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Chronic liver disease places patients at increased risk of malnutrition that can be challenging to identify clinically and treat. Nutrition support is a key aspect of the management of these patients as it has an impact on their quality of life, morbidity, and mortality. There are significant gaps in the literature regarding the optimal nutrition support for patients with different types of liver diseases and the impact of these interventions on long-term outcomes. This Position Paper summarizes the available literature on the nutritional aspects of the care of patients with chronic liver diseases. Specifically, the challenges associated with the nutritional assessment of these subjects are discussed, and recently investigated approaches to determining the patients' nutritional status are reviewed. Furthermore, the pathophysiology of the malnutrition seen in the context of chronic liver disease is summarized and monitoring, as well as treatment, recommendations are provided. Lastly, suggestions for future research studies are described.

Performing well-designed and ethical trials in pediatric inflammatory bowel diseases (IBD) is a priority to support optimal therapy and reduce the unacceptable long lag between adult and pediatric drug approval. Recently, clinical trials in children have been incorporating placebo arms into their protocols under conditions that created controversy. Therefore, 4 organizations (the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Crohn's and Colitis Organization; the Canadian Children IBD Network; and the Global Pediatric IBD Network) jointly provide a statement on the role of placebo in pediatric IBD trials. Consensus was achieved by 94 of 100 (94%) voting committees' members that placebo should only be used if there is genuine equipoise between the active treatment and placebo; for example, this may be considered in trials of drugs with new mechanisms of action without existing adult data, especially when proven effective alternatives do not exist outside the trial. Placebo may also be used in situations where it is an "add-on" to an effective therapy or to evaluate exit-strategies of maintenance therapy after long-term deep remission. It has been, however, agreed that no child enrolled in a trial should receive a known inferior treatment both within and outside the trial. This also includes withholding therapy in children who show clinical response after a short induction therapy. Given the similarity between pediatric and adult IBD regarding pathophysiology and response to treatments, drugs generally cannot be considered being in genuine equipoise with placebo if it has proven efficacy in adults. Continued collaboration of all stakeholders is needed to facilitate drug development and evaluation in pediatric IBD.

The article presents abstracts of geographical research papers. In the research paper "A Geographical Study of Nova Scotia," researcher R.H. Whitebeek discusses the geographic conditions of Nova Scotia. Lying nearer Europe and possessing many excellent harbors and peopled by immigrants from the best European stocks, the province of Nova Scotia in Canada has now, after 300 years, fewer people than the city of Boston, Massachusetts. Its total manufacturing output is less than that of single companies in New England, and the province has shared but slightly in Canada's economic growth.

Simple Summary: Oral cancer affects the mouth and throat areas. It is a major cause of death for older people in developed countries. This review looked at how living in rural areas influences oral cancer trends in these countries. The studies from these countries showed increasing rates of oral cancer in rural areas of the US, Australia, Canada, and Europe. Older people are more affected by these cancers than younger groups. The main risk factors are tobacco use, alcohol consumption, and HPV infections. People in rural areas often do not know much about HPV-related cancers. They also tend to use more tobacco and alcohol than city dwellers. Even in developed countries, living in rural areas can lead to shorter lifespans for oral cancer patients. This is mainly because it is harder for them to access specialized cancer treatment centres and advanced medical care. In summary, where people live can significantly impact their chances of surviving oral cancer, even in wealthy nations. Oral cancer is the general term used to describe cancers of the oral cavity and oropharyngeal region. These cancers are one of the leading causes of death in elderly residents within the Organisation for Economic Co-operation and Development (OECD) member countries in the 21st century. This scoping review was carried out to assess the influence of rurality on oral cancer trends and patterns among OECD member countries. Four online databases (Medline, PubMed, Scopus, and CINAHL) were searched for studies that reported on oral cancer trends in rural and remote areas in OECD member countries. A total of 1143 articles were obtained initially; among them, 995 papers were screened to include 18 articles for this scoping review. Studies have reported increasing incidence and prevalence in the United States, Australia, Canada, and European countries wherein risk factors such as tobacco, alcohol, and human papilloma virus (HPV) infections were associated with oral and oropharyngeal cancers. Awareness among people living in rural areas about HPV-related cancers was very low, while rates of tobacco and alcohol abuse were noted to be rising more rapidly than among their urban counterparts. Furthermore, the ageing population was most affected compared to the younger age groups of people with oral and oropharyngeal cancer that are prevalent in these regions. Overall, despite living in developed countries, rurality was noted to be a significant factor in the lower life expectancy of oral cancer patients, mainly due to the limited accessibility to tertiary cancer care centres and advanced medical care. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

As humanity reaches the 5.0 industrial revolution, education plays a critical role in boosting the quality of human resources. This paper reports bibliometric research on emerging TiP during 1993-2022 in the educational field to analyse its development on any level of education during the last three decades. This study employed a Scopus database. The findings are that the trend of TiP publication in educational fields has tended to increase every year during the past three decades and conference paper became the most published document type, the USA is the country which produces the most publications; "Students" being the most occurrences keyword and total link strength. The publication of the TiP is ranked to the Quartile 1, which implies that a publication with the cited performance is a publication with credibility because the publisher has a good reputation. Researchers can find the topics most relevant to other metadata sources such as Web of Science, Publish, and Perish.

