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This document is a comment on a previous article discussing the regulatory design of the Water Sustainability Act (WSA) in British Columbia, Canada. The comment argues that the WSA's regulatory design took a science-forward approach and considered specific regional factors. It addresses criticisms of the WSA and emphasizes the importance of licensing groundwater use for assessing environmental impacts. The WSA allows for nuanced water management through regulation-making authorities, but challenges remain in implementing the regulations, including Indigenous water rights and government resources. Recommendations for improving the WSA's design include defining sustainability goals, regionalizing regulatory action, and long-term planning. Ongoing resourcing and consideration of Indigenous rights are necessary for the effective implementation of the WSA. [Extracted from the article]

In this paper, I estimate a gravity model that provides strong evidence that border effects are heterogeneous by region and test for the presence of the spatial attenuation effect and international market access costs. I introduce GDP, importer population density, and importer metropolitan statistical area count as determinants of the border effect. I find the strong and robust result that border effects are decreasing in the GDP of the importing and exporting region: a 10% increase in importer GDP results in a 3.24% to 3.67% increase in international trade relative to domestic trade while a 10% increase in exporter GDP results in an increase in international trade relative to domestic trade by between 2.41% and 2.68%. These results are robust to a variety of specifications and indicate the existence of the spatial attenuation effect. However, this paper finds no indication of market access costs differing significantly when trade crosses the U.S.-Canada border. [ABSTRACT FROM AUTHOR]

This paper contributes to international feminist debates on shared parenting and family violence via reforms to Canada's Divorce Act, in force since 2021. Looking backwards, it reviews parliamentary debates and early judicial discussions. The documentary review reads the reforms as an unstable compromise between calls from feminist voices and experts on family violence and from groups representing fathers. Family violence is now defined broadly and declared relevant to children's welfare. But language in the statute may undermine its seriousness. Exposing the tensions underlying these reforms is useful for Canadian participants in family justice and for scholars, practitioners, and policymakers elsewhere, exemplifying the promise and perils of reform in this area. Looking ahead, the paper offers recommendations to higher courts. Appellate judges should read rules on contact with both parents and parental cooperation in the light of the new recognition of family violence, taking the latter as an overarching objective of the statute. [ABSTRACT FROM AUTHOR]

The social distancing imposed by the Covid-19 pandemic accelerated the digitalisation of societies, which also influenced habits related to the consumption and dissemination of news. In this context, older individuals are often blamed for contributing to disinformation, which is associated with the echo chambers fostered by social media. Mass media, social media and personal communication tools act as mass, social or personal intermediaries when it comes to keeping up to date with the news. This paper analyses the preferred intermediaries of older online adults (aged 60 and over) for following the news and how they change over time. We analysed two waves of an online survey-based longitudinal study conducted in Canada and Spain, before Covid-19 pandemic (2016/17), and during Covid-19 (in 2020). We found that most participants exclusively use mass intermediaries or combine mass with social and personal intermediaries to keep abreast of the news. However, only 28% of respondents inform themselves exclusively through the alleged echo chambers of social and personal intermediaries. Results also show that media ecologies evolve in different directions, and, despite the forced digitalisation driven by the pandemic, digital media usage did not always increase or evolve towards newer technologies. This paper contributes to understanding the diverse intermediaries used by older adults to obtain news and how such media ecologies can contribute to contrasting different sources of information beyond the alleged echo chambers of social media. [ABSTRACT FROM AUTHOR]

Objectives: Statistics Canada administers the Agricultural Census every 5 years, and this paper presents unsuppressed data from the 2016 and 2021 Census. The data set encompasses detailed information on farm types, sizes, technology choices, and a demographic profile of farm operators from the 2021 Census. Data on farm characteristics and operator demographics is crucial for understanding innovation in agriculture and formulating evidence-based policies. Data description: The data sets cover the two most recent agriculture censuses of 2016 and 2021, presenting data on the number of farmers by region, farm type, size, and the adoption of technologies. Additionally, a third data set lists the number of farm operators by age and sex. The census questionnaire inquires about using different technologies, varying the types across the two census periods. Notably, there is no data suppression in these data sets, and they cover all 10 provinces in Canada, excluding the three territories. Farm types are categorized based on the North American Industry Classification System (NAICS), and farm size is measured in acres. [ABSTRACT FROM AUTHOR]

There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency (ω >0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs. [ABSTRACT FROM AUTHOR]

Using the example of an industrial site in Edmonton, Alberta, this paper argues that industrial ruins represent instantiations of abstract abandonment, a kind of real abstraction that directly articulates to the logic of capital. Drawing from excavations of the industrial ruins of Mill Creek Ravine, one of the first industrial areas in Edmonton, this paper reveals how sites of abstract abandonment congeal critical histories of both abandonment and its afterlives. The history of these ruins, and the communities that emerged after they were abandoned materialize the failures of capitalist fantasies, as well as the sprouts that grow in its cracks. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to add to the research literature and begin to fill the gap in knowledge about shared parenting arrangements for women with young children and who have experienced domestic violence (DV), in three Canadian provinces; Alberta, Manitoba and Ontario. Method: This paper reports on the qualitative findings from a mixed methods study on shared parenting from women with children ages 4 and under. Twenty women participated in one-on-one individual interviews through electronic platform utilizing Zoom. Thematic analysis is used to analyze the data. Results: Despite efforts to not exclusively recruit women who had experienced domestic violence (DV) from their former partner, all participants identified as survivors of DV and ongoing survivors of DV, specifically, coercive controlling behaviours. Five themes describe the women's experiences of shared parenting with young children: 1) walking a tight-rope; 2) navigating post-separation relationships; 3) emotional realities of shared parenting; 4) shared parenting outcomes; and, 5) structural challenges. Conclusions: This paper not only adds to the significant and longstanding gap in knowledge directly from women with children ages 4 and under in shared parenting relationships, and who have experienced DV, and also helps to inform social service and legal actors. It is timely with the amendments to the Divorce Act in Canada which now includes DV as a factor in determining the best interests of the child. [ABSTRACT FROM AUTHOR]

The British Conquest of Quebec in 1760 was a key moment in Canadian history as it marked the beginning of a tense coexistence between French and English Canadians. Many argue that the Conquest had strong economic consequences in the form of the relative poverty of the French settlers. All the proposed mechanisms rely on a retreat from the market by French farmers. Using 171 years of wheat price data for Quebec City and Montreal, I test whether there are signs of this retreat and instead find the opposite: markets grew more integrated across regions. Additionally, over time, regional prices became better predicted by current prices elsewhere than by the lagged prices in the same region. By the 1830s, markets in Quebec were as well integrated as those in economies such as the USA, France, Britain and Germany. The evidence in this paper is consistent with recent empirical findings about Quebec's economic history, and so I argue that the case for the Conquest's initiation of the relative poverty of Quebec is non-existent as defined by conventional explanations. This does not exclude long-run consequences of the Conquest, but the correct answer must lie elsewhere than in conventional explanations. [ABSTRACT FROM AUTHOR]

