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Asthma often starts before six years of age. However, there remains uncertainty as to when and how a preschool-age child with symptoms suggestive of asthma can be diagnosed with this condition. This delays treatment and contributes to both short- and long-term morbidity. Members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Paediatric Society to develop a joint working group with the mandate to develop a position paper on the diagnosis and management of asthma in preschoolers. In the absence of lung function tests, the diagnosis of asthma should be considered in children one to five years of age with frequent (≥8 days/month) asthma-like symptoms or recurrent (≥2) exacerbations (episodes with asthma-like signs). The diagnosis requires the objective document of signs or convincing parent-reported symptoms of airflow obstruction (improvement in these signs or symptoms with asthma therapy), and no clinical suspicion of an alternative diagnosis. The characteristic feature of airflow obstruction is wheezing, commonly accompanied by difficulty breathing and cough. Reversibility with asthma medications is defined as direct observation of improvement with short-acting ß2-agonists (SABA) (with or without oral corticosteroids) by a trained health care practitioner during an acute exacerbation (preferred method). However, in children with no wheezing (or other signs of airflow obstruction) on presentation, reversibility may be determined by convincing parental report of a symptomatic response to a three-month therapeutic trial of a medium dose of inhaled corticosteroids with as-needed SABA (alternative method), or as-needed SABA alone (weaker alternative method). The authors provide key messages regarding in whom to consider the diagnosis, terms to be abandoned, when to refer to an asthma specialist and the initial management strategy. Finally, dissemination plans and priority areas for research are identified. [ABSTRACT FROM AUTHOR]

Decision makers in adult social care are increasingly interested in using evidence from research to support or shape their decisions. The scope and nature of the current landscape of adult social care research (ASCR) need to be better understood. This paper provides a bibliometric assessment of ASCR outputs from 1996 to 2011. ASCR papers were retrieved using three strategies: from key journals; using keywords and noun phrases; and from additional papers preferentially citing or being cited by other ASCR papers. Overall, 195,829 ASCR papers were identified in the bibliographic database Scopus, of which 16 per cent involved at least one author from the UK. The UK output increased 2.45-fold between 1996 and 2011. Among selected countries, those with greater research intensity in ASCR generally had higher citation impact, such as the USA, UK, Canada and the Netherlands. The top five UK institutions in terms of volume of papers in the UK accounted for 26 per cent of total output. We conclude by noting the limitations to bibliometric analysis of ASCR and examine how such analysis can support the strategic development of the field. [ABSTRACT FROM AUTHOR]

Crops genetically engineered to produce insect-killing proteins from Bacillus thuringiensis (Bt) have revolutionized management of some major pests, but their efficacy is reduced when pests evolve resistance. Practical resistance, which is field-evolved resistance that reduces the efficacy of Bt crops and has practical implications for pest management, has been reported in 26 cases in seven countries involving 11 pest species. This special collection includes six original papers that present a global perspective on field-evolved resistance to Bt crops. One is a synthetic review providing a comprehensive global summary of the status of the resistance or susceptibility to Bt crops of 24 pest species in 12 countries. Another evaluates the inheritance and fitness costs of resistance of Diabrotica virgifera virgifera to Gpp34/Tpp35Ab (formerly called Cry34/35Ab). Two papers describe and demonstrate advances in techniques for monitoring field-evolved resistance. One uses a modified F2 screen for resistance to Cry1Ac and Cry2Ab in Helicoverpa zea in the United States. The other uses genomics to analyze nonrecessive resistance to Cry1Ac in Helicoverpa armigera in China. Two papers provide multi-year monitoring data for resistance to Bt corn in Spain and Canada, respectively. The monitoring data from Spain evaluate responses to Cry1Ab of the corn borers Sesamia nonagrioides and Ostrinia nubilalis , whereas the data from Canada track responses of O. nubilalis to Cry1Ab, Cry1Fa, Cry1A.105, and Cry2Ab. We hope the new methods, results, and conclusions reported here will spur additional research and help to enhance the sustainability of current and future transgenic insecticidal crops. [ABSTRACT FROM AUTHOR]

Despite apparent agreement on the approach to the interpretation of statutes in Canada, a system of limited parliamentary sovereignty, judges differ on a fundamental point: how purpose is used in interpretation. Some judges craft arguments that view the text as the medium through which the legislature expresses its intention, using purpose to shed light on the meaning of the text in defined ways ('text-as-medium' interpretation). Others see the background purposes or values of the statutory context as binding constraints in a coherent legal order, with text as merely a signal to meaning ('purpose-as-medium' interpretation). This paper argues that text-as-medium interpretation offers the most persuasive account of the use of purpose in interpretation, especially in a system of legislative sovereignty, which constrains interpretive choice. By bringing to light the commitments of these two interpretive arguments in the Canadian context for the first time, the paper also raises deeper normative questions about how to view legislation in a Westminster parliamentary democracy. These questions are fundamental to the relationship between sovereign legislatures and courts. [ABSTRACT FROM AUTHOR]

The majority of the literature focused on whether consent should be extended to the adolescent population arises from themes adapted from American tort law. In contrast to the USA, Ontario does not delineate an age of consent for medical treatment and relying on American guidelines to guide practice in Ontario is problematic. While the literature is saturated with discussions for and against seeking adolescent consent, there are currently no bioethical guidelines on adolescent consent in the province of Ontario. This paper explores adolescent refusal of care and adolescent request for care in opposition to parental wishes. The paper seeks to answer the following questions: What is the difference between an adolescent and an adult in medical decision-making? What are the barriers to seeking adolescent consent? And, can the neurobiological argument be an accurate guide for obtaining adolescent consent? [ABSTRACT FROM AUTHOR]

