Canada co-developed with peer-researchers at Mount Royal University, a progressive form of action-oriented research that allowed the HIV community to develop and provide social gatherings to reduce the impact of stigma and isolation. The research project was developed with the community of people living with HIV to reduce the impact of isolation and stigma. The focus of the research was to better understand how social gatherings could improve the quality of life for those living with HIV. The action-oriented methodology allowed for HIV peer-researchers to bring their expertise on what was needed to reduce stigma and isolation. The HIV social support community created participatory action research processes that successfully contributed to building an inclusive, community for people living with HIV. This paper will share the themes that acknowledge the significant impact that a HIV high touch relationship research community can have for those, who face the barriers of isolation and stigma by increasing community connection, reducing financial constraints that limit participation, while increasing mental health wellness. [ABSTRACT FROM AUTHOR]

In this paper, the author explores how the practice of walking the city may open curricular spaces to nurture a deep engagement and feelings of enchantment with the world. By disrupting the taken-for-granted sensibilities of our everyday urban lives and being open to the unexpected voices, bodies and more-than-human beings who co-exist in urban spaces, the author contends that when we slow down and become attuned to our surroundings, possibilities of transformation can emerge. In this interdisciplinary unfolding, the author first shares how walking allows us to experience time and space to accentuate our relations, engagements, and being in the world. Through narrative and photography, the author then reflects on encounters from recent walks through the city of Calgary, addressing notions of self-reflexivity, play and experience. Through these walking encounters, this paper reflects on considerations for embodying a curriculum to promote a modern ecological ethic. [ABSTRACT FROM AUTHOR]

Galvanised by the increasing complexity in managing incidents of mass violence and mass casualty, the emergency response agencies in Calgary, Canada identified the need to develop research-based policies, establish common strategies/ tactics and conduct more joint training across all hazards. By identifying the challenges with initial command, coordination and control activities at scene, the Calgary first-responder community designed and implemented an integrated training programme to support interoperability between front-line incident commanders and supervisors. The training programme was created to address the differences in each respective agency's policies, procedures and cultures that can be barriers to integrating into a single incident management structure or unified command. Using features of interoperability like shared situational awareness and joint risk assessment, and applying the concepts into tactics like rescue taskforce, the training is building critical command relationships for the future. This training has further expanded into a programme with joint policy and procedure development, incident debriefings, expanded exercises, and tactic specific training. This paper describes how the members of Calgary's firstresponder community are stepping beyond their silos of excellence and unifying their planning, preparedness and response programme. [ABSTRACT FROM AUTHOR]

• A Hydro-environmental model developed to model fate and transport of bacteria. • Inverness stormwater pond in Calgary, Alberta, Canada, was used to test the model. • Volume of Fluid and sediment transport models improved the simulation of bacteria. • The middle of the pond was found as the optimal location for withdrawal for reuse. • Tree barriers are shown to reduce transport of bacteria toward the optimal location. This paper presents a three-dimensional CFD based hydro-environmental model that simulates fate and transport of bacteria in water bodies. The model numerically solves unsteady incompressible Reynolds-Averaged Navier-Stokes equations on a structured grid. Free-floating and particle-attached bacteria were modelled separately regarding both fate and transport. Therefore, a sediment transport model was integrated into the main model in order to model particle-attached bacteria transport. In addition, Volume of Fluid approach was implemented to capture the water surface movements. Wind effect was also considered in the modelling using shear stress on the water surface. Since stormwater reuse is the source of some public health concerns, a stormwater pond was chosen as the test case for the model. The model was applied to simulate the distribution of bacterial indicator organisms in the Inverness Stormwater Pond in Calgary, Alberta, which is a large T-shaped pond with several inlets and outlets. The bacteria distribution in the pond was simulated for three rain events that occurred in the area. In six locations of the pond the modelled bacteria distribution was compared to collected data using non-dimensional bacteria concentrations. The comparison showed good agreement and indicated that the middle of the pond, close to the surface had the lowest levels of bacteria and thus, was considered the optimal location for withdrawal for reusing pond water. Furthermore, planting a tree barrier on the north bank of the West wing of the pond was shown to mitigate bacteria transport away from the inlets into the pond body and substantially decrease the risk of contamination at the optimal water withdrawal location. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Counselling & Psychotherapy / Revue Canadienne de Counseling et de Psychothérapie is the property of Canadian Counselling & Psychotherapy Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The population of older adults in Canadian society is aging and becoming more ethnically diverse. Some scholars have explored the lived experiences of older immigrants in Western societies; however, studies on widowhood experiences among older immigrants are extremely limited. By adopting an intersectionality framework, this study seeks to address this gap by examining the influences of age, gender, immigrant status, and ethnicity on the lived experience of widowed older Chinese immigrants in Calgary, Canada. Data were collected from twelve in-depth qualitative interviews and thematically analyzed. Older Chinese immigrants' widowhood experiences were located within intersections of multiple identities. Findings suggest that an intersectionality perspective could be used to better inform the development of social work practice and policy-making for older immigrants. [ABSTRACT FROM AUTHOR]