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators. Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994–2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field. Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage (n = 4879) and Annals of the Rheumatic Diseases (n = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications. Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America. [ABSTRACT FROM AUTHOR]

Gaining ethical approval for qualitative health research and implementing all the planned research processes in a proposed study are not straightforward endeavours. The situation becomes more complex when qualitative research is conducted in a cross-national healthcare and academic context. Also, it is even exhausting when the study is student-based, as student researchers may be considered novices and inexperienced researchers, especially for field-based research. Our aim in this reflective paper is to present, reflect, and discuss the experiences of a doctoral researcher in dealing with two independent institutional review boards in Canada and Ghana during an interdisciplinary Ph.D. project and the ethical dilemmas encountered while collecting data in Ghana. Based on the researcher's experiences, it became apparent that consent and its documentation can have cultural implications in different settings; hence, institutional review boards must exercise reflexivity in their protocol review practice. Also, sharing research data with participants and institutional leaders while maintaining participant confidentiality and privacy in institutional ethnographic research requires sensitivity to bi-lateral ethical values. With the experiences shared in this paper, we advocate for a dialogic ethical review process in qualitative research where researchers and research ethics boards engage in ongoing dialogue rather than the usual prescriptive format research ethics reviews often assume. [ABSTRACT FROM AUTHOR]

In both Canada and the United States, immigrants often experience different residential outcomes than non-immigrants. Previous research often attributes these differences to differential treatment in either the labour market or the housing market. We adopt a unique approach in this paper, comparing the behavior of racial groups in Canada and the United States, two countries with large non-white immigrant populations, and distinct housing and labour markets. We examine the role that factors such as immigration status, ethnic group, and housing costs play in differentiating the housing careers of White, South Asian, Black, Latin American, Filipino, and Chinese immigrants from their White native-born counterparts. We find that immigrants often converge upon the native-born in both countries, and that the differences between countries are not nearly as stark as the differences between groups. [ABSTRACT FROM AUTHOR]

Recent changes in Canadian legislation have enabled First Nations to adopt property taxation and other forms of taxation on reserves, thereby allowing them to directly finance their local governments through local tax revenues. In this paper, we compile data on the passage of First Nations tax laws over a 30-year period from a centralized national database on First Nations by-laws, the First Nations Gazette. We combine those data with additional sources to analyze the factors that are associated with First Nations exercising their taxation authority. We find evidence of geographic policy diffusion consistent with First Nations learning from their neighbors and direct evidence that formal educational and institutional resources are important correlates of tax law adoption. Understanding that process informs the broader literature on the evolution of taxation structures and local political incentives, the analysis may contain important lessons for Indigenous tax jurisdiction in other contexts. It is also a critical first step towards assessing the long-term consequences of First Nations' new fiscal powers. [ABSTRACT FROM AUTHOR]

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

This paper aims to introduce a novel family of probability distributions by the well-known method of the T–X family of distributions. The proposed family is called a "Novel Generalized Exponent Power X Family" of distributions. A three-parameters special sub-model of the proposed method is derived and named a "Novel Generalized Exponent Power Weibull" distribution (NGEP-Wei for short). For the proposed family, some statistical properties are derived including the hazard rate function, moments, moment generating function, order statistics, residual life, and reverse residual life. The well-known method of estimation, the maximum likelihood estimation method is used for estimating the model parameters. Besides, a comprehensive Monte Carlo simulation study is conducted to assess the efficacy of this estimation method. Finally, the model selection criterion such as Akaike information criterion (AINC), the correct information criterion (CINC), the Bayesian information criterion (BINC), the Hannan–Quinn information criterion (HQINC), the Cramer–von-Misses (CRMI), and the ANDA (Anderson–Darling) are used for comparison purpose. The comparison of the NGEP-Wei with other rival distributions is made by Two COVID-19 data sets. In terms of performance, we show that the proposed method outperforms the other competing methods included in this study. [ABSTRACT FROM AUTHOR]

Purpose: Research on intimate partner violence (IPV) is generally focused on female survivors. However, in Canada, about half of all self-reported victims of IPV are men and 1 in 5 calls to police for domestic violence are for male victims. This paper takes a comparative approach to understanding survivors' experiences of IPV. Methods: Across Canada, 110 female and 45 male survivors of IPV were recruited through media, social media, and listservs for a survey and interviews in 2017. Results: Findings indicate areas of similarity (healthcare needs; difficulty accessing formal support; fear of false accusations) and areas of difference (availability of formal support; types of violence experienced most often; interactions with the justice system). Women and men reported similar types of IPV, with women experiencing higher rates of sexual violence, stalking, and damage to property. Women and men reported similar physical and mental health consequences following IPV. Men were less satisfied than women with the response of the justice system, and both female and male participants encountered gender bias within the justice system. Some women reported being turned away from services that were at their maximum capacity, and men reported difficulty identifying IPV-related services for male survivors. Conclusions: Findings can be used by frontline service providers and the justice system to ensure that services are gender-inclusive and gender-sensitive. [ABSTRACT FROM AUTHOR]

This paper introduces the MinCan database that presents mine-level estimates for the Canadian mining industry with a persistent annual coverage between 1950 and 2022. These estimates are based on archival maps and a selection of historical sources, which follows a hierarchy of criteria-based credibility and standardization. The information contained in MinCan covers 947 mines and provides information about their location (longitude and latitude in decimal), the company ownership, the principal commodities produced, and the years of operation (opening and closing dates). It is the first open access database to propose an exhaustive, free, and reliable compilation of the principal past and present mines producing in Canada. The geographic coordinates enable matching with other local, regional, and national databases, and allow for a wide range of research objectives to be met. [ABSTRACT FROM AUTHOR]

In Canada, in the early 2000s, the decriminalization of cannabis for recreational use seemed imminent. Between 2003 and 2005, three government decriminalization bills were introduced in the Canadian House of Commons, but none were adopted, and decriminalization efforts were abandoned. Subsequently, Canada went beyond decriminalization and legalized recreational cannabis in 2018. This paper examines why the Canadian decriminalization efforts failed, using the Advocacy Coalition Framework (ACF) and ACF policy change theory. Three ACF-based hypotheses to explain the failed reform attempts are developed and investigated, but none are empirically supported. A fourth hypothesis is developed using information processing insights from Punctuated Equilibrium Theory (PET) but adapted to the ACF. This hypothesis is empirically supported showing that Canada's decriminalization efforts failed, despite a supportive advocacy coalition, favourable conditions in the cannabis policy subsystem and favourable conditions in the Canadian political system, because its systemic advocates did not give it priority relative to other issues from other subsystems. This finding has implications for ACF policy change theory, identifying a necessary condition for major policy change that has been potentially overlooked, and illustrates the potential for cross-fertilization between PET and ACF theories of policy change. [ABSTRACT FROM AUTHOR]

This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions. [ABSTRACT FROM AUTHOR]

