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Introduction: Breast cancer is detected through screening or through signs and symptoms. In Canada, mammograms for breast cancer screening are offered in organized programs or independently (opportunistic screening). Province of Ontario breast Diagnostic Assessment Units (DAUs) are facility-based programs that provide coordinated breast cancer diagnostic services, as opposed to usual care, in which the primary care provider arranges the tests and consultations. This study describes breast cancer detection method, diagnostic interval and DAU use across Ontario. Methods: The study cohort consisted of 6898 women with invasive breast cancer diagnosed in 2011. We used the Ontario Cancer Registry linked to administrative health care databases. We determined the detection method using the Ontario Breast Screening Program (OBSP) data and physician claims. The diagnostic interval was the time between the initial screen, specialist referral or first diagnostic test and the cancer diagnosis. The diagnostic route (whether through DAU or usual care) was determined based on the OBSP records and biopsy or surgery location. We mapped the diagnostic interval and DAU coverage geographically by women’s residence. Results: In 2011, 36% of Ontario breast cancer patients were screen-detected, with a 48% rate among those aged 50 to 69. The provincial median diagnostic interval was 32 days, with county medians ranging from 15 to 65 days. Provincially, 48.4% were diagnosed at a DAU, and this ranged from zero to 100% across counties. Conclusion: The screening detection rate in age-eligible breast cancer patients was lower than published population-wide screening rates. Geographic mapping of the diagnostic interval and DAU use reveals regional variations in cancer diagnostic care that need to be addressed.

Introduction. Le cancer du sein est détecté soit par un examen de dépistage, soit à l’aide de signes et symptômes. Au Canada, les mammographies pour le dépistage du cancer du sein sont offertes dans le cadre de programmes organisés ainsi qu'en contexte indépendant (dépistage opportuniste). Les unités d’évaluation diagnostique (UED) de la province de l’Ontario sont des programmes en établissement qui fournissent des services diagnostiques coordonnés pour le cancer du sein, à la différence des soins habituels où le fournisseur de soins de première ligne organise les examens et les consultations. Cette étude décrit les méthodes de détection, l’intervalle diagnostique et l’utilisation des UED pour le cancer du sein en Ontario. Méthodologie. L’étude a porté sur une cohorte de 6 898 femmes ayant reçu un diagnostic de cancer du sein envahissant en 2011. Nous avons utilisé le Registre d’inscription des cas de cancer de l’Ontario jumelé à des bases de données administratives sur les soins de santé. Nous avons déterminé la méthode de détection à l’aide des données du Programme ontarien de dépistage du cancer du sein (PODCS) et des demandes de règlement des médecins. L’intervalle diagnostique a été défini comme le temps écoulé entre le dépistage initial, l’aiguillage vers un spécialiste ou la première épreuve diagnostique et le diagnostic de cancer lui-même. Le parcours diagnostique (qu'il passe par les UED ou les soins habituels) a été déterminé en fonction des dossiers du PODCS et du lieu de biopsie ou d’intervention chirurgicale. Nous avons cartographié l’intervalle diagnostique et de la couverture des UED en fonction du lieu de résidence des femmes. Résultats. En 2011, 36 % des cas de cancer du sein en Ontario ont été détectés par dépistage, dont 48 % chez des femmes de 50 à 69 ans. L’intervalle diagnostique provincial médian était de 32 jours, les médianes par comté variant entre 15 et 65 jours. À l’échelle provinciale, 48,4 % des cas ont été diagnostiqués dans une UED, ce pourcentage variant entre 0 et 100 % selon les comtés. Conclusion. Le taux de détection au dépistage correspondant aux patientes admissibles du fait de leur âge s'est révélé inférieur au taux de dépistage officiel du cancer du sein pour l’ensemble de la population. La répartition géographique de l’intervalle diagnostique et du recours aux UED révèle des variations régionales dans les soins diagnostiques en oncologie qu'il est nécessaire de corriger.

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The psychiatric question, the history of insanity, and psychiatric power have historical connections to the construction of the state and society around the principles of inclusion and exclusion. Asylum is an institution whose dominant feature has been far more exclusion than care. In Italy, starting with the Italian experience led by Basaglia in Gorizia in the early 1960s, a radical critique of psychiatry as an ideology of social control has been structured. This cycle of anti-institutional struggles, and the following debate, culminated in the passing of Law 180. In this context, the discussion on overcoming the judicial asylum occupied a wide space. The paper examines some of the issues around which the critique of the criminal asylum has been developed and intertwined with the struggle against the asylum.