A key public health response to the COVID-19 pandemic is the mandate to stay home and practice physical distancing. In Canada, with essential activities such as grocery shopping, outdoor exercise and transportation, people need to be able to safely navigate dense, urban spaces while staying at least two metres or six feet apart. This pandemic has exacerbated the health inequities across neighbourhoods in cities like Toronto, Canada which are often segregated along racial and income lines. These inequities impact who has access to urban infrastructure that promotes health and quality of life. Safety in a time of COVID-19 goes beyond just exposure to the virus, it is complicated by notions of who belongs where, and who has access to what resources. The built environment has a role in maintaining and promoting physical and mental health during this pandemic and beyond it. This paper puts forwards three considerations for built environment interventions to promote health equitably: (i) addressing structural determinants of health and embedding anti-racist intersectional principles, (ii) revisiting tactical urbanism as a health promotion tool and (iii) rethinking community engagement processes through equity-based placemaking. This paper outlines four built environment interventions in Toronto, Canada that seek to address the challenges in navigating urban space safely in the short term, including street design that prioritizes pedestrians, protected cycling infrastructure, access to inclusive green space and safe, affordable housing. Longer-term strategies to create health-promoting urban environments that are equitable are discussed and may be valuable to other cities with similar urban equity concerns. [ABSTRACT FROM AUTHOR]

This paper uses assemblage theory to consider the work that community does in a residential neighborhood in Toronto, Canada. It utilizes assemblage theory and connections between assemblage, affect, and emotion to advance an understanding of how community shapes capacity and action. The analysis shows how community has been enacted on the Islands, what actions and tendencies this assemblage makes possible or likely, and what it constrains. It also contributes to understanding what assemblage analysis can do. The mechanisms by which desire is channeled toward certain kinds of actions in the assemblage include the performance of community for self-preservation, the use of history and memory in the making of the community assemblage, and the role of territoriality, identity, and belonging in community-preserving actions. The analysis also reveals processes of stasis through reification of the assemblage and its interdependence with other processes like racial capitalism. Finally, I propose possibilities for shifting the assemblage, including telling different histories, and greeting emotional intensity experimentally. Seeing community through the lens of assemblage enables us to ask different questions, which may help us build the communities we need for a more just future. [ABSTRACT FROM AUTHOR]

This paper examines the role of partisanship at the provincial and federal levels in relation to the functioning of the Canadian economy. At the provincial level (1976–2019), we find no evidence of a traditional partisan effect but do find evidence weakly consistent with a rational partisan cycle a ′ la Alesina. At the federal level (1870–2020), we also find no evidence consistent with a distinctive expansion in output arising when the government is controlled by the left-leaning (Liberal) political party although we again find evidence of a weak rational partisan effect. The former result is reinforced by finding the absence of evidence of partisan changes in federal spending and/or taxation. But while the data do not support a theory of left-right partisan policy over the entire post-Confederation (1867) period of Canada's history, the data do support distinctive periods of partisan influence on aggregate output. The first is consistent with Sir John A. MacDonald's post-Confederation conservative government's adoption of a policy of nation-building based on the railway, immigration, and tariffs. The second is the period between 1885 and 1933 where traditional left-right partisanship is evident and the third is the period following the Great Depression where a distinction between the outcomes arising under left- versus right-leaning parties is no longer apparent. [ABSTRACT FROM AUTHOR]

Careful planning of an ambulance service is critical to reduce response times to emergency calls and make assistance more effective. However, the demand for emergency services is highly variable, and good prediction of the number of future emergency calls, and their spatial and temporal distribution, is challenging. In this work, we propose a Bayesian approach to predict the number of emergency calls in future time periods for each zone of the served territory. The number of calls is described by a generalized linear mixed effects model, and inference, in terms of posterior predictive distributions, is obtained through Markov chain Monte Carlo simulation. Our approach is applied in a large city in Canada. The paper demonstrates that using a model for areal data provides good results in terms of predictive accuracy and allows flexibility in accounting for the main features of the dataset. Moreover, it shows the computational efficiency of the approach despite the huge dataset. [ABSTRACT FROM AUTHOR]

While attention to the ethical issues that migrants face in accessing tuberculosis care has increased in the last few years, most of the attention has focused on challenges that refugees face when emigrating. Less attention has been given to ethical challenges that arise in the context of providing tuberculosis treatment and care to non-refugee migrants in high-income countries (HIC), particularly those that do not face immediate danger or violence. In this paper, we analyze some of the ethical challenges associated with treating migrants with tuberculosis in the Canadian context. In particular, we will discuss (i) inter- and intra-jurisdictional issues that challenge quotidian public health governance structures, and (ii) the ethical imperative for the Canadian government and its provinces to clearly differentiate access to healthcare from a person's immigration status to help overcome power imbalances that may exist between public health workers and their clients. The arguments presented herein could potentially apply to other HIC with some form of universal health coverage. [ABSTRACT FROM AUTHOR]

Background: Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children.Methods: A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950.Results: From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as 'good' quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research.Conclusions: We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally. [ABSTRACT FROM AUTHOR]

The United States and Canada began major efforts to acquire territory in North America's interior in the nineteenth century. In 1803, the United States purchased approximately 827,192 square miles of territory from France. Canada began to govern 1,409,900 square miles of territory known as Rupert's Land in 1869. Historical accounts of American and Canadian officials' efforts in Washington and Ottawa to obtain these vast territories are abundant. Historians have devoted less attention, however, to expansionists who supported American expansion in Louisiana and Canadian expansion in Rupert's Land. Daniel Clark, U.S. Consul to New Orleans, used his office to promote American acquisition of Spanish Louisiana. Canadian John Christian Schultz, an influential "doctor" and businessperson at Red River, became the owner of the only newspaper in the settlement and used it to advocate for Canadian possession of Rupert's Land. Clark arrived in Louisiana from Ireland in 1786 and Schultz from Upper Canada between 1859 and 1861. Clark and Schultz were opportunists who understood that American and Canadian territorial ambitions presented them with opportunities to advance their business and political careers. Far less important to both men were the futures of other residents of New Orleans and Red River. Clark and Schultz for example, both argued that representative local government should not be immediately introduced in their regions. [ABSTRACT FROM AUTHOR]