Introduction: Through interviews with 148 older persons from four countries and in four languages, the content for a 17-item measure of active living was developed. The purpose of this paper is to present further evidence of the extent to which this new measure, Older Persons Active Living (OPAL), is “fit-for-purpose” for measuring the extent of active living at one point in time.A cross-sectional study was carried out on a population aged 65 + and living independently, drawn from a participant panel, HostedinCanada, sampling people from Canada, United States, United Kingdom, and Netherlands. The survey instrument comprised the OPAL questionnaire rated on importance and frequency, sociodemographics, and information on physical and mental function. The argument-based approach to validity framed the analyses. Logistic regression, structural equation modeling, ordinary least-squares regression, and correlation were used to generate estimates for parameters underpinning validity evidence.A total of 1612 people completed the survey, 100 to 400 people across the 6 country-language strata. The proportion of people rating the items as extremely or quite important ranged from 60 to 90%, with no important differences between men and women and few differences between strata. A single-factor structure was supported. The ordinality of the response options justified an additive total score yielding a near normal distribution (mean: 33.1; SD: 11.5; range 0–51). Correlations with other measures of converging constructs were of moderate strength (~ 0.50), and differences across groups known to affect functioning and health were observed, suggesting a Miminal Important Difference (MID) of 6 out of 51.The results of this study provide evidence that the 17-item OPAL measure is fit for the purpose of estimating the extent to which older persons are living actively at one point in time.Methods: Through interviews with 148 older persons from four countries and in four languages, the content for a 17-item measure of active living was developed. The purpose of this paper is to present further evidence of the extent to which this new measure, Older Persons Active Living (OPAL), is “fit-for-purpose” for measuring the extent of active living at one point in time.A cross-sectional study was carried out on a population aged 65 + and living independently, drawn from a participant panel, HostedinCanada, sampling people from Canada, United States, United Kingdom, and Netherlands. The survey instrument comprised the OPAL questionnaire rated on importance and frequency, sociodemographics, and information on physical and mental function. The argument-based approach to validity framed the analyses. Logistic regression, structural equation modeling, ordinary least-squares regression, and correlation were used to generate estimates for parameters underpinning validity evidence.A total of 1612 people completed the survey, 100 to 400 people across the 6 country-language strata. The proportion of people rating the items as extremely or quite important ranged from 60 to 90%, with no important differences between men and women and few differences between strata. A single-factor structure was supported. The ordinality of the response options justified an additive total score yielding a near normal distribution (mean: 33.1; SD: 11.5; range 0–51). Correlations with other measures of converging constructs were of moderate strength (~ 0.50), and differences across groups known to affect functioning and health were observed, suggesting a Miminal Important Difference (MID) of 6 out of 51.The results of this study provide evidence that the 17-item OPAL measure is fit for the purpose of estimating the extent to which older persons are living actively at one point in time.Results: Through interviews with 148 older persons from four countries and in four languages, the content for a 17-item measure of active living was developed. The purpose of this paper is to present further evidence of the extent to which this new measure, Older Persons Active Living (OPAL), is “fit-for-purpose” for measuring the extent of active living at one point in time.A cross-sectional study was carried out on a population aged 65 + and living independently, drawn from a participant panel, HostedinCanada, sampling people from Canada, United States, United Kingdom, and Netherlands. The survey instrument comprised the OPAL questionnaire rated on importance and frequency, sociodemographics, and information on physical and mental function. The argument-based approach to validity framed the analyses. Logistic regression, structural equation modeling, ordinary least-squares regression, and correlation were used to generate estimates for parameters underpinning validity evidence.A total of 1612 people completed the survey, 100 to 400 people across the 6 country-language strata. The proportion of people rating the items as extremely or quite important ranged from 60 to 90%, with no important differences between men and women and few differences between strata. A single-factor structure was supported. The ordinality of the response options justified an additive total score yielding a near normal distribution (mean: 33.1; SD: 11.5; range 0–51). Correlations with other measures of converging constructs were of moderate strength (~ 0.50), and differences across groups known to affect functioning and health were observed, suggesting a Miminal Important Difference (MID) of 6 out of 51.The results of this study provide evidence that the 17-item OPAL measure is fit for the purpose of estimating the extent to which older persons are living actively at one point in time.Conclusion: Through interviews with 148 older persons from four countries and in four languages, the content for a 17-item measure of active living was developed. The purpose of this paper is to present further evidence of the extent to which this new measure, Older Persons Active Living (OPAL), is “fit-for-purpose” for measuring the extent of active living at one point in time.A cross-sectional study was carried out on a population aged 65 + and living independently, drawn from a participant panel, HostedinCanada, sampling people from Canada, United States, United Kingdom, and Netherlands. The survey instrument comprised the OPAL questionnaire rated on importance and frequency, sociodemographics, and information on physical and mental function. The argument-based approach to validity framed the analyses. Logistic regression, structural equation modeling, ordinary least-squares regression, and correlation were used to generate estimates for parameters underpinning validity evidence.A total of 1612 people completed the survey, 100 to 400 people across the 6 country-language strata. The proportion of people rating the items as extremely or quite important ranged from 60 to 90%, with no important differences between men and women and few differences between strata. A single-factor structure was supported. The ordinality of the response options justified an additive total score yielding a near normal distribution (mean: 33.1; SD: 11.5; range 0–51). Correlations with other measures of converging constructs were of moderate strength (~ 0.50), and differences across groups known to affect functioning and health were observed, suggesting a Miminal Important Difference (MID) of 6 out of 51.The results of this study provide evidence that the 17-item OPAL measure is fit for the purpose of estimating the extent to which older persons are living actively at one point in time. [ABSTRACT FROM AUTHOR]

Background: Bleeding in early pregnancy is a common emergency department (ED) presentation. Although variability in approaches has been demonstrated, research is relatively uncommon on practices and outcomes. This study investigated the influence of clinical pattern of care, utility, and contribution of pelvic examination aimed at diagnosing and managing bleeding in early pregnancy at three Canadian EDs. Methods: After obtaining informed consent, data were collected from adult women who were pregnant and from treating ED physicians using a structured questionnaire. We defined the change in management based on the initial clinical plan at the time of the initial physician assessment in the ED and any subsequent changes made after the pelvic examination was performed. Patient telephone follow-up was supplemented by linking with provincial administrative data for births. Univariable and multivariable binary logistic regression analyses were performed to identify factors associated with a change in patient management following pelvic examination in the ED. Results: Overall, 200 women were enrolled. The mean age was 31 years, patients had been bleeding for a median of 1 day and stayed in the ED for a median of 5 h. Of these, 166 (83.0%) received a pelvic examination, including speculum examination and/or bimanual palpation. Pregnancy outcome data were available for 192 pregnancies; 107 (56%) experienced a miscarriage. Factors significantly associated with a change in management after pelvic examination in the univariate logistic regression analysis were brown/dark-red bleeding per vaginam (physician determined), tachycardia, right lower quadrant tenderness, and bimanual palpation. In the multivariate logistic regression analysis, brown/dark-red bleeding per vaginam was independently associated with a reduced likelihood of a change in management after pelvic examination (aOR = 0.37; 95% CI: 0.14–0.98). Conclusion: Among women presenting to the ED with bleeding in early pregnancy prior to 20 weeks gestation, only brown/dark-red vaginal bleeding, potentially indicative of bleeding resolution, significantly independently influenced the baseline odds of a change in management after pelvic examination. Until the debate on the utility of pelvic examination in the ED for this presentation is resolved, physician preferences and shared decision making with patients should guide practice regarding speculum examination/bimanual palpation for the management of bleeding in early pregnancy. [ABSTRACT FROM AUTHOR]

