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Competency Based Medical Education (CBME) is pushing the medical profession to be more accountable in our standards of assessment. This has led us to focus our efforts at the top of Miller’s pyramid, where we aim to see what the trainee ‘does’ in the clinical environment. In Canadian Royal College specialty training, this has come in the form of workplace-based supervision of trainees performing Entrustable Professional Activities (EPAs). This is unfamiliar territory for many residents and faculty, and implementation of an additional assessment process into already busy clinical practice has been particularly challenging. Because EPA assessments serve as significant contributors in new programs of assessment, failure to collect high quality EPA assessments threaten the validity of this new system. Understanding the barriers to and enablers of EPA acquisition can inform faculty development initiatives to ensure success. Based on our previous work studying early experiences of EPA assessment acquisition in Emergency Medicine, we have identified eight key concepts to guide faculty development initiatives, namely: the rationale for CBME, the ‘behind the scenes’ of CBME, how to construct rich narrative comments, effective use of supervision scales, the tension of EPA assessments being both formative and summative, the importance of a shared responsibility between residents and faculty for EPA assessment completion, familiarity with the suite of EPAs, and tips and tricks for incorporating EPA assessment completion into busy clinical practice. These key concepts can be integrated into an overall faculty development strategy for building this now essential skill set.

Background: Cognitive integration occurs when trainees make conceptual connections between relevant knowledges and is known to improve learning. While several experimental studies have demonstrated how text and audio-visual instruction can be designed to enhance cognitive integration, clinical skills training in real-world contexts may require alternative educational strategies. Introducing three-dimensional (3D) printed models during clinical skills instruction may offer unique learning opportunities to support cognitive integration. Methods: Using case study methodology, we explore how learners and an instructor used 3D printed bones to augment their learning interactions during a clinical skills laboratory on shoulder on palpation, and to describe the instructional strategies with 3D printed bones that may support learning. Students (n = 21) worked in small groups and were given access to a 3D printed clavicle, scapula, and humerus. Data were collected through observation, a student focus group, and a semi-structured interview with the instructor. Thematic analysis to review and code the data and to generate themes. Results: We developed four themes that describe how 3D printed models were used in the classroom and how they may support cognitive integration: classroom interactivity, visualization of anatomy, integrating knowledge, and educational potential. Conclusions: The findings demonstrate several ways 3D printed models can augment how learners, instructors, and educational materials interact with one another and how readily learners make connections between different sources and types of knowledge. This research extends previous work by demonstrating how social learning processes and interactions with physical models can offer unique affordances that may support cognitive integration.

To cultivate a learning environment promoting meaningful engagement with research, Huron University College—a small, primarily undergraduate liberal arts institution—launched the Centre for Undergraduate Research Learning (CURL). One major initiative of CURL's pilot phase was to fund extracurricular research opportunities (Student Fellowships) for undergraduate students. These projects enable students to conduct independent research projects with the guidance of a faculty mentor. The current paper presents the findings from a case study of the first four CURL Student Research Fellowship award recipients and their faculty mentors, using the concept of transformative experience (Heddy and Pugh, 2015) as the lens to conduct a content analysis of participant interviews. Our findings show evidence of substantive dialogue and active collaboration between students and their faculty mentors, providing a safe space for students to experiment, explore and develop their research skills. The students articulated development of specific skills related to research process, connection between theory and practice, as well as personal intellectual and interpersonal gains, which are suggestive of a transformative experience in progress. Although this paper reports on a limited sample, the findings may provide insight into the potential transformative impact of mentored undergraduate research experiences in the liberal arts.

Arctic ecosystems are at risk to climate impacts, challenging existing conservation measures such as protected areas. This study aims to describe the ecological dynamics of the Canadian Beaufort Sea Shelf (BSS) ecosystem and the Tarium Niryutait Marine Protected Area (TNMPA) under historical changes in sea surface temperature and sea ice extent. Using Ecopath with Ecosim, we compared the status of the BSS between two time periods, 1970–1974 and 2008–2012, and against four ecosystem models (Eastern Chukchi Sea, Barents Sea, Eastern Bering Sea, Gulf of Alaska) to inform the relative long-term health and status of Arctic marine ecosystems. We find that relative to the comparable ecosystems, the BSS had a greater proportion of biomass from pelagic primary and secondary producers, and limited production from higher trophic levels. Estimates of trophic structure indices for the BSS indicate temporal ecosystem stability, and no loss in diversity. While beluga whales are a focus of the TNMPA management plan, they are not considered a key component of the modeled food web. Rather, Arctic and polar cods (main beluga prey group), arthropods, large copepods, micro-zooplankton, and herring and smelt, were identified as keystone species and warrant attention as proxies for both beluga whales and ecosystem health.

Urban trees contribute to decarbonisation. However, the removal of trees may release the stored carbon within them. In Hong Kong, Acacia confusa and Leucaena leucocephala are being removed, but with unknown carbon impacts. This industry-academia-government collaborative research aimed to: (1) report the amount of carbon stored inside Acacia confusa and Leucaena leucocephala harvested from slopes; (2) estimate the carbon storage of a tree using dendrometric measurements; and (3) explain the variation in carbon content percentage of urban trees with respect to tree species, part of the tree, and position within the part. 10 Acacia confusa and 10 Leucaena leucocephala were harvested during March–September, 2023. Each tree was weighed for carbon storage estimation. Results showed that Acacia confusa had higher mean wood volume, biomass and carbon storage than Leucaena leucocephala. The mean carbon content of the analysed samples (45.53−52.58%) were mostly significantly different from 50%. But the difference may become insignificant depending on how volatile carbon loss was controlled. Diameter at breast height (mm) was a significant predictor of carbon storage (kg) for both Acacia. confusa (β = 0.9574) and Leucaena leucocephala (β = 0.3909). Significant interaction between tree species and tree part on carbon content percentage was confirmed. This research demonstrated the impacts of past arboricultural decisions on present decarbonisation plans.