Background: In 2021, Canada implemented a pilot plasma program allowing some sexually active men who have sex with men (including but not limited to gay and bisexual men; gbMSM) to donate plasma. Changes to plasma donation policy could help address inequities in access to plasma donation and increase Canada's domestically collected plasma supply if more gbMSM donate as a result. We aimed to (1) examine views regarding plasma donation and the pilot program prior to implementation and (2) identify modifiable theory‐informed predictors of gbMSM's intention to donate plasma. Methods: We developed, piloted, and disseminated a questionnaire informed by the Theoretical Domains Framework (TDF). We recruited gbMSM in London (ON) and Calgary (AB) to an anonymous, online cross‐sectional survey. Results: A total of 246 gbMSM completed the survey. On scales from 1 (strongly disagree) to 5 (strongly agree), general intention to donate was high (mean = 4.24; SD = 0.94). The pilot program itself was mostly acceptable (mean = 3.71, SD = 1.16), but the intention to donate under the unique requirements of the pilot program was lower than general intention (mean = 3.58; SD = 1.26). Two domains from the theoretical domains framework (TDF) (beliefs about consequences of donating plasma and social influences) were independently associated with general intention to donate. Discussion: The pilot plasma program as an incremental step toward more inclusive policies was mostly viewed as acceptable by the impacted communities. Historical and ongoing exclusions create unique barriers to donation. There are clear opportunities for developing theory‐informed interventions to support gbMSM to donate plasma as policies continue to become more inclusive and more become eligible to donate. [ABSTRACT FROM AUTHOR]

Background: Physical Literacy (PL) is a synthesis construct that ties together movement competencies with affective, motivational, and knowledge-based elements. It is considered foundational to the development of physical activity-related outcomes. Many diverse organizations and programs have embraced the concept and are implementing programs targeting each of those core elements. However, research has lagged behind its interest and adoption. Among the more prominent gaps is the design and evaluation of programs that aim to increase PL within special populations such as new immigrants or refugee youth. Methods: The Immigrant-focused Physical Literacy for Youth (IPLAY) program is a co-developed evidence-informed 8-week PL program designed for new immigrant and refugee youths who have recently settled in Calgary, Alberta, Canada. This study aims to use a convergent parallel mixed-methods approach to collect, analyse, and interpret quantitative and qualitative data in the evaluation and iteration of the IPLAY program. Discussion: PL programs can be used as a tool to build confidence and physical competencies among newcomer youth. Furthermore, academic-community collaborations in the design and delivery of PL programs can help improve the access and interest for PL programs among newcomer youth. These partnerships are critical and timely considering the recent and upcoming waves of immigration to "arrival cities" across Canada. [ABSTRACT FROM AUTHOR]

Background: Recurrence and metastases are still frequent outcomes after initial tumour control in women diagnosed with breast cancer. Although therapies are selected based on tumour characteristics measured at baseline, prognostic biomarkers can identify those at risk of poor outcomes. Circulating progastrin or hPG80 was found to be associated with survival outcomes in renal and hepatocellular carcinomas and was a plausible prognostic biomarker for breast cancer. Methods: Women with incident breast cancers from Calgary, Alberta, Canada enrolled in the Breast to Bone (B2B) study between 2010 to 2016 and provided blood samples prior to any treatment initiation. Plasma from these baseline samples were analysed for circulating progastrin or hPG80. Participant characteristics as well as tumour ones were evaluated for their association with hPG80 and survival outcomes (time to recurrence, recurrence – free survival, breast cancer specific survival and overall survival) in Cox proportional hazards regression models. Results: The 464 participants with measurable hPG80 in this study had an average age of 57.03 years (standard deviation of 11.17 years) and were predominantly diagnosed with Stage I (52.2%) and Stage II (40.1%) disease. A total of 50 recurrences and 50 deaths were recorded as of June 2022. In Cox PH regression models adjusted for chemotherapy, radiation therapy, cancer stage and age at diagnosis, log hPG80 (pmol/L) significantly increased the risks for recurrence (Hazard Ratio (HR) = 1.330, 95% Confidence Interval (CI) = (0.995 – 1.777, p = 0.054)), recurrence-free survival (HR = 1.399, 95% CI = (1.106 – 1.770), p = 0.005) and overall survival (HR = 1.385, 95% CI = (1.046 – 1.834), = 0.023) but not for breast cancer specific survival (HR = 1.015, 95% CI = (0.684 – 1.505), p = 0.942). Conclusions: hPG80 levels measured at diagnosis were significantly associated with the risk of recurrence or death from any cause in women with breast cancer. Since the recurrence rates of breast cancer are still relatively high amongst women diagnosed at an early stage, identifying women at high risk of recurrence at their time of diagnosis is important. hPG80 is a promising new prognostic biomarker that could improve the identification of women at higher risk of poor outcomes. [ABSTRACT FROM AUTHOR]