Although seafood is considered to be an important part of a balanced diet, many national food consumption surveys suggest that seafood is not consumed in sufficient amounts. As consumers are moving to diversify their diet from animal-based protein, it is important to understand the factors influencing consumption of marine foods. This review aims to assess the characteristics of seafood consumers as well as the influences on seafood consumption in Europe, USA, Canada, Australia and New Zealand. Systematic search strategies were used to identify relevant journal articles from three electronic databases (PubMed, Web of Science and Embase). Three searches were carried out and identified 4405 unique publications from which 121 met the criteria for the review process. The reviewed studies revealed that seafood consumers were more likely to be older, more affluent and more physically active and were less likely to smoke compared with non-seafood consumers. Sex and BMI did not appear to have a directional association with seafood consumption. The most commonly reported barriers to seafood consumption were cost, followed by sensory or physical barriers, health and nutritional beliefs, habits, availability and cooking skills. The most commonly reported influences were beliefs about the contribution of seafood to health, environmental influences and personal preferences. Based on the findings of this review, future intervention strategies to increase seafood consumption may need to consider affordability and education in terms of health, nutrition and cooking skills. More research is needed to explore the effectiveness of specific interventions at increasing the consumption of seafood. [ABSTRACT FROM AUTHOR]

A major hurdle in pediatric formulation development is the lack of safety and toxicity data on some of the commonly used excipients. While the maximum oral safe dose for several kinds of excipients is known in the adult population, the doses in pediatric patients, including preterm neonates, are not established yet due to the lack of evidence-based data. This paper consists of four parts: (1) country-specific perspectives in different parts of the world (current state, challenges in excipients, and ongoing efforts) for ensuring the use of safe excipients, (2) comparing and contrasting the country-specific perspectives, (3) past and ongoing collaborative efforts, and (4) future perspectives on excipients for pediatric formulation. The regulatory process for pharmaceutical excipients has been developed. However, there are gaps between each region where a lack of information and an insufficient regulation process was found. Ongoing efforts include raising issues on excipient exposure, building a region-specific database, and improving excipient regulation; however, there is a lack of evidence-based information on safety for the pediatric population. More progress on clear safety limits, quantitative information on excipients of concern in the pediatric population, and international harmonization of excipients' regulatory processes for the pediatric population are required. [ABSTRACT FROM AUTHOR]

Post-secondary institutions spend considerable resources on programs, such as study abroad and international work-integrated learning, which involve students' participation in international experiences. One significant impetus for these programs is the hope that through exposing students to international settings these students will be better prepared to be successful in global workplaces upon graduation, in essence be more "global-ready". However, simply having an international experience does not necessarily lead to the development of capabilities that result in global workplace success. In addition to the knowledge, skills and abilities required for any workplace, being successful in these global workplaces also requires intercultural effectiveness. This paper presents the findings of a study that examined the development of cultural intelligence (CQ), the ability to be effective in intercultural encounters, in students participating in a Canadian-European exchange program (CANEU-COOP) where the European students had a study term in Canada and the Canadian students had a co-op work term in Europe. The study found that while both groups of students developed CQ, there were differences between the groups. These findings reaffirm the importance of intentionally structuring international experiences to include curriculum about and assessment of intercultural effectiveness. [Paper presented at the World Association for Cooperative and Work-Integrated Education, International Research Symposium on Cooperative and Work-Integrated Education, (2nd, Victoria, British Columbia, Canada, 2016).]

Despite high expectations for the sector, most marine energy technologies remain in the research and development, or at best demonstration, phase. The industry is in a period of stagnation, and requires new approaches to overcome the challenges that inhibit widespread deployment. Smallscale initiatives have proven to be a successful means of developing other renewable technologies but their role in supporting marine energy is not well researched. This paper provides a review of the barriers and opportunities presented by different policy landscapes, financial support mechanisms, markets, key actors, and wider regulatory and governance issues. Semi-structured interviews with marine energy stakeholders from the UK, Canada and Denmark were used to explore the role of small-scale marine energy projects, and were supplemented by interviews with the general public in England. This showed that while marine energy is appropriately scalable for local projects, financing remains a major hurdle. Discretionary local authority finance, as well as other novel options such as crowdfunding, tends to be relatively modest, supporting the argument for small-scale projects. A market for smaller devices exists, particularly for remote communities currently dependent on expensive energy from oil-fired generators. There remains a significant role for small-scale projects in testing the technology, contributing to reductions in cost and environmental risk. Current processes for environmental impact assessment can present a significant hurdle for small projects, but proportionate, adaptive assessments are evolving. Finally, community ownership and public participation have the potential to increase advocacy for the industry, with multi-actor partnerships presenting a positive way forward. [ABSTRACT FROM AUTHOR]