In 2019, the Canadian Nurses Association (CNA) published the Advanced Practice Nursing: A Pan-Canadian Framework, defining and highlighting the competencies of the clinical nurse specialist role (CNS). In response to the CNA publication, the CNS Community of Practice (CoP) at Princess Margaret Cancer Centre (PM) reviewed how the oncology CNS roles at PM aligned with the CNA competencies. The primary goal was to utilize the CNA (2019) document to guide the development of a PM CNS role-clarity document and new-hire CNS pathway to assist the onboarding process for new CNS hires at PM. The secondary goal was to raise awareness of the diverse CNS oncology roles at a local and national level through developing, implementing, and disseminating the PM CNS role-clarity document and new-hire CNS pathway. Keywords: Clinical Nurse Specialist, role-clarity, nursing practice guidelines, oncology

En 2019, l’Association des infirmières et infirmiers du Canada (AIIC) a publié le document Les soins infirmiers en pratique avancée : Un cadre pancanadien, qui définit et met en lumière les compétences de l’infirmière clinicienne spécialisée en oncologie (ICS). Dans la foulée de cette publication de l’AIIC, la communauté de pratique des ICS du Centre de cancérologie Princess Margaret (PM) a vérifié si le rôle des ICS en oncologie du Centre PM correspondait aux compétences formulées par l’AIIC. L’objectif principal était d’utiliser le document de l’AIIC (2019) pour clarifier le rôle des ICS du Centre PM et orienter les ICS nouvellement en poste. L’objectif secondaire était de faire connaître les différents rôles joués par les ICS en oncologie à l’échelle locale et nationale grâce à l’élaboration, la mise en œuvre et la distribution d’un document clarifiant le rôle des ICS du Centre PM et d’un guide d’orientation des ICS nouvellement embauchées. Mots-clés : infirmière clinicienne spécialisée, clarification du rôle, lignes directrices sur la pratique infirmière, oncologie

BackgroundThis 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility. MethodsWe recruited individuals aged 60 years and over, with a FRAIL scale score of 1 or higher and at least one chronic condition, who were not currently strength training. The program included 16 exercise physiologist-led hour-long group sessions and two dietitian-led hour-long nutrition sessions. We analyzed secondary outcomes—weight, gait speed, grip strength, physical capacity (fatigue levels), sit-to-stand functioning, dynamic balance, health-related quality of life (HRQoL), physical activity levels and protein intake—using a paired t test and a generalized estimating equation (GEE). ResultsOf 44 participants (mean [SD] age 79 [9.82] years), 35 were pre-frail and 9 were frail. At follow-up, participants had significantly improved grip strength (1.63 kg,95% CI: 0.62 to 2.63); sit-to-stand functioning (2 sit-to-stands, 95% CI: 1 to 3); and dynamic balance (1.68 s, 95% CI: 0.47 to 2.89). There were no significant improvements in gait speed, HRQoL index scores, self-rated health, physical activity levels (aerobic activity and strength training) or protein intake. GEE analysis revealed an interaction between exposure to MoveStrong and gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores. The total cost to administer the program and purchase equipment was CAD 14 700, equivalent to CAD 377 per participant. ConclusionExploratory analyses suggest MoveStrong exercises may improve gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores in older individuals who are frail and pre-frail.

IntroductionCet essai pilote randomisé par étapes de huit semaines a permis d’évaluer le programme MoveStrong, qui vise à enseigner aux adultes présentant une fragilité ou une préfragilité un entraînement à l’équilibre et à la force musculaire ainsi qu’un apport suffisant en protéines pour prévenir les chutes et améliorer la mobilité. MéthodologieNous avons recruté des personnes âgées de 60 ans ou plus, ayant un score de 1 ou plus sur l’échelle FRAIL et au moins une affection chronique et ne faisant pas d’entraînement musculaire. Le programme consistait en 16 séances de groupe d’une heure animées par un physiologiste de l’exercice et 2 séances de nutrition d’une heure animées par une diététiste. Nous avons analysé les résultats secondaires – poids, vitesse de marche, force de préhension, capacité physique (niveau de fatigue), transition assisdebout, équilibre dynamique, qualité de vie liée à la santé (QVLS), niveau d’activité physique et apport en protéines – à l’aide d’un test t d’échantillons appariés et d’une équation d’estimation généralisée (EEG). RésultatsSur les 44 participants (âge moyen [É.-T.] : 79 ans [9,82]), 35 étaient préfragiles et 9 étaient fragiles. Au moment du suivi, les participants avaient considérablement amélioré leur force de préhension (1,63 kg; IC à 95 % : 0,62 à 2,63), leur capacité à effectuer des transitions assis-debout (2 transitions assis-debout; IC à 95 % : 1 à 3) et leur équilibre dynamique (1,68 s; IC à 95 % : 0,47 à 2,89). Il n’y a pas eu d’amélioration statistiquement significative de la vitesse de marche, des scores QVLS, de l’autoévaluation de la santé, des niveaux d’activité physique (activité aérobique et entraînement musculaire) ou de l’apport en protéines. L’analyse par EEG a révélé une interaction entre l’exposition à MoveStrong et la vitesse de marche, la capacité à effectuer des transitions assisdebout, l’équilibre dynamique et les scores QVLS. Le coût total de mise en oeuvre du programme et de l’achat d’équipement s’est élevé à 14 700 $ CA, soit 377 $ CA par participant. ConclusionLes analyses exploratoires indiquent que les exercices MoveStrong améliorent la vitesse de marche, la capacité à effectuer des transitions assisdebout, l’équilibre dynamique et les scores QVLS chez les personnes âgées fragiles et préfragiles.

Introduction: In response to the COVID-19 pandemic, educators have increasingly shifted delivery of medical education to online/distance learning. Given the rapid and heterogeneous nature of adaptations; it is unclear what interventions have been developed, which strategies and technologies have been leveraged, or, more importantly, the rationales given for designs. Capturing the content and skills that were shifted to online, the type of platforms used for the adaptations, as well as the pedagogies, theories, or conceptual frameworks used to inform the adapted educational deliveries can bolster continued improvement and sustainability of distance/online education while preparing medical education for future large-scale disruptions. Methods: We conducted a scoping review to map the rapid medical educational interventions that have been adapted or transitioned to online between December 2019 and August 2020. We searched MEDLINE, EMBASE, Education Source, CINAHL, and Web of Science for articles pertaining to COVID-19, online (distance) learning, and education for medical students, residents, and staff. We included primary research articles and reports describing adaptations of previous educational content to online learning. Results: From an initial 980 articles, we identified 208 studies for full-text screening and 100 articles for data extraction. The majority of the reported scholarship came from Western Countries and was published in clinical science journals. Cognitive content was the main type of content adapted (over psychomotor, or affective). More than half of the articles used a video-conferencing software as the platform to pivot their educational intervention into virtual. Unfortunately, most of the reported work did not disclose their rationale for choosing a platform. Of those that did, the majority chose technological solutions based on availability within their institutions. Similarly, most of the articles did not report the use of any pedagogy, theory, or framework to inform the educational adaptations.