Background: Risk factors for nosocomial COVID-19 outbreaks continue to evolve. The aim of this study was to investigate a multi-ward nosocomial outbreak of COVID-19 between 1st September and 15th November 2020, occurring in a setting without vaccination for any healthcare workers or patients. Methods: Outbreak report and retrospective, matched case–control study using incidence density sampling in three cardiac wards in an 1100-bed tertiary teaching hospital in Calgary, Alberta, Canada. Patients were confirmed/probable COVID-19 cases and contemporaneous control patients without COVID-19. COVID-19 outbreak definitions were based on Public Health guidelines. Clinical and environmental specimens were tested by RT-PCR and as applicable quantitative viral cultures and whole genome sequencing were conducted. Controls were inpatients on the cardiac wards during the study period confirmed to be without COVID-19, matched to outbreak cases by time of symptom onset dates, age within ± 15 years and were admitted in hospital for at least 2 days. Demographics, Braden Score, baseline medications, laboratory measures, co-morbidities, and hospitalization characteristics were collected on cases and controls. Univariate and multivariate conditional logistical regression was used to identify independent risk factors for nosocomial COVID-19. Results: The outbreak involved 42 healthcare workers and 39 patients. The strongest independent risk factor for nosocomial COVID-19 (IRR 3.21, 95% CI 1.47–7.02) was exposure in a multi-bedded room. Of 45 strains successfully sequenced, 44 (97.8%) were B.1.128 and differed from the most common circulating community lineages. SARS-CoV-2 positive cultures were detected in 56.7% (34/60) of clinical and environmental specimens. The multidisciplinary outbreak team observed eleven contributing events to transmission during the outbreak. Conclusions: Transmission routes of SARS-CoV-2 in hospital outbreaks are complex; however multi-bedded rooms play a significant role in the transmission of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Background: Measurement of care quality and safety mainly relies on abstracted administrative data. However, it is well studied that administrative data-based adverse event (AE) detection methods are suboptimal due to lack of clinical information. Electronic medical records (EMR) have been widely implemented and contain detailed and comprehensive information regarding all aspects of patient care, offering a valuable complement to administrative data. Harnessing the rich clinical data in EMRs offers a unique opportunity to improve detection, identify possible risk factors of AE and enhance surveillance. However, the methodological tools for detection of AEs within EMR need to be developed and validated. The objectives of this study are to develop EMR-based AE algorithms from hospital EMR data and assess AE algorithm's validity in Canadian EMR data. Methods: Patient EMR structured and text data from acute care hospitals in Calgary, Alberta, Canada will be linked with discharge abstract data (DAD) between 2010 and 2020 (n~1.5 million). AE algorithms development. First, a comprehensive list of AEs will be generated through a systematic literature review and expert recommendations. Second, these AEs will be mapped to EMR free texts using Natural Language Processing (NLP) technologies. Finally, an expert panel will assess the clinical relevance of the developed NLP algorithms. AE algorithms validation: We will test the newly developed AE algorithms on 10,000 randomly selected EMRs between 2010 to 2020 from Calgary, Alberta. Trained reviewers will review the selected 10,000 EMR charts to identify AEs that had occurred during hospitalization. Performance indicators (e.g., sensitivity, specificity, positive predictive value, negative predictive value, F1 score, etc.) of the developed AE algorithms will be assessed using chart review data as the reference standard. Discussion: The results of this project can be widely implemented in EMR based healthcare system to accurately and timely detect in-hospital AEs. [ABSTRACT FROM AUTHOR]

In order to provide meaningful and effective support to refugees in Canada during the COVID-19 pandemic, as well as during post-pandemic recovery efforts, it is critical to explore the experiences of refugee mothers and families during the pandemic, and to identify sources of resilience that can be leveraged to promote individual and household wellbeing. From November 2020 to June 2021, we conducted in-depth interviews with mothers from refugee backgrounds (n = 28) who resettled in Calgary, Alberta and are currently participating in the Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY) program. Interviews were conducted virtually using Microsoft Teams; we sought to better understand the pathways and barriers to wellbeing experienced by refugee mothers during the pandemic. The results indicate that the refugee mothers and families in our study experienced widespread disruptions to education and employment and increased motherhood burden, contributing to diminished wellbeing. Mental health was further impacted by heightened levels of worry, stress and social isolation, as well as intense fear pertaining to the spread of SARS-CoV-2. Some mothers reported experiencing barriers to accessing healthcare services and reliable health information during the pandemic. In the face of these challenges, the mothers demonstrated great resilience and identified tangible individual, household and extra-household factors and resources that supported them in coping with the impact of the COVID-19 pandemic. Additionally, our findings suggest that participation in HIPPY played a significant role in fostering the resilience of the participating mothers and families during the pandemic, speaking to the potential of home visiting intervention models in mitigating household hardship during current and future public health crises. [ABSTRACT FROM AUTHOR]