The COVID-19 crisis has led to widespread temporary school closures and a deep economic recession. School closures have threatened children's ability to learn and later return to school well prepared. The impact of the economic recession is going to be even more devastating: first for students, but also for the ability of some Catholic schools to maintain their enrollment and remain sustainable financially in countries where they do not benefit from government support. This paper, the first in a set of two, looks at some of the likely impacts of the COVID-19 crisis on Catholic Schools in developed countries with a particular focus on the United States, a country not only hard hit by the crisis but also where Catholic schools are especially vulnerable to downturns. While Catholic schools may be able to respond to the immediate challenge of school closures among others through distance learning options, their ability to maintain enrollment during the economic downturn is less clear. How schools will respond to the twin challenges of ensuring learning during school closures and beyond, and remaining affordable for families at a time of economic stress, may affect whether they are able to maintain their comparative advantage. A key aim of the paper is to make Catholic school teachers and leaders aware of some of the discussions on how to respond to the crisis, and provide links to online resources that may be useful. [For Part II of the series, see EJ1278501.]

This paper examines the interplay of creativity, education, and the expressive arts. We begin by presenting a narrative literature review focusing on the use of artistic tools to promote creativity, self-expressiveness, and meaningful aspects of emotional and social learning. This review reveals strong connections between the different components of this interplay, and a special attention is given to the use of arts to promoting creativity and meaningful learning. We then propose the Empowering Creative Education Model (ECEM), which aims to provide a practical framework for employing artistic tools in each of the model's four developmental circles: I, Us, Educational and Community. Each of the four circles includes unique aspects of personal development.

Purpose - The purpose of this paper is to investigate the strategic profiles and differences across globally leading business schools. Design/methodology/approach - This paper used the concepts of strategic group identity and domain consensus to examine the differences across the business schools. Cluster analysis is applied to identify strategic groups among 82 global schools from the USA, Canada, Europe, Asia and Australia. Findings - Ten strategic groups - essentially similar strategic "clusters" - are identified by the clustering analysis. The results demonstrate that the groups do have different resource and reputation profiles. Research limitations/implications - Future research can improve the research base by collecting data on financial variables such as endowments, providing metrics by which a school's efficiency can be assessed, or collecting longitudinal data. Furthermore, a form of cognitive strategic mapping could be achieved through survey and interview mechanisms in order to highlight the perspectives of deans and senior managers of business schools. Originality/value - This research contributes to the literature in two aspects. First, this research provides a clear mapping of the strategic "bands" across globally branded business schools. The results are highly timely in today's debate about the nature and future of business schools. Second, this research demonstrates that strategic group theory can be applied in the business school context. [ABSTRACT FROM AUTHOR]

Background: Studies on differences between immigrant and non-immigrant groups in health care utilization vary with respect to the extent and direction of differences in use. Therefore, our study aimed to provide a systematic overview of the existing research on differences in primary care utilization between immigrant groups and the majority population. Methods: For this review PubMed, PsycInfo, Cinahl, Sociofile, Web of Science and Current Contents were consulted. Study selection and quality assessment was performed using a predefined protocol by 2 reviewers independently of each other. Only original, quantitative, peer-reviewed papers were taken into account. To account for this hierarchical structure, logistic multilevel analyses were performed to examine the extent to which differences are found across countries and immigrant groups. Differences in primary care use were related to study characteristics, strength of the primary care system and methodological quality. Results: A total of 37 studies from 7 countries met all inclusion criteria. Remarkably, studies performed within the US more often reported a significant lower use among immigrant groups as compared to the majority population than the other countries. As studies scored higher on methodological quality, the likelihood of reporting significant differences increased. Adjustment for health status and use of culture-/language-adjusted procedures during the data collection were negatively related to reporting significant differences in the studies. Conclusion: Our review underlined the need for careful design in studies of differences in health care use between immigrant groups and the majority population. The results from studies concerning differences between immigrant and the majority population in primary health care use performed within the US might be interpreted as a reflection of a weaker primary care system in the US compared to Europe and Canada. [ABSTRACT FROM AUTHOR]

Background: Migrant families' transnational ties (i.e., connections to their countries of origin) may contribute to their hardships and/or may be a source of resiliency. A care approach that addresses these transnational ties may foster a positive identity and give coherence to experiences. We conducted an integrative review to determine what is known about transnational ties and the care of migrant families during pregnancy, postpartum and early childhood.Methods: We searched 15 databases to identify literature reporting on a health or social program, service, or care experience of migrant families during pregnancy up to age five in a Western country (i.e., Canada, US, Australia, New Zealand or a European country). Information regarding if and how the service/program/care considered transnational ties, and care-providers' perceptions of transnational ties, was extracted, analyzed and synthesized according to transnational 'ways of belonging' and 'ways of being'.Results: Over 34,000 records were screened; 69 articles were included. Care, programs and services examined included prenatal interventions (a mhealth app, courses, videos, and specialized antenatal care), doula support, maternity care, support groups, primary healthcare and psycho-social early intervention and early childhood programs. The results show that transnational ties in terms of 'ways of belonging' (cultural, religious and linguistic identity) are acknowledged and addressed in care, although important gaps remain. Regarding 'ways of being', including emotional, social, and economic ties with children and other family members, receipt of advice and support from family, and use of health services abroad, there is very little evidence that these are acknowledged and addressed by care-providers. Perceptions of 'ways of belonging' appear to be mixed, with some care-providers being open to and willing to adapt care to accommodate religious, cultural and linguistic differences, while others are not. How care-providers perceive the social, emotional and economic ties and/or the use of services back home, remains relatively unknown.Conclusion: Significant knowledge gaps remain regarding care-providers' perceptions of transnational 'ways of being' and whether and how they take them into account, which may affect their relationships with migrant families and/or the effectiveness of their interventions. Continued efforts are needed to ensure care is culturally safe for migrants. [ABSTRACT FROM AUTHOR]