Background: Surveys are being increasingly used to gather feedback and study data in healthcare professions. However, it may be challenging to achieve high response rates in surveys administered to healthcare professionals. The aim of this paper is to report six strategies that contributed to a high response rate on the Independent Student Analysis at the University of Toronto (U of T), which can be applied to other surveys to achieve strong response rates amongst healthcare professionals. Methods: In 2019, as part of accreditation for the U of T MD Program, we conducted the Independent Student Analysis, a student-led survey examining a medical student’s experience. We review and critically evaluate the factors that contributed to a robust response rate amongst one of the largest cohorts of medical students in Canada. Results: Among 1080 students in the MD program, we achieved an unprecedented response rate of 87.2%. Six factors were identified that most contributed to our high response rate, including: faculty support, student representation, eliciting participant feedback, creating protected time for completion, offering incentives, and generating awareness. Conclusions: Eliciting high survey response rates from medical learners can be challenging. However, with careful consideration of learner feedback and effective employment of the strategies discussed in this paper, medical school faculty may better engage students in survey completion, achieving higher response rates and gathering richer insight, which can be used to more effectively enact meaningful change amongst healthcare professionals.

Luxury fashion brands heavily use celebrity endorsements for promotion. However, there are risks that a real-person celebrity may trigger controversial issues which may negatively affect the endorsed brand. Virtual influencers look very close to real people thanks to development of technology. Thus marketers have an opportunity to adopt virtual celebrities instead of real-person celebrities to avoid risks of scandals caused by human beings. It is of interest to find out whether virtual celebrities have similar influencing effect as realperson celebrities over customers’ purchase decision in the fashion industry? Will customers’ attitude and perceptions towards both types of celebrities the same? Will virtual celebrities replace real-person celebrities? As Gucci and LV adopt both real-person celebrities and virtual celebrities, we use video ads of Gucci and photo ads of LV for comparison. The results show that virtual celebrities may still lag behind real-person celebrities from the perspectives of a modified customer action model and characteristics of celebrities. However, the appearance of meta-human virtual celebrities and enhancing recognition of virtual celebrities may help improve the effectiveness of virtual celebrities.

Background: Competency based medical education (CBME) relies on supervisor narrative comments contained within entrustable professional activities (EPA) for programmatic assessment, but the quality of these supervisor comments is unassessed. There is validity evidence supporting the QuAL (Quality of Assessment for Learning) score for rating the usefulness of short narrative comments in direct observation. Objective: We sought to establish validity evidence for the QuAL score to rate the quality of supervisor narrative comments contained within an EPA by surveying the key end-users of EPA narrative comments: residents, academic advisors, and competence committee members. Methods: In 2020, the authors randomly selected 52 de-identified narrative comments from two emergency medicine EPA databases using purposeful sampling. Six collaborators (two residents, two academic advisors, and two competence committee members) were recruited from each of four EM Residency Programs (Saskatchewan, McMaster, Ottawa, and Calgary) to rate these comments with a utility score and the QuAL score. Correlation between utility and QuAL score were calculated using Pearson’s correlation coefficient. Sources of variance and reliability were calculated using a generalizability study. Results: All collaborators (n = 24) completed the full study. The QuAL score had a high positive correlation with the utility score amongst the residents (r = 0.80) and academic advisors (r = 0.75) and a moderately high correlation amongst competence committee members (r = 0.68). The generalizability study found that the major source of variance was the comment indicating the tool performs well across raters. Conclusion: The QuAL score may serve as an outcome measure for program evaluation of supervisors, and as a resource for faculty development.

In anticipation of the then forthcoming Tri-Agency Research Data Management Policy, a consortium of professionals from Canadian university libraries surveyed researchers on their research data management (RDM) practices, attitudes, and interest in data management services. Data collected from three surveys targeting researchers in science and engineering, humanities and social sciences, and health sciences and medicine were compiled to create a national dataset. The present study is the first large-scale survey investigating researcher RDM practices in Canada, and one of the few recent multi-institutional and multidisciplinary surveys on this topic. This article presents the results of the survey to assess researcher readiness to meet RDM policy requirements, namely the preparation of data management plans (DMPs) and data deposit in a digital repository. The survey results also highlight common trends across the country while revealing differences in practices and attitudes between disciplines. Based on our survey results, most researchers would have to change their RDM behaviors to meet Tri-Agency RDM policy requirements. The data we gathered provides insights that can help institutions prioritize service development and infrastructure that will meet researcher needs.

During the COVID-19 pandemic, the task of preparing students for workplace-based clerkship and supporting learners’ ongoing professional identity formation became incrementally more challenging. The former design of clerkship rotations was re-challenged and revolutionized going forward, as COVID-19 accelerated the development and implementation of e-Health and technology-enhanced learning (TEL). However, the practical integration of learning and teaching activities, and the application of well-thought-out first principles in pedagogy in higher education, remain difficult to implement in today’s pandemic era. In this paper, using the transition-to-clerkship (T2C) course as an example, we outline the steps taken to implement our clerkship rotation, discussing various curricular challenges from the lenses of various stakeholders, and practical lessons learned.

Les néoplasies myéloprolifératives (NMP) sont des leucémies chroniques rares sans chromosome Philadelphie. L’expertise de cette maladie peu commune est limitée et concentrée dans des centres spécialisés où les patients doivent se rendre pour obtenir confirmation du diagnostic, prendre des décisions complexes, recevoir des soins de soutien et accéder à de nouveaux médicaments par la participation à des essais cliniques. Toutefois, les nombreux déplacements nécessaires pour ces rendez-vous représentent un poids pour les patients; ils augmentent le fardeau financier, accroissent le stress des proches aidants et nuisent à la qualité de vie. Pour s’attaquer à ce problème, le programme du Centre de cancérologie Princess Margaret (PM) dédié aux NMP a mis en place un modèle de soins partagés et a misé sur la collaboration avec les équipes soignantes locales afin d’offrir aux patients atteints de NMP une prise en charge continue et des soins de soutien plus accessibles. Ainsi, les patients se déplacent moins et reçoivent des soins de qualité axés sur leurs besoins. Le présent article décrit l’expérience de mise en œuvre du modèle de soins partagés au Centre Princess Margaret, expérience qui pourrait s’étendre à d’autres hémopathies malignes chroniques et maladies chroniques rares. L’objectif ultime des soins partagés n’est pas de centraliser les services, mais plutôt de bâtir une communauté de soins accessibles pour le patient.

Myeloproliferative neoplasms (MPNs) are a group of rare Philadelphia-negative chronic leukemias. Disease rarity has resulted in limited expertise concentrated in specialist centres. Patients are often referred to such expert centres for diagnostic issues, complex decision-making, access to novel drugs through clinical trials, and supportive care. Attending such appointments may increase financial and travel burden, increase caregiver stress, and negatively impact quality of life. To address this, the MPN program at Princess Margaret (PM) Cancer Centre has implemented a shared-care model, working with local healthcare providers to provide ongoing management, and supportive care for MPN patients closer to home. This decreases patient travel burden, while maintaining high-quality patient-centered care. In this article we share our experience implementing the shared-care model. This model is potentially applicable to other chronic hematological malignancies and rare chronic diseases. The ultimate goal of shared-care is not to centralize care, but instead to build a community of accessible care for the patient.