Currently there is a severe lack of research on autism and Indigenous people in Canada. This scoping review explores this literature gap and assesses the same literature from an Indigenous perspective. Scoping reviews are an effective means to explore the literature in a specific area, in this case, autism and Indigenous people in Canada. We explored existing literature as it pertains to Indigenous populations and autism in Canada. To support this review, the Indigenous Quality Assessment Tool (QAT) was adapted to appraise the quality of literature. In total, there were a total of 212 articles identified of which 24 met the inclusion criteria: (1) some focus on autism, (2) a component specific to Indigenous people, and (3) specific to Canada. Of the 24 articles and reports, 15 were peer-reviewed and the rest considered grey literature. Most articles focused on program delivery with some literature using primary data (quantitative and/or qualitative). Overall, the quality of the research was appraised as poor, as determined by the QAT. Findings reaffirm the critical need for research that addresses autism in Indigenous communities within Canada and show the importance of having research done in full partnership with, or led by, Indigenous people. [ABSTRACT FROM AUTHOR]

This article examines supports available to trafficked migrants in Canada, namely access to a residence permit, income support, healthcare, housing and legal assistance. We demonstrate that supports are limited and unevenly available across Canada and argue that these gaps are correlated with the nature of government anti-human trafficking discourse, which pays limited attention to the circumstances of trafficked migrants. [ABSTRACT FROM AUTHOR]

Background: Given the significance of motor competence (MC) for healthy development and as a cornerstone for lifelong physical activity (PA), it is crucial to understand the manifold factors that are associated with MC. Thus, the aim of the present study was to investigate correlates of children's MC and their fundamental movement skills (FMS) within their daily life from a comprehensive biopsychosocial-ecological perspective. Methods: This is a cross-sectional sub-study of the 'Physical Literacy for Communities (PL4C)' WAVES cohort study conducted in the West Vancouver School District, Canada. Motor competence was assessed using the PLAYfun tool including overall MC score and five FMS category scores, namely, running, locomotor skills, upper and lower body control and balance skills. By means of structural equation modeling (SEM), direct associationswith MC and with the specific FMS categories addressing physical activity behavior, self-perceived physical literacy, parenting, and school ground design were investigated. Results: A total of 355 children with a mean age of 7.5 years and 111.1 min of MVPA per day participated. The group comprised 51% boys and 47% girls from 14 elementary schools. Most children were at an emerging MC-level (71%), while those at a competent MC-level exhibited significantly more daily minutes of MVPA (123 versus 109, p = 0.001). Additionally, they played outdoors more frequently and engaged in more instructor-led PA. The results revealed that logistical support from parents had not only a direct positive association with overall MC, both for girls and boys, but also with most of the FMS categories. However, the correlates of MC varied between genders and showed different patterns across the five FMS categories. While time spent in sports or coach-/instructor-led physical activities had a significant SEM generated direct effect only for boys' MC and for locomotor, upper body object control and balance, the aesthetic design of the school grounds was only associated with girls' MC and those same three FMS categories. Multivariate SEM could explain 26% of variance for girls' MC and 30% for boys'. Conclusions: This exploratory baseline assessment revealed parental logistical support as an important correlate of MC, irrespective of gender. There were distinct gender patterns across biopsychosocial-ecological correlates influencing MC and FMS. Despite the heterogeneity of the results, our findings indicate a potential role of school ground design in supporting the development of children's MC, especially for girls. Key Points: • The influence of biopsychosocial-ecological correlates on motor competence (MC) varied based on gender and the specific fundamental movement skill (FMS) categories. • While parental logistical support demonstrated a positive direct association with both genders' MC and most of the FMS categories, coach-led physical activities appeared to enhance only boys'. • The positive direct association of outdoor play on boys' MC and of school ground aesthetics on girls' MC might suggest the role of the physical environment in MC development. [ABSTRACT FROM AUTHOR]

Objective: To assess rates of traversing barriers to care to access optimal clinical outcomes in people with migraine internationally. Background: People in need of medical care for migraine should consult a health care professional knowledgeable in migraine management, obtain an accurate diagnosis, and receive an individualized treatment plan, which includes scientific society guideline-recommended treatments where appropriate. Methods: The Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study was a cross-sectional, web-based survey conducted from July 2021 through March 2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States (US). Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria for migraine and had Migraine Disability Assessment Scale (MIDAS) scores of ≥ 6 (i.e., mild, moderate, or severe disability) were deemed to need medical care and were included in this analysis. Minimally effective treatment required that participants were currently consulting a health care professional for headache (barrier 1), reported an accurate diagnosis (barrier 2), and reported use of minimally appropriate pharmacologic treatment (barrier 3; based on American Headache Society 2021 Consensus Statement recommendations). Proportions of respondents who successfully traversed each barrier were calculated, and chi-square tests were used to assess overall difference among countries. Results: Among 14,492 respondents with migraine, 8,330 had MIDAS scores of ≥ 6, were deemed in need of medical care, and were included in this analysis. Current headache consultation was reported by 35.1% (2926/8330) of respondents. Compared with the US, consultation rates and diagnosis rates were statistically significantly lower in all other countries except France where they were statistically significantly higher. Total appropriate treatment rates were also statistically significantly lower in all other countries compared with the US except France, which did not differ from the US. All 3 barriers were traversed by only 11.5% (955/8330) of respondents, with differences among countries (P < 0.001). Conclusions: Of people with migraine in need of medical care for migraine, less than 15% traverse all 3 barriers to care. Although rates of consultation, diagnosis, and treatment differed among countries, improvements are needed in all countries studied to reduce the global burden of migraine. Trial registration: NA. [ABSTRACT FROM AUTHOR]