The article examines several papers relating to public policy schools and programs around the world. According to the author, the paper focused on six emerging programs that had representatives present, including four that usefully supplemented the conference paper's survey of broad trends in Canada, Europe, Australia and New Zealand. In addition, the programs examined have complex relationship with the demand side of policy education. Furthermore, a table showing a descriptive overview of some of the programs discussed is offered.

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

This paper discusses recent migration to North America with reference to the 1962 and 1967 Canadian immigration regulations and the 1965 United States Immigration and Nationality Act. Despite the similar emphasis on manpower and kinship criteria as the basis for the admission of immigrants, differences between Canada and the United States exist with respect to the importance of immigration for the respective economies, the organization of immigration, the formal regulations, and the size and composition of migrant streams. After an examination of the volume, origin, and occupational composition of immigration to Canada and the United States, flows between the two countries are studied. The paper concludes with a scrutiny of changes in immigration regulations which are pending in both countries. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to draw on a socio-technical perspective to explore how information and communication technology (ICT) supports the validation of non-formal and informal learning (VNFIL) in specific practices and arrangements. Design/methodology/approach: The authors use qualitative content analysis to analyse 43 country reports of the "European inventory on validation" published by the European Centre for the Development of Vocational Training (Cedefop) in 2019. Findings: This study conceptualises ICT supported VNFIL practices and arrangements from a socio-technical perspective. Given this, the paper finds that ICT is used mainly to provide information on validation practices and arrangements, store qualification registers online and identify and document learning outcomes. The use of ICT to assess and certify learning outcomes remains limited. Originality/value: VNFIL is very rarely seen in a technical context. This paper contributes to a theoretical perspective and highlights the mutual interdependence of social and technical components. Furthermore, this study provides an overview of inasmuch ICT is currently used to support VNFIL practices and arrangements. Based on the results, validation researchers and practitioners can get inspiration on how to develop ICT supported VNFIL practices and arrangements further.

This paper examines international patent application decisions of nine agricultural biotechnology firms from 1990–2000 in Australia, Brazil, Canada, China, the European Patent Office, Japan and South Africa. The data reveal a low frequency of international applications despite an initial United States' application, indicating very low values for patents abroad. The results indicate that invention quality plays an important role in firms' decisions to patent abroad and that a single international application is a good predictor of multiple international applications. Further, significant country fixed effects suggest wide differences in business climates and patent enforcement among countries. [ABSTRACT FROM AUTHOR]

The paper presents the design guidelines for Active SAR Antennas followed for the development of COSMO SkyMed SAR Antenna Subsystem. They have brought to define the antenna architecture, the RF, and electrical requirements for all the antenna RF, digital and power units, taking into account the available technologies and achievable performance. The antenna design is described for what the main subsystems is concerned, such as RF, power, digital, including mechanical and thermal aspects. Finally the paper reports also a brief description of the most recent development carried out in Canada and in Europe in the last ten years, including the on-going programs. [ABSTRACT FROM AUTHOR]

How will countries handle idiosyncratic macroeconomic shocks under the single currency? Since the regional adjustment patterns currently prevailing within European currency unions are likely to prevail at the national level under the single currency, looking at the ways in which European countries react to internally asymmetric shocks today provides a good preview for the answer to that question. In this paper, we compare the USA with Germany, Italy and the UK, and with Canada, which is closer to Europe than the USA in its labour market and fiscal institutions. Europe's (and to some extent Canada's) model of regional response differs from that of the USA. Changes in regional real exchange rates are small in all countries. Outside of the USA, however, there is more reliance on interregional transfer payments, less on labour migration, and the pace of regional adjustment appears to be slower. If EMU aims at the same degree of economic and social cohesion that its constituent nations enjoy today, this suggests that its members may find it hard to resist the eventual extension of existing EU mechanisms of income redistribution -- a transfer union. We propose an alternative strategy based on a relaxed Stability Pact, further strictures against central EU borrowing, labour market and fiscal reform, and the issuance by individual member states of debt indexed to nominal GDP. [ABSTRACT FROM AUTHOR]