In an era of international terrorism, interviews with high-value detainees may have the dual purpose of extracting useful information and of disengagement. We conducted a small-scale, qualitative study using in-depth, individual interviews with 11 experienced interviewers in the Southeast Asia region and Australia, in order to provide insights into the types of interviewing strategies employed in terrorist rehabilitation. Our findings highlight the potential efficacy of creating a physically comfortable and relaxed interview setting, and of using interview strategies that focus on rapport-building, principles of social persuasion and elements of procedural justice, along with a patient and flexible stance to questioning. We suggest that interviewers performing rehabilitation interviews with high-value detainees ought to be trained to use the social approach to interviewing.

SARS-CoV-2 has been recognized to be airborne transmissible. With the increased transmissibility leading to increasingly reported positive cases, home quarantine is adopted for the infected patients who are not seriously ill. However, the risk of household aerosol transmission is not well studied. We conducted tracer gas experiment to simulate the exhaled virus laden aerosols from a patient under home quarantine situation inside a residential testbed. The Sulphur hexafluoride concentration (SF6,conc) was measured both inside and outside the quarantine room under various scenarios including, (i) air-conditioning (AC) vs natural ventilation (NV), (ii) operation of ceiling fan, and (iii) operation of window exhaust fan. The ratio of outside-to-inside SF6,conc (O/ISF6) was an indicator for potential exposure of occupants in the same household. Our findings showed, without an exhaust fan, the in-room SF6,conc in AC settings was 4 times higher than in the NV scenarios. Meanwhile, we found the exhaust fan was effective in reducing the O/ISF6 in the AC scenarios (with or without ceiling fan), but its function was diminished in the NV setting with ceiling fan. We suspected the effectiveness of exhaust fan was reduced by air infiltration from other window openings in NV situation. Meanwhile, the operation of ceiling fan continuously pushing tracer gas outwards from the quarantine room through the door gap. Our results suggested that natural ventilation with windows open or switching on a window exhaust fan could reduce aerosol transmission risk from the quarantine room. This study provides useful evidence in recommending low risk ventilation strategies for home quarantine situations.

Les dix derniers millénaires d’occupation humaine paléolithique ont laissé d’abondants témoignages le long du versant nord-pyrénéen. Si les fluctuations climatiques et leurs conséquences environnementales ont pu conditionner l’exploitation de certains territoires en altitude, le piémont semble en revanche avoir constitué un vaste espace favorable à l’implantation humaine entre des reliefs et vallées progressivement libérées des glaces, l’ouverture de la plaine aquitaine, les littoraux atlantiques et méditerranéens. À partir de travaux récemment aboutis ou en cours, et d’ensembles de sites clés révisés, nous proposons une synthèse sur les principales évolutions des équipements lithiques et osseux et sur des comportements originaux (économie littorale, consommation des petits gibiers) entre 21000 et 11000 cal BP. Les différents segments chronoculturels sont représentés de façon très inégale. Au-delà de ce constat, nous évoquerons les raisons possibles de cette situation contrastée (conservation des sites, état de la recherche ou réalité de peuplement). Il s’agira finalement de mieux comprendre ses variations internes et ses interactions avec le Bassin aquitain et le nord de la Péninsule ibérique mais également avec les rivages atlantiques et méditerranéens. ______________________________________________________________________________ From the start of the Magdalenian to the end of the Laborian, ten millennia of human occupation have provided abundant evidence along the north Pyrenean slope. Climatic fluctuations (from GS-2b to GS-1), glacial history and their environmental consequences may have influenced the exploitation of certain altitude territories. In contrast, the foothills seem to have constituted a favourable area between reliefs and valleys gradually freed from ice, the opening Aquitaine plain, the Atlantic and Mediterranean coasts. Based on recently completed or ongoing work, and revised key sites or sets of sites, we propose here a synthesis to review the main changes in lithic and osseous equipment and original behaviours (coastal economy, use of small game) between 21000 and 11000 cal BP. However, the different moments of this evolution are represented in a very uneven way. Beyond that, we will discuss the possible reasons of the statement (conservation of the sites, state of research or settlement data). Among the privileged sectors, the Arudy basin is the scene of recent field operations and revaluations of collections. Other sites, such as Belvis, Gouërris, Troubat or Rhodes II, have benefited from PhD research (lithic and bone industries, archaeofauna, chronology, etc.). Data on the early Magdalenian period remain limited. With the exception of certain sites assigned to this period from dates C14 onwards, only the altitude site of Montlleó makes it possible to testify to an increase in altitude as early as post-Late Glacial Maximum period. The Early Middle Magdalenian, mainly documented by ancient excavations, which are difficult to re-evaluate from an archaeostratigraphic point of view, remains poorly understood in the Pyrenees. Nevertheless the presence of certain objects establish links with Aquitaine and the Cantabrian Sea. The Recent Middle and Upper Magdalenian are particularly well documented periods in the Pyrenees. These occupations illustrate, in particular, a development of occupations in the context of often decorated cave bottoms and the anthropization of valleys freed from ice with hunting camp to ibex. The Azilian region has significant regional economic variations with a decline of craftsmanship in the bone industry and a technical simplification of lithic production. The Laborian is documented by the revaluation of old series provides evidence of Aquitaine region influences but in stratigraphically complicated contexts. Beyond the question of the unity of the Pyrenean chain between Magdalenian and Laborien, it will finally be a question of better understanding its interactions with the Aquitaine basin and the north of the Iberian Peninsula but also to the Atlantic and Mediterranean coastlines.

Introduction: ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. This study assesses the capacity of Canadian organizations to adopt, implement, and promote physical activity initiatives. The four objectives were to compare findings from baseline (2008) and follow-up (2013) with respect to: (1) awareness of ParticipACTION; (2) organizational capacity to adopt, implement and promote physical activity initiatives; (3) potential differences in capacity based on organizational size, sector, and mandate; and (4) assess perceptions of ParticipACTION five years after relaunch. Methods: In this cross-sectional study, representatives from local, provincial/territorial, and national organizations completed an online survey assessing capacity to adopt, implement, and promote physical activity. Descriptive statistics and one-way analyses of variance were conducted to examine the objectives. Results: Response rate for opening an email survey invitation and consenting to participate was 40.6% (685/1688) and 540 surveys were completed. Awareness of ParticipACTION increased from 54.6% at baseline to 93.9% at follow-up (Objective 1). Findings at both baseline and follow-up reflected good organizational capacity to adopt, implement and promote physical activity (Objective 2) although some varied by organizational sector and mandate (Objective 3). Most respondents reported that ParticipACTION provided positive leadership (65.3%), but there was less agreement regarding ParticipACTION’s facilitation of infrastructure (44.0%) or organizational will/motivation (47.1%)(Objective 4). Conclusion: Canadian organizations continue to report having good capacity to adopt, implement, and promote physical activity. There was no discernible change in capacity indicators five years after ParticipACTION’s relaunch although its broader contribution to the physical activity sector was endorsed.