Introduction: Certolizumab pegol (CZP) is an anti-tumor necrosis factor alpha (TNFα) approved for the treatment of moderate to severe plaque psoriasis (PSO). However, data on its real-world use is currently limited. The objective of this study was to describe the 1-year real-world effectiveness of CZP, its impact on health-related quality of life (HRQoL), and safety outcomes in patients with moderate to severe PSO in multi-country settings. Methods: CIMREAL, a prospective, noninterventional study, was conducted across Europe and Canada from August 2019 to December 2022. Patients were followed for 1-year, receiving CZP 400 mg initial doses at weeks 0, 2, and 4, followed by CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg Q2W maintenance dosing. Effectiveness was assessed using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Safety was also evaluated. Results: Overall, 399 patients with moderate to severe PSO were included. Of these, 93.7% (374/399) and 77.9% (311/399) completed months 3 and 12, respectively. Mean age (± standard deviation) was 42.9 ± 13.5 years and body mass index was 28.5 ± 6.8 kg/m2, with the majority of patients being female (68.2%). At 12 months, CZP showed substantial effectiveness, achieving PASI 75 and PASI 90 response rates (≥ 75% and ≥ 90% improvement from baseline, respectively) of 77% and 56.5%, respectively. Patients with PASI score of ≤ 3 and ≤ 2 experienced improvement from 3 months (49.8% and 41.1%, respectively) to 12 months (82.0% and 75.3%, respectively). HRQoL considerably improved, with mean DLQI scores decreasing from 12.4 to 2.3 after 12 months of treatment, and the proportion of patients with DLQI 0/1 increased from 28.6% at 3 months to 59.4% at 12 months. The 1-year probability of persistence was approximately 85%. Overall, 30.6% of the patients experienced any adverse events and 9.3% had serious adverse events. Conclusion: In routine clinical practice, CZP exhibited consistent effectiveness, positively impacting both skin psoriasis activity and HRQoL. The 1-year persistence of CZP was high, and no new safety signals were identified. Trial Registration Number: ClinicalTrials.gov Identifier: NCT04053881 https://www.clinicaltrials.gov/study/NCT04053881. [ABSTRACT FROM AUTHOR]

Youth involved in child welfare may benefit from programming that enhances their relationship skills given their susceptibility to engaging in high-risk interpersonal behaviors that can lead to challenges such as, engaging in or experiencing violence, housing and job insecurity, and poor physical and mental health. This research explored the feasibility of implementing an evidence-based healthy relationships program, the Healthy Relationships Plus Program - Enhanced (HRP-E), with youth involved in child welfare. Over 9 months, four HRP-E groups were facilitated at a Children's Aid Society in Ontario, Canada, involving 28 youth. Interviews were conducted with facilitators (n = 5) and youth (n = 13) to examine their views of the program. Facilitators also completed surveys that evaluated the facilitation of each session and overall program implementation. A thematic analysis of the data was conducted and results indicated that the HRP-E was perceived as a valuable program that is relevant and useful for youth involved in child welfare. Participants highlighted trauma-informed practices and organizational resources that are required when facilitating the HRP-E within a child welfare context. The present findings address the theory-to-practice gap by illustrating the practical application of trauma-informed program facilitation. The outcomes of this study contribute to understanding considerations and best practices for implementing a healthy relationships program with youth involved in child welfare. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. Methods: We implemented cross-sectional surveys with adolescents aged 13–18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). Results: Most participants (n = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. Conclusions: Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth. [ABSTRACT FROM AUTHOR]

Canada legalized non-medical cannabis use and supply for adults in 2018. We examined developments and changes associated with the legalization policy reform on key indicators for public health, namely cannabis (including frequent/problematic) use prevalence, cannabis-related hospitalizations, cannabis-impaired driving, and cannabis sourcing. We identified peer-reviewed and "grey" study data that featured population-level or other quasi-representative samples and comparable outcome data for pre- and post-legalization periods, including possible trends of changes over time. Cannabis use has increased in select population groups, with use modes shifting away from smoking. Evidence on cannabis-related hospitalizations (e.g., for mental health) is mixed. The prevalence of cannabis-impaired driving appears to be generally steady but THC exposure among crash-involved drivers may have increased. Increasing proportions of users obtain cannabis products from legal sources but some—especially regular—users continue to use illicit sources. Overall, data suggest a mixed and inconclusive picture on cannabis legalization's impacts on essential public health indicators, including select extensions in trends from pre-legalization. [ABSTRACT FROM AUTHOR]

Domestic violence (DV) impacts the safety and well-being of adult victims and their children who are exposed to the violence. Police play a critical role in providing intervention strategies to protect the welfare of victims of DV. Police training, policy and procedures on intervention strategies are often adult-centric leaving little direct police interaction with children. Objective: The objective of the current study is to identify the challenges police officers perceive in providing effective safety planning and risk management strategies for domestic violence victims and their children. Participants, Setting & Methods: Interviews with domestic violence police specialists (n = 12) in Ontario, Canada were used to gather information on police officers' perspective on the challenges they face in executing safety planning and risk management strategies. A dual deductive/inductive approach to a thematic analysis at the sematic level was used (Braun and Clarke, Qualitative Research in Psychology 3:77–101, 2006) to explore themes. Results: The major themes that emerged from the interviews were: (a) challenges with the broader economic/social and judicial system; (b) challenges created by organizational factors; and (c) individual challenges affiliated with police officers' perception of barriers they encountered. These challenges all impact the police response to providing intervention strategies to DV victims and their child(ren). Conclusions: This study highlights the need for police organizations to formalize training, policies, and directives specific to safety planning and risk management for adult victims of DV and their children. [ABSTRACT FROM AUTHOR]

Purpose: The bond between mother and child is biological, genetic, spiritual, and unique. In times of intimate partner violence (IPV), mothering continues with efforts to protect and care for their children. The purpose of this project is to understand Indigenous mothering within the contexts of Indigenous identities, IPV, and rural, remote, and northern (RRN) places. Method: A secondary analysis of the Canadian Domestic Homicide Prevention for Vulnerable Populations Phase 3 Database revealed 16 cases identified as Indigenous mothers residing in RRN places. Grounded theory analyses explicated a preliminary theory of 'Colonial Pathways In, Indigenous Pathways Through' the social process of Indigenous mothering through IPV experiences in RRN places. Results: Indigenous mothering through IPV in RRN places is a responsive and embodied experience within a storied space, occurring through three pathways: Colonial pathways' into IPV; survival pathways during IPV; and recovery of cultural identity as providing an escape from IPV, expressed through themes of 1. comparative mothering, 2. continuous hypervigilance, protective nurturance, pursuit of safety, and 3. cultural recovery. Indigenous mothers demonstrates resilience in striving for safety while caring for their children within an IPV context. Conclusions: Indigenous mothering occurs even in the worst of times, such as during IPV. 'Colonial Pathways In, Indigenous Pathways Through' theory increases our understanding of Indigenous mothering in RRN places. Of significance is the occurrence of traumatic brain injury, pointing to the need for recognition that it is occurring and screening and treatment is required. Most of all, the study highlights the resilience, resistance, and resourcefulness of Indigenous mothers striving to keep themselves and their children safe. [ABSTRACT FROM AUTHOR]