This paper briefly surveys the history of natural gas use and describes the main features of current gas consumption. The share of gas in total energy consumption, and the sectoral distribution of its use in major consuming regions are discussed. The main changes in the pattern of gas consumption since 1980 are reviewed and explained. I analyze the likely implications of (a) the emergence of the combined cycle gas power generation; (b) the rising environmental premium of gas; and (c) the transformation of the West European gas market structure. The paper concludes that natural gas will substantially increase its share of global energy consumption in the next 15-20 years. [ABSTRACT FROM AUTHOR]

Background: Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process.Methods: Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).Results: Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization.Conclusions: Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness. [ABSTRACT FROM AUTHOR]

Business fluctuations are associated with business cycles but are not implying the regularity. We consider that the lobbying activities can influence the periods of economic recession and expansion from business fluctuations. The role of lobbying is to affect the decisions made by officials in the government or international corporations and agencies or organizations. In this paper we describe the structure of lobbying practice in European Union, Canada and United States of America and the characteristics of business fluctuations. Specifically, this paper looks at the lobbying activities evolution in European Union, Canada and United States of America and also at a potential relationship between lobbying and business fluctuations, from periods of boom to periods of recession. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design factors (including confounders, applied exposure model, population age, and outcome definition) on PM2.5 effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991-2016], the United States (Medicare, 2000-2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000-2016] as much as possible. METHODS: We harmonized the study populations to individuals 65+ years of age, applied the same satellite-derived PM2.5 exposure estimates, and selected the same sets of potential confounders and the same outcome. We evaluated whether differences in previously published effect estimates across cohorts were reduced after harmonization among these factors. Additional analyses were conducted to assess the influence of key design features on estimated risks, including adjusted covariates and exposure assessment method. A combined CRF was assessed with meta-analysis based on the extended shape-constrained health impact function (eSCHIF). RESULTS: More than 81 million participants were included, contributing 692 million person-years of follow-up. Hazard ratios and 95% confidence intervals (CIs) for all-cause mortality associated with a 5-μg/m³ increase in PM2.5 were 1.039 (1.032, 1.046) in MAPLE, 1.025 (1.021, 1.029) in Medicare, and 1.041 (1.014, 1.069) in ELAPSE. Applying a harmonized analytical approach marginally reduced difference in the observed associations across the three studies. Magnitude of the association was affected by the adjusted covariates, exposure assessment methodology, age of the population, and marginally by outcome definition. Shape of the CRFs differed across cohorts but generally showed associations down to the lowest observed PM2.5 levels. A common CRF suggested a monotonically increased risk down to the lowest exposure level. [ABSTRACT FROM AUTHOR]

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Traditional educational and training settings have dictated that the act of learning is an activity that is motivated by learners, directed by a teacher expert and based on information transfer and data manipulation. In this scenario, it has been assumed that learners more or less acquire knowledge or develop sets of skills as a result of such activity. With this model in place, learning ends when the training activities cease - and implies that repeated doses of similar training are required over time. Various computer technologies, as they have been generally integrated into educational settings, have taken on the role as tools to support such a model. In some cases they are used to replace the teacher in these contexts although not without serious implications for learners and their learning it has been argued. During the last three decades, a growing movement in educational research, based on the theoretical support of Leon Vygtosky and Mikhail Bakhtin, is advocating that the traditional conceptualization of the learning process is misconceived. From the perspective of this movement, learning is understood as a life-long, social act of constructing knowledge in a dialogic activity with others. Within this model, social interaction is the precursor to higher order thinking rather than the reverse. The challenging question emerging for many educators is how new technologies can support knowledge and skill building in social constructivist-based learning settings. And a corollary to this question arises: Depending on the particular technology chosen, what are the implications for learning and identity construction? In this paper, we describe the Language Learning Through Conferencing project (LLTC) in which an affordable video-based web conferencing technology and desktop computers were used to conduct language learning sessions via the Internet. The project description, project content, and the experiences that took place over a sustained period, as well as the potential future for this approach to distance learning in a variety of fields are presented. The aim of the Language Learning Through Conferencing project (LLTC) has been to exploit a particular Web 2.0 technology to connect language learners internationally between Canada and new democracies in Central and Eastern Europe and more recently in the public sector in Canada. More specifically, the project was a means to respond to learners who faced challenges in finding opportunities for language learning both in Europe and in Canada. Outcomes from ongoing qualitative and quantitative findings gathered by the respective authors are indicating that these dialogic opportunities are also having a powerful influence on learners' professional, linguistic and personal identities as well as their views of technology and learning. [ABSTRACT FROM AUTHOR]

This paper provides a perspective on post-secondary education systems in the countries of the former USSR with the objective of building potential linkages for North American Colleges with the higher education institutions in Eastern Europe. (Contains 3 tables.)