Innovative health technologies are not well regulated under current pathways, leading regulators to adopt contextual, life-cycle regulatory models, which authorize drugs based on earlier clinical evidence subject to the conduct of post-market trials that confirm clinical benefit and safety. In this paper, we evaluate all drugs authorized in Canada under the Notice of Compliance with conditions (NOC/c) policy from 1998 to 2021 to analyze its function, identify challenges and areas for improvement, and make recommendations to inform Health Canada's regulatory reforms. We analyzed a sample of 148 drugs authorized between 1998 and 2021, including characteristics about the pre- and post-market clinical trials, finding that most NOC/c authorizations are based on one, single-arm clinical trial using a surrogate endpoint. Post-market trials are more likely to be randomized, Phase III trials but mostly use surrogate endpoints. Based on our findings, we recommend increasing decision-making transparency throughout the regulatory process, developing comprehensive eligibility criteria for selecting appropriate health technologies, modernizing pre-market evidence requirements, adopting a more active role in designing post-market trials, and utilizing automatic expiry, stronger penalties, and ongoing disclosure of the status of post-market trials to promote compliance. [ABSTRACT FROM AUTHOR]

Using a data set integrating information about researchers' funding and publications in Quebec (Canada), this paper identifies the main determinants of citation counts as one measure of research impact. Using two-stage least square regressions to control for endogeneity, the results confirm the significant and positive relationship between the number of articles and citation counts. Our results also show that scientists with more articles in higher impact factor journals generally receive more citations and so do scientists who publish with a larger team of authors. Hence the greater visibility provided by a more prolific scientific production, better journals, and more co-authors, all contribute to increasing the perceived impact of articles. All else being equal, male and female receive the same number of citations. These results suggest that the most important determinants of researchers' citations are the journals in which they publish, as well the collaborative nature of their research. [ABSTRACT FROM AUTHOR]

While reports of twin pairs concordant for insanity began to appear in the 19th century, the first modern psychiatric twin study that fulfilled Galton's 1875 promise of the value of the twin method was published by the German Psychiatrist and Geneticist Hans Luxenburger in 1928. Luxenburger introduced four major methodological advances: the use of representative sampling, proband-wise concordance, rigorous zygosity diagnoses, and age correction. He used a narrow Kraepelinian diagnostic approach diagnosis and ascertained twins hospitalized, on a specific day, in all large Bavarian asylums. We include a brief biography of Luxenburger, summarize the findings of his paper and provide a full English translation in the appendix. Luxenburger presents evidence that the frequency of twinning in those with severe mental illness were as expected and reports proband-wise concordance for probable and definite dementia praecox (MZ—76%, DZ—0%) and manic-depressive insanity (MZ—75%, DZ—0%). He also examined eccentricity and hyperthymic or hypothymic personality in the dementia praecox and manic-depressive pairs, respectively. Luxenburger's substantial contributions to the history of psychiatric genetics should be considered in the context of his intimate but ambivalent relationship with the racial-hygiene policy of the German National Socialists. [ABSTRACT FROM AUTHOR]

This paper presents SGAC (Solution de Gestion Automatisée du Consentement / automated consent management solution), a new healthcare access control model and its support tool, which manages patient wishes regarding access to their electronic health records (EHR). This paper also presents the verification of access control policies for SGAC using two first-order-logic model checkers based on distinct technologies, Alloy and ProB. The development of SGAC has been achieved within the scope of a project with the University of Sherbrooke Hospital (CHUS), and thus has been adapted to take into account regional laws and regulations applicable in Québec and Canada, as they set bounds to patient wishes: for safety reasons, under strictly defined contexts, patient consent can be overriden to protect his/her life (break-the-glass rules). Since patient wishes and those regulations can be in conflict, SGAC provides a mechanism to address this problem based on priority, specificity and modality. In order to protect patient privacy while ensuring effective caregiving in safety-critical situations, we check four types of properties: accessibility, availability, contextuality and rule effectivity. We conducted performance tests comparison: implementation of SGAC versus an implementation of another access control model, XACML, and property verification with Alloy versus ProB. The performance results show that SGAC performs better than XACML and that ProB outperforms Alloy by two order of magnitude thanks to its programmable approach to constraint solving. [ABSTRACT FROM AUTHOR]

Climate change has facilitated the introduction, establishment, and movement of invasive species in northern regions, enabling the colonization of previously unsuitable areas. While the responses of insects to these changes have been increasingly studied, our understanding of how such alterations impact trophic interactions still requires further research to make reliable predictions about the spread of diseases in a warming world. Phytoplasmas, a group of obligate parasitic unculturable Mollicutes, primarily rely on leafhoppers (Hemiptera: Cicadellidae) for transmission, spread, and survival. Phytoplasmas are associated with over 600 diseases affecting more than 1,000 plant species, including berries, grapevines, and other small fruits. In North America, diseases such as grapevine yellows, blueberry stunt, and strawberry green petal diseases have been linked to phytoplasma strains transmitted by known leafhopper species. However, the number of phytoplasma diseases has significantly increased in North America over the past decade, suggesting the presence of unidentified vectors or an abundance of leafhopper vectors. This short review provides an overview of the current knowledge on leafhoppers as vectors of phytoplasmas to berries, focusing on the last decade's research in Canada. This paper also explores the potential implications of climate change on this pathosystem, including the anticipated range expansion of leafhopper species, changes in phytoplasma acquisition and transmission, and the risk of new leafhopper-transmitted plant-pathogen introductions through the arrival of new leafhopper species. [ABSTRACT FROM AUTHOR]

This paper studies the effects of carbon pricing on inflation dynamics. We construct a sample of carbon taxes implemented in Europe and Canada over three decades and estimate the response of inflation and price components to carbon pricing. Our empirical results suggest that carbon taxes did not significantly increase inflation, with dynamic effects estimated around zero in most specifications. Instead we find support for relative price changes, increasing the cost of energy but leaving the price of other goods and services unaffected. This is consistent with previous findings on the limited aggregate economic costs of carbon taxes. Based on the cross-section of taxes in Europe, we provide suggestive evidence that the response of inflation was especially muted in countries with revenue-neutral carbon taxes and autonomous central banks that can accommodate potential inflationary pressure associated with carbon pricing. [ABSTRACT FROM AUTHOR]