Background: The Good Life with osteoArthritis: Denmark (GLA:D™), an evidence-based education and exercise program designed for conservative management of knee and hip osteoarthritis (OA), has been shown to benefit participants by reducing pain, improving function, and quality of life. Standardized reporting in the GLA:D databases enabled the measurement of self-reported and performance-based outcomes. There is a paucity of qualitative research on the participants' perceptions of this program, and it is important to understand whether participants' perceptions of the benefits of the program align with reported quantitative findings. Methods: We conducted semi-structured telephone interviews with individuals who participated in the GLA:D program from January 2017 to December 2018 in Alberta, Canada. Data were analyzed using an interpretive description approach and thematic analysis to identify emergent themes and sub-themes associated with participants perceived benefits of the GLA:D program. We analyzed the data using NVivo Pro software. Member checking and bracketing were used to ensure the rigour of the analysis. Results: 30 participants were interviewed (70% female, 57% rural, 73% knee OA). Most participants felt the program positively benefited them. Two themes emerged from the analysis: wellness and self-efficacy. Participants felt the program benefited their wellness, particularly with regard to pain relief, and improvements in mobility, strength, and overall well-being. Participants felt the program benefited them by promoting a sense of self-efficacy through improving the confidence to perform exercise and routine activities, as well as awareness, and motivation to manage their OA symptoms. Twenty percent of participants felt no benefits from the program due to experiencing increased pain and feeling their OA was too severe to participate. Discussion: The GLA:D program was viewed as beneficial to most participants, this study also identified factors (e.g., severe OA, extreme pain) as to why some participants did not experience meaningful improvements. Early intervention with the GLA:D program prior to individuals experiencing severe OA could help increase the number of participants who experience benefits from their participation. Conclusion: As the GLA:D program expands across jurisdictions, providers of the program may consider recruitment earlier in disease progression and targeting those with mild and moderate OA. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the Province of Ontario, Canada, launched a wastewater surveillance program to monitor SARS-CoV-2, inspired by the early work and successful forecasts of COVID-19 waves in the city of Ottawa, Ontario. This manuscript presents a dataset from January 1, 2021, to March 31, 2023, with RT-qPCR results for SARS-CoV-2 genes and PMMoV from 107 sites across all 34 public health units in Ontario, covering 72% of the province's and 26.2% of Canada's population. Sampling occurred 2–7 times weekly, including geographical coordinates, serviced populations, physico-chemical water characteristics, and flowrates. In doing so, this manuscript ensures data availability and metadata preservation to support future research and epidemic preparedness through detailed analyses and modeling. The dataset has been crucial for public health in tracking disease locally, especially with the rise of the Omicron variant and the decline in clinical testing, highlighting wastewater-based surveillance's role in estimating disease incidence in Ontario. [ABSTRACT FROM AUTHOR]

The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients' risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary. [ABSTRACT FROM AUTHOR]

This qualitative study was conducted to assess the responses of emerging adults with pre-existing mood and anxiety disorders to the third wave of the COVID-19 pandemic. Patients from the First Episode Mood and Anxiety Program in London, Ontario, Canada, which treats individuals aged 16–29 with mood and anxiety disorders, were invited between April 16th – 21st, 2021 to complete a survey on their current emotional states, activities and coping. Responses were analyzed using thematic analysis. A thematic analysis identified the theme of "Languishing," among responses comprised of 3 organizing subthemes: "Dominance of Negative Emotion," "Waiting and Stagnating," and "Loss of Opportunity." This study suggests that emerging adults with pre-existing mental illness languished as the pandemic and associated restrictions persisted. Emphasis on "Coping through Intentional Action," a separate theme identified among those coping well, may be protective for this group. [ABSTRACT FROM AUTHOR]

Escalating drug overdose death rates in Canada are of ever-increasing concern. To better understand the extent of this health threat, we obtained mortality statistics and population figures for the years 2000 to 2020, and examined rates of overdose deaths, coded (using ICD-10) as accidental, suicide or "undetermined intent." The drug deemed as primarily responsible for the death was categorized as opioid, non-opioid, or unspecified. Age patterns of drug deaths were graphed. Joinpoint analysis was used to test the significance of changes in death rates. Accidental opioid and stimulant overdose death rates in Canada have climbed faster since 2011, though not as high as corresponding US rates. Unknown cause death rates have increased. However, opioid and non-opioid suicide rates have decreased significantly since 2011, and there have been fewer drug deaths of undetermined intent. Increased attention to the possibility that some suicides are being misclassified is warranted. [ABSTRACT FROM AUTHOR]

Synchytrium endobioticum (Schilb.) Perc. is a chytrid fungus causing potato wart disease and is one of the most important quarantine diseases on cultivated potato. Infected host tissues develop warts rendering the crop unmarketable. Resting spores, that can remain viable and infectious for decades, are formed in warted tissues and are released into the surrounding soil when host tissue decays. To better understand the pathogen's diversity and to potentially uncover pathways of migrations and introduction events, molecular characterization was performed on the historical S. endobioticum resting spore collection of the Dutch National Plant Protection Organization. Mitochondrial genomes were assembled and annotated, and four novel structural variants were identified from these materials with intronic presence-absence variation in cox1 or cob genes and structural variation in the dpoB – TIR region. Several fungal isolates were shown to contain mixtures of structural variants. We analyzed the mitogenomic sequences obtained from recent potato wart disease findings in Canada and the Netherlands in the context of the historical materials and found that fungal isolates from the new Dutch outbreak contained a specific mixture of mitogenomic variants previously not observed in the Netherlands. Based on the mitogenomic profile, pathotype 38(Nevşehir) was suspected which was later verified with the Spieckermann bioassay. To further facilitate dissemination of data and interactive visual analytics we created a public Nextstrain webpage with S. endobioticum mitogenomic sequences and associated metadata on their geographic origin, pathotype identity and (mixture) of mitogenomic variants (https://nextstrain.nrcnvwa.nl/Sendo). [ABSTRACT FROM AUTHOR]

Equity, diversity, and inclusion remain a prominent focus in medical schools, yet the phenomenon of "belonging" has arguably been overlooked. Little is known regarding how belonging is experienced by medical students from groups that face systemic oppression and exclusion. We employed a sequential explanatory mixed methods design to explore how students from equity-deserving groups (EDGs) experience belonging during medical school, including those who are women, racialized, Indigenous, disabled, and 2SLGBTQIA+. First, we conducted a national cross-sectional survey of medical students (N = 480) measuring four constructs: belonging, imposter syndrome, burnout, and depression. Belonging scores were overall lower for students from EDGs and, more specifically, significantly lowest amongst racialized students. Structural equation models show that poor sense of belonging precedes imposter syndrome and further exacerbates burnout and depression. Next, we sampled and interviewed students (N = 16) from the EDG whose belonging scores were significantly lowest. Participants described the essence of belonging as being able to exist as one's "true self" while emphasizing feelings of acceptance, comfort, and safety as well as being valued and seen as an equal - yet described how routine experiences of "othering" inhibited a sense of belonging, often due to differences in social identity and structural privilege. Poor sense of belonging negatively affected learners' well-being and career trajectory. We illuminate the range of psychological and professional consequences associated with diminished sense of belonging and highlight the need to expand traditional notions of equity, diversity, and inclusion to consider structural barriers to belonging. [ABSTRACT FROM AUTHOR]