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Most Canadians use some form of Complementary and Alternative Medicine (CAM) and most Canadian physicians are not able to address their patients' use due to inadequate training. Integrative Medicine (IM) in the medical profession has grown over the last 20 years and is now recognized as a sub-specialty in the United States. Canada is lagging behind. The current state of CAM and IM education for physicians in Canada is described, using the United States' experience in comparison. The landscape and obstacles for Integrative Medicine for Canadian physicians is reviewed. A case is made for recognition of Integrative Medicine by Canadian Medical Colleges in order to advance this field in Canada. [ABSTRACT FROM AUTHOR]

[This paper is part of the Focused Collection on Qualitative Methods in PER: A Critical Examination.] This article details methodologies employed to enable sharing and coconstructing the stories of three women's lives in physics. The first case explores the usefulness of timeline interviewing, where participants narrate episodes that are coconstructed with the researcher as meaningful over time. We illustrate this method in the case of a mature student in Sweden from a working-class background who shared moments that added up to a life outside of physics and then a sharp turn into physics later in life. The second case explores life-history interviewing using a narrative-inquiry approach and deep relationship building which enabled the coconstruction of stories of experiences over time. These moments are coconstructed with the researcher and analyzed using an intersectionality lens to yield a story depicting the transnational experiences of a woman of color moving across various European contexts into the North American physics context. The final case is of a first-generation Canadian woman of color who shared her navigations of in and out of school physics via a method known as the "Rivers of Life." Using this method, the participant narrates their experiences with physics as a river, using metaphorical tools like rafts, rocks, rapids, tributaries to discuss various moments described as twists and turns over time that together amount to a life in physics. We discuss the value of different approaches to coconstructing narratives with participants and, in particular, the need for this kind of research in physics contexts.

On a per capita basis, Canadian drug costs are already the second highest in the world after the United States and are among the fastest rising in the Organization for Economic Co- Operation and Development. The Comprehensive Economic and Trade Agreement (CETA) between the European Union (EU) and Canada will further exacerbate the rise in costs by: • Committing Canada to creating a new system of patent term restoration thereby delaying entry of generic medicines by up to two years; • Locking in Canada's current term of data protection, and creating barriers for future governments wanting to reverse it; • Implementing a new right of appeal under the patent linkage system that will create further delays for the entry of generics. CETA will only affect intellectual property rights in Canada-not the EU. This analysis estimates that CETA's provisions will increase Canadian drug costs by between 6.2% and 12.9% starting in 2023. The Canadian government committed to compensating provinces for the rise in costs for their public drug plans. Importantly, this means that people paying out-ofpocket for their drugs or receiving them through private insurance, will be charged twice: once through higher drug costs and once more through their federal taxes. As drug costs continue to grow, there are limited options available for provincial/territorial governments: restrict the choice of medicines in public drug plans; transfer costs to patients who typically are either elderly or sick; or take money from other places in the health system, and threaten the viability of Canada's single payer system. CETA will therefore negatively impact the ability of Canada to offer quality health care. [ABSTRACT FROM AUTHOR]

Background: A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada.Methods: We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000-2016 and checked the reference lists of all included papers.Results: Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited.Conclusion: Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies. [ABSTRACT FROM AUTHOR]

Student learning outcomes assessment examines whether programs cover the material stated in their learning goals, whether students are learning the material, and the impact on student retention, graduation, post-graduation outcomes, and institutional accreditation, with the aim of providing faculty with data that can be used to help programs evolve or improve. While there is a plethora of research regarding effective methods of assessment used in the United States, little has been written regarding cross-national comparisons of assessment methodologies. This paper examines the current state of assessment in several nations and regions, and draws parallels in practices across countries. A literature search using the term "outcomes assessment" yielded 228 articles, of which, only 35 described practices outside the United States. Generally, searches on the terms "outcomes assessment" and "global" tend to return studies of outcomes assessment of teaching about global issues as it is practiced in the United States, rather than results about outcomes assessment practices used in other countries.

This paper aims to identify the current state of knowledge management (KM) diffusion in LIS schools. In terms of content, we have identified two principal approaches to the perception of KM in the LIS community: an active approach, seeing KM as an opportunity for the LIS community to change; and a passive approach, seeing KM merely as a topic of information management with a new label. Our research analyzed study programs at 145 LIS schools and in 188 LIS study programs in the United States, Canada, Europe (in particular, Russia), Australia, India, South Africa, China, Japan, Singapore, and Brazil and observed the inclusion or non-inclusion of KM courses in those programs. We employ a narrower approach to defining a KM course as being one having the term "knowledge management" in its name. The findings indicate that KM courses are integrated in one-third of the LIS study programs analyzed, and in schools with an information science focus this figure can rise to around 45%. Given the importance of this area and various views regarding KM diffusion in LIS schools, we recommend that those who have already implemented a KM course in their LIS programs create an informal community of practice (CoP) on KM implementation in LIS schools and build an open database of lessons learned from such integration, thereby capturing and sharing this crucial knowledge in a single place.