Introduction: Poor diet quality has been shown to increase the risk of common chronic diseases that can negatively impact quality of life and burden the healthcare system. Canada’s Food Guide evidence-based recommendations provide dietary guidance aimed at increasing diet quality. Compliance with Canada’s Food Guide can be assessed with the Canadian Healthy Eating Index (C-HEI), a diet quality score. The recently designed Canadian Diet History Questionnaire II (C-DHQ II), a comprehensive food frequency questionnaire could be used to estimate the C-HEI in Canadian populations with the addition of food group equivalents (representing Canada’s Food Guide servings) to the C-DHQ II nutrient database. We describe methods developed to augment the C-DHQ II nutrient database to estimate the C-HEI. Methods: Food group equivalents were created using food and nutrient data from existing published food and nutrient databases (e.g. the Canadian Community Health Survey — Cycle 2.2 Nutrition [2004]). The variables were then added to the C-DHQ II companion nutrient database. C-HEI scores were determined and descriptive analyses conducted for participants who completed the C-DHQ II in a cross-sectional Canadian study. Results: The mean (standard deviation) C-HEI score in this sample of 446 adults aged 20 to 83 was 64.4 (10.8). Women, non-smokers, and those with more than high school education had statistically significant higher C-HEI scores than men, smokers and those with high school diplomas or less. Conclusion: The ability to assess C-HEI using the C-DHQ II facilitates the study of diet quality and health outcomes in Canada.

Introduction. ParticipACTION est un organisme canadien relancé en 2007 dédié à la communication et au marketing social en matière d’activité physique. Cette étude porte sur le pouvoir d'action des organismes canadiens dans l'adoption, la mise en oeuvre et la promotion des initiatives en ce domaine. Nos objectifs étaient de comparer les résultats de base (2008) avec les résultats de suivi (2013) en ce qui concerne (1) la connaissance de ParticipACTION, (2) la capacité d'un organisme à adopter, à mettre en oeuvre et à promouvoir des initiatives d’activité physique et (3) les différences potentielles en matière de pouvoir d'action d'une organisation en fonction de sa taille, de son secteur et de son mandat ainsi que (4) d’évaluer la perception de ParticipACTION cinq ans après sa relance. Méthodologie. Dans le cadre de cette étude transversale, des représentants d’organismes locaux, provinciaux, territoriaux et nationaux ont rempli un questionnaire en ligne visant à évaluer la capacité de leur organisme à adopter, à mettre en oeuvre et à promouvoir des initiatives d’activité physique. Nous avons utilisé des méthodes de statistique descriptive et des analyses de variance à un facteur pour répondre à nos objectifs. Résultats. Le taux de réponse correspondant aux personnes ayant ouvert le courriel d’invitation à répondre au sondage et ayant consenti à y participer était de 40,6 % (685/1 688). Au total, 540 questionnaires de sondage ont été remplis. Le taux de connaissance de ParticipACTION, qui se chiffrait à 54,6 % lors de l’étude initiale, avait atteint 93,9 % au moment du suivi (objectif 1). Tant les résultats initiaux que les résultats de suivi ont fait état d’un pouvoir d'action important des organismes dans l'adoption, la mise en oeuvre et la promotion d'initiatives d’activité physique (objectif 2), avec cependant de légères variations en fonction du secteur et du mandat de chaque organisme (objectif 3). La plupart des répondants ont affirmé que ParticipACTION exerçait un leadership positif (65,3 %), mais les avis étaient plus partagés quant à son rôle de conseil aux infrastructures (44,0 %) ou encore de soutien à la motivation organisationnelle (47,1 %) (objectif 4). Conclusion. Les organismes canadiens font marque d’un pouvoir d'action important en matière d'adoption, de mise en oeuvre et de promotion d'initiatives d’activité physique. Cependant, cinq ans après la relance de ParticipACTION et malgré une meilleure reconnaissance de sa contribution globale au secteur de l’activité physique, aucun changement notable n’a été relevé dans les indicateurs mesurant le pouvoir d'action des organismes.

Introduction. ParticipACTION est un organisme canadien de communication et de marketing social faisant la promotion de l’activité physique qui a été relancé en 2007. Notre étude visait à évaluer de manière qualitative le pouvoir d’action des organisations canadiennes en matière de promotion de l’activité physique ainsi que l’influence de ParticipACTION sur ce pouvoir cinq ans après sa relance. Méthodologie. Des entrevues téléphoniques semi-structurées ont été réalisées auprès de 44 informateurs clés sélectionnés par échantillonnage dirigé. Les informateurs étaient représentatifs d’organismes nationaux, provinciaux et locaux ayant un mandat en matière de promotion de l’activité physique. Les données tirées des entrevues ont été analysées par thèmes. Résultats. Depuis la relance de ParticipACTION, le pouvoir d’action en matière de partenariats et de collaborations ainsi que le climat général dans le domaine de la promotion de l’activité physique se sont améliorés. Bien que diverses contraintes financières aient réduit la capacité des organisations à remplir leur mandat, leur impact a été atténué par des facteurs internes comme la présence d’employés compétents et les partenariats ainsi que par des facteurs externes comme les progrès technologiques dans les communications et les échanges d’information. Les avis étaient mitigés en ce qui concerne la contribution de ParticipACTION à l’amélioration de ce pouvoir d’action. Bien que ParticipACTION ait attiré l’attention sur l’inactivité, sa contribution a surtout été perçue comme complémentaire aux activités déjà en place. Certains organismes ont considéré que la relance de ParticipACTION avait accru la compétition pour le financement et l’accès aux médias populaires, tandis que d’autres étaient d’avis qu’il s’agissait d’une opportunité d’établir des partenariats officiels pour des campagnes de marketing social et de tirer parti des réalisations et de la réputation de ParticipACTION. Conclusion. Selon les participants, le pouvoir d’action des organisations en matière de promotion de l’activité physique au Canada a augmenté depuis 2007 de façon subtile mais significative, en raison d’un climat favorable à la promotion de l’activité physique, de la présence d’employés compétents et des technologies d’échange d’information. La contribution de ParticipACTION à l’amélioration de ce pouvoir a été jugée faible.