The compassionate community movement as both a public health approach and a social model of care for various life stages is gaining traction in Canada and elsewhere. One example is the Windsor-Essex Compassion Care Community (WECCC), an evidence-based model and set of tools to improve the quality of life, health and wellness of vulnerable and aging populations by identifying and addressing upstream and downstream social and other risks to physical and mental health. This paper presents findings from the WECCC pilot evaluation. The WECCC initiative provided one-on-one volunteer-supported quality of life assessment, resource navigation and goals support program (Catalyzing Community Connections). This was augmented with public education sessions on social connection and loneliness (Importance of Being Connected) for the broader population. The RE-AIM framework was used to frame evaluation of WECCC through the first 4 years. Questionnaires were used to evaluate participant outcomes related to implementation and effectiveness. Interviews and focus groups were completed to understand impacts. From 2017 to 2020, WECCC has engaged over 2,500 individuals, 65 organizations and 400 volunteers combined in both programs. Nearly all (82% to 95%) participants reported positive changes to health, quality of life and/or social connections. This developmental phase of a compassionate community initiative has allowed piloting of an evaluation framework focusing on reach, adoption, implementation and early signals of effectiveness and maintenance. This demonstration provides information on feasibility, acceptability and potential impacts of this type of over-arching community initiative. [ABSTRACT FROM AUTHOR]

The supercluster is a new initiative promoted by the Canadian federal government to strengthen Canada's most promising clusters and allow innovative firms to operate more productively in sourcing inputs and accessing information, knowledge, and technology. This paper contributes to the scientific research on superclusters and pursues two objectives. First, we discuss the origins of the supercluster initiative and trace its roots back to major research traditions on regional agglomerations and territorial innovation models, in particular the cluster theory, the regional innovation system, and the entrepreneurial ecosystem approaches. Second, we conduct a critical analysis and identify four critical questions (or challenges) that need to be addressed to clarify the scope and objectives of the policy. [ABSTRACT FROM AUTHOR]

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]

Trucking is a key industry in Canada with around 180 000 professional drivers. As an industry it has a disproportionately high injury claim rate, particularly for back injuries. Whole-body vibration (WBV) can contribute to the onset and development of low back disorders, and is a well-documented exposure among driving professions. A widely adopted WBV mitigation measure focuses on hydraulic and/or pneumatic passive suspension systems both in the driver's seat and underneath the vehicle cab. Passive suspension 'air-ride' seats are the current industry standard but new technologies such as the electromagnetic active vibration cancelling (EAVC) seats offer potentially substantial improvements in WBV reduction. In this paper, we evaluate and compare four commonly used truck seats (three air-ride, one EAVC) for their vibration damping characteristics and WBV exposure attenuation in on- and off-road conditions. We recruited 24 professional truck drivers who drove 280 km (mixed on-road and off-road) in ore-haul trucks under four different seating conditions. Following the ISO 2631-1 WBV standard, vibration measurements were made on the cab floor and seat pad, and 8-h average weighted vibration (A(8)) and 8-h vibration dose values (VDV(8)) were calculated, as well as the Seat Effective Amplitude Transmissibility (SEAT), and daily vibration action limits (DVALs). These measures were compared between seat types, as well as road conditions. The EAVC seat gave best performance for both A(8) (0.27 m s−2) and VDV(8) (6.6 m s−1.75). The EVAC seat had the lowest SEAT tested (36.2%) and the longest DVAL. However, among the three passive air-suspension seats, two showed significantly reduced A(8) (0.43 and 0.44 m s−2) and VDV(8) (9.1 and 9.3 m s−1.75) exposures relative to the third passive air-suspension seats [A(8) (0.54 m s−2) and VDV(8) (11.1 m s−1.75)]. These differences in exposures among the three passive air-suspension seats resulted in varying DVAL times, with the worst performing seat reaching the DVAL after only 6.3 h of driving. There was also a seat by road type interaction; there were performance differences between the passive air-suspension seats on-road, but not off-road. The observed reduction of the WBV exposures measured from the EAVC seat was consistent with previous results. But we showed that there can also be substantive differences among seats that are the current industry standard. These differences were more evident on-road than off-road, which suggests that more work needs to be done to understand seat performance characteristics, and in matching the correct seat technology to the driving task. We demonstrated that WBV exposures in current industry conditions may exceed health-based exposure limits; this has policy relevance because WBV exposures are linked to prevalent and costly adverse health conditions in a working population that is ageing. Increased WBV measurement collection is recommended to ensure the anticipated exposure attenuations are achieved when seats are relied upon as an engineered control against WBV. [ABSTRACT FROM AUTHOR]

Striving to be a full-fledged profession with statutorily delegated self-regulatory authority has been a goal of the social work profession in many countries since Abraham Flexner's (1915 'Is social work a profession?', Paper presented at the Forty-Second Annual Session of The National Conference of Charities and Correction, Baltimore, MD, pp. 581, 584–8, 590. denial of its professional status in the USA. A full self-regulation requires two gatekeeping mechanisms: professional education and registration. Whereas professional social work education has been in place in many parts of the world, the establishment of a mandatory registration system is still limited to a few countries. Although two mechanisms share the same mandate and function as self-regulation, they tend to be discussed separately in the literature. How they connect and work with each other is seldom explored. In this article, by examining the development of these two mechanisms in Canada, Hong Kong and South Korea, we present three different ways of how these mechanisms are connected and discuss observations of those connections. [ABSTRACT FROM AUTHOR]

Through the granting of refugee status to victims of sexual persecution, the Canadian government simultaneously acknowledges and scorns the human rights practices of other states, while also assuring refugees that Canada is a modern, safer alternative. Canada is safe, however, only for those non-citizens--current and future--who adhere to Canada's sexual customs, regulations, and norms. This paper explores the Canadian state's use ofWestern understandings of sexuality and discrimination to assess the validity of refugee claims of sexual persecution. Ultimately, this paper questions the current Canadian refugee system's dependency on a rigid conception of sexuality and discrimination, and explores the implications this has for non-Western sexual minorities. [ABSTRACT FROM AUTHOR]