This article presents the development of a Geographical Information Systems (GIS) workflow that harvests high‐volume and high‐frequency near real‐time data from a public General Transit Feed Specification (GTFS) and calculates metrics for the assessment of on‐time and route speed performance for a public transit system. The approach is applied to near real‐time and static GTFS data collected over a 9‐month period for the City of Calgary, Alberta, Canada. The workflow uses two Azure Virtual Machines (VMs), one to harvest the data and the other to process observations in parallel using Python and the ArcGIS API libraries. A Web GIS application is described that queries data from MongoDB to visualize the performance results in spatiotemporal form. The purpose of the workflow and Web GIS application is to provide actionable information to transit planners to improve public transportation systems. The data management and analysis workflow is transferable to similar GTFS data from other cities. [ABSTRACT FROM AUTHOR]

Simple Summary: In this article, we report on action research in the Canadian province of Alberta, based on forging alliances with officers who enforce federal, provincial, and municipal legislation involving animals. Some of these officers worked in rural areas, and others worked in urban areas. Some mainly enforced Alberta's Animal Protection Act, while a few specialized in enforcing Canada's Criminal Code. For the most part, however, participating officers had a mandate to enforce animal-related local bylaws. Such ordinances or rulebooks exist because Alberta's Municipal Government Act allows local councils to enact legislation regarding domestic and wild animals, particularly as regards people's health, property, safety, and welfare. Many professionals refer to policies such as these, which are deeply rooted in the western legal tradition, such as "animal control." Our findings illuminate how animal-control policies and personnel can help to protect domesticated animals, not just people. Even so, our research highlights that animal-control policies as well as animal-protection policies routinely fail to protect officers who enforce legislation involving animals. Furthermore, whenever officers who enforce legislation involving animals work in unsafe conditions, this endangers human as well as non-human lives. Across Canada and internationally, laws exist to protect animals and to stop them from becoming public nuisances and threats. The work of officers who enforce local bylaws protects both domestic animals and humans. Despite the importance of this work, research in this area is emergent, but growing. We conducted research with officers mandated to enforce legislation involving animals, with a focus on local bylaw enforcement in the province of Alberta, Canada, which includes the city of Calgary. Some experts regard Calgary as a "model city" for inter-agency collaboration. Based on partnerships with front-line officers, managers, and professional associations in a qualitative multiple-case study, this action-research project evolved towards advocacy for occupational health and safety. Participating officers spoke about the societal benefits of their work with pride, and they presented multiple examples to illustrate how local bylaw enforcement contributes to public safety and community wellbeing. Alarmingly, however, these officers consistently reported resource inadequacies, communication and information gaps, and a culture of normalized disrespect. These findings connect to the concept of "medico-legal borderlands," which became central to this study. As this project unfolded, we seized upon opportunities to improve the officers' working conditions, including the potential of relational coordination to promote the best practices. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Disability Studies is the property of Canadian Disability Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: We studied the impact of fine particulate matter (PM2.5) exposure due to a remote wildfire event in the Pacific Northwest on daily outpatient respiratory and cardiovascular physician visits during wildfire (24-31 August, 2015) and post-wildfire period (1-30 September, 2015) relative to the pre-wildfire period (1-23 August, 2015) in the city of Calgary, Canada.Methods: A quasi-Poisson regression model was used for modelling daily counts of physician visits due to PM2.5 while adjusting for day of the week (weekday versus weekend or public holiday), wildfire exposure period (before, during, after), methane, relative humidity, and wind direction. A subgroup analysis of those with pre-existing diabetes or hypertension was performed.Results: An elevated risk of respiratory disease morbidity of 33% (relative risk: RR) [95% confidence interval (CI): 10%-59%] and 55% (95% CI: 42%-69%) was observed per 10µg/m3 increase in PM2.5 level during and after wildfire, respectively, relative to the pre-wildfire time period. Increased risk was observed for children aged 0-9 years during (RR = 1.57, 95% CI: 1.21-2.02) and after the wildfire (RR = 2.11, 95% CI: 1.86-2.40) especially for asthma, acute bronchitis and acute respiratory infection. The risk of physician visits among seniors increased by 11% (95% CI: 3%-21%), and 19% (95% CI: 7%-33%) post-wildfire for congestive heart failure and ischaemic heart disease, respectively. Individuals with pre-existing diabetes had an increased risk of both respiratory and cardiovascular morbidity in the post-wildfire period (RR = 1.35, 95% CI: 1.09-1.67; RR = 1.22, 95% CI: 1.01-1.46, respectively).Conclusions: Wildfire-related PM2.5 exposure led to increased respiratory condition-related outpatient physician visits during and after wildfires, particularly for children. An increased risk of physician visits for congestive heart failure and ischaemic heart disease among seniors in the post-wildfire period was also observed. [ABSTRACT FROM AUTHOR]