Introduction : Dans cette étude de suivi transversale, nous avons exploré la notoriété de ParticipACTION et le niveau d’activité physique chez les Canadiens après sept ans de campagnes. Méthodologie . Une enquête à l’échelle de la population a été menée auprès de 7 282 adultes entre février 2014 et mai 2015. Elle a consisté en une série de questions destinées à évaluer la notoriété de ParticipACTION dans le Sondage indicateur de l’activité physique de 2014-2015. Divers modèles de régression logistique pondérée ont été établis pour déterminer si cette notoriété était associée aux croyances à propos de l’activité physique, aux intentions et à l’activité physique pratiquée durant les loisirs. Résultats. Environ 20 % des Canadiens avaient une connaissance spontanée de ParticipACTION et le taux de notoriété assistée de ParticipACTION était de 82 %. L’éducation, le revenu et le fait d’avoir des enfants étaient significativement corrélés à la notoriété au sein de la population canadienne. Le rapport de cotes (RC) ajusté de la notoriété (assistée et spontanée) de ParticipACTION était plus élevé chez les personnes à haut niveau de scolarité (RC = 1,57, IC à 95 % : 1,04 à 2,39; RC = 2,00, IC à 95 % : 1,24 à 3,24), à revenu élevé (RC = 3,92, IC à 95 % : 2,35 à 6,53; RC = 2,29, IC à 95 % : 1,44 à 3,62) et ayant des enfants (RC = 1,93, IC à 95 % : 1,40 à 2,66; RC = 1,70, IC à 95 % : 1,26 à 2,30). La notoriété de ParticipACTION était également positivement associée aux attentes en matière de résultats et à l’auto-efficacité, et négativement associée à l’activité physique durant les loisirs. Conclusion. Le taux de notoriété non assistée de ParticipACTION est plus élevé qu’auparavant et, par ailleurs, les Canadiens inactifs sont plus nombreux que les Canadiens actifs à connaître l’organisme. Étant donné que ParticipACTION a principalement ciblé les parents d’enfants inactifs au cours des sept dernières années, il semble que l’organisme ait partiellement atteint ses objectifs en matière de communication.

Introduction: This study examined the association between time to diagnosis and sociodemographic and clinical characteristics, as well as time to diagnosis and physical and mental health status, among Canadian adults with a self-reported mood and/or anxiety disorder diagnosis. Methods: We used data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorders Component. The study sample (n=3212) was divided into three time to diagnosis subgroups: long (> 5 years), moderate (1-5 years) and short (< 1 year). We performed descriptive and multinomial multivariate logistic regression analyses. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results: The majority (61.6%) of Canadians with a mood and/or anxiety disorder diagnosis reported having received their diagnosis more than one year after symptom onset (30.0% reported a moderate delay and 31.6% a long delay). Upon controlling for individual characteristics, we found significant associations between a moderate delay and having no or few physical comorbidities; a long delay and older age; and both moderate and long delays and early age of symptom onset. In addition, a long delay was significantly associated with "poor" or "fair" perceived mental health and the greatest number of activity limitations. Conclusion: These findings affirm that a long delay in diagnosis is associated with negative health outcomes among Canadian adults with mood and/or anxiety disorders. Time to diagnosis is particularly suboptimal among older adults and people with early symptom onset. Tailored strategies to facilitate an early diagnosis for those at greatest risk of a delayed diagnosis, especially for those with early symptom onset, are needed.

Introduction : Cette étude examine les relations entre le délai écoulé avant l'établissement d'un diagnostic et les caractéristiques sociodémographiques et cliniques, ainsi que les relations entre ce délai de diagnostic et l'état de santé physique et mental des adultes canadiens ayant déclaré avoir reçu un diagnostic de trouble de l'humeur et/ou d'anxiété. Méthodologie : L'Enquête sur les personnes ayant une maladie chronique au Canada - Composante sur les troubles de l'humeur et d'anxiété de 2014 a été utilisée pour cette étude. L'échantillon de l'étude (n = 3 212) a été divisé en trois sous-groupes en fonction du délai de diagnostic : long (plus de 5 ans), modéré (1 à 5 ans) et court (moins d'un an). Nous avons réalisé des analyses de régression logistique multivariées descriptives et multinomiales. Nous avons pondéré toutes les estimations afin que les données soient représentatives de la population canadienne adulte vivant en logement privé dans l'une des 10 provinces et ayant déclaré avoir reçu un diagnostic de troubles de l'humeur et/ou d'anxiété. Résultats : La plupart (61,6 %) des adultes canadiens ayant déclaré avoir reçu un diagnostic de trouble de l'humeur et/ou d'anxiété ont dit avoir reçu leur diagnostic plus d'un an après l'apparition des symptômes (délai modéré : 30,0 %; délai long : 31,6 %). Après ajustement des caractéristiques individuelles, nous avons constaté qu'un délai modéré était significativement associé à la présence d'un faible nombre de comorbidités physiques ou d'aucune, qu'un délai long était significativement associé à un âge plus avancé, et qu'un délai long ou modéré étaient significativement associés à l'apparition de symptômes à un jeune âge. Finalement, un délai long était significativement associé à une santé mentale perçue comme « mauvaise » ou « passable » et à un nombre plus élevé de limitations d'activité. Conclusion : Ces résultats confirment qu'un long délai de diagnostic est associé à des résultats de santé négatifs chez les adultes canadiens atteints de trouble de l'humeur et/ou d'anxiété. Le délai de diagnostic est particulièrement sous-optimal chez les adultes plus âgés et les personnes dont les symptômes sont apparus à un jeune âge. La mise en œuvre de stratégies adaptées facilitant l'établissement d'un diagnostic précoce chez les personnes les plus susceptibles d'obtenir un diagnostic tardif, surtout chez celles dont les symptômes sont apparus à un jeune âge, est nécessaire.

Introduction: There is a paucity of information about the impact of mood and anxiety disorders on Canadians and the approaches used to manage them. To address this gap, the 2014 Survey on Living with Chronic Diseases in Canada–Mood and Anxiety Disorders Component (SLCDC-MA) was developed. The purpose of this paper is to describe the methodology of the 2014 SLCDC-MA and examine the sociodemographic characteristics of the final sample. Methods: The 2014 SLCDC-MA is a cross-sectional follow-up survey that includes Canadians from the 10 provinces aged 18 years and older with mood and/or anxiety disorders diagnosed by a health professional that are expected to last, or have already lasted, six months or more. The survey was developed by the Public Health Agency of Canada (PHAC) through an iterative, consultative process with Statistics Canada and external experts. Statistics Canada performed content testing, designed the sampling frame and strategies and collected and processed the data. PHAC used descriptive analyses to describe the respondents’ sociodemographic characteristics, produced nationally representative estimates using survey weights provided by Statistics Canada, and generated variance estimates using bootstrap methodology. Results: The final 2014 SLCDC-MA sample consists of a total of 3361 respondents (68.9% response rate). Among Canadian adults with mood and/or anxiety disorders, close to two-thirds (64%) were female, over half (56%) were married/in a common-law relationship and 60% obtained a post-secondary education. Most were young or middle-aged (85%), Canadian born (88%), of non-Aboriginal status (95%), and resided in an urban setting (82%). Household income was fairly evenly distributed between the adequacy quintiles; however, individuals were more likely to report a household income adequacy within the lowest (23%) versus highest (17%) quintile. Forty-five percent reported having a mood disorder only, 24% an anxiety disorder only and 31% both kinds of disorder. Conclusion: The 2014 SLCDC-MA is the only national household survey to collect information on the experiences of Canadians living with a professionally diagnosed mood and/or anxiety disorder. The information collected offers insights into areas where additional support or interventions may be needed and provides baseline information for future public health research in the area of mental illness.