Objectives This scoping review aims to systematically map the empirical evidence on publicly funded medication reviews provided by community pharmacists in Canada and identify gaps that could inform future research directions. Methods We used a scoping review framework and PRISMA guidelines for Scoping Reviews to conduct the study. Three electronic databases were searched for papers published between January 2000 until August 2020. Data was charted on study characteristics, and a thematic synthesis was performed. Key findings Of 41 original studies included, most were conducted in Ontario (n = 21). Majority of the studies employed quantitative designs (70%). Five major themes identified were program uptake, patient health outcomes, stakeholder beliefs and attitudes, processes and collaboration and pharmacy workplace culture, which varied considerably. At the individual, organizational and policy levels, many factors were interrelated and influenced the implementation of reimbursed medication reviews by community pharmacists. Gaps in eligibility policy highlighted some patients who may have complex needs are excluded. Variation in clinical outcomes may relate to different types of medication review and pharmacist practice across Canada. Few researchers evaluated eligibility criteria, the impact of policy changes, strategies to engage patients and healthcare professionals, patient–pharmacist communication or compared practice models of medication reviews. About 12% of the research applied a theoretical framework. Summary Publicly funded medication reviews in Canadian community pharmacies reduce medication-related problems and potentially improve patient health outcomes. Future research and policies could consider addressing barriers and exploring models for sustainable delivery of high-quality medication reviews internationally. [ABSTRACT FROM AUTHOR]

In recent years, health promotion has come under critique for being framed according to the contexts and priorities of Western communities, with the notion of 'control' underpinning much of its theoretical and practical development. Ceding space to Indigenous voices and knowledge is one way forward to overcoming this limitation and decolonizing the field. This paper reports on insights gained from a participatory digital storytelling project focused on Indigenous health promotion that took place at M'Wikwedong Indigenous Friendship Centre in the city of Owen Sound, Canada. The research team was formed by M'Wikwedong's Executive Director, five Indigenous youth and two university researchers. We co-created data through an 8-month digital storytelling process that involved 13 weekly research meetings, the creation of 4 digital stories and video screenings. We analysed data from seven group interview transcriptions, field notes and video transcripts through qualitative coding and theme building. The four themes we identified speak to the ways M'Wikwedong reinforced connections to youth, their sense of self, place in the city and Indigenous cultures. From our findings, we theorize that egalitarianism of knowledge, restoring balance in relationships and Indigenous leadership are core components of an 'ethos of connection' that underlies Indigenous health promotion. The 'ethos of connection' challenges Western notions of 'control' and brings attention to the unique expertise and practices of urban Indigenous communities and organizations as a primary basis for health promotion. [ABSTRACT FROM AUTHOR]

Neurodevelopmental disability in children covers a vast array of congenital and acquired long-term conditions associated with brain or neuromuscular impairments that impact function. While some presentations of neurodevelopmental disability align with diagnostic labels, many do not, leaving children whose conditions don't fit neatly under diagnostic labels struggling to access services or families and professionals feeling pressured to assign a diagnostic label in order to access services. In this paper, we (1) discuss the evidence showing that there is often a mismatch between a child's neurodevelopmental diagnosis, or lack of diagnosis, and function, (2) comment on the inequities exacerbated by diagnosis-based approaches for services, and (3) highlight the potential benefits of using a function and participation-based approach for providing services to children with neurodevelopmental disabilities. We close with three calls to action for function and participation-based approaches that could better support equitable services for children with neurodevelopmental disabilities. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic has led to large proportions of the labour market moving to remote work, while others have become unemployed. Those still at their physical workplace likely face increased risk of infection, compared to other workers. The objective of this paper is to understand the relationship between working arrangements, infection control programs (ICP), and symptoms of anxiety and depression among Canadian workers, not specifically working in healthcare. Methods A convenience-based internet survey of Canadian non-healthcare workers was facilitated through various labour organizations between April 26 and June 6, 2020. A total of 5180 respondents started the survey, of which 3779 were assessed as employed in a full-time or part-time capacity on 2 March 2020 (prior to large-scale COVID-19 pandemic responses in Canada). Of this sample, 3305 (87.5%) had complete information on main exposures and outcomes. Anxiety symptoms were measured using the Generalised Anxiety Disorder screener (GAD-2), and depressive symptoms using the Patient Health Questionnaire screener (PHQ-2). For workers at their physical workplace (site-based workers) we asked questions about the adequacy and implementation of 11 different types of ICP, and the adequacy and supply of eight different types of personal protective equipment (PPE). Respondents were classified as either: working remotely; site-based workers with 100% of their ICP/PPE needs met; site-based workers with 50–99% of ICP/PPE needs met; site-based workers with 1–49% of ICP/PPE needs met; site-based workers with none of ICP/PPE needs met; or no longer employed. Regression analyses examined the association between working arrangements and ICP/PPE adequacy and having GAD-2 and PHQ-2 scores of three and higher (a common screening point in both scales). Models were adjusted for a range of demographic, occupation, workplace, and COVID-19-specific factors. Results A total of 42.3% (95% CI: 40.6–44.0%) of the sample had GAD-2 scores of 3 and higher, and 34.6% (95% CI: 32.–36.2%) had PHQ-2 scores of 3 and higher. In initial analyses, symptoms of anxiety and depression were lowest among those working remotely (35.4 and 27.5%), compared to site-based workers (43.5 and 34.7%) and those who had lost their jobs (44.1 and 35.9%). When adequacy of ICP and PPE was taken into account, the lowest prevalence of anxiety and depressive symptoms was observed among site-based workers with all of their ICP needs being met (29.8% prevalence for GAD-2 scores of 3 and higher, and 23.0% prevalence for PHQ-2 scores of 3 and higher), while the highest prevalence was observed among site-based workers with none of their ICP needs being met (52.3% for GAD-2 scores of 3 and higher, and 45.8% for PHQ-2 scores of 3 and higher). Conclusion Our results suggest that the adequate design and implementation of employer-based ICP have implications for the mental health of site-based workers. As economies re-open the ongoing assessment of ICP and associated mental health outcomes among the workforce is warranted. [ABSTRACT FROM AUTHOR]