Please cite this paper as: Schanzer et al. (2010) A composite epidemic curve for seasonal influenza in Canada with an international comparison. Influenza and Other Respiratory Viruses 4(5), 295–306. Background Empirical data on laboratory-confirmed seasonal influenza is limited by very low and possibly non-systematic case ascertainment as well as geographical variation. Objective To provide a visual representation of an influenza epidemic at the community and regional level using empirical data and to describe the epidemic characteristics. Methods Weekly influenza A confirmations were obtained from the Canadian FluWatch program and American FluView program for the 1997/1998–2006/2007 seasons; 1- year data were also available for Europe (FluNet, WHO). For seasons where at least 80% of the influenza A strains were antigenically similar, a composite epidemic curve was created by centring the local epidemics relative to their epidemic midpoint. Results The range in timing of the regional peaks varied from 5 to 13 weeks. Once the epidemic curves were centred relative to their peak, the composite epidemic curves were similar for Canada, the United States and Europe, and the epidemic growth rates were similar for most subgroups (city size; regions; H1N1 versus H3N2 seasons). During the exponential growth period, the number of cases increased by a factor of 1·5–2·0 per week, averaging 1·8. Exponential growth was evident approximately 10 weeks before the peak. Evidence of sustained transmission occurred from mid-September to early June. Discussion The shape of the composite curve created in this study clearly demonstrates a consistency in the epidemic pattern across geographically disparate locales. Laboratory confirmation will likely play an increasing role in the development of better methods for early detection and summary measures of influenza activity. [ABSTRACT FROM AUTHOR]

This paper sets out to bridge my experience in Canada working in the intersecting space between culture and technology and my more recent experience in Europe as the Canadian director of a European initiative called LabforCulture. The experiences in Europe with respect to the impact of digital technologies on culture and the development of cultural policy are not so different from those in Canada. The issues of culture and technology are decidedly similar arid the challenges are shared. What follows is a reflection, briefly and randomly, on overall policy trends across Europe and their similarities to the Canadian situation. [ABSTRACT FROM AUTHOR]

The article offers information on medicine utilization research in Europe. One cross-sectional study focused on patterns of anti-psychotic drug use among nursing home residents in Switzerland between 1999 and 2002 and compared those with data from Canada. Another paper discussed the association of socio-demographic factors within and across European countries with non-compliance with medical drugs.

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Due to the popularity of sport, the need to have sport management programs that properly train practitioners is justified (Pedersen & Thibault, 2014). However, with 505 sport management bachelors programs worldwide ("Degrees in Sports," n.d.) housed in various academic units, there is little consistency within the field of study. This paper strives to explore the field of sport management and to better understand sport management faculty members' perceptions of the discipline. Grounded in Foucault's (1971) theory of discourse, total of 154 sport management faculty members worldwide participated in the study. The data revealed there is a lack of consistency within the field regarding faculty members' perceptions of sport management. This study offers a vital, first step in an empirical examination of a critical phenomenon in the sport management academy.

This literature review aims to examine the approach given to open science policy in the different studies. The main findings are that the approach given to open science has different aspects: policy framing and its geopolitical aspects are described as an asymmetries replication and epistemic governance tool. The main geopolitical aspects of open science policies described in the literature are the relations between international, regional, and national policies. There are also different components of open science covered in the literature: open data seems much discussed in the works in the English language, while open access is the main component discussed in the Portuguese and Spanish speaking papers. Finally, the relationship between open science policies and the science policy is framed by highlighting the innovation and transparency that open science can bring into it.

The telecommunication industry has experienced significant growth and consolidation in the last decade. The desire of large, multinational customers to obtain fully-integrated, end-to-end global telecommunications services from a single source pushed telecom firms to offer multiservice broadband and seamless worldwide telecommunications networks. However, a major barrier to achieving this goal is the significant capital required to construct and deploy a global network. To overcome these constraints, telecom companies typically adopt approaches like--mergers and acquisitions (M&A), joint ventures, legal partnerships and strategic alliances. As the marketplace continues to grow globally, convergence among major enforcement authorities on fundamental competition principles, such as the role of efficiencies, will be critical. The treatment of efficiencies is however controversial and poses many questions. This research paper explores some of the efficiencies-based motivations and rationales for Telecom M&A. It reviews the procedures and regulatory authorities responsible for telecom merger review in the U.S., Europe and Canada. It also examines the treatment of efficiencies in the context of merger review in three jurisdictions and finally it discusses some of the outstanding policy issues related to treatment of efficiencies.

The article examines current trends in the development of the national models of higher education in Russia and European countries. The paper reveals the key problems of their functioning in the context of the processes of globalization, standardization, and integration into the pan-European and global educational space. These processes are described through the prism of the national interests of the states. Emerging from the comparative description, content presentation and qualitative analysis, the article assesses the level of development of the national models of higher education, i.e., Russian, European and American. This allowed identifying key similarities, as well as the most important differences, which mainly stem from the difference in the state regulation of national educational systems. It is the role of the state that is leading in the formation of national educational systems and the creation of high-quality models of higher education. The state is also responsible for the transformation and adaptation of these models. The models target providing the national and world labor market with highly professional human resources. Based on the comparative aspects outlined in the article, as well as on the qualitative analysis data, the authors have come to the following main conclusions regarding the trends and prospects for the development of the Russian higher education sector: a) Firstly, the Russian model of higher education was built during an accelerated transition from a one-level to a multilevel education. The result of this shift is the labor market disbalance, which nowadays does not allow the formation of the adequate perception of specialists holding a "bachelor's degree" which is unfamiliar and obscure to many employers; b) Secondly, the Russian educational system, and the higher education model, replicate the Western European and American approaches without considering the realities of the national educational market and the labor market. Therefore, the high proportion of the population with higher education cannot provide the necessary socio-economic development potential of the country; c) Thirdly, the reform of the Russian model of higher education should continue but not in terms of accelerating the processes of its integration into the world educational system. There is much evidence that the correct direction lies within the domain of creating incentives and conditions that will ensure the training of highly skilled professionals correlating with the market demand.