Background: Medical students are anxious about not getting a preferred residency position. We described elective patterns of two recent cohorts and examined associated match outcomes. Methods: We conducted a retrospective review of the final-year electives of all students who participated in the residency match (first iteration) at one school for 2017 and 2018. We categorized elective patterns and associated them with aggregated match outcomes. We examined high-demand/low-supply (HDLS) disciplines separately. Results: We described three elective patterns: High Dive, Parallel Plan(s), and No Clear Pattern. Many students had High Dive and Parallel Plans patterns; only a few showed No Clear Pattern. Match rates for High Dive and Parallel Plan patterns were high but many students matched to Family and Internal Medicine. When we separated out HDLS predominance, the match rate remained high but a significant number matched to disciplines in which they did not have a majority of electives. Most High Dive and Parallel Plan students who went unmatched did so with HDLS discipline electives. Conclusion: Many students chose High Dive and Parallel Plan strategies to both high-capacity and HDLS disciplines. Match rates were high for both patterns but students also matched to non-primary disciplines. Back-up planning may reside in the entire application, and not just electives selection.

The global supply chain currently thrown into chaos due to the Suez Canal incident. On 23 March 2021, the Suez Canal, one of the most heavily used shipping routes, was blocked by vast container ship – the Ever Given. Affecting over 400 vessels scheduled to pass through the Canal in the East-West and West-East directions. Such vessels experienced a dilemma of the use of routes and schedules. Other victims included vessels that were scheduled to arrive at/pass through the Canal, shippers, consignees, ship operators, ship owners, and container terminals. About USD$15 to 17 billion has been held up. This paper aims to reveal the potential damage caused to parties involved and examine the liability of parties involved. Specifically, the impact and legal consequences of the obstruction such as how the scope of general average applies as well as the possible solutions to minimise damage are discussed, followed by future developments. These results suggested that maritime transport support global supply chain linkages and economic growth, any disruption could bring huge impact and costs on various stakeholders along the supply chain. On this basis, the world should learn a lesson from this incident and the need for thoroughness prevention measure should be considered.

Introduction : Il existe peu de données à propos des répercussions des troubles de l’humeur et d’anxiété sur les Canadiens et sur la gestion de ces troubles. L’Enquête sur les personnes ayant une maladie chronique au Canada – Composante des troubles de l’humeur et d’anxiété (EPMCC-THA) de 2014 a été élaborée pour combler les lacunes à ce chapitre. Le but du présent article est de décrire la méthodologie de l’EPMCC-THA de 2014 et de présenter les caractéristiques sociodémographiques de l’échantillon final. Méthodologie : L’EPMCC-THA de 2014 est une enquête transversale de suivi menée auprès de Canadiens des 10 provinces âgés de 18 ans et plus qui souffrent d’un trouble de l’humeur ou d’anxiété diagnostiqué par un professionnel de la santé et dont on s'attend à ce qu'il dure (ou durant depuis déjà) six mois ou plus. L’enquête a été élaborée par l’Agence de la santé publique du Canada (ASPC) au moyen d’un processus itératif et consultatif avec Statistique Canada et des experts externes. Statistique Canada a mis à l’essai le contenu, a conçu la base et les stratégies d’échantillonnage et a recueilli et traité les données. L’ASPC a procédé à des analyses descriptives pour déterminer les caractéristiques sociodémographiques des répondants, a produit des estimations représentatives à l’échelle nationale à l’aide des coefficients de pondération fournis par Statistique Canada et a produit des estimations de la variance à l’aide de la méthode bootstrap. Résultats : L’échantillon final de l’EPMCC-THA de 2014 était constitué de 3 361 répondants (taux de réponse de 68,9 %). Parmi ceux qui vivaient avec un trouble de l'humeur ou d'anxiété, près des deux tiers (64 %) étaient des femmes, plus de la moitié (56 %) étaient mariés ou vivaient en union libre et 60 % avaient obtenu un diplôme d’études postsecondaires. La plupart étaient jeunes ou d’âge moyen (85 %), étaient nés au Canada (88 %), étaient non Autochtones (95 %) et vivaient en milieu urbain (82 %). Le revenu du ménage était distribué assez également entre les quintiles de suffisance du revenu avec cependant un revenu déclaré plus souvent dans le quintile le plus bas (23 %) que dans le plus haut (17 %). Quarante-cinq pour cent ont déclaré avoir un trouble de l’humeur seulement, 24 %, un trouble d’anxiété seulement et 31 %, les deux types de trouble. Conclusion : L’EPMCC-THA de 2014 est la seule enquête nationale auprès des ménages ayant recueilli de l’information sur les expériences des Canadiens avec un trouble de l’humeur ou d’anxiété diagnostiqué par un professionnel de la santé. Cette information permet de déterminer les secteurs où un soutien ou des interventions supplémentaires pourraient être requis et fournit un support aux futurs travaux de recherche en santé publique dans le domaine des maladies mentales.

The concept of postdramatic theatre has raised discussions, inspired creative explorations and led to research in theatre in recent years. Through the review and reflections on two original medicine-themed site-specific performances created by the authors, The Hong Kong Plague of 1894 (2014) and Morbid Anatomy (2016), the interconnecting relationships among medicine, theatre and light and the potentiality of light in the era of postdramatic theatre are studied. The cross-disciplinary and cross-media flow in the network of medicine, theatre and light could evoke reflection, re-thinking and re-proposal on the concepts of medicine, contemporary theatre and its aesthetics.

In this article, the carbon doped TiO2 (C-TiO2) quantum dots (QDs) were prepared through the hydrothermal method and calcination. The size of the C-TiO2 QDs is about 5.7 nm. The doping amount of carbon can be tuned by adjusting the volumes of the carbon source, ethylene glycol added. The carbon atoms are proved to be doped into the interstitial sites of TiO2 lattice and induce the change of chemical states of Ti 2p and C 1s. The doping of carbon leads to the increasing photocatalytic sterilization of E. coli under the visible light irradiation. The survival rate of E. coli cells over C-TiO2 is only 1.5 % after 6 h. The reactive oxygen species (ROS), such as hydroxyl radical and superoxide radical, are considered as the primary factors for the photocatalytic sterilization. Due to oxidative stress of the attack by ROS, the enzyme activity per cells increases for self-protection during the photocatalytic sterilization.