Diatom cultures can help answer taxonomic, biogeographic and ecological questions on a local and global scale. Unialgal cultures are derived from a single cell and provide abundant material for morphological and molecular analyses. The link between the historic morphological species concept and molecular data is becoming increasingly important with the use of eDNA metabarcoding. Additionally, cultures provide insights into the life cycle of diatoms and thereby complement taxonomy and species ecology. In this study, we present an approach to extract benthic diatoms from an environmental sample to generate unialgal cultures. We explored diatom diversity in preserved assemblages and by culturing as many different taxa as possible from benthic freshwater samples taken on the same day from the Bow River in Calgary, Canada. With both methods we found a total of 221 different benthic diatom taxa, of which 182 were identified in the preserved diatom assemblages. Interestingly, an additional 39 taxa only appeared in the cultures. In total 129 strains were cultivated, representing 71 different taxa. This study includes pictures of living cells demonstrating the additional merits of unialgal cultures, as they provide information on plastid details, auxospores and endosymbionts. Both, the identification of the diatom assemblages and the generation and identification of strains provide the foundation for additional water quality assessment tools, taxonomic insights, and molecular references libraries. [ABSTRACT FROM AUTHOR]

Background: Family physicians and other members of the primary health care (PHC) team may be ideally positioned to provide transition care to adolescents and young adults (AYAs; aged 12-25 years) exiting pediatric specialty services. Potential solutions to well-known challenges associated with integrating PHC and specialty care need to be explored.Objective: To identify strategies to transition care by PHC professionals for AYAs with chronic conditions transitioning from pediatric to adult-oriented care.Methods: Participants were recruited from six Primary Care Networks in Calgary, Alberta. A total of 18 semi-structured individual interviews were completed, and transcribed verbatim. Data were analyzed using a qualitative description approach, involving thematic analysis.Results: Participants offered a range of strategies for supporting AYAs with chronic conditions. Our analysis resulted in three overarching themes: (i) educating AYAs, families, and providers about the critical role of primary care; (ii) adapting existing primary care supports for AYAs and (iii) designing new tools or primary care practices for transition care.Conclusions: Ongoing and continuous primary care is important for AYAs involved with specialty pediatric services. Participants highlighted a need to educate AYAs, families and providers about the critical role of PHC. Solutions to improve collaboration between PHC and pediatric specialist providers would benefit from additional perspectives from providers, AYAs and families. These findings will inform the development of a primary care-based intervention to improve transitional care. [ABSTRACT FROM AUTHOR]

Background: Long term care (LTC) facilities provide health services and assist residents with daily care. At times residents may require transfer to emergency departments (ED), depending on the severity of their change in health status, their goals of care, and the ability of the facility to care for medically unstable residents. However, many transfers from LTC to ED are unnecessary, and expose residents to discontinuity in care and iatrogenic harms. This knowledge translation project aims to implement a standardized LTC-ED care and referral pathway for LTC facilities seeking transfer to ED, which optimizes the use of resources both within the LTC facility and surrounding community.Methods/design: We will use a quasi-experimental randomized stepped-wedge design in the implementation and evaluation of the pathway within the Calgary zone of Alberta Health Services (AHS), Canada. Specifically, the intervention will be implemented in 38 LTC facilities. The intervention will involve a standardized LTC-ED care and referral pathway, along with targeted INTERACT® tools. The implementation strategies will be adapted to the local context of each facility and to address potential implementation barriers identified through a staff completed barriers assessment tool. The evaluation will use a mixed-methods approach. The primary outcome will be any change in the rate of transfers to ED from LTC facilities adjusted by resident-days. Secondary outcomes will include a post-implementation qualitative assessment of the pathway. Comparative cost-analysis will be undertaken from the perspective of publicly funded health care.Discussion: This study will integrate current resources in the LTC-ED pathway in a manner that will better coordinate and optimize the care for LTC residents experiencing an acute change in health status. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy are major causes of maternal mortality and morbidity, and postpartum hypertensive complications have significant implications on maternal health and public health care system. Antepartum community care programs for hypertension are in place at major centers of Canada, however, such a program for postpartum are usually lacking, and could be a cost-effective solution to reduce postpartum hypertensive complications.Objectives: To assess the proportion of women who present to the emergency department (ED) or outpatient clinics for postpartum hypertensive (PPHTN) complications up to 6 weeks postpartum, among pregnancies complicated by antenatal hypertensive disorders in Calgary, Canada. Secondary objectives were to identify risk factors for PPHTN complications, and to perform a cost-benefit analysis to support postpartum community care program (PCCP) as a way to decrease ED and clinic visits for PPHTN complications, and thus has a favorable economic impact on the public health care system.Study design: Retrospective cohort study using administrative databases, followed by chart review of ED visits to confirm diagnoses and estimate cost of visits and admissions. The participants were women followed by the Calgary Antenatal Community Care Program (ACCP) for hypertensive disorders, from 2014 to 2015, inclusive. The primary outcome was ED or clinic visit associated with an outpatient database record of hypertensive disorder diagnosis, within 42 days postpartum.Results: Among 319 deliveries included in the study, 30 women (9.4, 95%CI: 6.2-12.6%) visited ED or clinics for PPHTN. We identified multiple antihypertensive medication uses and abnormal postpartum gestational hypertension labs as risk factors for ED visit among these women. We estimate a CAD$152 per antenatal hypertensive patient cost benefit for PCCP.Conclusion: The proposed PCCP appears to have an economic benefit to health care system with a decrease in ED and clinic visits. Further studies with greater sample size could strengthen the findings in this study. [ABSTRACT FROM AUTHOR]