Objectives The nail salon industry has seen significant growth in recent years. Nail technicians provide manicures, pedicures and apply artificial nails; tasks that expose them to chemicals, including acrylates that are known skin and respiratory sensitizers. This paper reports on potential skin exposure to acrylates among nail technicians in Toronto, Canada. Methods Hand skin wipes were collected after (i) the application of artificial nails, (ii) the application of ultraviolet cured gel nail polish, and (iii) deliberate contact with nail polish. Surface wipes were collected from work areas and surfaces contaminated with known products. Wipe samples were analysed for eight acrylates: methyl acrylate (MA), ethyl acrylate (EA), methyl methacrylate (MMA), ethyl methacrylate (EMA), 2-hydroxyethyl acrylate (HEA), 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA), and ethylene glycol dimethacrylate (EGDMA) by gas chromatography with mass spectrometry. Results Thirty-five wipe samples were collected. No acrylates were detected in skin samples (n = 8) or work surfaces (n = 6). However, MMA, EMA, EA, HEMA, and HPMA were detected in the samples of surfaces contaminated with known products. MMA was detected in 28% of products tested. HEMA and HPMA were detected where deliberate contact with nail polish occurred. Conclusions These results confirm that acrylates are present in nail products. However, no acrylates were detected in skin wipes. MMA, a chemical prohibited for use in cosmetics in Canada, was detected in nail polishes. Nail technicians should continue to employ safe work practices that reduce the probability of skin contact with acrylates and other chemicals. [ABSTRACT FROM AUTHOR]

Drawing from focus groups and semi-structured interviews, this paper examines decision-making practices and monitoring techniques of Canadian Intensive Supervision Units (ISUs) managing high-risk individuals in the community. We argue that ISU subjects are hyper-individualized through their unique conditions of release, contesting notions that actuarial risk assessments have eclipsed individual understandings of dangerousness in risk, correctional and policing literature. Using Foucault's disciplinary, pastoral and confessional dispositifs , we highlight how ISU agents make subjects active participants in their own punishment. Moreover, we illustrate how dispositifs not only allow ISU agents to understand, select and govern subjects but also, more problematically, transform subjects into ostensibly dangerous entities reifying and necessitating escalating criminal justice interventions under auspices of protecting the community from potential—not guaranteed—harm. [ABSTRACT FROM AUTHOR]

Physician-assisted suicide and voluntary euthanasia are two procedures of Medical Assistance in Dying (MAiD) that are readily requested by patients internationally. In April 2016, the legalization of these procedures occurred in Canada after the pursuit of many jurisdictional cases. Known as Bill C-14, this legislation aims to balance patient autonomy at end-of-life with revised standardizations for medical and healthcare professionals. Music therapists may be included in the medical and healthcare team that can be recommended by patients considering MAiD. At present, there are no written guidelines that empirically outline the role of music therapists in this area. This paper explores the global history of MAiD as well as MAiD in the Canadian healthcare system and its implications. Information on the legislation Bill C-14 will be explained, along with a discussion on the current practices of music therapy at end-of-life and the potential scope of a music therapist during the MAiD procedure. Ethical issues and future research are also presented as recommendations to healthcare and music therapy professionals. [ABSTRACT FROM AUTHOR]

Developing meaningful indicators to track youth mental health (MH) is important to support the development and evaluation of responsive mental health promotion (MHP) initiatives that address the socio-economic determinants of youth MH. Development of relevant indicators is challenged, however, by the lack of knowledge regarding the relations among socio-economic factors and youth MH. Thirty diverse young people from a Canadian metropolitan area were engaged within a process of social praxis to explore their experiences of the inter-relationship between their socio-economic environments and their MH and their processes of seeking to realize their MH. Participants emphasized 'needs' as foundational to MH, whereas 'wants', driven by materialistic and wealth-oriented values and social norms, constrained their MH. Their reflections on the inter-relations among their MH and socio-economic processes highlight eight inter-related MH needs within the Canadian socio-economic context. In this paper, we present these needs and show how these needs, young people's affective states, and their access to resources within co-evolving socio-economic processes (to enable their needs) illustrate the fundamental inter-relation between young people's MH and socio-economic processes. We identify implications for measuring youth MH within MHP practice, including the importance of iterative indicator frameworks that include measures of young people's access to resources to enable their MH needs and their degree of distress. [ABSTRACT FROM AUTHOR]

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Recent work on health system strengthening suggests that a combination of leadership and policy capacity is essential to achieve transformation and improvement. Policy capacity and leadership are mutually constitutive but difficult to assemble in a coherent and consistent way. Our paper relies on the nested model of policy capacity to empirically explore how health reformers in seven Canadian provinces address the question of policy capacity. More specifically, we look at emerging representations of policy capacity within the context of health reforms between 1990 and 2020. Based on the exploration of the scientific and grey literature (legislation, annual reports of Ministries, agencies and organizations, meeting minutes, press, etc.) and interviews with key informants (n=54), we identify how policy capacity is considered and framed within health reforms A series of core dilemmas emerge from attempts by each province to develop policy capacity for and through health reforms. [ABSTRACT FROM AUTHOR]

Background Early care and education (ECE) settings represent an important point of intervention for childhood obesity prevention efforts. The objective of this paper was to compare ECE licensing regulations for each Canadian province/territory to evidence-based, obesity prevention standards. Methods Two authors reviewed existing ECE regulations for each province/territory and examined whether the regulatory text supported standards for nutrition (n  = 11), physical activity (n  = 5) and screen time (n  = 4). Provinces/territories were evaluated on the strength of regulatory language for each standard (i.e. fully, partially, or not addressed) and a total comprehensiveness score (maximum score of 20). ECE centres and homes were examined separately. Results The majority of provinces/territories required providers to follow Canada's Food Guide, but few had regulations for specific foods or beverages. Most provinces/territories included standards related to written menus and drinking water, but the strength of these standards was weak. Many provinces/territories required physical activity and outdoor opportunities to be provided daily, but few included a time requirement. Only two provinces included any screen time standards. Total comprehensiveness scores averaged 5.7 for centres and 5.4 for homes. Conclusions Canadian provinces/territories have insufficient obesity prevention regulations in ECE settings, highlighting a potential point of intervention to prevent obesity. [ABSTRACT FROM AUTHOR]