A agricultura familiar é parte importante do agronegócio brasileiro e sul-mato-grossense. Para fortalecer o processo produtivo e comercial, as famílias de agricultores buscam alternativas como a atuação conjunta através de associações e cooperativas. Estabelece-se que a cooperação é uma variável que pode lhes proporcionar maior competitividade frente ao mercado, sendo facilitada através do capital social. O trabalho teve por objetivo a análise do capital social na cooperativa COOP-GRANDE, no município de Campo Grande (MS), bem como identificar sua influência sobre as relações entre os membros da cooperativa. Foram entrevistados associados da cooperativa a partir de um questionário semiestruturado, elaborado de forma a abranger variáveis que caracterizam as interações entre os agricultores, analisar a reciprocidade e suas formas entre os associados, e a confiança entre cooperados e destes para com a liderança da cooperativa. Os resultados indicaram a fragilidade do capital social entre os agricultores, com a falta de confiança entre eles. Os associados percebem a importância da cooperativa, mas não a vantagem de trabalhar juntos e de cooperar com os outros sócios da cooperativa.

Les programmes de cancérologie ontariens se sont fixés comme objectif de dispenser des soins infirmiers de haute qualité et des traitements sécuritaires à la fois pour les patients et pour le personnel. Dans le domaine de la santé, les contraintes financières inhérentes à la prestation des soins exigent que les mécanismes de financement rendent compte non seulement du coût des médicaments mais encore de facteurs tels que les coûts des ressources humaines en pharmacie et en soins infirmiers. Alors que certaines organisations ont élaboré des systèmes de classification des patients afin de mesurer l’intensité des soins infirmiers et la charge de travail des infirmières, ces systèmes s’appliquent principalement aux clientèles hospitalisées et présentent de nombreux défis tels que la nécessité pour les infirmières de documenter la charge de travail exigée par les soins à des fins de justification. Cet article a pour but de tracer les grandes lignes de la méthodologie et de l’implication des infirmières en vue d’élaborer une pondération de la consommation des ressources basée sur les protocoles pouvant être appliquée aux salles de chimiothérapie ambulatoire. La méthodologie inclut la détermination de la charge de travail reliée au temps dont les infirmières ont besoin pour préparer, conseiller et évaluer les patients et leur fournir l’enseignement requis ainsi que le temps nécessaire pour rassembler les fournitures, accéder aux lignes de perfusion, surveiller, gérer les effets indésirables, gérer les symptômes et documenter les soins. La pondération de la consommation des ressources fournit une meilleure mesure de la complexité des soins exigés par les patients atteints de cancer traités en milieu ambulatoire.

Ontario cancer programs aim to deliver high-quality nursing care and treatment that is safe for patients and staff. The reality of health care is that financial constraints, inherent in the delivery of care, require that funding mechanisms count not only the cost of drugs, but factors such as pharmacy and nursing human resource costs. While some organizations have developed patient classification systems to measure nursing intensity and workload, these systems apply primarily to inpatient populations, and are fraught with numerous challenges, such as the need for nurses to document to justify the workload required for care. The purpose of this paper is to outline the methodology and engagement of nurses to develop regimen-based resource intensity weights that can be applied to ambulatory chemotherapy suites. The methodology included determination of workload related to nursing time to prepare, teach, counsel and assess patients, as well as time to gather supplies, access lines, monitor, manage adverse reactions, manage symptoms and document care. Resource intensity weights provide better measures of the complexity of care required by cancer patients in ambulatory settings.

This exploratory study examines a three-year Summer English Teaching Service-Learning Program (SETSLP) in a high school in Yunnan, China. Students from Lingnan University acted as tutors to teach English to around 300 Chinese students of which 181 participants finished and returned the questionnaires over the three years of SETSLP through a Communicative Language Teaching (CLT) approach from 2009 to 2011. Results showed that CLT significantly (i) increased the students’ self-perceived English abilities in the areas of listening (t = 2.62, p < .05 in 2009; t = 4.60, p < .01 in 2011), comprehension (t = 2.33, p < .05 in 2009; t = 5.16, p < .01 in 2010; t = 7.11, p < .01 in 2011), and oral communication (t = 2.22, p < .05 in 2009; t = 6.39, p < .01 in 2010; t = 7.85, p < .01 in 2011); (ii) increased the students’ confidence in speaking English as most students throughout the three years chose oral ability as their greatest achievement in the program; and (iii) increased the students’ interest and motivation in learning English. Students also revealed that SETSLP increased their interest in English and students were more motivated to learn English (Mean = 8.44, SD = 1.51). Besides, students mentioned that the tutors who participated in the service-learning program, played a crucial role to encourage and motivate them to learn English. This also teaches the students the importance of doing service-learning in their daily life.

CyberManufacturing System is a vision for future manufacturing where physical components are fully integrated with computational processes in a connected environment. However, realizing the vision requires that its security be adequately ensured. This paper presents a vision-based system to detect intentional attacks on additive manufacturing processes, utilizing machine learning techniques. Particularly, additive manufacturing systems have unique vulnerabilities to malicious attacks, which can result in defective infills but without affecting the exterior. In order to detect such infill defects, the research uses simulated 3D printing process images as well as actual 3D printing process images to compare accuracies of machine learning algorithms in classifying, clustering and detecting anomalies on different types of infills. Three algorithms - (i) random forest, (ii) k nearest neighbor, and (iii) anomaly detection - have been adopted in the research and shown to be effective in detecting such defects.

Entre os principais fatores climáticos que causam interferência nas coleções e devem ser controlados pelo sistema de climatização estão à temperatura, umidade absoluta, saturação e a condensação. Durante o monitoramento do acervo etnográfico exposto no Museu das Culturas Dom Bosco verificou-se a ocorrência de infestação causada por fungos. A presença desses organismos indicou que os artefatos estavam susceptíveis a danos permanentes e de difícil restauração, devido à rápida taxa de reprodução desses organismos em condições favoráveis e ao modo pelo qual utilizam o substrato para alimentação. Desse modo, a equipe administrativa, junto à equipe técnica, decidiu antecipar a instalação do sistema de climatização do salão de exposição permanente. Além da instalação dos climatizadores foram estabelecidas várias medidas associadas ao controle e manutenção da temperatura e umidade estabelecidas.

Irregular and mixed migration is still of great concern in post-revolutionary Libya, made more complex by the securitisation of border control issues and the inherent challenges of an interim government consolidating its authority.