Background: Delirium is very common in critically ill patients admitted to the intensive care unit (ICU) and results in negative long-term outcomes. Family members are also at risk of long-term complications, including depression and anxiety. Family members are frequently at the bedside and want to be engaged; they know the patient best and may notice subtle changes prior to the care team. By engaging family members in delirium care, we may be able to improve both patient and family outcomes by identifying delirium sooner and capacitating family members in care.Methods: The primary aim of this study is to determine the effect of family-administered delirium prevention, detection, and management in critically ill patients on family member symptoms of depression and anxiety, compared to usual care. One-hundred and ninety-eight patient-family dyads will be recruited from four medical-surgical ICUs in Calgary, Canada. Dyads will be randomized 1:1 to the intervention or control group. The intervention consists of family-partnered delirium prevention, detection, and management, while the control group will receive usual care. Delirium, depression, and anxiety will be measured using validated tools, and participants will be followed for 1- and 3-months post-ICU discharge. All analyses will be intention-to-treat and adjusted for pre-identified covariates. Ethical approval has been granted by the University of Calgary Conjoint Health Research Ethics Board (REB19-1000) and the trial registered. The protocol adheres to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist.Discussion: Critically ill patients are frequently unable to participate in their own care, and partnering with their family members is particularly important for improving experiences and outcomes of care for both patients and families.Trial Registration: Registered September 23, 2019 on Clinicaltrials.gov NCT04099472. [ABSTRACT FROM AUTHOR]

Background: Endoscopic retrograde cholangio-pancreatography (ERCP) is commonly performed in the management of pancreatic and biliary disease. Duodenoscopes are specialized endoscopes used to perform ERCP, and inherent to their design, a high rate of persistent bacterial contamination exists even after automated reprocessing and disinfection. Consequently, in recent years, ERCP has been associated with infection transmission, leading to several fatal patient outbreaks. Due to increasing fears over widespread future duodenoscope-related outbreaks, regulatory bodies have called for alterations in the design of duodenoscopes. A duodenoscope has recently been developed that employs a disposable cap. This novel design theoretically eliminates the mechanism behind persistent bacterial contamination and infection transmission. However, there are no data demonstrating persistent bacterial contamination rates, technical success rates, or clinical outcomes associated with these duodenoscopes.Methods: A parallel arm randomized controlled trial will be performed for which 520 patients will be recruited. The study population will consist of consecutive patients undergoing ERCP procedures for any indication at a high-volume tertiary care centre in Calgary, Alberta, Canada. Patients will be randomized to an intervention group, that will undergo ERCP with a novel duodenoscope with disposable cap, or to a control group who will undergo ERCP with a traditional duodenoscope. Co-primary outcomes will include persistent bacterial contamination rates (post automated reprocessing) and ERCP technical success rates. Secondary outcomes include clinical success rates, overall and specific early and late adverse event rates, 30-day mortality and healthcare utilization rates, procedure and reprocessing times, and ease of device use.Discussion: The ICECAP trial will answer important questions regarding the use of a novel duodenoscope with disposable cap. Specifically, persistent bacterial contamination, technical performance, and relevant clinical outcomes will be assessed. Given the mortality and morbidity burden associated with ERCP-related infectious outbreaks, the results of this study have the capacity to be impactful at an international level.Trial Registration: This trial was registered on clinicaltrials.gov (NCT04040504) on July 31, 2019. [ABSTRACT FROM AUTHOR]