Alarming trends in childhood obesity even among preschool children have re-focused attention on the importance of physical activity in this age group. With this increased attention comes the need to identify the amount and type of physical activity appropriate for optimal development of preschool children. The purpose of this paper is to provide the scientific evidence to support a link between physical activity and biological and psychosocial development during early childhood (ages 2-5 years). To do so, we summarize pertinent literature informing the nature of the physical activity required to promote healthy physical, cognitive, emotional, and social development during these early years. A particular focus is on the interaction between physical activity and motor skill acquisition. Special emphasis is also placed on the nature of physical activity that promotes healthy weight gain during this period of childhood. The paper also discusses the strongest determinants of physical activity in preschool-age children, including the role of the child’s environment (e.g., family, child-care, and socio-economic status). We provide recommendations for physical activity based on the best available evidence, and identify future research needs. [ABSTRACT FROM AUTHOR]

Em tempos recentes, as investigações sobre o significado e os limites da autonomia privada frequentemente tomaram em exame decisões jurisprudenciais que fizeram recurso aos princípios e às cláusulas gerais. Um elemento comum nos pronunciamentos dos juízes atém-se ao referimento às normas constitucionais e à cláusula geral da boa-fé. Por exemplo, em dois casos muito discutidos, a Corte Constitucional sustentou a aplicabilidade em via direta do princípio da solidariedade e da cláusula geral da boa-fé para afirmar a nulidade de uma cláusula contratual, elaborando um controle substancial que não encontra expressa previsão nas normas do Código Civil.

The core values of community health nursing practice are rooted in the social determinants of health, health equity and social justice. Throughout the COVID-19 pandemic, community health nurses (CHNs) witnessed first-hand the impact on individuals in situations of marginalization. This research inquiry explored how health inequities among client populations contributed to experiences of MD among CHNs in Canada during the pandemic. A total of 245 CHNs from across Canada participated in an online survey. Participants reported that during the pandemic individuals living in situations of marginalization were disproportionately impacted. CHNs were unable to provide the necessary health promotion interventions and experienced high levels of moral distress. The negative impact of the pandemic on individuals living in situations of marginalization illuminated the intersecting social and structural inequities that drive negative health outcomes and emphasized the need to adopt an equity focus for current and future pandemic planning, response, and recovery.

The convergence of electronic media and literary forms during the digital revolution has produced a variety of new hybrid genres which we call today ‘electronic literature’. In Italy, electronic literature has a rich history. It was born in the cultural milieu of the Neoavanguardia in the early 1960s and, since then, it has produced a significant number of experimental works and practices. In this article, I take into consideration the cultural milieu in which it originated and I examine some of the works of the first Italian “electronic” writer, Nanni Balestrini. I will first contextualise Umberto Eco’s 'Opera aperta' in its cultural context, with a special focus on some of the foundational concepts of the “open work” (crisis, interactivity, entropy). In section 3, I argue that 'Opera aperta' does not only coincide with the birth of the first Italian electronic literary work, namely Nanni Balestrini’s 'Tape Mark I', but it also provides a theoretical and methodological framework to analyse Italian electronic literature across decades from both an aesthetic and critical perspective. In my analysis of some of Balestrini’s key works and collaborations in electronic literature in the following section, I emphasise how formal experimentation and political intention are strictly intertwined and critically address some important questions about our relationship with technologies, such as automation and alienation. Finally, in the conclusion, I highlight the points that make the modern concept of ‘'opera aperta'’ an effective methodological tool for exploring the ‘open textuality’ of electronic literature and how artists have come to terms with the new forms of expression offered by new media.

This study investigates the intended, enacted, and perceived curriculum in an authentic research-based science program using curriculum mapping as a tool for analysis. The main research inquiry guiding this study is: How do the students’ perceptions on their achieved learning outcomes in an authentic research-based learning environment align with the intended and enacted outcomes? A mixed method approach was adopted, where the program and its core-courses were mapped from different perspectives. Data on the learning outcomes and perceptions of students learning were collected through questionnaires, focus groups, and interviews from multiple perspectives. Results of the curriculum mapping showed consistency and cogency of program and course-level learning outcomes. Students’ perceptions of their authentic research experiences were well-aligned with the intended and enacted learning outcomes. The results of this study could be used to help other programs implement similar curriculum review approaches in their context. Cette étude examine le programme d’études visé, adopté et perçu dans un programme de sciences authentiquement basé sur la recherche en utilisant la cartographie de programme comme outil d’analyse. L’objet principal de la recherche qui a guidé cette étude était le suivant : comment les perceptions des étudiants concernant leurs résultats d’apprentissage dans un environnement d’apprentissage authentiquement basé sur la recherche s’alignent-elles avec les résultats visés et adoptés? Une approche à méthodes mixtes a été adoptée, dans laquelle le programme et ses cours de base ont été cartographiés à partir de diverses perspectives. Les données relatives aux résultats d’apprentissage et aux perceptions de l’apprentissage des étudiants ont été recueillies par le biais de questionnaires, de groupes de discussion et d’entrevues à partir de diverses perspectives. Les résultats de la cartographie du programme ont indiqué une uniformité et une force du programme et des résultats d’apprentissage au niveau des cours. Les perceptions des étudiants concernant leurs expériences de recherche authentiques étaient parfaitement alignées avec les résultats d’apprentissage visés et adoptés. Les résultats de cette étude pourraient être utilisés pour aider d’autres programmes à mettre en oeuvre des approches pour la révision de programme d’études dans leur propre contexte.