This paper presents the results of the first comprehensive international survey to catalogue health technology assessment (HTA) activities. By 1995, there were formal HTA programs in 24 countries, established mostly in the late 1980s and early 1990s. European countries generally have one or two federal or provincial HTA programs each. Canada has an extensive network of federal and regional organizations coordinated by a central body, and the US has 53 HTA organizations, the vast majority of which are in the private sector. While the commitment of the US government to HTA has been erratic, the private sector has been witness to an expansion of HTA activities by insurance companies, hospitals, medical/device manufacturers, consulting firms, and health professional societies. In contrast to other developed countries, the current state of technology assessment in the US is decentralized, fragmented, and duplicative. We conclude by discussing the importance of a US HTA agency at the national level. [ABSTRACT FROM AUTHOR]

Objective: To describe the radiographic phenotype of axial spondyloarthritis (SpA) according to the presence of HLA-B27.Methods: An international collaboration compared the radiographic phenotype of axial SpA according to HLA-B27 status. Patients with ankylosing spondylitis (AS) and axial psoriatic arthritis (PsA) were collected. Radiographs were read centrally, blinded to clinical details. The symmetry of the sacroiliac joints and lumbar syndesmophytes and the morphology of syndesmophytes (typical marginal versus atypical chunky), together with the modified Stoke Ankylosing Spondylitis Spine Score and the Psoriatic Arthritis Spondylitis Radiographic Index, were recorded.Results: A total of 244 patients with PsA and 198 patients with AS were included. In PsA, 60 patients (25%) were HLA-B27 positive while in AS, 148 patients (75%) were HLA-B27 positive. Patients with HLA-B27 were younger and more often male and had a longer duration of disease. In multivariable logistic regression, HLA-B27 was significantly associated with syndesmophyte symmetry (odds ratio [OR] 3.02 [95% confidence interval (95% CI) 1.38, 6.61]) and marginal syndesmophytes (OR 1.97 [95% CI 1.16, 3.36]) but not with sacroiliac symmetry. Mean radiographic scores were higher for patients with HLA-B27.Conclusion: Patients with axial SpA who are positive for HLA-B27 have more severe radiographic damage, more marginal syndesmophytes, and more frequent syndesmophyte symmetry compared to patients who are negative for HLA-B27. [ABSTRACT FROM AUTHOR]

The article focuses on the fertility transition in Ireland during 1880-1911. The decline in Irish marital fertility was neither uniform nor universal. Between 1881 and 1911, there were increases in Counties Galway, Mayo, Roscommon and Donegal, while the decline in several other counties was small. Cohort parity analysis (CPA), a fertility measure devised by researcher Paul David and his research associates, provides a means of inferring the extent and timing of birth control within marriage from distributions of married women by number of children born. A key aspect of CPA is the extent to which married couples resort to contraception in order to "space" births. Ireland has played an important part in the development of CPA, because David and his colleagues believe that the rural Irish of 1911 provide a suitable model, not only for urban Ireland in 1911 and the United States around the turn of the century, but also for Western Europe, Canada, Australia, and New Zealand, from the mid-nineteenth through the early twentieth centuries.

This paper reports on visits to 24 national operations-research societies (two in Germany) and to operations researchers in ten other countries. It considers each visit to a society specific-ally, plus some of the visits in countries not having societies. My purpose was to promote closer relations between the OPERATIONS RESEARCH SOCIETY OF AMERICA and operations researchers of other countries. The first visits were made during July-August of 1967,in conjunction with the Operations Research Around-the-World Meetings. Canada was visited in November, Central and South America in December-January, and the remaining countries in Europe during March-April of 1968. These visits included all of the world's major operations-research societies, and some others. [ABSTRACT FROM AUTHOR]

The article develops an economic hypothesis about the origin of social movements. The paper is divided into three parts: the first elaborates a theory of demand for social change or, more specifically, a theory about why the demand for change manifests itself in social movements. This first part, in turn, is subdivided into two sections examining: first, some structural components of the environment in which social movements originate and discussing, second, the definitions and assumptions of the proposed theory as well as its essential mechanisms. The second part introduces the concept of the supply of social movements and examines how this supply is related to the demand for social change. This discussion sheds some new light on the question of social change itself. This is briefly discussed in Section III. The hypothesis formulated appears to be consistent, at least in the large, with what is known of the history of social movements in Canada, in the United States, and in Europe during the first part of the twentieth century.