Abstract Field measurements of operational plantations and research plots demonstrate that growth rates of exotic larches in unmanaged stands can exceed 12 m3 per hectare per year in Maine and elsewhere. This paper briefly reviews the recent history of exotic larch (Larix decidua , L. kaempferi , and L. × marschlinsii) in northeastern United States and Canada. Stands can be commercially thinned as early as 15 years; further thinnings add to significant volume accumulation, based on stand table projections. Genetic development of the hybrid (L. × marschlinsii) could yield additional volume. Even at current low stumpage values, exotic larch plantations offer positive returns at realistic discount rates. In map form, we report a current inventory of known trials and operational plantings across the Northern United States, including adjacent Canada. [ABSTRACT FROM AUTHOR]

From a public health perspective, gambling shares many of the same characteristics as alcohol. Notably, excessive gambling is associated with many physical and emotional health harms, including depression, suicidal ideation, substance use and addiction and greater utilization of health care resources. Gambling also demonstrates a similar 'dose-response' relationship as alcohol—the more one gambles, the greater the likelihood of harm. Using the same collaborative, evidence-informed approach that produced Canada's Low-Risk Alcohol Drinking and Lower Risk Cannabis Use Guidelines, a research team is leading the development of the first national Low-Risk Gambling Guidelines (LRGGs) that will include quantitative thresholds for safe gambling. This paper describes the research methodology and the decision-making process for the project. The guidelines will be derived through secondary analyses of several large population datasets from Canada and other countries, including both cross-sectional and longitudinal data on over 50 000 adults. A scientific committee will pool the results and put forward recommendations for LRGGs to a nationally representative, multi-agency advisory committee for endorsement. To our knowledge, this is the first systematic attempt to generate a workable set of LRGGs from population data. Once validated, the guidelines inform public health policy and prevention initiatives and will be disseminated to addiction professionals, policy makers, regulators, communication experts and the gambling industry. The availability of the LRGGs will help the general public make well-informed decisions about their gambling activities and reduce the harms associated with gambling. [ABSTRACT FROM AUTHOR]

This paper examines police militarization in Canada between 2007 and 2017. We contrast media and police accounts of militarization with special weapons and tactics (SWAT) team deployment records disclosed under freedom of information (FOI) law. Discourse analysis reveals a series of armoured vehicle purchases has been justified by police claims about the danger faced by police officers, and the need to keep police officers and the public safe. Media and police accounts thus suggest militarization is limited. However, our FOI research shows planned and unplanned deployment of SWAT teams have risen in major Canadian cities and are higher in some cases than those reported by Kraska on public police militarization in the USA. After revealing this juxtaposition between media rhetoric and the organization and operational reality of police militarization, we reflect on the implications of police militarization in Canada and the challenges that police may face in communications about armoured vehicle purchases as public awareness of SWAT team use rises and police legitimacy is questioned. [ABSTRACT FROM AUTHOR]

In this pa per, we argue for the importance of unsettling dominant narratives in the current terrain of harm-reduction policy, practice and research. To accomplish this, we trace the historical developments regarding the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and harm-reduction policies and practice. We argue that multiple historical junctures rather than single causes of social exclusion engender the processes of marginalisation, propelled by social movements, institutional interests, state legislation, community practices, neo-liberalism and governmentality techniques. We analyse interests (activist, lay expert, institutional and state) in the harm-reduction field, and consider conceptualisations of risk, pleasure, stigma, social control and exclusionary moral identities. Based on our review of the literature, this paper provides recommendations for social workers and others delivering health and social care interested in the fields of substance use, HIV prevention and harm reduction. [ABSTRACT FROM AUTHOR]

In this paper, we revisit the possibility, first raised using a data set collected in the 1970s, that there is a link between average radon concentrations and the incidence of childhood leukaemia and lymphoma in Canada. Following the launch of the National Radon Program in 2007, Health Canada completed a long-term radon survey in 33 census metropolitan areas (CMAs), which covers about 70% of the Canadian population. We used this data, together with leukaemia and lymphoma incidence rates among children (0–14 years of age) in the past decade (2006–15), and tried to link the city-level average radon concentrations to the leukaemia and lymphoma incidence rates in 33 major Canadian cities. Analyses were conducted for six subtypes (ALL, AML, CMD, HL, NHL and BL) of leukaemia and lymphoma. Estimated doses to red bone marrow from domestic radon exposure were low and we did not find any association between radon exposure at home and the increased risk for developing leukaemia among children under 15 years of age living in the CMAs. The results indicate a slight positive association for AML among 1–4 year males in CMAs of Peer Group C and NHL among 5–9 year females in CMAs of Peer Group A; however, these should be interpreted with caution owing to the crude exposure assessment and possibilities of other confounding factors. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between schedule instability and underemployment among hourly employees. The value to employers of specific hours of work often varies over short intervals, motivating variable scheduling and incomplete contracts that do not specify hours or availability. When employers offer variable weekly total hours, competition for scarce hours motivates employees to be available for work over a broader range of times. Workers may consequently be rewarded with more hours, but they garner fewer hours than their counterparts with stable hours. Cross-sectional analysis of the Canadian Workplace and Employee Survey demonstrates that underemployment is significantly more likely among hourly workers on unstable schedules. Longitudinal analysis indicates that even among the initially underemployed, who are strongly motivated to increase their availability, switching into an unstable schedule results in significantly fewer hours, providing evidence of employer-driven constraints on hours. There is no evidence of compensating differentials for unstable schedules. [ABSTRACT FROM AUTHOR]