Since the 1990s, homelessness has increased in Canada, but the strategies of the government and public health service providers to manage the situation have had limited success. Researchers have also noted the lack of inclusion of those experiencing homelessness in homelessness research to better understand and develop a solution to the issue. In the present study, this is addressed through inclusion of homeless participants from diverse backgrounds. The purpose of this phenomenological study, framed by social cognitive theory, reciprocal determinism, and symbolic interaction, was to understand homelessness from the perspectives of people who do not have homes. Data were collected from open-ended interviews with a purposeful sample of 15 individuals who were homeless. Several themes emerged after interview data were transcribed via hand coding and analyzed using cognitive data analysis. The prominent themes were lack of money, home, privacy, and support; discrimination directed primarily toward First Nations people and those of African descent; mental illness and addiction; the need for a review of housing policy that addresses rent, mortgage qualification criteria, and house tax; and the creation of awareness of government support systems and the services that they provide. Public health service providers and designated authorities can use the findings of this study to understand the phenomenon from the perspective of people who are experiencing homelessness, which can influence the development of better homelessness reduction strategies that could improve the lives of those experiencing homelessness and their communities. Because homelessness is a public health issue, bringing it under control could positively impact the health and safety of the public. [ABSTRACT FROM AUTHOR]

Background Of hospitalized patients in Canada, 7.5% experience an adverse event (ae). Physicians whose patients experience aes often become second victims of the incident. The present study is the first to evaluate how physicians in Canada cope with aes occurring in their patients. Methods: Survey participants included oncologists, surgeons, and trainees at the Foothills Medical Centre, Calgary, AB. The surveys were administered through REDCap (Research Electronic Data Capture, version 9.0: REDCap Consortium, Vanderbilt University, Nashville, TN, U.S.A.). The Brief cope (Coping Orientation to Problems Experienced) Inventory, the ies-r (Impact of Event Scale-Revised), the Causal Dimension Scale, and the Institutional Punitive Response scale were used to evaluate coping strategies, prevalence of post-traumatic stress, and institutional culture with respect to aes. Results: Of 51 responses used for the analysis, 30 (58.8%) came from surgeons and 21 (41.2%) came from medical specialists. On the ies-r, 54.9% of respondents scored 24 or higher, which has been correlated with clinically concerning post-traumatic stress. Individuals with a score of 24 or higher were more likely to report self-blame (p = 0.00026) and venting (p = 0.042). Physicians who perceive institutional support to be poor reported significant post-traumatic stress (p = 0.023). On multivariable logistic regression modelling, self-blame was associated with an ies-r score of 24 or higher (p = 0.0031). No significant differences in ies-r scores of 24 or higher were observed between surgeons and non-surgeons (p = 0.15). The implications of aes for physicians, patients, and the health care system are enormous. More than 50% of our respondents showed emotional pathology related to an ae. Higher levels of self-blame, venting, and perception of inadequate institutional support were factors predicting increased post-traumatic stress after a patient ae. Conclusions: Our study identifies a desperate need to establish effective institutional supports to help health care professionals recognize and deal with the emotional toll resulting from aes. [ABSTRACT FROM AUTHOR]

In June 2013, a severe flooding of the Bow and Elbow Rivers affected southern Alberta, a province in Canada. The flood was subsequently described to be the costliest natural disaster in Canadian history. Among the hardest hit communities was the Siksika First Nation, located on the Bow River banks about 100 kilometers east of the city of Calgary. A community-university partnership was formed to qualitatively document the Siksika First Nation community-based response to the health and social impacts to their community resulting from the flood. Our findings informed the development of a culturally appropriate framework for disaster and emergency planning in First Nations communities. The Siksika Nation's work to mitigate the impacts from the flood followed a holistic and socio-ecological approach that took the determinants of Indigenous peoples' health into consideration. [ABSTRACT FROM AUTHOR]

Objectives: Children's dental caries is an important and urgent public health concern that is largely preventable. Using a social equity framework, our objectives were to identify and critically examine government legislation relevant to the issue of children's dental health in Calgary, Alberta, Canada.Methods: We conducted a systematic, gray literature search of federal, provincial (Alberta), and municipal (Calgary) statutes and bylaws related to children's dental caries, through the relevant law databases. Eligibility criteria were applied for document screening and selection. Data extraction and synthesis pertained to objectives of the legislation (policy task), relevant agent or actor (level of government), and upstream or downstream focus, in terms of potential impact on social inequities in health.Results: Legislation (n = 114) was retrieved and grouped into eight policy tasks. Most legislation fit under the policy tasks: protection of public safety and health promotion (n = 40) and benefits and compensation (n = 27). Federal and provincial governments have greater involvement in children's dental caries than municipal (Calgary) government. The majority of legislation was classified as upstream in orientation (e.g., improving living and working conditions; macro-level policies).Conclusions: Analysis of legislation relevant to children's dental caries reveals policies that are more often upstream in nature, and unsurprisingly are multijurisdictional. Despite this, there remains a high prevalence and inequitable distribution of children's dental caries in Canada. This suggests that the nature of upstream involvement and fragmented government involvement is ineffective in tackling this pervasive and urgent public health issue. Implications for children's dental health are discussed. [ABSTRACT FROM AUTHOR]