Purpose: Domestic violence (DV) experienced by immigrant women is a global health concern. Precarious immigration status, language barriers, and discrimination can lead to reluctance in seeking support. Is a non-profit charitable organization and support center for immigrant women. Participants in this study were immigrant women who attended Changing Together. The aim of this study is to illustrate immigrant women's experiences of DV and identify the community services they access. Methods: The files of a social worker at Changing Together were audited for this project. There were 1,034 files available to audit. The six steps of thematic analysis were used to create themes from the notes of each file, specifically to answer the question: what are the experiences of immigrant women with domestic violence and what are the services they access through Changing Together? Results: Three themes were developed: Building Independence, Surviving Abuse, and Services to Support Surviving. Building Independence centres on women building solid foundations to start their lives in Canada to support themselves and their families. Surviving Abuse encompasses the hardships women endured for the perceived sake of their children until there was an event leading to the unavoidable need for change. Services to Support Surviving explores the services women accessed through the social worker at Changing Together. Conclusions: This study highlights the complexities of immigrant women enduring DV in a foreign country. The file notes described women's experiences of living with hardships and endurance of challenges. Further research should identify community resources for this population. [ABSTRACT FROM AUTHOR]

Despite advances in systemic care, diabetic disease of the eye (DDE) remains the leading cause of blindness worldwide. There is a critical gap of up-to-date, evidence-based guidance for ophthalmologists in Canada that includes evidence from recent randomized controlled trials. Previous guidance has not always given special consideration to applying treatments and managing DDE in the context of the healthcare system. This consensus statement aims to assist practitioners in the field by providing a spectrum of acceptable opinions on DDE treatment and management from recognized experts in the field. In compiling evidence and generating consensus, a working group of retinal specialists in Canada addressed clinical questions surrounding the four themes of disease, patient, management, and collaboration. The working group reviewed literature representing the highest level of evidence on DDE and shared their opinions on topics surrounding the epidemiology and pathophysiology of diabetic retinopathy and diabetic macular edema; diagnosis and monitoring; considerations around diabetes medication use; strategic considerations for management given systemic comorbidities, ocular comorbidities, and pregnancy; treatment goals and modalities for diabetic macular edema, non-proliferative and proliferative diabetic retinopathy, and retinal detachment; and interdisciplinary collaboration. Ultimately, this work highlighted that the retinal examination in DDE not only informs the treating ophthalmologist but can serve as a global index for disease progression across many tissues of the body. It highlighted further that DDE can be treated regardless of diabetic control, that a systemic approach to patient care will result in the best health outcomes, and prevention of visual complications requires a multidisciplinary management approach. Ophthalmologists must tailor their clinical approach to the needs and circumstances of individual patients and work within the realities of their healthcare setting. [ABSTRACT FROM AUTHOR]

Greenhouse gases (GHGs) can be produced from a broad range of anthropogenic activities at different spatial and temporal scales. In particular, emissions from urban area are an import source of GHGs. City is a complicated system consisting of various component and processes. Efforts have been made to reduce urban GHG emissions. However, there is a lack of available methods for effective assessment of such emissions. Many urban sources and factors which can influence the emissions are still unknown. In the present study, the GHG emissions from municipal activities was assessed. A model for the assessment of urban GHG emissions was developed. Based on the collected data, a case study was conducted to evaluate urban GHG emissions. The comprehensive assessment included the emissions from transportation, electricity consumption, natural gas, waste disposal, and wastewater treatment. There was a variation for GHG emissions from these sectors in different years. This study provided a new approach for comprehensive evaluation of urban GHG emissions. The results can help better understand the emission process and identify the major emission sources. [ABSTRACT FROM AUTHOR]

Freshwater ecosystems are biologically important habitats that provide many ecosystem services. Calcium concentration and pH are two key variables that are linked to multiple chemical processes in these environments, influence the biology of organisms from diverse taxa, and can be important factors affecting the distribution of native and non-native species. However, it can be challenging to obtain high-resolution data for these variables at regional and national scales. To address this data gap, water quality data for lakes and rivers in Canada and the continental USA were compiled and used to generate high-resolution (10 × 10 km) interpolated raster layers, after comparing multiple spatial interpolation approaches. This is the first time that such data have been made available at this scale and resolution, providing a valuable resource for research, including projects evaluating risks from environmental change, pollution, and invasive species. This will aid the development of conservation and management strategies for these vital habitats. [ABSTRACT FROM AUTHOR]

Varicella zoster virus (VZV) is a highly contagious human herpes virus responsible for causing chickenpox (varicella) and shingles (herpes zoster). Despite the approval of a highly effective vaccine, Shingrix®, the global incidence of herpes zoster is increasing and the economic burden to the health care system and society are substantial due to significant loss of productivity and health complications, particularly among elderly and immunocompromised individuals. This is primarily because access to the vaccines remains mostly limited to countries within developed economies, such as USA and Canada. Therefore, similarly effective vaccines against VZV that are more accessible to the rest-of-the-world are necessary. In this study, we aimed to evaluate immunogenicity and memory response induced by three mRNA-LNP-based vaccine candidates targeting VZV's surface glycoprotein E (gE). C57BL/6 mice were immunized with each candidate vaccine, and humoral and cellular immune responses were assessed. Our results demonstrate that the mRNA-LNP-based vaccine candidates elicited robust and durable humoral responses specific to the gE antigen. Notably, mice vaccinated with the mRNA-LNP vaccines exhibited significantly higher antigen-specific T-cell cytokine production compared to the group receiving Shingrix®, the current standard of care vaccine. Additionally, mRNA-LNP vaccines induced long-lasting memory response, as evidenced by detection of persistent gE-specific Long-Lived Plasma Cells (LLPCs) and memory T cells four months after final immunization. These findings underscore the potential of our mRNA-LNP-based vaccine candidates in generating potent immune responses against VZV, offering promising prospects for their clinical development as an effective prophylactic vaccine against herpes zoster. [ABSTRACT FROM AUTHOR]

Despite their strong humanitarian reputations abroad, Norway and Canada have adopted domestic immigration policies that produce permanently precarious residents. These policies affect individuals—including refugees, permanent residents, and naturalized citizens—who have traditionally enjoyed secure legal statuses. Adopting the analytic lens of 'probationary immigration', this article explores the legal mechanisms behind three interrelated developments in both countries: 1) the fragmentation of protection regimes in terms of access, rights and duration; 2) stricter/less predictable requirements for permanent residence and citizenship; and 3) intensified practice regarding the revocation of citizenship. [ABSTRACT FROM AUTHOR]