In this article, you will learn how to integrate digital literacy and Modern Languages through digital videos. The first part of the article is mainly addressed to teachers and instructors and will extensively discuss pedagogical questions. It looks at how the digital video can help teach and learn the four language skills. In the second part of this article, i.e. the actual tutorial, you will learn how to make your own teacher/student-generated videos. The tutorial will explain how to combine and edit text, video and audio in a variety of ways, in order to serve different teaching and learning outcomes in Modern Languages, as well as looking at what software and applications can assist this purpose. In the final section, I will present a number of pedagogical activities using digital videos and what learning outcomes they can help achieve.

Democratic institutions and practice depend on trust, in two ways. Citizens must trust each other to abide by shared rules and norms that together govern a political community; it is a feature of democratic states that they direct their resources not to enforcement of rule abidingness, but rather towards providing collective and public goods. Instead, states rely on the semi-voluntary compliance of citizens with these shared norms and laws. Citizens must also trust their political representatives, who via their election are granted discretion to make decisions that will have significant impact on the lives of those they represent. Yet, according to many scholars across many disciplines, this trust is at risk of being undermined, if it hasn’t yet been so. The possible reasons for weakened and broken trust are many, ranging from escalating wealth inequalities, to increasing cultural and ethnic diversity, to political incompetence of both voters and political representatives, to corruption among political representatives. In this article, I examine the trust that underpins the discretion accorded to elected representatives, to identify when the improper use of this discretion may reasonably be thought to be a source of distrust. In particular, I argue that where discretion is used arbitrarily, it may threaten to undermine the trust relations between citizens and their representatives, and therefore the efficient and effective running of democratic states.

Abstract There are many different ways in which one might describe the goal of Canada’s Private Sponsorship of Refugees Program. For sponsors, though, one goal is clear: to get “their” refugees ready to handle the rigors of “month 13.” The supposed ideal is that, by month 13, newcomers are employed and living independently in Canada, as productive members of society. The reality is messier. The objective in this article is to offer an account of how sponsors think of their job, in relation to month 13. Using data collected via interviews with nearly sixty private sponsors in Ottawa, it is shown that sponsors are motivated by securing stability for newcomers by the time month 13 arrives, but that sponsors differently flesh out the meaning of the stability they are seeking to achieve on behalf of newcomers. In particular, the data suggest, sponsors believe that newcomers’ attitude to integration is especially strongly related to their actual integration, and newcomers do especially well by month 13 to the extent that sponsors are able to build and support a positive attitude towards it.

A infertilidade é definida como ausência da concepção após 12 meses de atividade sexual sem uso de contraceptivos. Sua prevalência na população varia entre os diferentes países: entre um mínimo de 5% e um máximo de 30% de todos os casais. As técnicas empregadas para o tratamento da infertilidade são conhecidas como "reprodução assistida". A realização do presente trabalho teve como objetivo principal investigar, nas mulheres entrevistadas, os aspectos inconscientes do desejo singular pela maternidade e a dificuldade do feminino em lidar com a impossibilidade de gerar um filho. A amostra foi composta por 200 mulheres que estavam sendo submetidas a tratamentos de reprodução humana assistida. Foram realizadas quatro entrevistas com cada participante, e os aspectos inconscientes foram analisados a partir de cada um dos discursos, que foram analisados e interpretados numa visão biopsicossocial, com ênfase, entretanto, no pensamento psicanalítico. A análise dos discursos foi realizada através da confrontação dos dados e supostos teóricos; a pesquisa segue, dessa maneira, uma metodologia quali-quantitativa.

One of the most significant challenges facing global egalitarian theorists is the motivational gap: there is a noted gap between the duties imposed by a global commitment to the equal moral worth of all people and the willingness of the wealthy to carry out these duties. For Pablo Gilabert, the apparent absence of motivation to act justly on a global scale presses us to consider the importance of feasibility in developing a persuasive account of global justice, part of which requires being attentive to what motivates us to act in support of global egalitarianism. In this article, I am critical of Gilabert’s account of the role that relationships between individuals play in conceiving our global justice duties. I begin with an account of some confusion in Gilabert’s account of the actual costs likely to be imposed on citizens of wealthy states as a result of the duties he demands of us and why it is important to resolve that confusion. I will then consider, and critique, Gilabert’s account of special responsibilities. I shall argue that, fundamentally, there is an ineliminable tension between the special responsibilities individuals legitimately possess and the duties they have to eradicate global poverty.