In 1916, Canadians were swept up in the rhetoric of a purifying Holy War. The citizen soldier became the embodiment of Christ in the ultimate fight against evil. As the mirror for the nation, he reflected the moral character and aspirations of purity. The behaviour of soldiers stationed in Calgary were publically scrutinised, especially as to their use of alcohol. The evils of alcohol galvanised various groups to move towards Prohibition as the ultimate war measure. This directly affected military recruitment efforts and served to alienate the soldier and the reality of his experiences from the home front. [ABSTRACT FROM AUTHOR]

BACKGROUND Ambient air pollutant exposures have been associated with a wide variety of cardiovascular events; however, few studies have evaluated their impact upon acute emergency department (ED) visits for hypertension. METHODS The purpose of this study was to examine the associations between ED visits for hypertension and ambient air pollution concentrations among 6,532 patients during the period of January 2010 to December 2011 in Edmonton and Calgary, Alberta, Canada. The associations were evaluated using a case-crossover design. RESULTS Odds ratios and their 95% confidence interval have been calculated for 1 unit increase in their interquartile range for lags (the time between air pollutant measurement and exposure-response) 0-8 days. During the cold season, statistically significant positive results were observed for SO2 among lag days 4-6 and 8 for females and lag days 5 and 6 for males. Moreover, statistically significant positive results were observed for NO2 on lag day 7 for females and for PM2.5 on lag days 5 and 7, for females and lag day 6 for males. During the warm season, statistically significant positive results were observed for O3 on lag days 3 and 4 and for SO2 on lag days 2 and 8 for females. CONCLUSIONS These findings support the hypothesis that recent exposures to ambient levels of several air pollutants can be capable of elevating blood pressure to a clinically significant extent such that it leads to ED visits for hypertension. [ABSTRACT FROM AUTHOR]

Aim The ileocaecal junction ( ICJ) region is an epithelial transition zone in which carcinomas are frequently diagnosed. However, it is currently unknown whether ICJ carcinomas ( ICJ- CAs) have distinctive features. This study aimed to characterize the clinicopathological features of ICJ- CAs. Method All ileal and colorectal resections for carcinoma, performed in Calgary, Canada between January 2009 and June 2012, were reviewed. Carcinomas in which the epicentre was within 5 cm of the ileocaecal valve ( ICV) were defined as ICJ- CAs. Of 1003 carcinomas studied, 199 (19.8%) were ICJ- CAs, including 93 (9.3%) that crossed the ICV. Comparison of clinicopathological features with carcinomas of the other ileo-colorectal regions was made. Survival was also assessed. Results Clinically, ICJ-CAs were more common in female than male patients (56.3% female) compared with left-colonic (42.9% female) and rectal (37.9% female) carcinomas, and were more common in older age-groups of patients (71.8 ± 12.7 years) compared with appendiceal (62.6 ± 11.3 years), left-colonic (69.4 ± 12.3 years) and rectal (67.1 ± 11.9 years) carcinomas. Macroscopically, ICJ- CAs were similar to other colorectal carcinomas and were mostly described as ulcerated (63.3%). Histologically, ICJ- CAs had more mucinous, signet-ring cell and/or neuroendocrine features (39.7%, 8.0% and 7.5%, respectively) than did carcinomas of the left colon (16.8%, 1.6% and 1.1%, respectively) and the rectum (14.1%, 1.0% and 0.0%, respectively). They were higher grade (20.1% were high grade) than those of the left-colon (10.3%) and the rectum (9.8%). ICJ- CAs presented at a higher T-stage (25.6% were T4) compared with rectal carcinomas (11.6%). Most significantly, ICJ- CAs presented at a higher N-stage (25.6% were N2) than did right-colonic (14.1%) and rectal (16.2%) carcinomas. Although survival of patients with ICJ- CAs did not differ from those with right-colonic carcinomas, those with carcinomas directly involving the ICV did show a significantly decreased survival. Conclusion ICJ- CAs display several distinct clinicopathological features that may require special diagnostic, prognostic and management attention. [ABSTRACT FROM AUTHOR]