This paper introduces the Migrant Populations Equity Extension for Ontario's Health Equity Impact Assessment (HEIA) initiatives. It provides a mechanism to address the needs of migrant populations, within a program and policy framework. Validation of an equity extension framework using community leaders and health practitioners engaged in HEIA workshops across Ontario. Participants assessed migrants' health needs and discussed how to integrate these needs into health policy. The Migrant Populations Equity Extension's framework assists decision makers assess relevant populations, collaborate with immigrant communities, improve policy development and mitigate unintended negative impacts of policy initiatives. The tool framework aims to build stakeholder capacity and improve their ability to conduct HEIAs while including migrant populations. The workshops engaged participants in equity discussions, enhanced their knowledge of migrant policy development and promoted HEIA tools in health decision-making. Prior to these workshops, many participants were unaware of the HEIA tool. The workshops informed the validation of the equity extension and support materials for training staff in government and public health. Ongoing research on policy implementation would be valuable. Public health practitioners and migrant communities can use the equity extension's framework to support decision-making processes and address health inequities. This framework may improve policy development and reduce health inequities for Ontario's diverse migrant populations. Many countries are now using health impact assessment and health equity frameworks. This migration population equity extension is an internationally unique framework that engages migrant communities. [ABSTRACT FROM AUTHOR]

Background Injuries are the leading cause of death among younger Canadians and represent a large economic burden on the Canadian population. Although immigrants comprise more than 20% of the Canadian population, the research landscape on injury in this group is unclear. We conducted a scoping review to summarize existing research regarding injuries among Canadian immigrants to identify research gaps and future research opportunities. Methods Relevant electronic databases of peer-reviewed articles and grey literature were systematically searched. Original articles were selected based on predefined criteria. Relevant information from the articles was extracted and reported in the review. Results After a comprehensive search, screening and full-text evaluation, 28 articles were selected for the synthesis. Of the injuries that have been studied among Canadian immigrants, the majority focused on occupational injuries, followed by road traffic accidents. Of the 28 studies, 16 were quantitative and 12 were qualitative. The research themes among occupational injury papers centred on factors leading to injury, factors leading to delayed reporting and compensation of injury and post-occupational injury experiences. Language barriers, informal training and the mismatch between education and occupation among immigrants were found to be the most frequent determinants of injury risk. Conclusions The synthesized knowledge in this scoping review offers an understanding of the current research landscape on injury among immigrants that can be used to assist policymakers, service providers, employers and researchers regarding injuries in this population. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

Objectives: In precision medicine, where oncologic management is tailored to the individual's clinical and genetic profiles, advanced diagnostic testing provides prognostic information and guides management in a growing number of malignancies. There is a need to capture the work pathologists perform to meet this demand by providing medically relevant, timely, and accurate testing results. This work includes not only direct patient consults (interpretation of results and issuing reports) but the administrative and medical oversight as well as the research needed to provide the necessary quality assurance, quality control, direction, and framework for the laboratory.Methods: An expert panel of Canadian pathologists involved in advanced diagnostics was convened to establish and beta test a model for workload assessment in advanced diagnostics.Results: All aspects of the advanced diagnostics workload were detailed and applied to models based on members' experience, including medical oversight, administration, and the introduction of new testing and platforms. Models for biomarker testing were developed for simple and complex or multiplexed assays, and a detailed model was developed to assess the workload for next-generation sequencing-based assays.Conclusions: This paper provides the first detailed proposal for capturing an advanced diagnostic workload to enable appropriate pathologist allotment for performing all the steps required to run an advanced diagnostic service. [ABSTRACT FROM AUTHOR]

Several scholars have begun to assess the benefits of role play simulations in the university classroom. This study provides a model to assess the effectiveness of active learning exercises on student engagement and learning. The paper describes role play simulations related to climate change negotiations run in four courses at two universities in the United States and Canada, identifies the learning outcomes, and aligns them with four knowledge domains (factual, conceptual, procedural, and metacognitive), developed from Anderson and Krathwohl's (2001) work, a revision of Bloom's (1959) taxonomy. We offer a useful assessment model, and discuss several assignments designed to assess the educational effectiveness of the simulations, and conclude by identifying additional areas for future research. [ABSTRACT FROM AUTHOR]

Computing is entering a new era where the laws of quantum physics take precedence over the classical mechanics and the ensuing logic that has governed the first wave of computing, writes Dr. Mark Jackson, Senior Quantum Evangelist, and event speaker at BCS Canada. [ABSTRACT FROM AUTHOR]

Introduction Job coding into a standard occupation or industry classification is commonly performed in occupational epidemiology and occupational health. Sometimes, it is necessary to code jobs into multiple classifications or to convert job codes from one classification to another. We developed a generic tool, called CAPS-Canada (http://www.caps-canada.ca/), that combines a computer-assisted coding tool covering seven International, Canadian and US occupation and industry classifications and an assistant facilitating crosswalks from one classification to another. The objectives of this paper are to present the different functions of the CAPS-Canada tool and to assess their contribution through an inter-rater reliability study. Method The crosswalk assistant was built based on a database of >30,000 jobs coded during a previous project. We evaluated to what extent it would allow automatic translation between pairs of classifications. The influence of CAPS-Canada on agreement between coders was assessed through an inter-rater reliability study comparing three approaches: manual coding, coding with CAPS-Canada without the crosswalk assistant, and coding with the complete tool. The material for this trial consisted of a random sample of 1000 jobs extracted from a case–control study and divided into three subgroups of equivalent size. Results Across the classification systems, the crosswalk assistant would provide useful information for 83–99% of jobs (median 95%) in a population similar to ours. Eighteen to eighty-one percent of jobs (median 56%) could be entirely automatically recoded. Based on our sample of 1000 jobs, inter-rater reliability in occupation coding ranged from 35.7 to 66.5% (median 53.7%) depending on the combination of classification/resolution. Compared with manual coding, the use of CAPS-Canada substantially improved inter-rater reliability. Conclusion CAPS-Canada is an attractive alternative to manual coding and is particularly relevant for coding a job into multiple classifications or for recoding jobs into other classifications. [ABSTRACT FROM AUTHOR]