The present study aimed to reveal science education research (SER) general trends via VOSviewer version 1.6.17 software program. For this purpose, a bibliometric analysis of 13,242 articles in the Education and Educational Research (E&ER) category of Web of Science (WoS) was performed. It was found that there was a significant increase in article counts since 2007, and that the most articles were published in 2020. The first conclusion of the current research was that funding support is an important factor in SER article counts published in WoS. The bibliometric analysis results showed that the most frequently used keywords in SER articles were science education, STEM/STEM education, nature of science, assessment, professional development, science, scientific literacy, argumentation, gender, and conceptual change. Another conclusion of this study was that science education researchers' interest varied according to certain year intervals. The study revealed that the most preferred topics were nature of science and professional development during 2007–2021. Additionally, research interest in the topics of conceptual change, scientific literacy, chemistry education, and attitudes during 2007–2016 declined during 2017–2021. The top four research topics in recent years were STEM, argumentation, self-efficacy, and motivation. The countries where most publications came from were the USA, UK, Australia, Turkey, and Canada. The results of this study showed that science education researchers' interest varied according to countries. The results of the study revealed that STEM/STEM education is mostly referred to in articles from the USA, Australia, UK, Taiwan, and Canada. Additionally, while there was more interest in the nature of science in the USA, Turkey, UK, and Canada there was more interest in argumentation in the USA, Turkey, UK, and Taiwan. Additionally, this study revealed the most cited SER articles' distinctive features and strength collaborations between countries and between authors. The results provided a comprehensive review to understand the recent developments in the SER. [ABSTRACT FROM AUTHOR]

Academic labor has expanded beyond the walls of academic institutions. Academics are expected to communicate with students online, use digital tools to complete their work, and share their research with broad audiences—often through online spaces like social media. Academics also face technology-facilitated violence and abuse (TFVA) in these same spaces. When this happens, employers have a responsibility to protect and support workers. However, recent events have shown that universities are not always prepared to do so. We use data from a discourse analysis of harassment and discrimination policies and interviews with university managers (including Vice President Academics/Provost, Faculty Deans, and directors of human rights offices) to examine how prepared Canadian universities and colleges are to support academics targeted by TFVA. We found that institutions are unprepared in three ways: first, they focus on physical safety over non-contact harms; second, they envision perpetrators to be named, local, and part of the campus community; and third, the reporting process is cumbersome and outpaced by the speed and frequency with which TFVA occurs. We consider these findings in the context of work-overflow and context collapse to demonstrate how the institutional apparatus for maintaining a safe and respectful working environment has not expanded in kind with the extensification of contemporary academic labor. [ABSTRACT FROM AUTHOR]

Background: Non-valvular atrial fibrillation (AF) is a common heart arrhythmia in the elderly population. AF patients are at high-risk of ischemic strokes, but oral anticoagulant (OAC) therapy reduces such risks. Warfarin had been the standard OAC for AF patients, however its effectiveness is highly variable and dependent on close monitoring of the anticoagulant response. Newer OACs such as rivaroxaban and apixaban address these drawbacks but are more costly. It is uncertain which OAC therapy for AF is cost-saving from the healthcare system perspective. Methods: We followed a cohort of patients in Ontario, Canada, aged ≥ 66 who were newly diagnosed with AF and prescribed OACs between 2012 and 2017. We used a two-stage estimation procedure. First, we account for the patient selection into OACs using a multinomial logit regression model and estimated propensity scores. Second, we used an inverse probability weighted regression adjustment approach to determine cost-saving OAC options. We also examined component-specific costs (i.e., drug, hospitalization, emergency department and physician) to understand the drivers of cost-saving OACs. Results: We found that compared to warfarin, rivaroxaban and apixaban treatments were cost-saving options, with per-patient 1-year healthcare cost savings at $2436 and $1764, respectively. These savings were driven by cost-savings in hospitalization, emergency department visits, and physician visits, outweighing higher drug costs. These results were robust to alternative model specifications and estimation procedures. Conclusions: Treating AF patients with rivaroxaban and apixaban than warfarin reduces healthcare costs. OAC reimbursement policies for AF patients should consider rivaroxaban or apixaban over warfarin as the first-line treatment. [ABSTRACT FROM AUTHOR]

Shifting demographics—that is, the growing number of older adults in Canada and internationally—and intersecting climatic risks create a complex landscape of aging in place in disaster contexts. Some older adults are vulnerable due to their underlying health conditions and limited physical mobility. Yet they also exhibit resilience in a distinct manner, owing to their wealth of knowledge, wisdom, and ability to navigate adversities. This article elucidates potential avenues for promoting the involvement of older adults in disaster recovery efforts. Our intention is to recognize and foster older adult resilience and mitigate vulnerability by drawing upon insights from the study titled "In the Aftermath of the 2016 Alberta Wildfires: The Role of Social Work Practitioners and Human Service Professionals in Long-Term Disaster Recovery." Employing a qualitative research approach, that study recruited 51 participants for semistructured interviews and focus groups. A thematic analysis of the collected data unveiled the pivotal roles played by social workers and human service practitioners in facilitating recovery from the 2016 wildfires in the research. Notably, three overarching themes emerged concerning the promotion of older adults' involvement in disaster recovery: fostering supportive relationships, building partnerships and enhancing collaboration, and addressing ongoing challenges. These findings offer valuable insights into how social work practitioners and human service professionals can effectively facilitate the engagement of older adults in disaster recovery initiatives. This article emphasizes the significance of actively promoting the participation of older adults in disaster mitigation efforts, thereby fostering greater resilience within communities. [ABSTRACT FROM AUTHOR]

The lognormal statistical distribution was used to present the reliable integrated data on the content of various physicochemical forms of tritium in air, natural water, and components of aquatic ecosystems at nuclear facility sites. Statistics of lognormal distributions took into account the left truncation, which reflects the effect of finite sensitivity of measurements. The statistics of lognormal distributions were used to obtain estimates for ecosystems of NPP sites at limited sets of data. Specific activities were estimated for various forms of tritium such as HTO (free water), TFWT (tissue free water tritium), and OBT (organically bound tritium). The measurement results show that the specific activity of tritium in the body in bound forms was, as a rule, higher than its specific activity in free water in the ambient environment. Equilibrium concentration ratios (CRs) (partition coefficients of hydrogen) ranged from 1 to about 20. The results obtained by the Radium Institute research team agree with those obtained by the researchers from Canada and France for the specific activity of tritium in different chemical forms in environmental samples. [ABSTRACT FROM AUTHOR]

Integrated renewable energy systems are becoming a promising option for electrification in remote communities. Integrating multiple renewable energy sources allows the communities to counteract the weaknesses of one renewable energy source with the strengths of another. This study aims to model, design and optimize integrated renewable energy systems consisting of solar photovoltaic (PV) panels, wind turbines, a biomass power generator, and storage batteries for applications in remote communities in Canada. Biomass is used as a fuel to produce electricity during periods when solar power and wind power are not capable of meeting the power demand. A methodology is developed to optimize the integrated renewable energy systems design, with the aim of minimizing the net present cost (NPC) and the levelized cost of electricity (LCOE) of the energy systems. Results show that the NPC is $3.61 M and the LCOE is $0.255/kWh for an optimized integrated renewable energy system in a sample remote community that has a peak power consumption of 238.7 kW and an average load demand of 2230 kWh/day. Through the present research, the integrated energy systems are evidenced to be an effective option for electrification in remote communities. [ABSTRACT FROM AUTHOR]